Objective. This study assessed the prevalence of failed developmental screens in 30- to 60-month-old children who presented with a behavioral complaint of disruptive behavior to a referral clinic. Methods. A retrospective chart review was performed in a specialty behavioral pediatric clinic. Outcome measures were obtained from children referred to the clinic with parental concern of disruptive behavior. Results. Out of 151 patients, 66% (99/151) had been screened for developmental delays with a formal screening instrument. Of these, 71% (70/99) failed developmental screening in one or more domains. Conclusions. Preschoolers referred to a behavioral clinic for parental concerns of disruptive behaviors were more than 4 times more likely to be at risk for developmental delays than the general population, with a majority of suspected delays in communication and problem-solving domains. This finding suggests that developmental screening should be a part of the initial workup for children with disruptive behaviors.
KeenanKBoeldtDChenD. Predictive validity of DSM-IV oppositional defiant and conduct disorders in clinically referred preschoolers. J Child Psychol Psychiatry. 2011;52:47-55.
2.
WakschlagLSBriggs-GowanMJCarterAS. A developmental framework for distinguishing disruptive behavior from normative misbehavior in preschool children. J Child Psychol Psychiatry. 2007;48:976-987.
3.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association; 2000.
4.
EggerHLAngoldA. Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology. J Child Psychol Psychiatry. 2006;47:313-337.
5.
RozaSJHofstraMBvan der EndeJVerhulstFC. Stable prediction of mood and anxiety disorders based on behavioral and emotional problems in childhood: a 14-year follow-up during childhood, adolescence, and young adulthood. Am J Psychiatry. 2003;160:2116-2121.
6.
HeneghanAGarnerASStorfer-IsserAKortepeterKSteinREKHorwitzSM. Pediatricians’ role in providing mental health care for children and adolescents: do pediatricians and child and adolescent psychiatrists agree?J Dev Behav Pediatr. 2008;29:262-269.
7.
HowellETeichJ. Variations in Medicaid mental health service use and cost for children. Administration and Policy in Mental Health and Mental Health Services Research. 2008;35:220-228.
8.
RingelJSturmR. National estimates of mental health utilization and expenditures for children in 1998. J Behav Health Serv Res. 2001;28:319-333.
9.
CostelloEJEdelbrockCS. Detection of psychiatric disorders in pediatric primary care: a preliminary report. J Am Acad Child Psychiatry. 1985;24:771-774.
10.
ComerJSOlfsonMMojtabaiR. National Trends in Child and Adolescent Psychotropic Polypharmacy in Office-Based Practice, 1996-2007. J Am Acad Child Adolesc Psychiatry. 2010;49(10):1001-1010.
11.
Subcommittee on Attention-Deficit/Hyperactivity Disorder (SCOQIAM). ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;128:1007-1022.
12.
SimpsonGAColpeLGreenspanS. Measuring functional developmental delay in infants and young children: prevalence rates from the NHIS-D. Paediatr Perinat Epidemiol. 2003;17:68-80.
13.
BoyleCABouletSSchieveLA. Trends in the prevalence of developmental disabilities in US children, 1997-2008. Pediatrics. 2011;127:1034-1042.
14.
CormackKFMBrownACHastingsRP. Behavioural and emotional difficulties in students attending schools for children and adolescents with severe intellectual disability. J Intellect Disabil Res. 2000;44:124-129.
15.
DekkerMCKootHM. DSM-IV disorders in children with borderline to moderate intellectual disability: II. Child and family predictors. J Am Acad Child Adolesc Psychiatry. 2003;42:923-931.
16.
EinfeldSLTongeBJ. Population prevalence of psychopathology in children and adolescents with intellectual disability: II. Epidemiological findings. J Intellect Disabil Res. 1996;40:99-109.
17.
EmersonE. Mothers of children and adolescents with intellectual disability: social and economic situation, mental health status, and the self-assessed social and psychological impact of the child’s difficulties. J Intellect Disabil Res. 2003;47:385-399.
18.
KoskentaustaTIivanainenMAlmqvistF. Risk factors for psychiatric disturbance in children with intellectual disability. J Intellect Disabil Res. 2007;51:43-53.
19.
BakerBLNeeceCLFenningRMCrnicKABlacherJ. Mental disorders in five-year-old children with or without developmental delay: focus on ADHD. J Clin Child Adolesc Psychol. 2010;39:492-505.
20.
CohenNJDavineMMeloche-KellyM. Prevalence of unsuspected language disorders in a child psychiatric population. J Am Acad Child Adolesc Psychiatry. 1989;28:107-111.
DonnoRParkerGGilmourJSkuseDH. Social communication deficits in disruptive primary-school children. Br J Psychiatry. 2010;196:282-289.
23.
Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics. 2006;118:405-420.
24.
SquiresJBrickerD. Ages & Stages Questionnaires®: A Parent-Completed, Child-Monitoring System. Baltimore, MD: Paul H. Brookes; 1999.
25.
RadeckiLSand-LoudNO’ConnorKGSharpSOlsonLM. Trends in the use of standardized tools for developmental screening in early childhood: 2002–2009. Pediatrics. 2011;128:14-19.
26.
LaggesAMDunnDW. Depression in children and adolescents. Neurol Clin. 2003;21:953-960.
27.
EmslieGJ. Pediatric anxiety: underrecognized and undertreated. N Engl J Med. 2008;359:2835-2836.
28.
ThomasCRHolzerCEIII. The continuing shortage of child and adolescent psychiatrists. J Am Acad Child Adolesc Psychiatry. 2006;45:1023-1031.
29.
KingTMGlascoeFP. Developmental surveillance of infants and young children in pediatric primary care. Curr Opin Pediatr. 2003;15:624-629.
30.
GardnerWMurphyJChildsG. A brief pediatric symptom checklist with psychosocial problem subscales: a report from PROS and ASPN. Ambul Child Health. 1999;5:225-236.
31.
SynderHN. Epidemiology of official offending. In: FarringtonL, ed. Child Delinquents: Development, Intervention, and Service Needs. Thousand Oaks, CA: Sage; 2001:25-46.
32.
TremblayREPagani-KurtzLMasseLCVitaroFPihlRO. A bimodal preventive intervention for disruptive kindergarten boys: its impact through mid-adolescence. J Consult Clin Psychol. 1995;63:560-568.
33.
CareyKB. Clinically useful assessments: substance use and comorbid psychiatric disorders. Behav Res Ther. 2002;40:1345-1361.
