Mental Health Diagnoses of Young Children With and Without Medical Concerns

Abstract

Objective: Emotional and behavioral challenges are common in children aged birth to 5 years, and often co-occur with medical conditions. The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0–5) is recommended for accurately diagnosing and planning treatment for this age group, yet research on its application and common diagnoses in clinical settings is limited. Methods: This descriptive, exploratory study involved a retrospective chart review of diagnostic information for 627 children aged birth to 5 years referred for Medicaid-funded mental health services in a large, urban, ethnically diverse children’s hospital setting. Results: Young children referred for mental health services were predominantly males, aged 4–5 years, referred by a primary care provider, and presenting with both medical and developmental concerns. Most common DC:0–5 mental health diagnoses were trauma and neurodevelopmental disorders. Infants and toddlers were more likely than preschoolers to be referred by inpatient medical providers or child welfare systems. Conclusions: Young children referred for mental health services have complex needs. These findings highlight the importance of early screening for mental health symptoms and suggest the need for further research on the intersection of medical, developmental, and mental health needs and their impact on treatment for this age group.

Implications for Impact Statement

Children ages birth to 5 years referred for mental health treatment have complex needs. Application of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood revealed that the most common diagnoses in this age group were trauma disorders and neurodevelopmental disorders. More than 60% of children referred had a medical concern or condition, indicating that mental health services for this age group should address medical concerns, developmental delays, and traumatic life experiences, all of which can influence mental health symptoms and treatment response.