AAP recommendations for behavioral and emotional problems in young children

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Most young children with an emotional, behavioral, or relationship problem receive no interventions for their disorder.
Most young children with an emotional, behavioral, or relationship problem receive no interventions for their disorder.

According to the American Academy of Pediatrics (AAP), preschool-aged children have a high risk for developing emotional, behavioral, and relationship problems that interfere with their current well-being, jeopardize the foundations of emotional and behavioral health, and have the potential for long-term consequences. Currently, most young children with an emotional, behavioral, or relationship problem receive no interventions for their disorder. The AAP has released recommendations for primary care pediatricians and specialty care providers to increase the access of treatment options for children to substantially reduce their symptoms.

A summary of the recommendations is as follows:

  • Pediatricians should advocate for:

    • Funding programs that increase dissemination and implementation of evidence-based treatments, such as pharmacologic and nonpharmacologic therapies, especially in areas with limited resources;

    • Addressing the early childhood mental health workforce shortage by providing incentives for training in these professions;

    • Decreasing third-party payer barriers to accessing mental health services to very young children;

    • Promoting accountable care organization regulations that protect early childhood mental health services.

  • Pediatricians should advocate for more research that will enhance the evidence base for treatment of very young children with emotional, behavioral, and relationship issues.  

  • Pediatricians should collaborate with local governmental and private agencies to identify local and national clinical services that can serve young children and explore opportunities for innovative service delivery models such as consultation or co-location.

  • Primary care pediatricians and developmental-behavioral pediatricians, together with early childhood mental health providers can create educational materials for trainees and providers to enhance the care that young children receive.

  • Adequate payment for early childhood preventive services will benefit both the patients and society and should be supported.

  • Graduate medical education and continuing medical education should include opportunities for training that ensure that pediatric providers:

    • Are competent to identify young children with emotional, behavioral, and relationship problems as well as risk and protective factors;

    • Are aware that common early childhood emotional, behavioral, and relationship problems can be treated with evidence-based treatments;

    • Recognize the limitations in the data supporting use of medications in very young children, even for ADHD;

    • Are prepared to identify and address parental factors that influence early childhood development;

    • Can collaborate and refer across disciplines and specialties, including developmental-behavioral pediatrics, child and adolescent psychiatry, and other mental health services.

Reference

  1. Gleason, MM, Goldson E, Yogman MW, et al. Addressing Early Childhood Emotional and Behavioral Problems. Pediatrics. 21 November 2016. DOI: 10.1542/peds.2016-3023. 

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