PRESCHOOLER'S BEHAV PROBLEMS: PEDIATRIC RECOG/MANAGEMENT

儿科医生可以在早期识别和治疗中发挥重要作用 预防精神病；然而，没有研究仔细地 检查了儿科医生识别行为问题的能力 学龄前儿童，他们经常接触的群体。通过一个 参与办公室研究的儿科医生联盟，这 研究将检查：1)儿科医生如何准确地识别 学龄前儿童行为问题；2)儿科医生的行为模式 学龄前儿童向心理健康专家的转介；3)模式 儿科医生，学龄前儿童转介给医学专家，以及 他们对行为诊断的准确性对此有何影响？ 问题；4)初级儿科保健利用模式 有行为问题的学龄前儿童，有准确的也有不准确的 确诊；5)家庭是否遵守精神健康转介 从业者；6)儿科医生是否能发现问题 短期稳定性好于较多的暂态问题。设计 遵循两个阶段的方法。在最初阶段，4000名儿童年龄 2-5人将在去他们的儿科医生办公室时进行筛查。这个 儿科医生会指出孩子是否有行为问题，以及 孩子的母亲将完成一份行为问题清单。300人 第90百分位以上的儿童和第90百分位数以下的300名儿童 行为问题清单上的百分位数将被邀请参加 彻底的第二阶段评估，包括游戏观察， 问卷调查、家长访谈和儿童智力测试。 两位心理学家将审查这些材料，并达成共识 关于行为问题存在的意见。儿科医生的 识别行为问题的能力将通过比较 他们的意见与心理学家给出的共识诊断一致。 进一步的数据分析将检查转诊和管理模式 (根据图表复习得出)在儿童中准确和不准确 诊断出来了。

Pediatricians can play an important role in the early recognition and prevention of psychopathology; however, no studies have carefully examined the pediatrician's ability to recognize behavior problems among preschoolers, a group with whom they have frequent contact. Through a consortium of pediatricians involved in office-based research, this study will examine: 1) how accurately pediatricians identify preschooler's behavior problems; 2) the pattern of pediatricians' referrals of preschoolers to mental health specialists; 3) the pattern of pediatricians, referrals of preschoolers to medical specialists, and how is this influenced by the accuracy of their diagnosis of behavior problems; 4) patterns of utilizing primary pediatric care among preschoolers with behavior problems, both accurately and inaccurately diagnosed; 5) whether families comply with referrals to mental health practitioners; 6) whether pediatricians can detect problems exhibiting short-term stability better than more transient problems. The design follows a two-stage approach. In the initial stage, 4000 children ages 2-5 will be screened during a visit to their pediatrician's office. The pediatrician will indicate whether the child has a behavior problem, and the child's mother will complete a behavior problem checklist. 300 children above the 90th percentile and 300 children below the 90th percentile on the behavior problem checklist will be invited to a thorough second stage evaluation involving play observations, questionnaires, parental interview and the child's intelligence testing. Two psychologists will review the material and reach a consensus opinion.about the presence of behavior-problems. The pediatricians' ability to identify behavior problems will be examined by comparing their opinions with the consensus diagnosis given by the psychologists. Further data analyses will examine referral and management patterns (derived from chart review) among children accurately and inaccurately diagnosed.