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Do child healthcare professionals and parents recognize social-emotional and behavioral problems in 1-year-old infants?

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Abstract

Growing evidence supports the existence of clinically significant social-emotional/behavioral (SEB) problems among as young as 1-year-old infants. However, a substantial proportion of early SEB problems remain unidentified during contacts with child healthcare professionals. In this study, child healthcare nurse (CHCN; N = 1008) and parental (N = 518) reports about SEB worries were gathered, along with the maternal and paternal Brief Infant-Toddler Social and Emotional Assessment (BITSEA) ratings, for 12-month-old infants randomly recruited through Finnish child health centers. Only 1.4–1.8 % of CHCNs, 3.9 % of mothers, and 3.2 % of fathers reported of being worried about the assessed child’s SEB development. When the CHCNs’ and parental reports were combined, 7.7 % (33/428) of the infants assessed each by all three adults had one (7.0 %), two (0.7 %) or three (0 %) worry reports. Even the combination of the CHCN’s and parental worry reports identified only 7.0–13.8 % of the infants with the maternal and/or paternal BITSEA Problem or Competence rating in the of-concern range. Identified associations across the three informants’ worry reports, parental BITSEA ratings and sociodemographic factors are discussed in the paper. Routine and frequent use of developmentally appropriate screening measures, such as the BITSEA, might enhance identification and intervening of early SEB problems in preventive child healthcare by guiding both professionals and parents to pay more attention to substantial aspects of young children’s SEB development and encouraging them to discuss possible problems and worries.

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Acknowledgments

We are grateful to the families who participated, the healthcare nurses, and statistician Leena Joskitt who helped us to process data. The research has been supported by grants from the following Finnish organizations: The Alma and K. A. Snellman Foundation, Oulu, Finland; The Emil Aaltonen Foundation; Finnish Brain Foundation Terttu Arajärvi Trust; The Mannerheim League for Child Welfare (research foundation); The Päivikki and Sakari Sohlberg Foundation; The Sigrid Jusélius Foundation; The Stockmann Foundation; The Thule Institute, University of Oulu, and the research funding by Finnish government for the Northern Ostrobothnia Hospital District.

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Authors and Affiliations

  1. PEDEGO Research Unit, Clinic of Child Psychiatry, University of Oulu, P.O. Box 26, 90029, Oulu, Finland

    Jaana Alakortes, Susanna Kovaniemi, Irma K. Moilanen & Hanna E. Ebeling

  2. Clinic of Child Psychiatry, Oulu University Hospital, P.O. Box 26, 90029, Oulu, Finland

    Jaana Alakortes, Susanna Kovaniemi, Irma K. Moilanen & Hanna E. Ebeling

  3. Department of Psychology, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA, 02125, USA

    Alice S. Carter

  4. Medical Informatics and Statistics Research Group, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland

    Risto Bloigu

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  1. Jaana Alakortes
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  2. Susanna Kovaniemi
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  3. Alice S. Carter
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  4. Risto Bloigu
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  5. Irma K. Moilanen
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  6. Hanna E. Ebeling
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Correspondence to Jaana Alakortes.

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Ethical standards

The study was approved by the Regional Ethics Committee of the Northern Ostrobothnia Hospital District and the Municipal Boards of the Social and Health Care Units of the participated municipalities and performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflict of interest

Alice S. Carter receives royalties on the sale of the BITSEA from Pearson Assessment (not in the context of this study). The other authors declare that they have no conflict of interest.

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The funding sources mentioned in the acknowledgements have no involvement in the collection, analysis or interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

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Alakortes, J., Kovaniemi, S., Carter, A.S. et al. Do child healthcare professionals and parents recognize social-emotional and behavioral problems in 1-year-old infants?. Eur Child Adolesc Psychiatry 26, 481–495 (2017). https://doi.org/10.1007/s00787-016-0909-3

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