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

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.