Update on Screening, Referring, and Treating the Behavioral, Social, and Mental Health Problems of Very Young Children

Abstract

Very young children can experience a wide range of mental health disorders including posttraumatic stress disorder, anxiety disorders, depression, and parent-child relationship disorders, among others. These disorders cause young children true psychological suffering and family stress and often do not resolve without treatment. Pediatricians have a pivotal role in routinely screening all young children for mental health concerns and referring to specialized early childhood mental health providers when concerns are present. A “watchful waiting” approach is strongly discouraged. There are a number of highly effective evidence-based practices that exist to treat most mental health problems in young children. We strongly espouse dyadic mental health services that focus clinical interventions on the parent-child relationship, which is seen as the vehicle of change at these developmental stages. The conservative use of psychiatric medications should be reserved for preschoolers ages 3 and over, should occur only after a course of psychotherapy has been unsuccessful in ameliorating severe symptoms, and should be managed under the supervision of a child and adolescent psychiatrist.