title: Social-emotional problems in preschool-aged children: opportunities for prevention and early intervention.
abstract: OBJECTIVE
  To estimate the prevalence of positive screens for social-emotional problems among preschool-aged children in a low-income clinical population and to explore the family context and receptivity to referrals to help guide development of interventions.
  
  
  METHODS
  Observational, cross-sectional study.
  
  
  METHODS
  Two urban primary care clinics.
  
  
  METHODS
  A total of 254 parents of 3- and 4-year-old children at 2 urban primary care clinics.
  
  
  METHODS
  Score on a standardized screen for social-emotional problems (Ages and Stages Questionnaire: Social-Emotional) and answers to additional survey questions about child care arrangements, parental depressive symptoms, and attitudes toward preschool and behavioral health referrals.
  
  
  RESULTS
  Twenty-four percent (95% CI, 16.5%-31.5%) of children screened positive for social-emotional problems. Among those screening positive, 45% had a parent with depressive symptoms, and 27% had no nonparental child care. Among parents of children who screened positive for social-emotional problems, 79% reported they would welcome or would not mind a referral to a counselor or psychologist; only 16% reported a prior referral.
  
  
  CONCLUSIONS
  In a clinical sample, 1 in 4 low-income preschool-aged children screened positive for social-emotional problems, and most parents were amenable to referrals to preschool or early childhood mental health. This represents an opportunity for improvement in primary prevention and early intervention for social-emotional problems.
authors.affiliation: Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. courtneym.brown@cchmc.org
authors.forename: Courtney M
authors.initials: CM
authors.lastname: Brown
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Copeland
authors.forename: Heidi
authors.initials: H
authors.lastname: Sucharew
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kahn
mesh_terms: D000293:Adolescent; D000328:Adult; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D002654:Child Care / Q000379:methods / Q000706:statistics & numerical data; D002675:Child, Preschool; D003376:Counseling; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009820:Ohio / Q000453:epidemiology; D010290:Parents / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011203:Poverty; D015995:Prevalence; D011320:Primary Health Care; D011581:Psychological Tests; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012920:Social Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data; D019037:Urban Health Services; D055815:Young Adult