Four-year-olds in a new suburb: the need for medical and social care.

The standardized Swedish health examination of 4-year-olds was performed in a residential suburb of Stockholm with a high percentage of young families and immigrants. Emphasis was placed on identifying children in need of pedagogic and psychological measures. Psychological problems were identified by: a structured interview with the parents, and an examination of the child, including developmental screening tests and the parents' assessment of the child's behaviour at home. We have placed more emphasis on the findings and evaluation at the examination than on interview data when arriving at a psychological diagnosis. The somatic part of the examination revealed only minor problems, confirming previous studies on four-year-olds in Sweden. Twelve percent of the 257 children were referred for further psychological investigation, and 16% were recommended early admittance to preschool because of psychological problems. Among the 46 immigrant children who did not have any Swedish parent, more than 50% did not speak Swedish and were recommended early admittance to preschool. In the whole material, 41% needed or were already (17%) in preschool or day nurseries. This indicates unfulfilled demands on such services within the community. The mother's perception of her lack of social contacts in the neighbourhood correlated with the presence of psychological problems and the need for subsequent measures for her child.