Screening Mexicans for psychosocial and behavioral problems during pediatric consultation.

BACKGROUND

Psychosocial and behavioral problems should be detected early during the pediatric consultation to prevent more severe psychosocial impairment as children move into adolescence. The pediatric visit offers an excellent opportunity to assess possible problems using screening tools. The aim of this study is to assess whether an adaptation of a screening tool (Pediatric Symptom Checklist) using visual aids is valid and suitable for the early detection of psychosocial problems among a sample of Mexican children and adolescents.

METHODS

We included 411 of 468 (87.8%) Mexican mothers or female caretakers of children and adolescents aged 4-16 undergoing routine health assessments in two Preventive Child Health Clinical Services in El Paso, Texas, USA. Mothers or female caretakers completed the Pictorial Pediatric Symptom Checklist and a psychological comprehensive test known as the Child Behavior Checklist (CBCL). Sensitivity and specificity was established using the CBCL as criteria for the validity of the PPSC.

RESULTS

The PPSC screening tool performed well as demonstrated by its detection rates of psychosocial and behavioral problems among the sample of Mexican children. Sensitivity and specificity at the standard cut-off scores was 69.6% and 95.2% for children 4-5 years old and 61.8% and 91.8% for children 6-16 years old respectively. The results were slightly lower than those found using the PSC among other ethnic groups in the United States, with a sensitivity and specificity of 71.7% and 93.0%, respectively.

CONCLUSIONS

The PPSC is a simple, effective tool that can detect on average more than 65% of the children and adolescents with possible psychosocial problems during pediatric consultations. This free screening tool detected psychosocial problems in pediatric populations of Mexican origin living on the border and may be also effective for Mexican children living in Mexico.