Charach Alice, Bélanger Stacey Ageranioti, McLennan John D, Nixon Mary Kay
Canadian Paediatric Society, Mental Health and Developmental Disabilities Committee, Ottawa, Ontario.
Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario.
Paediatr Child Health. 2017 Nov;22(8):478-493. doi: 10.1093/pch/pxx128. Epub 2017 Nov 27.
Disruptive behaviour problems in preschool children are significant risk factors for, and potential components of, neurodevelopmental and mental health disorders. Some noncompliance, temper tantrums and aggression between 2 and 5 years of age are normal and transient. However, problematic levels of disruptive behaviour, specifically when accompanied by functional impairment and/or significant distress, should be identified because early intervention can improve outcome trajectories. This position statement provides an approach to early identification using clinical screening at periodic health examinations, followed by a systematic mental health examination that includes standardized measures. The practitioner should consider a range of environmental, developmental, family and parent-child relationship factors to evaluate the clinical significance of disruptive behaviours. Options within a management plan include regular monitoring, accompanied by health guidance and parenting advice, referral to parent behaviour training as a core evidence-based intervention, and referral to specialty care for preschool children with significant disruptive behaviours, developmental or mental health comorbidities, or who are not responding to first-line interventions.
学龄前儿童的破坏性行为问题是神经发育和精神健康障碍的重要风险因素及潜在组成部分。2至5岁儿童出现一些不服从、发脾气和攻击行为是正常且短暂的。然而，破坏性行为达到问题水平，特别是伴有功能损害和/或严重困扰时，应予以识别，因为早期干预可改善预后轨迹。本立场声明提供了一种在定期健康检查时通过临床筛查进行早期识别的方法，随后进行包括标准化测量在内的系统心理健康检查。从业者应考虑一系列环境、发育、家庭及亲子关系因素，以评估破坏性行为的临床意义。管理计划中的选项包括定期监测，并提供健康指导和育儿建议，转介至基于核心循证干预的家长行为训练，以及将有严重破坏性行为、发育或精神健康合并症或对一线干预无反应的学龄前儿童转介至专科护理。
