Parents did a better job dealing with their youngsters' emotional issues when their pediatricians also offered the services of a behavioral specialist, according to Johns Hopkins University scientists who oversaw a 14-state study released today.
The parents were more likely to recognize sleep problems, aggression and other behavioral problems and were less apt to strike their children than were parents who went to traditional pediatric practices.
Immunization rates were also higher among families getting the help, the study found
Dr. Bernard Guyer, senior author of a paper in today's Journal of the American Medical Association, said today's harried families are particularly in need of behavioral advice.
"Since all kids come to the pediatrician, and parents look to pediatricians for advice, why not strengthen the pediatrics practice to help parents with behavioral issues?" said Guyer, who is a professor in children's health and chairman of the Department of Population and Family Health Sciences at Hopkins' Bloomberg School of Public Health.
In the study, more than 5,500 families were assigned to see either a primary-care pediatrician or a pediatrician working with a nurse or specialist trained in behavioral health. The comparison was made over the first three years of each child's life.
The specialists mainly saw families in their doctors' offices but also made three home visits and were available to answer questions by phone.
Doctors used a "Healthy Steps" model created by the Commonwealth Fund, a private foundation that partially funded the study. The practices were in urban and suburban locations - none in Maryland - and served families across a range of incomes.
Researchers will follow the families to see whether the services brought concrete results, such as fewer injuries and less serious problems in school.
Insurance plans don't reimburse generously for behavioral services, and it could take a demonstration of cost-effectiveness to change that, said Guyer.
Dr. Daniel Levy, an Owings Mills pediatrician with family medicine training who makes a social worker available three days a week, estimates that a third of his own time is devoted to behavioral matters.
"If you take time and effort to bring up behavioral issues with families, it opens up a whole window of opportunities to discuss a host of issues," Levy said.
"It tends to make parents more open to call for things other than a snotty nose."