This article describes the implementation of a behavioral management training program into pediatric and combined medicine-pediatric residencies at a large urban academic medical center in southwest Florida. We describe 2 modalities for training residents in effective behavioral modification strategies immediately useable in pediatric practice. Results indicate that residents significantly increased their knowledge of effective, evidence-based strategies and continued to use them 6 to 12 months following completion of the training.
Behavioral health concerns are commonly reported among caregivers in primary care pediatric visits.
Most children have a pediatrician, making the primary care visits an ideal time to counsel caregivers on effective parenting strategies.
Providing behavioral management training for resident pediatricians is critical to preventing long-term behavioral issues.
Behavioral management training can be incorporated with success into pediatric residency without significant time burdens.
Behavioral health concerns are common among young children in the United States and can be very challenging for their caregivers to manage [
, ]. Approximately 1 in 6 children aged 2 to 8 years are reported to have an emotional, behavioral, or developmental condition but only about half of them receive adequate mental health support [ ]. Additionally, young children aged younger than 7 years with challenging behavior are at increased risk for maltreatment compared with older children [ ]. Children with developmental disabilities are 1.5 to 3.5 times more likely to be maltreated than their typically developing peers [ ]; often times, this is due to developmental behaviors that parents find overwhelming. Unaddressed behavioral health disorders early in childhood increase the risk for long-term poor outcomes including school failure, substance abuse, delinquency, chronic health problems, and suicide [
]. The negative outcomes associated with untreated challenging behaviors of early childhood reflect an important need for early prevention and intervention services.
Supporting caregivers is key to prevention and early intervention for child behavioral health concerns. Caregiver support for childhood mental health conditions also promotes maternal mental health and reduces the risk for maternal depression. There are many evidence-based programs with demonstrated success at improving child behavior problems, parenting stress, and parenting skills, but access to these behavioral health services is limited for many families [
]. Thus, embedding behavioral health resources into primary care settings is crucial to prevention, early detection, and treatment of mental, emotional, and behavioral disorders among children and adolescents. Optimal integrated health care involves screening children for developmental and behavioral concerns, coordinating appropriate care for children, and providing in-the-moment behavioral management training for caregivers.