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Pediatricians are well-positioned to screen for early childhood adversities, but effective responses to positive screens require an understanding of which adversities typically co-occur, and to what extent they are associated with other risk or protective factors. Among children seen at an urban academic pediatric practice, this study aimed to (1) examine the prevalence of different types of early adversity and protective experiences reported by primary caregivers, and (2) define latent classes of co-occurring adversities. Of 1434 children whose parents completed the Safe Environment for Every Kid (SEEK) at well-child visits during November 2019–January 2021, three classes of adverse experiences emerged, including those reporting low adversity (L; 73%), caregiver stress (CS; 17%), and both caregiver stress and depression (CSD; 10%). Among those who also completed the Adverse Childhood Experiences Questionnaire (ACE-Q, n = 1373) and the Protective and Compensatory Experiences Scale (PACES, n = 1377), belonging to the L class was associated with lower ACE-Q and higher PACES scores. For parent-respondents only, ACE-Q scores were significantly greater for the CSD class compared to the CS and L classes. Pediatricians should attend to the needs of caregivers reporting both stress and depression, as these families may face especially high levels of adversity and low levels of protective factors. [ABSTRACT FROM AUTHOR]

Psychiatric disorders are becoming more frequently diagnosed within the pediatric primary care setting. Despite increased diagnosis within primary care, only a minority of patients receive further psychiatric or specialty care. The integrated/collaborative care treatment model was designed to improve access within primary care. The purpose of this review is to identify randomized controlled trials and quasi-experimental studies that have investigated whether increased access improves treatment engagement, satisfaction, and improved mental health outcomes. Six studies met inclusion criteria. Studies reviewed indicated increased access to behavioral health treatment through use of the integrated/collaborative care model and improved mental health outcomes. Recommendations for screening and treatment are provided. Limitations of the reviewed studies include lack of generalizability to urban populations, minority youth, and youth younger than 4 years of age. Practice recommendations to address these limitations are identified. [ABSTRACT FROM AUTHOR]

The goal of this Clinical Perspectives is to present pediatric medicine updates on populations seen in child psychiatry settings. Physicians trained in palliative care and child psychiatry, pediatrics and psychiatry, and child psychiatry will present a pediatric medicine perspective on the status of palliative care and chronic pain treatment and the multidisciplinary approach to patients in these unique populations. [Extracted from the article]

An abstract of the article "DC Map (Mental Health Access in Pediatrics" by Mary T. Gabriel and Leandra Godoy is presented.