Provider Recognition of Psychosocial Problems in Low-Income Latino Children

In 2001–2002, 269 low-socioeconomic status (SES) Latino children aged 2–16 who were seen by primary care providers (PCPs) at a well-child care center were screened for a variety of psychosocial disorders, in order to determine how effective PCPs were at identifying such disorders. Benchmark data were compiled from parent-completed child behavior checklists (CBCLs) and compared with data provided by four different PCPs fluent in Spanish. CBCLs have been used worldwide to gauge children's mental health. PCPs completed a Physician Psychosocial Assessment Form for each patient in the study. The clinic is in East Palo Alto, Calif., and the clientele is predominantly Mexican. Latino youth populations, and low SES populations in general, are at higher risk for anxiety, depression, and other psychosocial disorders. Approximately 30 percent of Latino children live at or below poverty level and are generally poorly studied in regard to children's mental health, in part because of language and cultural barriers.

Key Findings:

  • Compared with CBCL data, PCPs identified only 20 percent of children with aggression symptoms, 18 percent with attention deficit/hyperactivity and zero percent with anxiety/depression symptoms.
  • Overall, 39.8 percent of children had one or more psychosocial problem identified by their PCP.
  • Boys, children of families with incomes below $20,000, children who scored higher on the CBCL, and children of unmarried parents were (to varying degrees) more likely to have psychosocial problems identified. Marital status was the strongest predictor of identification.

Limitations of the study include reliance on the CBCL rather than information from multiple sources, including child self-reports and restricting participants to well-child visits. Specific explorations of variables such as interactions between race, ethnicity and income, neighborhood environment, and perceived social placement can help guide the development of future interventions to address Latino children's mental health.