Infant Mental Health for the Pediatric Nurse Practitioner

Screening and Assessment Tools

Consistent routine screening for emotional and behavioral problems is important to provide appropriate infant mental health care. Some tools can be self-administered by parents in the waiting room or mailed to parents in advance of a scheduled visit for completion.

Examples of tools that may be used for infants and their parents or caregivers include: ASQ-SE, Bright Futures Surveillance Questions, Bright Futures Pre-visit and Supplemental Questionnaires, Pediatric Intake Form (Family Psychosocial Screen), PSI (Parent Stress Index), and CHADIS-DSM pre-visit parent questionnaire (American Academy of Pediatrics, 2010). 

During the infant’s first year of life, the PNP needs to use a few screening tools on a systematic basis. Besides observation of parent-infant interaction and awareness of development and behavior during the physical examination. the PNP wants to screen for postpartum depression in the mother especially in the first six months of the infant’s life using a tool such as the Edinburgh Postnatal Depression Scale  http://www.fresno.ucsf.edu/pediatrics/downloads/edinburghscale.pdf , consider the use of a temperament questionnaire such as the Early Infancy Temperament Questionnaire http://journals.lww.com/jrnldbp/Abstract/1993/08010/The_Early_Infancy_
Temperament_Questionnaire.4.aspx  designed for infants one to four months of age, and consider having parents complete the ASQ: SE to screen for social-emotional development http://agesandstages.com/. Early detection of motor delays is important, too with helpful information to be found at: pathways.org

When infants and younger children fail routine developmental screenings, fail autism screenings, or are observed to have poor growth, attachment issues, excessive crying, or psychosocial issues brought forth by parents, the infant and family should receive further evaluation and intervention, as required.

References and Resources:

Ages and Stages Questionnaire: http://agesandstages.com/
Bright Futures Developmental Tools for Families and Providers: http://www.brightfutures.org/tools/index.html 
CSBS DP Infant-Toddler Checklist: http://www.brookespublishing.com/store/books/wetherby-csbsdp/CSBSDP_Checklist.pdf
KySS Assessment Questions for Parents of Older Infants and Toddlers: http://www.napnap.org/Docs/KySSAssess.pdf
Screening and Assessment: http://www2.aap.org/sections/dbpeds/screening.asp