UTILITY OF THE PEDIATRIC SYMPTOM CHECKLIST AS A PSYCHOSOCIAL SCREEN TO MEET THE FEDERAL EARLY AND PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT (EPSDT) STANDARDS - A PILOT-STUDY

Objective: To examine the usefulness of the Pediatric Symptom Checklis t (PSC) as the psychosocial screening measure to meet federal Medicaid /Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) standa rds in a low-income Hispanic community. Design and setting: Three hund red seventy-nine children (aged 6 to 16 years) were screened with the PSC in a 10-month period during well child visits to three clinics in Ventura and San Mateo counties in California. The PSC was available in English and Spanish and was administered both in written (paper-and-p encil) and oral formats. Follow-up services were provided for children identified as needing evaluation. Results: The Cronbach alpha was hig h (r = 0.91) for the PSC in the whole sample and virtually identical f or English, Spanish, oral, and written formats. All the PSC items were significantly associated with total score on the PSG in English, Span ish, oral, and written formats. Overall, the PSC identified 10.6% of t he sample as at risk for psychosocial problems. Thirty-six children (9 .5% of sample) were referred for mental health followup, Public health data from Ventura County showed a statistically significant increase in referrals for psychologic problems during the study period in two l ocations using the PSC: from 0.5% to 2.9% of the school-aged children seen. Conclusion: The PSG provides a feasible, well-accepted method fo r screening for psychosocial problems during EPSDT examinations of sch ool-aged children. Psychosocial screening using a validated instrument such as the PSC, as well as increased efforts to refer positive scree ning results, track outcomes, and assess cost benefits should be essen tial requirements in capitated Medicaid approaches to caring for poor children.