Plan to address behavioral-social-emotional health concerns
Mental health conditions and addiction are frequently comorbid conditions. Pediatricians can assess birth parents and other primary caregivers for mental and emotional health. When a behavioral-social-emotional health screen generates a positive result, pediatricians can implement appropriate primary care interventions and/or offer specific referrals to the family for an appropriate community resource. The urgency and level of the intervention is informed by the concerns and symptoms identified and ranges from in-office discussion/consultation with parents, referral to Early Intervention Programs, or specific behavioral health services based on need. Once the plan is created to address the behavioral-social-emotional health needs identified, the pediatrician can document the plan in the patient’s chart.

For a comprehensive description of possible primary care interventions to include in the plan, refer to Infancy Visits: Prenatal Through 11 Months, from Bright Futures. The plan should include referrals to community resources for primary caregiver(s) as indicated from the screening, which may include outreach to behavioral health, childcare, transportation, food insecurity, and/or housing assistance resources.
The AAP Bright Futures guidelines recommends developmental surveillance for all pediatric health supervision visits and developmental screening using a standardized/formal, tool at the 9-, 18-, and 30-month health supervision visits; autism screening is recommended at 18- and 24-months. Infants and children with known or suspected prenatal exposure to opioids are at increased risk for developmental alterations and more frequent follow-ups and screenings using a formal/standardized tool are encouraged.