Social Emotional Screening in Early Childhood


CatherineWrightbw150Glenace-Edwallbw150TomScottBy Catherine L. Wright, PsyD, MS, LPCC, Glenace E. Edwall, PhD, PsyD, LP, MPP, and Tom Scott, MD

Social emotional screening in primary care identifies infants, toddlers, and preschoolers in need of referral for mental health services. This screening process is currently receiving increased clinical and public health attention because of concerns about low rates of detection and treatment of behavioral and emotional problems in the United States.

The CDC (2013) reports that between 13 and 20 percent of children in the United States have a diagnosable mental health disorder in any given year. In addition, childhood trauma not only negatively impacts child development, but also negatively affects the long-term physical, emotional and cognitive health of adults. However, early detection of mental health conditions and early interventions have the greatest potential positive impact on addressing the effects of childhood trauma and mental health development (CSECD-BCYF, 2000).

With children and their families being seen in primary care more than in any other system (Nelson and Schiff, 2015), primary care clinicians have an opportunity to incorporate this component of preventive pediatric care into their practices (Weitzman & Wegner, 2015).

Screening Instrument Resource Info
To address the issues around social emotional screening in primary care, Minnesota has developed a long-standing interagency screening committee that identifies developmental and social emotional screening tools for young children with appropriate psychometric properties:

Selection of Screening Instruments
Clinics should use social emotional screeners that have strong psychometric properties – sensitivity and specificity .70 or greater (Glascoe, 2014).

Parent Completion of Screening Information
Clinics are advised to use electronic screening that may occur in the waiting room or by the family prior to attending the primary care visit to save time, money and scoring issues (Wright & Holm-Hansen, 2010). For families who do not read English, screenings should be conducted with an interpreter trained in and knowledgeable about the tool (Glascoe, 2014).

Online Pilot
Minnesota is piloting electronic screening and the use of audio versions of screenings in Hmong, Somali, English and Spanish. More information about the electronic screening project is available at:

Minnesota System of Care
Minnesota has developed an early childhood mental health system of care to assist primary care referral based on agencies that employ highly trained mental health professionals in the areas of early childhood mental health assessment and treatment; these agencies currently serve young children. A map of these agencies is available at:

Successful Referrals
Families are more likely to follow through on referrals when a care coordinator within the clinic system is available to assist the family (Talmi et al., 2014).

Steps to Implement Screening

  • Reading the practice
  • Identifying resources
  • Establishing office routines for screening and surveillance
  • Tracking referrals
  • Seeking payment
  • Fostering collaboration

Social emotional screening in primary care has the potential to identify early onset mental health conditions and address childhood trauma more than in any other system. Social emotional screening must include the use of standardized tools with acceptable psychometric properties. Electronic screening tools have been found to save on costs, time, and eliminate scoring errors. Additionally, all screening efforts must include a referral system to competent mental health assessors and intervenors. Referral systems using care coordinators are a sound means for ensuring that families have access to the care they need.

References available upon request. Email

Annual Sponsors

Children's Minnesota
Gillette Children's
Hennepin Healthcare
University of Minnesota Health
Essentia Health
Mayo Clinic
Shriners Healthcare for Children-Twin Cities