The goal of this clinical trial is to evaluate the feasibility, acceptability, and initial effectiveness of using the Adaptive Behavioral Counseling Decision Framework to provide behavioral counseling for common preschool behavior problems in pediatric primary care. The interventions will be provided by integrated behavioral health clinicians and provided to primary caregivers of children aged 18-65 months who screen positive on the Preschool Pediatric Symptom Checklist (PPSC) or otherwise identify a child behavior concern. Participants will receive behavioral guidance based on the Adaptive Behavioral Counseling Decision Framework during their child's medical visit or a single behavioral health visit. The main question\[s\] it aims to answer are:
* What is the feasibility and acceptability of using a decision framework to guide selection and delivery of a single-session intervention for early childhood behavior concerns in pediatric primary care? * What is the initial effectiveness of framework-guided brief interventions in reducing parent-reported behavior concerns based on caregiver report?
The hypotheses are that the intervention will be delivered with fidelity in the time allotted, and that caregivers will rate the intervention as feasible and acceptable.
Caregivers of children ages 18-65 months who screen positive on the Preschool Pediatric Symptom Checklist (PPSC) or otherwise identify a child behavior concern.
Caregivers must be at least 18 years old.
Caregivers must speak English or Spanish sufficiently to complete study procedures. Study procedures in other languages are not feasible.
Children with moderate to severe intellectual disabilities.
Child and caregiver are already receiving more intensive behavioral parent training intervention (either at OHSU or in the community).
Single group
Adaptive Behavioral Counseling Decision Framework
BehavioralThe intervention components are common elements of evidence-based parenting interventions. In this study, they are distinguished by their delivery in the context of a single behavioral health consultation (about 20 minutes) during a pediatric health care visit.
Intervention Acceptability Survey
11-item, study-specific survey evaluating participants acceptance of the intervention. Each item is on a 4-point scale and total scores range from 11-44 with lower scores indicating higher acceptability.
Top Problems Assessment
The Top Problems Assessment is a brief instrument to identify and monitor caregivers' top behavioral concerns. Caregivers may identify between 1-3 problems. The severity of each problem is rated from 0 (not a problem) to 4 (a very big problem).
Preschool Pediatric Symptom Checklist
The Preschool Pediatric Symptom Checklist (PPSC) is an 18-item validated screening tool used by caregivers to assess emotional and behavioral problems in children aged 18 to 65 months. Each item is on a 0-2 point scale, with a total possible range of 0-36, with higher scores indicating more severe problems.
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