Executive Control and Adolescent Health: Toward A Conceptual Framework.

Executive control is a set of cognitive abilities that may impact a variety of adolescent health behaviors and outcomes; however, research on executive control as a contributor to the physical health of youth is relatively limited. Therefore, the current article explores the possible role of executive control in adolescent health by reviewing relevant literature and proposing a conceptual framework to guide future research in this area. The development of executive control from preschool through adolescence is described, with particular attention to executive control in the unique health context of adolescence. A new conceptual model is proposed, focusing on how executive control may play a critical role in supporting health in adolescence and beyond through the mechanisms of attentional, behavioral, and emotional control. Literature exploring associations between youth executive control and key health behaviors (including diet, physical activity, sleep and substance use) is reviewed. Researchers and clinicians are encouraged to consider executive control as an important cross-cutting contributor to health during adolescence and beyond and to incorporate this construct into longitudinal studies of health.

Feasibility of Screening for Preschool Behavioral and Emotional Problems in Primary Care Using the Early Childhood Screening Assessment.

The American Academy of Pediatrics recommends screening young children for behavioral and emotional problems (BEP) during primary care visits. Because of time constraints, few primary care providers (PCPs) use standardized screening tools to detect BEP. The Early Childhood Screening Assessment (ECSA) is a brief screening tool developed specifically to meet the needs of pediatric primary care providers (PCPs). The ECSA has established psychometric properties, but the feasibility and acceptability of the ECSA have not been established. This study examines the degree to which PCPs would incorporate ECSA screening and how PCPs value the ECSA as a tool to detect children with BEP. Twenty-seven pediatric PCPs were trained to implement ECSA screening. Six months after training, 96% of PCPs reported that the ECSA was practical for use at well-visits, 70% were still screening and 89% agreed that it helped detect more cases of BEP than by routine history-taking alone.

Collaborative Care: a Pilot Study of a Child Psychiatry Outpatient Consultation Model for Primary Care Providers.

A Child Psychiatry Consultation Model (CPCM) offering primary care providers (PCPs) expedited access to outpatient child psychiatric consultation regarding management in primary care would allow more children to access mental health services. Yet, little is known about outpatient CPCMs. This pilot study describes an outpatient CPCM for 22 PCPs in a large Northeast Florida county. PCPs referred 81 patients, of which 60 were appropriate for collaborative management and 49 were subsequently seen for outpatient psychiatric consultation. The most common psychiatric diagnoses following consultation were anxiety (57%), ADHD (53%), and depression (39%). Over half (57%) of the patients seen for consultation were discharged to their PCP with appropriate treatment recommendations, and only a small minority (10%) of patients required long-term care by a psychiatrist. This CPCM helped child psychiatrists collaborate with PCPs to deliver mental health services for youth. The CPCM should be considered for adaptation and dissemination.