Screening for Infant Crying Problems to Support Family Well-being and Prevent Infant Maltreatment

• In Event: Poster Session 05
  In Poster Session: PS 05 Topic - Prevention and Interventions

Abstract

Inconsolable and excessive infant crying has repeatedly been shown to negatively impact caregivers, increasing depression and parenting stress levels and decreasing parenting self-efficacy (Bebe et al., 1993; Oldbury & Adams, 2015). Perhaps most importantly, inconsolable crying is the primary trigger for abusive head trauma (Barr, 2014). Despite the risks associated with excessive crying, providers often only discuss infant crying if the parents bring up a concern. Further, there is a lack of standardized assessment tools available to help facilitate discussions regarding infant crying, family support and co-parenting, resulting in the absence of routine screenings for families stressed by excessive infant crying. The Infant Crying and Parent Well-being (ICPW) screening tool was developed to provide a standardized method to identify families who are struggling with infant crying. Evidence supporting the construct validity of the ICPW tool was found in a study with a community sample. Overall, 28% of parents in this study screened positive on the ICPW, indicating that they are struggling with infant crying and may need additional support (see Figure 1). To better understand how the tool works in practice, the ICPW tool was recently tested with 17 pediatric resident trainees in an outpatient continuity clinic setting in an urban community. Evaluation of the clinical implementation of the ICPW was conducted through an interdisciplinary collaboration with an early childhood researcher, a clinical infant mental health specialist, a Neonatologist, and a Pediatrics Clerkship Director. The results of this interdisciplinary clinical evaluation study will be the focus of this presentation.

This presentation will provide a brief overview of the ICPW screening tool, as well as its conception and development. We will review key findings from the clinical implementation study, which revealed the ICPW screening tool benefitted resident practice by increasing their awareness of infant crying problems for nearly 90% of participants. The ICPW helped to facilitate conversations about infant crying with parents during clinic visits for 94% of the visits in which the tool was administered. The proportion of residents who provided anticipatory guidance on infant crying increased from 8% at baseline to 69% after using the ICPW tool (see Figure 2). Additionally, the tool initiated conversations around family support and co-parenting that might not otherwise have occurred. We will discuss how residents found it valuable to have a brief, standardized protocol for screening families for infant crying problems and how they found the screening tool helpful in determining which families to refer for support services. We will highlight the benefits of using the ICPW to identify families who are struggling with infant crying, and ways in which such a tool might be used in various clinical and research settings. Lastly, we will share lessons learned from an implementation standpoint, including training required to screen for infant crying concerns. The ICPW screening tool and the practice guide will be shared, and utility of the ICPW in different settings will be reviewed.

Authors

• Leslie Katch, National Louis University
  Presenting Author

• Tiffany Burkhardt, Chapin Hall at the University of Chicago
  Non-Presenting Author