Pediatricians encouraged to refer patients to community resources for childhood aggression

May 3 2006

Training pediatricians to recognize the signs of aggression and make a referral to an appropriate community organization may help prevent future violence.

However, providers don't often do this, according to a new study by a pediatrician at Brenner Children's Hospital, part of Wake Forest University Baptist Medical Center.

Shari Barkin, M.D., says making pediatricians aware of local resources and encouraging them to make referrals early is vital, yet even after training, providers do not often do this, according to her research presented at the Pediatric Academic Society Meeting in San Francisco, Calif.

"We know that aggression in children is a predictor of violence later in life," Barkin said. "We must train pediatricians to identify aggression early and use the resources in their local communities, such as parenting classes and Boys and Girls Clubs."

In a recent study of 1,100 parents nationwide with children ages two to 11, 12 percent said they worry that their child is more aggressive than children in their peer group. But only 3.7 percent received a referral to an appropriate community agency by their pediatrician.

"When we asked pediatricians about this, they said it was hard to identify resources in their community," Barkin said. "In addition, physicians said they were concerned about insurance issues and long wait lists at some referral agencies."

Of the 3.7 percent of parents who had received a referral, 38 percent had asked for the referral directly. Other times, referrals were made when physicians noticed signs of a possible mental health issue, there was high parental stress or they observed an abnormal interaction between the parent and child in the office.

"We must work to dismantle these barriers and get children the services they need early," she said.

Physical aggression is defined as using your body to push, shove hit or bite to express frustration. The rate of childhood aggression is increasing and it occurs more frequently with boys than girls. Parents often turn to their pediatricians for help, Barkin said.