How Mental Health Screenings Benefit Neurodiverse Children, If Insurers Cover Them
“The AAP’s screening recommendation is a great first step for neurodiverse children, but we need insurance payer guidelines to ensure pediatricians and primary care providers are prepared to offer behavioral health screenings at every visit, not just during annual well-child checkups.”
The American Academy of Pediatrics (AAP) recently issued new guidance that recommends mental and behavioral health screenings for children, beginning at 6 months old.
Citing the rising rates of mental, emotional, and behavioral health concerns for children in the United States – estimated to affect 13% to 20% of the population – the AAP says an additional 19% of children experience problems that cause impairment or distress but don’t meet diagnostic criteria for a specific disorder.
As a pediatrician well acquainted with the AAP’s Bright Futures screening for well visits, I know mental health screening is an important and much-needed tool to better identify mental health concerns early and effectively. There’s an extra layer of urgency around providing early, comprehensive screening for neurodiverse children.
Many parents and even pediatricians know that neurodiversity can be misunderstood, overwhelming, and/or confusing. Many primary care physicians and pediatricians simply didn’t receive enough mental-health training during medical school and in their residencies. Because of this, they often have a limited understanding of the brain and its effect on behavior and the emotional development of children with ADHD and its comorbid conditions.
Early Intervention Is Key
Half of the mental health challenges that progress into adulthood are identified by age 14. By age 24, that number jumps to 75%. The signs of neurodiversity can emerge as early as toddlerhood and can be easily overlooked or misunderstood.
[Read: Youth Mental Health Care Is Vital. And Hard to Access.]
The AAP guidance recommends an initial mental, emotional, and behavioral health screening at 6 months and continuing those screenings at 12-, 24- and 36-month well visits. After age 3, the screening, including questions to reveal autism spectrum disorder and developmental disorders, continues annually.
We also know that children with neurodevelopmental disorders including autism have a higher risk for co-occurring mental health issues. This approach of more comprehensive mental and developmental screening will help identify these disorders earlier and allow for more targeted, early interventions. These early actions can address and build up critical skills needed to support a child’s ability to thrive and grow into a healthy and capable adult.
And although there may be some hesitation around conducting behavioral health screenings in schools, teachers are often the first to notice when a student is struggling emotionally. Early intervention is essential to support not only the student but also their peers and school staff. Research also shows that addressing behavioral health within the school environment can help reduce stigma. When challenges are identified, parents and caregivers can be guided to seek evidence-based interventions to support their child’s emotional, mental, psychosocial, and academic well-being.
More Support Needed
These screenings are essential, and this guidance is welcome in this community. We know the benefits of upstream, preventative mental healthcare on children and families. But there needs to be supportive infrastructure for pediatricians to properly screen children at their well checks. Many pediatricians today have limited time to conduct the screenings needed to ensure patients are meeting age-appropriate milestones – a problem exacerbated by the clinician shortage. In most clinics, during pediatricians’ short interactions with their patients, there’s rarely time to ensure full screenings are completed or that parents’ concerns are discussed beyond the reason for the visit.
Insurance payer guidelines for these screenings are needed for this effort to be successful. There’s very little parity when it comes to children’s mental health in the payer space, particularly for those children on Medicaid, which covers a fraction of the Medicare rate, which is a fraction of the private insurance rate.
[Read: How Collaborative Care Models Deliver Quality ADHD Care]
The AAP’s screening recommendation is a great first step for neurodiverse children, but we need the infrastructure to ensure pediatricians and primary care providers are prepared to offer behavioral health screenings at every visit, not just during annual well-child checkups.
Mental Health Screenings: Next Steps
- Read: Closing the ADHD Care Gap
- Read: Mental Health Screenings in Schools Reduce Stigma. And Save Lives.
- Read: 8 Questions to Ask Before Your Child’s ADHD Evaluation
SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.
