It is invaluable to identify families with psychosocial characteristics associated with a higher risk of having children with behavioral problems to assist the child.

Children grow up in a family environment. Family function significantly affects children’s social and psychological adaptation and mental health. Some family psychosocial risk factors have been shown to increase the risk of behavioral problems in children. The early identification of families with psychosocial characteristics associated with a higher risk of having children with behavioral problems is invaluable for prevention and early intervention services for these children.

A psychosocial evaluation is generally in the form of a questionnaire evaluating a family’s psychosocial risk profiles in the primary care setting. This evaluation is a valuable screening tool for identifying families with psychosocial risk profiles associated with increased risk of childhood behavioral problems.

Some of the psychosocial risk factors include the following:

Parental mental health problems

Parents' and children's mental health are linked in a variety of ways. Parents who are dealing with their own mental health issues, such as depression or anxiety (fear or concern), may find it more challenging to care for their children than parents who describe their mental health as good. Caring for children can be difficult for parents, especially if they lack resources and support, and this can negatively impact a parent's mental health. Inherited vulnerabilities, living in hazardous situations, and facing prejudice or deprivation are all dangers that parents and children may face.

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Parental substance abuse

Children who grow up in homes where their parents take drugs often suffer from various emotional and developmental delays. Parental drug abuse and neglect of children are common conditions in the family. When drugs and alcohol became the top priority, parents began to stop paying attention to their role and the importance of making their children physically and emotionally available. The emotional impact of substance abuse is serious because children learn that their needs are no longer a priority. Neglect can have a lasting effect on children's mood, and may even have physiological side effects and negative health results. Children living in families where parents have addiction problems often experience behavioral and emotional problems; this can mean outbursts of anger, depression, anxiety, or alienation.

Parental conflict

Parental disagreement is harmful to children, and this is true whether the parents are married or living together. When their parents quarrel, children display distress from an early age. They are more likely to experience a variety of health problems, interrupted sleep, and difficulties focusing and excelling at school as a result of their reactions, which can include fear, anger, worry, and sadness. Parents in high-conflict relationships are more likely to criticize, be aggressive, threaten, shout, and beat their children. High-conflict relationships might sometimes result in parents who are simply uninterested in their children. In any instance, children may struggle to build a strong bond with their parents.

Domestic violence

Children are affected deeply by the conflict in the family. Children may develop serious emotional and behavioral problems as a result of domestic violence in the home. When there is domestic violence between partners, there is often child abuse as well. Children in homes with domestic violence may feel fearful and anxious, always be on guard, wondering what will happen next. Children brought up with domestic violence are at greater risk for repeating the cycle themselves by entering into abusive relationships or becoming abusers themselves.


Poorer children and teenagers are also more likely to experience a variety of negative consequences, including low academic performance, school dropout, abuse and neglect, behavioral and socioemotional issues, physical health issues, and developmental delays. Poverty is linked to unfavorable situations such inferior housing, homelessness, inadequate nutrition and food insecurity, inadequate child care, lack of access to health care, hazardous neighborhoods, and underfunded schools, all of which have a detrimental influence on our country's children.

Foster care

Children who have been in foster care are at a significantly higher risk of mental and physical health problems, ranging from learning disabilities, developmental delays and depression to behavioral issues. They are more likely to experience depression, exhibit behavioral problems, feel anxiety, have attention deficit disorder, hearing impairments and vision issues, and suffer from learning disabilities, developmental delays, asthma, obesity and speech problems

Parental stress

When parents are stressed, they are less involved, impatient, and aloof with their young children. Positive parent-child bonding experiences and interactions are critical for the development of competences that promote growth and development. Parental negativity or over-reactivity, as well as a lack of early parental nurturing, can have negative long-term consequences for children's emotional and behavioral development, including, but not limited to, negative adjustment outcomes and an increased risk of mental health and substance use problems as they grow older.

This differs from a psychological evaluation which is an individualized assessment focusing upon a child’s intelligence, achievement, memory, attention, behavioral, emotional and social development.

Pediatric Psychosocial Assessment Tools

There are several different psychosocial risk assessment tools available for specialists and evaluators to use in conducting a psychosocial evaluation. The most commonly used ones are the Psychosocial Risk Assessment in Pediatrics (PRAP) and the Psychosocial Assessment Tool (PAT).

The Psychosocial Risk Assessment in Pediatrics (PRAP) is a screening tool used to determine the likelihood of a child experiencing elevated distress during a medical contact. Included in the PRAP is a database that stores, organizes, and analyzes psychological data, which can then be compared to that of other facilities. Child life specialists, psychologists, and physicians conducted empirical research to determine the risk factors assessed in the Psychosocial Risk Assessment in Pediatrics.

The Psychosocial Assessment Tool (PAT) is an assessment of psychosocial risk based on the Pediatric Psychosocial Preventative Health Model (PPPHM) that can be used for families of infants through adolescents. The Pediatric Psychosocial Preventative Health Model (PPPHM) outlines three levels of family psychosocial risk, which the PAT measures in its results.

Early life exposure to psychosocial adversity, such as child abuse and neglect, witnessing family violence, having a parent with untreated mental illness, or other significant psychosocial stressors, can affect developmental processes across cognitive, socio-emotional, and physical domains, with implications for long-term health and social outcomes. A psychosocial evaluation in a professional setting gives valuable insights into the child’s home life, and the effects of the stresses that home life may be providing.

If the psychosocial evaluation uncovers evidence of abuse, a Court Appointed Special Advocates (CASA). may be appointed by a judge in Family Courts to be an unbiased advocate for the child’s best interests in child abuse and neglect cases.