Current Treatment Options in Pediatrics

, Volume 4, Issue 1, pp 37–48 | Cite as

Approaches to the Management of Young Children’s Externalizing Behavior Problems in the Primary Care Setting

  • Catherine S. Wolcott
  • Karen A. Frankel
  • Ross E. Goodwin
  • Joyce N. Harrison
Mental Health (WF Njoroge and TD Benton, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Mental Health


Purpose of review

The current review summarizes the management of early-childhood externalizing behavior problems (ages 2–5) within the primary care setting. The review highlights factors pediatricians should consider when addressing externalizing behavior problems and summarizes general principles, opportunities for prevention and health promotion, parent-training interventions, integrated models, and therapies to consider when referring families to a specialty mental health provider.

Recent findings

Pediatricians have an important role in addressing early-childhood externalizing behavior problems in the primary care setting, and practices can take a range of meaningful steps to address these issues both universally and for children with higher levels of impairment. In particular, integrated approaches offer the opportunity to increase access to behavioral health services while also providing the chance to build medical providers’ skills in managing early-childhood externalizing behavior problems in the primary care setting.


Pediatricians have a range of options to consider and can use the literature regarding evidence-based programs to guide their decisions on the best interventions to implement in their settings. Further dissemination work is needed to better understand which programs are most effective when implemented in community settings.


Externalizing behavior problems Pediatric primary care Integrated behavioral health Early childhood mental health 



Dr. Harrison would like to acknowledge the support of Maryland’s BHIPP team and Maryland State Department of Education’s Race to the Top initiative team members Kay Connors MSW, Larry Wissow MD, Kelly Coble MSW, Mary Leppert MBBCH, Janna Steinberg, MA, Kate Wasserman, MSW, and Catharine Weiss, PhD.

Compliance with Ethical Standards

Conflict of Interest

Karen A. Frankel declares that she has no conflict of interest. Ross E. Goodwin declares that he has no conflict of interest. Joyce N. Harrison declares that she has no conflict of interest.

Catherine S. Wolcott reports completing postdoctoral training with project CLIMB (Consultation Liaison in Mental Health and Behavior) at the University of Colorado School of Medicine/Children’s Hospital Colorado.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Catherine S. Wolcott
    • 1
  • Karen A. Frankel
    • 2
  • Ross E. Goodwin
    • 3
  • Joyce N. Harrison
    • 4
  1. 1.Department of PsychiatryUniversity of Colorado School of MedicineAuroraUSA
  2. 2.Departments of Psychiatry and PediatricsUniversity of Colorado School of MedicineAuroraUSA
  3. 3.Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent PsychiatryThe Johns Hopkins HospitalBaltimoreUSA
  4. 4.Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Kennedy Krieger InstituteThe Johns Hopkins HospitalBaltimoreUSA

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