The Child Network for Parents to Track Their Child's Mood and Behavior

Introduction: A wide range of psychiatric disorders are common in young children, especially in those at high risk because of a parent with a unipolar or bipolar mood disorder in the United States. Yet in part because most children are seen in primary care, these illnesses are often not recognized or treated in a timely fashion. To begin to address this problem, we started the Child Network. Methods: The Child Network is for parents of children age 2-12 with mood or behavioral symptoms or at high risk for them. The parents rate the severity of symptoms of depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional behavior, and mania on a once a week basis on a secure website under a Johns Hopkins Intramural Review Board (IRB)-approved protocol. These ratings can then be printed out along with any treatments given to aide in visualization of symptom course. A demographics form, which includes diagnoses given to the child in the community, and a symptom checklist are filled out upon Network entry. We report on the retrospective diagnoses and prospective treatment of the first 65 parents to join the Network. Results: The most common diagnoses were anxiety disorders and ADHD followed by disruptive behavioral disorders and bipolar spectrum disorders. Prospective ratings of two or more consecutive weeks of moderate to severe rating in any of the five symptom domains paralleled these diagnoses given in the community. Atypical antipsychotics, anticonvulsant mood stabilizers, and medications for ADHD were among the most widely used drugs. An illustrated example of symptom course is presented. Discussion: Many children continued to show substantial symptom severity despite treatment with an average of 2.2 medications. The Child Network provides a useful longitudinal approach to visualize the course of symptoms, which should help lead to earlier and more effective treatment.