Relationship Between the Family APGAR and Behavioral Problems in Children
William D. Smucker, MD;
Beth G. Wildman, PhD;
Thomas R. Lynch, MA;
Mary C. Revolinsky, MD
Arch Fam Med. 1995;4(6):535-539.
Abstract
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Objectives
To assess the use of the Family APGAR instrument as a supplement to usual clinical methods for the detection of psychosocial problems in children and to evaluate the relationship between the Family APGAR and physician diagnosis and elevated Child Behavior Checklist (CBCL) scores.
Design
Cross-sectional.
Setting
Ambulatory care center of a community-based, university-affiliated family medicine training program.
Subjects
One hundred fifty-two parents of children aged 3 to 16 years.
Main Outcome Measures
Family functioning was considered poor if Family APGAR scores were 5 or less. For the CBCL, sum total T scores greater than the 90th percentile for nonreferred children were considered clinically significant. Physicians used a checklist to indicate the presence of psychosocial problems or family dysfunction.
Results
Agreement between the Family APGAR scores and the physician's detection of child psychosocial problems was weak (k=0.23). There was no relationship between the Family APGAR scores and physician perception of family dysfunction (k= ^ 0.05). Although agreement between the Family APGAR and CBCL classifications was weak (k=0.20), families with low Family APGAR scores were more than twice as likely to have children with clinically significant CBCL scores than those with higher scores (risk ratio=2.08; 95% confidence interval=1.02 to 4.24).
Conclusions
The relationships among the Family APGAR and CBCL scores and physician detection of child psychosocial problems were weak. Child psychosocial problems were more than twice as likely to be present when the Family APGAR score was low. These findings suggest that family functioning is related to child psychosocial problems, but that the Family APGAR may not improve screening for child psychosocial problems.
Author Affiliations
From the Department of Family Medicine, Summa Health System, Akron, Ohio (Drs Smucker and Revolinsky), and the Department of Psychology, Kent (Ohio) State University (Dr Wildman and Mr Lynch).
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McInerny et al.
Pediatrics 2000;106:930-936.
ABSTRACT
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