PMHS key terms

The ongoing, longitudinal process of observing and tracking a child's developmental progress during routine primary care visits, combining parental concerns, clinical observation, and milestone review rather than relying on a single screening test.

Use of a validated, standardized instrument at scheduled intervals to identify children at risk for developmental delay, producing a score that flags those needing further evaluation rather than a diagnosis.

Ages and Stages Questionnaire, Third Edition: a parent-completed screening tool covering communication, gross motor, fine motor, problem solving, and personal-social domains for children one month to five and a half years.

Modified Checklist for Autism in Toddlers, Revised with Follow-Up: a two-stage parent-report screen for autism spectrum disorder administered between 16 and 30 months, where failed items trigger a structured follow-up interview.

The capacity to share focus on an object or event with another person through gaze, pointing, or showing, typically emerging by 9 to 14 months; its absence is a red flag for autism spectrum disorder.

An infant's use of a caregiver's facial expression or tone to interpret an ambiguous situation and guide their own behavior, reflecting early emotional understanding and attachment-based learning.

An experimental procedure in which a caregiver briefly stops responding to an infant; the infant's reduced gaze, protest, and self-soothing behavior illustrate early expectations of social contingency and affect regulation.

The match between a child's temperament and the demands, expectations, and supports of their caregiving environment; a poor fit raises risk for behavioral and emotional problems.

Biologically based, relatively stable individual differences in reactivity and self-regulation, such as activity level, negative affectivity, and effortful control, that shape how a child responds to the environment.

The temperament dimension reflecting a child's capacity to voluntarily inhibit a dominant response and shift attention or behavior as needed; it underpins early self-regulation and predicts later adjustment.

A set of higher-order cognitive processes, including working memory, inhibitory control, and cognitive flexibility, that support planning, problem solving, and goal-directed behavior; deficits are common in several childhood psychiatric conditions.

The enduring emotional bond between a child and a primary caregiver, formed in the first years of life, that shapes expectations about safety, comfort, and the availability of others under stress.

A structured laboratory procedure for infants aged roughly 12 to 18 months involving brief separations and reunions with a caregiver, used to classify attachment patterns as secure, avoidant, resistant, or disorganized.

An attachment classification marked by contradictory, freezing, or apprehensive behaviors toward a caregiver, often linked to frightening or unpredictable caregiving and elevated risk for later psychopathology.

A trauma- and stressor-related disorder of early childhood characterized by markedly inhibited, emotionally withdrawn behavior toward caregivers and limited positive affect, arising after severe neglect or deprivation.

A condition following gross neglect in which a young child shows overly familiar, culturally inappropriate behavior toward unfamiliar adults, such as wandering off with strangers or seeking comfort from them indiscriminately.

Potentially traumatic events occurring before age 18, such as abuse, neglect, household mental illness, or caregiver substance misuse; cumulative exposure correlates with later mental and physical health problems.

An organizational and clinical approach that recognizes the prevalence and impact of trauma, avoids retraumatization, and builds safety, trust, and choice into all interactions with children and families.

A brief, evidence-informed early intervention after a distressing event that provides safety, stabilization, connection to supports, and practical help without requiring detailed trauma narration.

Attention-deficit/hyperactivity disorder: a neurodevelopmental condition with persistent inattention and/or hyperactivity-impulsivity that impairs functioning across at least two settings, with onset before age 12.

A parent and teacher questionnaire assessing ADHD symptom frequency plus common comorbid concerns such as oppositional behavior, anxiety, and depression, widely used in primary care for diagnosis and treatment monitoring.

Standardized parent, teacher, and self-report measures of attention, hyperactivity, impulsivity, and related difficulties, with age- and gender-based norms useful for screening and tracking response to treatment.

A pattern of angry or irritable mood, argumentative or defiant behavior, and vindictiveness lasting at least six months and causing impairment, distinguished from typical developmental limit-testing by intensity and persistence.

A more severe disruptive behavior disorder involving violations of others' rights or major societal norms, such as aggression, property destruction, deceitfulness, or serious rule breaking, with significant functional impairment.

Limited empathy, shallow affect, and reduced guilt or remorse that identify a subgroup of children with conduct problems who show more persistent antisocial behavior and respond differently to parenting interventions.

A structured behavioral intervention teaching caregivers to reinforce prosocial behavior, set consistent consequences, and use positive attention, delivered as first-line treatment for disruptive behavior disorders in young children.

An umbrella term for interventions that coach parents in antecedent and consequence strategies, functional analysis of behavior, and communication skills to reduce child behavior problems and improve family functioning.

A systematic process of identifying the antecedents and consequences that maintain a behavior, used to design targeted support plans rather than relying on punishment alone.

An evidence-based approach that applies principles of learning, such as reinforcement and shaping, to build functional skills and reduce interfering behaviors, frequently used in autism spectrum disorder intervention.

High-intensity, structured behavioral teaching delivered in early childhood, typically for autism spectrum disorder, aiming to improve communication, social, and adaptive skills through repeated, reinforced practice.

Developmentally inappropriate, excessive fear or distress about separation from attachment figures, lasting at least four weeks in children and impairing school, sleep, or social functioning.

A pattern in which a child resists or refuses attending school, often driven by anxiety, depression, or family factors; distinguished from truancy by emotional distress and parental awareness of the absence.

A consistent failure to speak in specific social situations where speaking is expected, despite speaking in other settings, lasting at least one month and interfering with education or social participation.

Marked, persistent fear of negative evaluation in social or performance situations, leading to avoidance or distress that is out of proportion to the actual threat and impairs daily functioning.

Excessive, difficult-to-control worry across multiple domains, accompanied by restlessness, fatigue, irritability, muscle tension, or sleep disturbance, persisting for at least six months.

A structured, skills-based psychotherapy targeting unhelpful thoughts and avoidance behaviors through psychoeducation, cognitive restructuring, and gradual exposure, with strong evidence in pediatric anxiety and depression.

A core component of anxiety treatment in which a child gradually and repeatedly confronts feared situations or sensations in a planned, safe manner until distress diminishes through habituation and new learning.

A depression intervention that systematically increases engagement in rewarding, values-consistent activities to counter withdrawal and inactivity, often adapted for adolescents in primary care settings.

Patient Health Questionnaire for Adolescents: a self-report depression screen adapted for teens that scores symptom severity and flags suicidal ideation, commonly used to guide further assessment in primary care.

A structured, brief interview assessing the presence, severity, and recency of suicidal ideation and behavior, used to stratify risk and determine the appropriate level of safety planning.

A collaborative, written plan developed with a patient that lists warning signs, coping strategies, supportive contacts, and means-restriction steps to use during a suicidal crisis.

Reducing access to highly dangerous methods, such as firearms or medications, in the homes of at-risk youth; a practical, evidence-supported suicide prevention step discussed with caregivers.