Maternal depression screening as an opening to address social determinants of children's health

The burgeoning interest in having child health care professionals screen for social determinants of health, including adverse childhood experiences, is getting ahead of the capacity of pediatric practices to implement reliable procedures and to initiate appropriate interventions and referrals. The importance of social factors in shaping children’s health and development cannot be denied, and pediatric practices are a unique, universal point of access to children’s families. However, reliable standardized screening instruments are not readily available, nor is adequate reimbursement routinely provided for the additional time to screen, assess, refer, and manage identified problems. How can pediatricians address social factors affecting their patients without overwhelming their staff and practices?