Use of Infant Crying Screening Tool Improves Family Support

Research has consistently found that excessive infant crying negatively affects caregivers, elevating their levels of depression and parenting stress and decreasing parenting self-efficacy. Pediatricians traditionally screen for infant crying problems only by asking parents about the amount of crying, but research suggests that parental perception of infant crying is a better predictor of parent well-being than the amount of infant crying reported. We developed a brief screening tool to identify families who need support with infant crying. In this pilot study, funded by the University of Chicago – Chapin Hall Joint Research Fund, we analyzed the tool’s utility in a pediatric clinical setting.

What We Did

We recruited pediatric residents at two Federally Qualified Health Clinics affiliated with the University of Chicago and trained them to use the Infant Crying and Parent Well-being (ICPW) screening tool. They began using the five-question, verbally administered screening in clinics with infants and parents. Residents completed a baseline survey prior to using the ICPW screening tool, post-visit surveys after each patient visit, and a follow-up phone interview. This pilot study aimed to answer three main research questions:

  1. Does the ICPW increase provider awareness of infant crying problems for families with infants under 9 months of age?
  2. Does use of the ICPW facilitate conversations around issues of infant crying and family support/coparenting?
  3. Does the ICPW provide a brief, simple method of determining which patients to refer for further support with infant crying?

What We Found

  1. The ICPW screening tool increased awareness of infant crying problems for nearly 90% of pediatric residents in the study.
  2. The ICPW tool facilitated a conversation about infant crying for 94% of the visits in which the tool was administered, whereas prior to use of the ICPW screening tool, less than 30% of participant residents asked parents about infant crying during wellness visits. For 78% of residents, the ICPW tool changed how they talked to families about infant crying and fussing during visits. They further perceived that the ICPW improved conversations surrounding family support and coparenting.
  3. Residents found the ICPW tool helpful for detecting families with infant crying problems. They valued having a standardized protocol for screening families and appreciated the usability and brevity of the tool. All interview respondents said they would recommend the screening tool to other providers.

What It Means

Findings suggest that the ICPW screening tool increases pediatric resident awareness of infant crying, changes the way that crying is discussed at clinical visits, and encourages residents to provide anticipatory guidance to parents. The preventative potential of the ICPW screening tool is especially relevant since inconsolable crying is one of the most common reasons for infant visits to the emergency room. These pilot study results suggest that the ICPW is an effective method for providers to screen for families at risk of detrimental consequences of excessive infant crying. Furthermore, its implementation in pediatric clinics has the potential to improve support for families struggling with infant crying, reduce risk of child abuse, and decrease associated healthcare costs.

Recommended Citation
Burkhardt, T., Katch, L., Andrews, B., & Alkureishi, M. (2019, October). Evaluating the clinical implementation of the Infant Crying and Parent Well-being screening tool. Chicago, IL: Chapin Hall at the University of Chicago.
ICPW Pilot Study Report ICPW Practice Guide One Page