AAP Clinical Report: How to Help Military Families Navigate Health Care for Their Children

Frequent relocations and transitions can be tough on children, who obtain care in both military and civilian medical practices

Children in U.S. military families are challenged by frequent moves, prolonged separations and deployment of family members, yet many show increased resiliency when provided with family and community supports.

The American Academy of Pediatrics provides guidance for clinicians and families with a clinical report on "Health and Mental Health Needs of Children in U.S. Military Families," which updates recommendations published in 2013. The report, published in the January 2019 issue of Pediatrics (Dec. 24, 2018 online), provides a background on military culture and resources to assist families, including those with children who have special needs.

"The military health care system is vast and can be difficult to navigate, especially for families that are in transition or relocating," said pediatrician CDR Chadley R. Huebner, MD, MPH, FAAP, lead author of the report. "We hope to equip pediatricians with tools to identify common problems and provide them with resources for military families."

About 58 percent of 2.2 million members serving on active duty and the National Guard and Reserve have families, and 40 percent have at least two children, according to the report. Because of their wide geographic distribution, military children are cared for in both military and civilian medical practices, sometimes in remote locations.

Military children may experience a move in geographical location every two to four years, and transition between schools up to nine times by age 18, according to the report. One large study of military children showed that those who had moved within the prior year had more mental health encounters compared with those who hadn't. Affected teens also experienced more psychiatric hospitalizations and emergency department visits.

Research examining the impact of deployment showed that children in families where a caregiver was stressed or struggling with mental health issues were at a higher risk of maltreatment or substance abuse.

The AAP recommends that physicians:

• Establish a clinical process to identify children who are connected to the military and document the parents' deployment, relocation and mental health histories.
• Integrate a screening tool to identify children at risk of behavioral and emotional problems.
• Become familiar with the deployment cycle and common reactions to deployment.
• Identify a list of community-based resources for families of deployed service members. AAP has provided descriptions of various programs offered by the military in the clinical report.
• Work with local schools to identify military children and provide resources for transitions or upcoming move.

"We know that children are remarkably resilient, and we can help find them support within and outside of the military community," Dr. Huebner said. "Our goal is to support the families wherever their tour of duty takes them."

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds