Ecomaps (drawing-based assessments of social networks) were administered to primary school-aged children in order to ascertain whether Ecomaps might be useful in universal screening. Participants included 61 children (40.9% female) aged six to ten (M = 7.39, SD = 1.19), Kindergarten through third grade students in a predominantly African American (89.5%) public charter school in New Orleans. The study hypothesis was that children who report experiencing higher levels of social support and lower levels of social stress (derived from Ecomap index of Support-Stress balance) would have better social-emotional, behavioral, and academic outcomes than children who report lower levels of support and higher levels of stress. Ecomaps were administered to all participants and correlated with school-based archival data, including results of the Behavior Assessment System for Children, 2nd Edition (BASC-2), school behavior grades, and academic records. Stress-support indices from Ecomaps were significantly correlated with social-emotional and behavioral outcomes, but correlations with academic outcomes were not significant, providing partial support for the study’s hypothesis. Based on these findings, Ecomaps might be used as self-report measures to identify children at risk for, or currently experiencing, social-emotional or behavioral problems. This measure could be helpful to school psychologists and other school-based mental health professionals who are attempting to understand and respond to the strengths and needs of the children in their care. / acase@tulane.edu

The birth of a child can be a stressful time accompanied by an array of emotions including depression. Postpartum depression (PPD) affects approximately 1 out of 7 new mothers. It can affect a new mother’s sleep, appetite, mood, and bond with her baby, as well as impact child development and well-being, if left untreated. Beginning in March, 2013, ETSU Pediatrics deployed an evidence based screening tool, the Edinburgh Postpartum Depression Scale (EPDS), to identify mothers of newborns with PPD. Mothers attending well-visits with their baby from birth to six months of age who score above an eight on the screener are provided with education about PPD, referrals, brief on-site counseling, and phone-call follow- up. Many of these mothers express concerns about resources and social factors that impact their health and mood. An Ecomap is a visual representation of strengths and stressors of a patient’s relationship with their environment, social supports, and resources. The awareness of a patient’s relationships and support within their environment can be useful for assessment of needs and intervention on their behalf. The objective of this study is to pilot the utility of the Ecomap to illuminate common stressors of the social determinants contributing to or exacerbating symptoms of PPD, in order to provide brief solution-focused interventions and referrals to alleviate the stressors. Although Ecomaps have been utilized in clinic settings, there is a lack of research on their effectiveness in identifying social determinants of mothers with PPD. We hypothesized that implementing the Ecomap with mothers that present with an elevated EPDS score will identify a significant number of social determinates that are actionable by social workers on staff. When a mother presented with a score of eight or above on the EPDS administered during a well-child check, the social work staff completed an Ecomap with mothers via a warm handoff. The social determinants identified on the Ecomaps were then categorized and counted to determine biggest social needs of mothers at the ETSU Pediatric clinic from 11/13/2015 through 02/28/2016. The clinic completed 27 ecomaps with mothers who scored 7 or above at well child checks. Transportation and mental health services presented as the most common domains that social work was able to effectively act to rectify. Overall, the utilization of the Ecomap was successful in identifying social determinants contributing to or exacerbating symptoms of PPD. Addressing these stressors through resource allocation and brief solution-focused therapies may contribute to a reduction of PPD symptoms. Future research, therefore, should examine whether addressing these social stressors reduces symptoms of PPD above and beyond targeting depressive symptoms alone in mothers presenting at pediatric clinics.