{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T16:20:42Z","timestamp":1792254042553,"version":"4.4.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009192","name":"Alberta Innovates","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009192","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100009192","name":"Alberta Innovates","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009192","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100015753","name":"Mental Health Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015753","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004489","name":"Mitacs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004489","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Simon & Martina Sochatsky Fund for Mental Health"},{"name":"Howard Berger Memorial Schizophrenia Research Fund"},{"name":"Abraham & Freda Berger Memorial Endowment Fund"},{"name":"Alberta Synergies in Alzheimer\u2019s and Related Disorders (SynAD) program"},{"DOI":"10.13039\/501100018911","name":"University Hospital Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018911","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosdigitalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Digit Health"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>In the context of the COVID-19 pandemic, it becomes important to comprehend service utilization patterns and evaluate disparities in mental health-related service access among children.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>This study uses administrative health records to investigate the association between early developmental vulnerability and healthcare utilization among children in Alberta, Canada from 2016 to 2022.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Children who participated in the 2016 Early Development Instrument (EDI) assessment and were covered by public Alberta health insurance were included (N = 23 494). Linear regression models were employed to investigate the association between service utilization and vulnerability and biological sex. Separate models were used to assess vulnerability specific to each developmental domain and vulnerability across multiple domains. The service utilization was compared between pre- and post-pandemic onset periods.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>The analysis reveals a significant decrease in all health services utilization from 2016 to 2019, followed by an increase until 2022. Vulnerable children had, on average, more events than non-vulnerable children. There was a consistent linear increase in mental health-related utilization from 2016 to 2022, with male children consistently experiencing higher utilization rates than females, particularly among vulnerable children. Specifically, there was a consistent linear increase in the utilization of anxiety-related services by children from 2016 to 2022, with females having, on average, 25 more events than males. The utilization of ADHD-related services showed different patterns for each group, with vulnerable male children having more utilization than their peers.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Utilizing population-wide data, our study reveals sex specific developmental vulnerabilities and its impact on children\u2019s mental health service utilization during the COVID-19 pandemic, contributing to the existing literature. With data from kindergarten, we emphasize the need for early and targeted intervention strategies, especially for at-risk children, offering a path to reduce the burden of childhood mental health disorders.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pdig.0000611","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T17:33:29Z","timestamp":1726594409000},"page":"e0000611","update-policy":"https:\/\/doi.org\/10.1371\/journal.pdig.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Six-year (2016\u20132022) longitudinal patterns of mental health service utilization rates among children developmentally vulnerable in kindergarten and the COVID-19 pandemic disruption"],"prefix":"10.1371","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6114-4233","authenticated-orcid":true,"given":"Fernanda","family":"Talarico","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Metes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengzhe","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake","family":"Hayward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0406-8056","authenticated-orcid":true,"given":"Yang S.","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0535-8426","authenticated-orcid":true,"given":"Julie","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanbo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Greenshaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Gaskin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9500-6776","authenticated-orcid":true,"given":"Magdalena","family":"Janus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9338-3271","authenticated-orcid":true,"given":"Bo","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,9,17]]},"reference":[{"issue":"4","key":"pdig.0000611.ref001","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1111\/jcpp.13261","article-title":"Research review: A meta-analysis of the international prevalence and comorbidity of mental disorders in children between 1 and 7 years.","volume":"62","author":"M Vasileva","year":"2021","journal-title":"J Child Psychol Psychiatry"},{"issue":"10","key":"pdig.0000611.ref002","doi-asserted-by":"crossref","first-page":"e0276461","DOI":"10.1371\/journal.pone.0276461","article-title":"Healthcare utilization in children across the care continuum during the COVID-19 pandemic.","volume":"17","author":"AR Schroeder","year":"2022","journal-title":"PLOS ONE"},{"key":"pdig.0000611.ref003","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jad.2021.06.021","article-title":"Prevalence of mental health problems among children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis","volume":"293","author":"L Ma","year":"2021","journal-title":"J Affect Disord"},{"issue":"5","key":"pdig.0000611.ref004","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1002\/jmv.27549","article-title":"A large-scale meta-analytic atlas of mental health problems prevalence during the COVID-19 early pandemic","volume":"94","author":"E Dragioti","year":"2022","journal-title":"J Med Virol"},{"issue":"4","key":"pdig.0000611.ref005","first-page":"e2020149","article-title":"Psychological and psychiatric impact of COVID-19 pandemic among children and adolescents.","volume":"91","author":"M Deolmi","year":"2020","journal-title":"Acta Biomed."},{"issue":"9","key":"pdig.0000611.ref006","article-title":"Quality of Life and Mental Health in Children and Adolescents after the First Year of the COVID-19 Pandemic: A Large Population-Based Survey in South Tyrol","volume":"19","author":"V Barbieri","year":"2022","journal-title":"Italy. 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