From the Guidelines
The HEADSS exam is a crucial tool for pediatricians to assess the psychosocial well-being of adolescent patients, and it should be conducted in a compassionate and non-judgmental manner, starting with less sensitive topics and progressing to more sensitive ones, as outlined in the trauma-informed care approach 1. When conducting a HEADSS exam, it is essential to establish rapport and explain confidentiality limits before systematically exploring each domain, including Home, Education/Employment, Activities, Drugs, Sexuality, and Suicide/Depression.
- The assessment should begin with open-ended questions about home life and family relationships,
- followed by inquiries about school performance or work environment,
- then recreational activities and peer relationships,
- substance use including alcohol and drugs,
- sexual behaviors and identity,
- and finally, thoughts of self-harm or mood disturbances. As noted in the study on trauma-informed care 1, recognizing that certain symptoms may indicate exposure to childhood adversities, pediatricians can ask questions like “What has happened to you (or your family)?” to explore the possibility of adverse experiences. The HEADSS framework is particularly valuable because adolescents may not spontaneously disclose psychosocial concerns during routine medical visits, yet these issues significantly impact their health and development, making it essential to identify risk factors and protective factors in adolescents' lives, allowing for early intervention when needed 1.
From the Research
HEADSS Exam for Pediatrics
The HEADSS exam is a tool used to assess the psychosocial well-being of adolescents and pediatric patients. It covers various aspects of a patient's life, including:
- Home environment
- Education and employment
- Activities
- Drugs
- Sexuality
- Suicide and depression
Components of the HEADSS Exam
The HEADSS exam is designed to facilitate dialogue with teens and address challenges faced by this age group 2. It is an effective way to engage with pediatric patients and assess their risk-taking behaviors. The exam can be used in various settings, including emergency departments, to identify potential barriers and facilitators to implementing standardized assessments and discharge planning for pediatric mental health patients 3.
Applications of the HEADSS Exam
The HEADSS exam can be used to assess the comprehensive pediatric headache examination, which is an important part of any pediatric practice 4. It can also be used to identify substance use disorders and their association with suicidal ideation, planning, and attempts among adolescents and adults 5. Additionally, the exam can be used to assess mental health, substance use, and suicidal ideation during the COVID-19 pandemic 6.
Key Findings
Studies have shown that the HEADSS exam is an effective tool for assessing the psychosocial well-being of adolescents and pediatric patients. It can help identify potential risk factors and provide appropriate interventions to address these risks 2, 3. The exam can also be used to identify substance use disorders and their association with suicidal ideation, planning, and attempts among adolescents and adults 5. Furthermore, the exam can be used to assess mental health, substance use, and suicidal ideation during the COVID-19 pandemic 6.