All diagnoses, from infancy to adulthood, begin with an examination. While an organic basis for most medical disorders can be determined through the use of diagnostic testing, the field of psychiatry is different in that patients cannot be sent to the lab for blood tests to determine the degree of depression. Similarly, patients cannot be sent to the radiology department for a “scan” to determine the severity of their bipolar disorder. Instead, the field of psychiatry must use psychiatric assessments, such as the comprehensive integrated physical exam, diagnostic interviews, and questionnaires to make diagnoses. These tools must be specialized to address the needs of children and adolescents.
Diagnostic assessment of the child and adolescent is a specialized area of expertise. The PMHNP will often see children who have already been seen by a primary care provider. Many PCPs are comfortable handling attention-deficit/hyperactivity disorder (ADHD) and other straightforward childhood disorders. That means that the PMHNP will often treat the more complicated patients. This week, you explore psychiatric assessment techniques and tools for children and adolescents. You also examine the role of the parent/guardian in the assessment process for this patient population.
Learning Objectives
Students will:
Developmental assessment is the process of observing whether a child meets the typical developmental milestones in moving, behaving, speaking, learning and playing (Choo, Yeleswarapu, How & Agarwal, 2019). The assessment is essential because it helps in establishing development behavior concerns and delays on time. The assessment ensures that intellectual impairment is identified and it evaluates how the impairment affects developmental milestones. The assessment also helps in coming up with individualized management programs. It points to child strengths and weaknesses making it easy for parents, teachers, and psychologists to collaborate in developing interventions that meet the child’s development and learning needs. Evaluating children and adolescents helps in diagnosing developmental disabilities which provide a leeway to access school-based and government funding required to cater to home and school support for the affected children (Choo, Yeleswarapu, How & Agarwal, 2019). Lastly, development assessment can be combined with a cognitive assessment to establish if areas of concern can be linked to learning disorder or intellectual disability.
The assessment can be executed using the Behavioral and Emotional Rating Scale. The scale is ideal for children and adolescents because it is designed for use in child welfare agencies, juvenile justice settings, mental health clinics and schools (Dulcan, Ballard, Jha & Sadhu, 2017). It helps in measuring the personal competencies and strengths of children ages 5-0 through 18-11. The tool measure three perspectives of a child’s behavior which are the child, parent, and teacher and other professionals. The perspectives are obtained using Youth Rating Scale, Parent Rating Scale and Teacher Rating Scale respectively. It assesses a child’s strength, career strength, affective strength, school functioning intrapersonal strength and involvement with the family. Another tool used among children and adolescents is the Child and Adolescent Needs and Strengths (CANS). As a functional assessment tool, it helps in making decisions, coming up with quality improvement initiatives and monitoring service-related outcomes (Dulcan, Ballard, Jha & Sadhu, 2017). The tool offers consistent information and enhances communication between service providers and families benefiting from the services. The tool evaluates the child and family life and views the strengths and need using past behaviors and focusing on current needs.
For children with psychiatric problems, two therapy only applicable to them are play therapy and parent-child interaction therapy (PCIT). Play therapy helps a child verbalize, identify and recognize feelings using games, drawings, puppets, dolls, blocks and toys (Reddy, Files-Hall & Schaefer, 2016). The therapy combines play and talks ensuring that the child gets an opportunity
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