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The assessment of child’s development is important within child and adolescent mental health services for clinicians assessing mental health issues of a child. Assessment tools are routinely relied upon to aid assessment and to monitor and evaluate treatment and service effectiveness (Bentley, N., Hartley, S., & Bucci, S. (2019). Child and adolescent care focus on mental health symptoms and diagnoses as they apply to their development and is focused on supporting children and their parents on the path to recovery.
Why Development assessment of children and adolescent important
Child development refers to the continuous but predictably sequential biological, psychological and emotional changes that occur in human beings between birth and the end of adolescence (Choo, Y. Y., Yeleswarapu, S. P., How, C. H., & Agarwal, P., 2019). Children and adolescent development assessment is important because children develop at different rates, which are determined by a complex interplay of environmental and genetic factors and the age of attainment for each milestone ranges widely. Therefore, a thorough developmental assessment may help to highlight normal or abnormal development pattern and timings and be aware of the red flags that would warrant further specialist referrals when necessary (Choo, Y. Y., Yeleswarapu, S. P., How, C. H., & Agarwal, P., 2019). Additionally, identifying signs and symptoms through detailed clinical history and developmental examination may help discover key areas of concern and presence or absence of a mental health disorder. It may also help the practitioner to come to a case formulation that would guide management decisions and develop a patient centered care plan. The developmental history of a child, across different domains gives the “background” on which to understand the current behavioral concerns and to plan pharmacological and psychotherapeutic management (Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019) According to Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019), a child with a developmental history of social and language delay, presenting with peer relationship issues and bullying in school, may probably have social skill deficits arising from autism spectrum disorder.
Two assessment instruments used for children and adolescents but not adults.
The two main assessment instruments that are used specifically for the children and adolescent are the diagnostic interviews and questionnaires (Sadock, B. J., Sadock, V. A., & Ruiz, P., 2014). One interviewer-based diagnostic interview is the child and Adolescent Psychiatric Assessment (CAPA). CAPA can be used for children from 9 to 17 years and it focused on symptoms occurring during the preceding 3-month period (Jozefak, & Berg- Nielsen,2016). Tt is tailored to feelings and behaviors pertinent to young children with somatic issues, schizophrenia, PTSD, disruptive behavior disorders, mood disorders, anxiety, sleep, eating, substance use, and elimination disorders and it can be used to collect information that may help to make diagnosis based on the DSM-5 (Sadock, B. J., Sadock, V. A., & Ruiz, P., 2014). Another interview-based tool is the children’s interview for psychiatric syndrome. According to Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014), children’s interview for psychiatric syndrome is structured interview tool used for children from 6 to 18 years of age and it is composed of 15 sections. It provide information on psychiatric symptoms and psychosocial stress relevant to 20 psychiatric disorders in the DSM-5 criteria including anxiety, OCD,ADHD, depression, mania, anorexia, bulimia, conduct and substance use disorders (Sadock, B. J., Sadock, V. A., & Ruiz, P., 2014).
One questionnaire based diagnostic instrument is the parent and teacher Achenbach child behavior checklist. It covers a broad range of symptoms and several positive attributes related to academic, and social competence. It assesses items related to mood, frustration tolerance, hyperactivity, oppositional behavior, anxiety and other behaviors. Though it is not used to make diagnosis, it may be used to identify specific problem areas that may be overlooked questionnaires (Sadock, B. J., Sadock, V. A., & Ruiz, P., 2014).
Treatment options for children and adolescents that may not be used when treating adults.
While the brain is still developing, mental health care can be a challenge in children. Treatments that work for adults may not fully address the same issues in children since their care is often focus on using methods that may help them to develop skills to manage their illnesses in a way that they can understand and build upon as they get older. Treatment option used for children and adolescent and not for adults is positive parenting program (Triple P). Triple P-Positive Parenting Program is an evidence-based parenting program that is useful in the management of Attention deficit hyperactivity disorder (ADHD) in children. According to Aghebati, Gharraee, Hakim Shoshtari & Gohari,(2014), triple P is a parent training program that is designed to prevent severe behavioral, emotional, and developmental problems in children by enhancing the knowledge, skills, and confidence of parents. It incorporates five levels of intervention of increasing strengths that help parents of children from birth to age 12 (Aghebati, Gharraee, Hakim Shoshtari & Gohari, 2014).
The role parents play in assessment and treatment.
Parents are entrusted with the responsibility for taking care of their children. Because parents are essential to the physical, mental, emotional, and spiritual development of their children, it is vital that parents are also involved in their child’s mental health assessment and children. Parent involvement positively may influence the outcome of assessment and treatment and empowers them to continue to nurture their child’s development (Haine-Schlagel, R., & Walsh, N. E. (2015). Parents play a critical role in the evaluation process by providing information about developmental skills that cannot be easily assessed in a clinical environment and by judging the validity of the child's performance in clinic in comparison with his or her typical behavior in home settings. Also, involving parents in treatment services may significantly increase the likelihood of positive outcomes for the child. Engaged caregivers aid the treatment process by ensuring the child's participate in treatment to completion. Further, as the experts in the child’s life, parents can help providers in increasing treatment compliance and monitoring for effectiveness or adverse effects of treatment at home. Parents involvement in assessment and treatment may provide the child with additional supports that can significantly increase their likelihood of attaining the goal for treatment.
References
Aghebati, A., Gharraee, B., Hakim Shoshtari, M., & Gohari, M. R. (2014). Triple p-positive
parenting program for mothers of ADHD children. Iranian journal of psychiatry and
behavioral sciences, 8(1), 59–65. Retrieved from,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078694/
Bentley, N., Hartley, S., & Bucci, S. (2019). Systematic Review of Self-Report Measures of
General Mental Health and Wellbeing in Adolescent Mental Health. Clinical Child &
Family Psychology Review, 22(2), 225–252. https://doi-org.ezp.waldenulibrary.org
/10.1007/s 10567-018-00273-x
Choo, Y. Y., Yeleswarapu, S. P., How, C. H., & Agarwal, P. (2019). Developmental assessment:
practice tips for primary care physicians. Singapore medical journal, 60(2), 57–62.
https://doi.org/10.11622/smedj.2019016
Haine-Schlagel, R., & Walsh, N. E. (2015). A review of parent participation engagement in child
and family mental health treatment. Clinical child and family psychology review, 18(2),
133–150. https://doi.org/10.1007/s10567-015-0182-x
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry:
Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical Practice Guidelines for
Assessment of Children and Adolescents. Indian journal of psychiatry, 61(Suppl 2), 158–
175. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18
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