Description
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A pediatric psychiatric assessment serves as a diagnostic procedure aimed at identifying mental health issues in children. Grounded in evidence-based methodologies, this process seeks to discern the root causes of a child’s challenges, assess their symptoms comprehensively, and determine the most suitable support measures to guide them toward enhanced mental well-being (Srinath et al., 2019).
Key Elements of Psychiatric Assessment and Interviewing of Children
For the assessment of children and potential diagnoses for children having mental health issues following key elements should be considered for the psychiatric interview. When conducting a psychiatric assessment and interviewing children, it is important to create and provide a safe and comfortable environment where maximum clinically significant information can be gained (Vijverberg et al., 2022). Key elements of psychiatric assessment and interview of children include the following:
Understanding the child’s age, developmental stage, and cognitive abilities is essential (Srinath et al., 2019). The questions should be developed accordingly, and the communication style should be adapted accordingly.
Establishing rapport by building a positive relationship with the child and the parents is essential for obtaining accurate information (Srinath et al., 2019). This relationship is known as a therapeutic alliance which leads to a case formulation and eventually creating a treatment plan. For this purpose, making them secure and comfortable are the key elements.
Gathering information from multiple sources, such as parents, teachers, and caregivers, helps form a comprehensive understanding of the child’s behavior and challenges.
Observing the child’s behavior, interactions, and play can provide valuable insights into their emotional and social functioning (Srinath et al., 2019).
The clinician should utilize age-appropriate and non-threatening techniques to engage the child, such as play therapy, drawing, or storytelling.
The clinician would need to utilize validated assessment tools (Srinath et al., 2019). These tools are designed for children to screen for various psychiatric disorders according to their age, history, and symptoms. When diagnosing a child with obsessive-compulsive disorder (OCD), tools like the Children’s Yale-Brown Obsessive Compulsive Scale gauge the severity of the condition or treatment response. Additionally, anxiety or depression screening tools may be employed alongside clinical interviews to identify comorbidities not easily apparent in this population. It is crucial to use these measures thoughtfully, considering the specific purpose each measure serves.
Role of Parents in the Assessment of Children
Parents play a crucial role in the assessment process of children as their physical and mental developmental stage and state may not be appropriate to understand their issues completely. Furthermore, parents are the individuals who know and observe their children more than any other individual. Parents can offer valuable historical information regarding the child’s development, behavior patterns, and family dynamics (Srinath et al., 2019). Collaboration with parents ensures a more accurate understanding of the child’s challenges and facilitates the development of a treatment plan (Srinath et al., 2019). Parents can provide insights into the child’s behavior at home, which complements the clinician’s observations.
Steps Needed if The Child Discloses Information About the Parents Engaging in Illicit Behavior
If a child discloses information about a parent engaging in illicit behavior, the following steps should be taken by the clinician.
If it is believed that the child is in immediate danger, the clinician should take necessary steps to ensure their safety and prevent recurrence (Guastaferro et al., 2021). For example, if parent(s) are involved in drug abuse, sexual abuse, domestic violence, etc. then the actions are needed immediately to protect the child.
The practitioner should not promise confidentiality and not tell anyone in this case as it is essential to report the issue. In many jurisdictions, professionals are obligated to report child abuse or endangerment. The practitioner should be familiar with local reporting laws.
Creating a supportive environment for the child to express their feelings and concerns is also essential (Guastaferro et al.,2021). They should be ensured that they will be protected, and reports will be provided to only those who will help protect them.
A Potential DSM-5-TR Diagnosis and Treatment Plan for Children with this Disorder
There are several mental health disorders observed in children. One such potential disorder diagnosed on the criteria of DSM-5-TR is attention deficit hyperactivity disorder (ADHD). ADHD stands out as one of the most common disorders in child and adolescent psychiatry, affecting over 5% of this population (Drechsler et al., 2020). According to the Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition revised text (DSM-5-TR), this disorder is characterized by persistent patterns of inattention, hyperactivity, and impulsivity that can interfere with daily functioning or development (APA, 2022). Children with ADHD may struggle with sustaining attention, completing tasks at school or games, and controlling impulsive behaviors (Drechsler et al., 2020).
Widely recognized diagnostic frameworks, including the DSM-5 and ICD-10/11, persist in defining ADHD through behavioral criteria, relying on observations and informant reports. The treatment for a child diagnosed with ADHD usually comprises primarily of medication and behavioral therapy (Drechsler et al., 2020). Parent’s education, training, and support can play a very important role in enhancing the effectiveness of ADHD treatment (Schein et al., 2022). Parent training in children up to 12 years of age is considered a very important and helpful factor. In the domain of ADHD medication, stimulants are generally considered the primary and most efficacious form of therapy (Drechsler et al., 2020). Examples of stimulants commonly prescribed for ADHD treatment encompass methylphenidate, dextroamphetamine, dexmethylphenidate, lisdexamfetamine, dexmethylphenidate, and amphetamine.
The treatment plan for a child with ADHD would consist of a stimulant and behavioral therapy. They would be asked for follow-up visits and would be told how important it is for them to adhere to the treatment. The parent’s training and education would also be provided regarding medication use, potential adverse effects, and medication adherence.
ONE Peer-Reviewed Article That Provides a Rationale
One peer-reviewed article that provides a rationale for the treatment approach is by Drechsler et al (2022). This article provides insight into different treatment options including pharmacological and non-pharmacological interventions. The article also sheds light on the importance of parent training to enhance the effectiveness of the treatment.
