Assessment in Child and Adolescent Psychiatry
Kathryn Barnard was a nurse first and second an early developmental specialist with a PhD in early ecological development. Dr. Barnard, with her nursing background, was instrumental in developing assessment tools and interventions to promote infant mental health. A center is named after her at the University of Washington, aptly named the Kathryn Barnard Center for Infant Mental Health and Development. Dr. Barnard reminds us that mental health is lifelong. Proper treatment of children from their earliest moments is instrumental to their development. One of her sayings was “infants can’t wait” (Weber, 2015).
All diagnosis, from infancy to adulthood, begins 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 how severe their bipolar disorder is. 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. Some of the diagnostic and clinical features will be like your assessment of the adult. However, the PMHNP will be seeing children who have been to the PCP. Many PCPs are comfortable handling ADHD and other straightforward childhood disorders. That means that the PMHNP and those in his or her office will be seeing the more complicated patients.
This week, you explore the many different psychiatric assessment tools and begin to explore treatment options. You also begin developing your resume and portfolio.
Photo Credit: JGI/ Jamie Grill / Blend Images / Getty Images
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
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.
· Chapter 2, “Contributions of the Psychosocial Sciences” (pp. 93–130)
· Chapter 6, “Classification in Psychiatry” (pp. 290–299)
· Chapter 31, “Child Psychiatry” (pp. 1107–1152)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
· “Neurodevelopmental Disorders”
· “Intellectual Disabilities”
· “Communication Disorders”
Note: You will access this book from the Walden Library databases.
Optional Resources
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.
· Chapter 2, “Diagnosis, Diagnostic Formulations, and Classification” (pp. 17–30)
Discussion: Working With Children and Adolescents Versus Adults
Infant, childhood, and adolescent development are a continual interplay between nature (genetic or biologic predisposition) and nurture (environmental experiences). The nature/nurture continuum and debate will always be a part of your career as a PMHNP. Knowing common developmental milestone is important in the role as a child provider. Not only is it essential to the diagnostic process, but it is also important to the interdisciplinary interactions with other mental health professionals. The study of normal developmental processes, however, is only one tool that allows the mental health professional to understand the child being evaluated. There are many different assessment instruments and interviewing techniques that PMHNPs can have in their toolkit when working with children and adolescents.
In this Discussion, you examine the differences in assessing and treating children and adolescents versus adults. You take into consideration your own clinical experiences, as well as your experiences in your clinical rotation, and the information from the readings thus far.
Learning Objectives
Students will:
· Analyze the importance of developmental assessments
· Analyze assessment instruments used for evaluating children and adolescents
· Analyze treatment options used for children and adolescents
· Analyze roles parents play in assessment and treatment
To Prepare for the Discussion
· Review the Learning Resources concerning psychiatric assessments and assessment tools.
Post your answers to the following:
· Explain why a developmental assessment of children and adolescents is important.
· Describe two assessment instruments and explain why they are used for children and adolescents but not adults.
Please use these tools
PSC-17: Pediatric Symptom Checklist-17;
SCARED: Screen for Childhood Anxiety-Related Emotional Disorders.
· Describe two treatment options for children and adolescents that may not be used when treating adults.
· Explain the role parents play in assessment and treatment.
