Assessing Mental Health
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Developmental Assessment
Being aware of normal child and adolescent development will help a clinician to identify developmental shortcomings. Specific delays in development can be symptoms of varying psychiatric or neuropsychiatric disorders. Intellectual disabilities, communication disorders, speech sound disorders, autism spectrum disorders, and more can be discovered through assessing the development of the child. For example, a normally developing infant should be using single words 12 to 18 months old. If by 12 to 18 months the infant has not begun using any words, there is a concern for an autism spectrum disorder (Saddock et al., 2015).
Assessment Instruments
The Dominic-R structured interview, or the computerized version, Dominic Interactive, is designed for children ages 6 to 11 years old. Children in that age bracket have concrete thought processes and are unable to answer abstract questions about their mental health. The Dominic R is a pictorial which illustrates abstract emotional and behavioral content (Saddock et al., 2015). Similar to a video game, the Dominic Interactive has pictures accompanied by a multimedia audio track for the child to follow along with (Hardoon & Derevensky, 2002). Pictures of a child experiencing varying symptoms are showed to the client, and the client are asked if he or she is feeling the way the child in the picture is. These diagnostic instruments screen for attention deficit hyperactive disorder (ADHD), opposition, conduct problems, depression, separation anxiety, generalized anxiety disorder, and specific phobias (Hardoon & Derevensky, 2002).
The Pictorial Instrument for Children and Adolescents (PICA-III-R) is another diagnostic instrument used for children and adolescents ages 6 to 16. Pictures of a child experiencing varying emotions are showed to the client, asking which ones the client identifies with using a 5 point rating scale. The pictures cover mood, anxiety, psychosis, disruptive disorders, and substance abuse disorders. Children and adolescents cannot always verbalize their stressors and symptoms like adults can. Young children are unable to understand the abstract concepts of psychiatry. That is why these two pictorial instruments are used for children and adolescents but not for adults, who are able to verbalize and understand abstract thoughts.
Treatment Options
Treatment options differ between children/adolescents and adults for certain psychiatric disorders. Oppositional Defiant Disorder (ODD) is a childhood disorder characterized by a persistent pattern of angry mood, defiant behavior, or vindictiveness (APA, 2013). Since this is a childhood disorder, treatment for ODD would not be the same as treatment for adults who have a disorder with similar characteristics such as antisocial personality disorder. The Incredible Years Program (IYP) is a treatment option that consists of parent training and child therapy programs for children with ODD (Hobbel & Drugli, 2013). Problem-solving skills training and parent management training is another treatment modality for ODD. The focus is teaching parents how to use essential behavior management techniques, such as stimulus control, shaping, reinforcement, extinction, and punishment (Gale, 2011). These are two treatment options that are specifically geared towards children and adolescents.
Parents Role
For younger children, the parents play an important role in providing a chronological picture of the child’s growth and development (Sadock et al., 2015). Interviewing parents can help to identify any contradictions that arise after speaking with the child or adolescent. Parents can also provide insight on history that the child or adolescent cannot remember, their perception of the family dynamic, their marital history, and any familial psychiatric history (Sadock et al., 2015). Getting the full picture of the family can help clinicians to gain insight about the child or adolescent’s behaviors. Consistency in parent’s actions and reactions towards the child/adolescent client are important to maintain structure during treatment.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: Author.
Gale, B. M. (2011). Oppositional defiant disorder. In W. T. O’Donohue & C. Draper
(Eds.), Stepped care and e-health: Practical applications to behavioral disorders. (pp. 181–202). Springer Science + Business Media. https://doi-org.ezp.waldenulibrary.org/10.1007/978-1-4419-6510-3_10
Hardoon, K., & Derevensky, J. L. (2002). Test review: The Dominic Interactive. Canadian
Journal of School Psychology, 17(2), 69-74. Retrieved from https://journals.sagepub.com/doi/pdf/10.1177/082957350201700206
Hobbel, S., & Drugli, M. B. (2013). Symptom changes of oppositional defiant disorder after
treatment with the Incredible Years Program. Nordic Journal of Psychiatry, 67(2), 97–103. https://doi-org.ezp.waldenulibrary.org/10.3109/08039488.2012.685888
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry:
Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
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Relying on structured assessments and validated measures is important in mental health to ensure proper evaluation. There have been changes in the DSM definition of various disorders, including the diagnostic criteria identifying patterns and behaviors present for a specific period. Oppositional Defiant Disorder (ODD) is one of the externalizing behavior problems where the children and adolescents affected tend to have attachment problems. ODD is mostly a juvenile disorder. When using assessment instruments to evaluate such a disorder, there is a need to identify the children and adolescents affected, even as behavior patterns may be similar in adults.
When assessing children, there is a need to consider the child, parent, and teacher input in the reports and evaluation. There is the use of different methods by relying on data gathering procedures. Involving adults in assessment is useful to better understand a child's or adolescent's psychological problems and behaviors (Husky et al., 2018). Parents are less likely to identify their children's internalizing problems than...
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