Clemons WK 2
Discussion Week 2
Explain why a developmental assessment of children and adolescents is important.
The human anatomy and developmental process have been well defined by the medical and scientific community, which also includes psychological development. The chronological development of children and adolescents allows clinicians, and to some extent, parents to assess whether specific milestones are being met in relation to age (Sadock, Sadock & Ruiz, 2015). Professionally trained clinicians are required to have basic knowledge of the normal maturation processes experienced by children and adolescents. Any deviation from the expected developmental landmark should be further assessed to ascertain whether the process has been altered by a known pathology or the occurrence of a malformation. Thus, developmental assessment is important to address any abnormalities that can be corrected. An example in Sadock et al., 2015 referenced a child who was unable to talk because of uncontrolled seizures originating in the left hemisphere. Language is one of those developmental functions that has clear hemispheric localization, thus it was expected that the child in the example would learn to speak after the malformation was removed (Sadock et al., 2015). A surgical procedure to remove the left hemisphere abnormality was performed at the age of 9, which allowed the child to learn to speak (Sadock et al., 2015). Because speech did not develop in the expected time frame, it signaled a malformation within his speech center. This is just one example of the importance of developmental assessment. A simple way to assess for puberty would be the presence of axillary hair in a young client. These are just a couple of examples of why developmental assessments of children and adolescent clients are important.
Describe two assessment instruments and explain why they are used for children and adolescents but not adults.
Wechsler Individual Achievement Test (WIAT)
The Wechsler Individual Achievement Test (WIAT) is administered to children and adolescents, kindergarten through 12th grade (Vaughan-Jensen et al., 2011). The test may be administered to children as young as 4 years old through 19 years (Vaughan-Jensen et al., 2011). It scores their basic knowledge of reading, mathematical reasoning, spelling, reading comprehension, numerical operations, listening comprehension, oral and written expression (Sadock et al.,2015). As indicated above, the test is used to assist professionals in ascertaining whether a child is eligible for special education or has a learning disability (Vaughan-Jensen et al., 2011). The instrument further aids the response to the intervention model (RTI), No Child Left Behind legislation, and the Individual with Disabilities Act (Vaughan-Jensen et al., 2011). Thus, it is not a tool used for adults. However, the Wechsler Adult Intelligence Scale can be used for adult assessments if a similar instrument is needed (Sadock et al.,2015).
Behavioral Assessment System for Children (BASC)
The Behavioral Assessment System for Children (BASC) is a multi-reporter rating scale used by teachers, parents, and children to report on numerous domains in which the child operates (Sadock et al., 2105). The BASC tool helps differentiate attention deficit/hyperactivity disorder (ADHD) from non-ADHD (Ostrander et al., 1998). The child is assessed in home, school, and their community (Sadock et al.,2015). The BASC tool provides validity, clinical and adaptive scales to confirm or deny the presence of ADHD in a child (Sadock et al., 2015). The tool is an excellent non-biased instrument used to diagnose children who would otherwise be considered as behavioral problems. It further confirms the diagnosis for parents who question the clinician’s diagnosis. Adult ADHD is typically diagnosed by self-reporting. Although the BASC criteria is not used to assess ADHD in adults, clinicians may utilize the Wender-Utah criteria to diagnose adults with AHDH (Glöckner-Rist, Pedersen & Rist, 2013). It is only fitting that children and adolescents have a different diagnostic instrument than adults due to the maturation differences.
Describe two treatment options for children and adolescents that may not be used when treating adults.
The Parent-Child Interaction Therapy Emotional Development (PCIT-ED) is a technique where a therapist coach the parent in a positive play format to improve preschool depression (Sadock et al.,2015). The parents in PCIT-ED learned to recognize their emotions and recognize the child emotions. Ultimately serving to regulate both the child’s and their own emotions. (Sadock et al., 2015). Parent-Child Interaction Therapy (PCIT) is another technique where the therapist teaches specific management techniques based on social learning theory (Zisser & Eyberg, 2010). PCIT is intended to interrupt the dysfunctional interaction between the parent and the child. The parent must be taught to change their behavior and set clear boundaries for the child in the context of an authoritative relationship (Zisser & Eyberg, 2010). They were thereby interrupting the mutual aversive behaviors of the parent and the child (Zisser & Eyberg, 2010). The outcome should be an improved parent-child relationship and improved parenting skills.
Explain the role parents play in assessment and treatment.
The developmental stage of a child or an adolescent will dictate their ability to participate in assessment and treatment planning; thus, parental participation in the two aforementioned processes is imperative (Dulcan et al., 2018). The structure of an evaluation will be guided by the child’s or adolescent’s reason for the evaluation. Children being seen for suspected abuse will likely be seen alone, whereas those being seen for conduct related disorders may be evaluated with their parent or guardian. Parents are key contributors to biopsychosocial history obtained during the assessment period. They (the parent) has likely been with the child or adolescent since birth and are excellent sources of information. The information would include (1) whether or not the client met developmental milestones as anticipated, (2) health history (medical, psychiatric), (3) development of current symptoms, (3) stressors, (4) traumatic events, and (5) family circumstances to name a few (Dulcan et al., 2018). Parental treatment participation is essential if the client is to achieve any form of symptom relief. Underage clients are wholly dependent upon their parents to for all of life’s necessities, including obtaining prescription drugs, healthcare appointments, attending therapy sessions, and medication administration. The success or failure of a treatment plan may depend entirely on the level of parental participation.
Dulcan, M.K., Ballard, R.R., Jha, P., & Sadhu, J.M. (2018) Concise guide to child and
adolescent psychiatry (5th ed.). Arlington, VA: American Psychiatric Association
Glöckner-Rist, A., Pedersen, A., & Rist, F. (2013). Conceptual structure of the symptoms of
adult ADHD according to the DSM-IV and retrospective Wender-Utah criteria. Journal
of Attention Disorders, 17(2), 114-1
Ostrander, R., Weinfurt, K. P., Yarnold, P. R., & August, G. J. (1998). Diagnosing attention
deficit disorders with the Behavioral Assessment System for Children and the Child Behavior Checklist: Test and construct validity analyses using optimal discriminant classification trees. Journal of consulting and clinical psychology, 66(4), 660
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
Vaughan-Jensen, J., Adame, C., McLean, L., & Gámez, B. (2011). Test Review: D. Wechsler
Wechsler Individual Achievement Test. San Antonio, TX: Pearson, 2009. Journal of
Psychoeducational Assessment, 29(3), 286-291.
Zisser, A., & Eyberg, S. M. (2010). Parent-child interaction therapy and the treatment of
disruptive behavior disorder
Discussion – Week 2
Discussion Board week Two
Reasons Why it is Important to Assess Children and Adolescent’s Development
There are multiple reasons for assessing the developmental milestone of children and Adolescents. First, it is essential to know if the child meets the normal developmental milestone for an average child from birth to Adolescent medically, psychologically, and physically. A study by Choo, Y. Y., Yeleswarapu, S. P., How, C. H., & Agarwal, P. (2019), indicates that 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. Assessing the development of children will enable the clinician to understand if their learning skills or cognition are developing typically and will be able to let the parent understands where the child stands as far as their developmental milestones are a concern. For us, as practitioners, it is essential to assess and monitor children and adolescent growth and development to identify any risk or abnormality in their development as they grow and treat them as soon as possible.
Two Assessment Instruments Used for Children and Adolescents
The two-assessment instrument are Child and Adolescent Psychiatric Assessment (CAPA) and the Diagnostic Interview for Children and Adolescents (DICA). The CAPA is a diagnostic tool used to collect psychiatric information from children and Adolescents through an interview. The CAPA is also used in diagnosing psychiatric disorders in children such as anxiety, ADHD, depression, panic disorder, phobia, and oppositional defiant disorder. A study by Angold, A. et al. (2012) indicates that CAPA relies upon interviewers’ having been trained to understand the form of psychiatric symptoms defined in an extensive glossary written by a child and adolescent group psychiatrists. The assessment also provides an understanding of the question being asked, provides clear information on behavior or feelings related to symptoms, and if any symptoms are present, questions are asked about functional impairment (Angold, A. et al. (2012). The DICA was developed to assess children and adolescent mental health conditions. It is a handy tool in assessing psychiatric issues in children and adolescents between the ages of 6 to 17, such as depression, anxiety disorder, and substance use disorder. They are not very good assessment tools for adults because of the interview’s direct nature and longer hours of completing the assessment (Sadock, Sadock & Ruiz, (2014).
Two Children and Adolescents Treatment Option
Some of the treatment options present for children and Adolescent include training the parent and family members close to the child on how to identify behaviors and triggers and learn how to de-escalate them. A study by Gopalan G et al. (2010) also indicate that Improving engagement and access to child mental health services has also been improved by programs operating outside the traditional clinic environment. Second option is for teachers and parents to promote a positive attitude in school and at home by posting rules, behavior contingencies, individualized reward systems, and family-directed services. Also, groups co-facilitated by clinicians and parent advocates services are significant for children and Adolescent as well, and home base therapy program has been very significant in providing psychiatric care for children and Adolescent (Gopalan, G et al, (2010).
The Role Parents Play in Assessment and Treatment.
Parents have a significant role to play in the assessment and treatment of their children and therefore are excellent tools needed by the clinician to complete mental health assessment for their children. Parents are also significant in treatment because, since birth, parents have been there to understand their children’s growth and development and can provide vital information for treatment. According to Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019), Clinical assessments with children and adolescents are, therefore, elaborate and require the clinician to be astute and conscientious in obtaining information from multiple sources and settings, i.e., the child, parents, teachers, and other caregivers.
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
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
Angold, A., Erkanli, A., Copeland, W., Goodman, R., Fisher, P. W., & Costello, E. J. (2012). Psychiatric diagnostic interviews for children and adolescents: a comparative study. Journal of the American Academy of Child and Adolescent Psychiatry, 51(5), 506–517. https://doi.org/10.1016/j.jaac.2012.02.020
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
Gopalan, G., Goldstein, L., Klingenstein, K., Sicher, C., Blake, C., & McKay, M. M. (2010). Engaging families into child mental health treatment: updates and special considerations. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l’Academie Canadienne de Psychiatrie de l’enfant et de l’adolescent, 19(3), 182–196.
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