Assessment and Treatment of Childhood Disorders

Assessment and Treatment of Childhood Disorders

• Clinical/Psychological Assessment Goals: Screening, Diagnosis, Prognosis, Treatment Planning, Monitoring Treatment Progress.
• Pillars of Clinical/Psychological Assessment (Interviews): Often with parents only. Purpose is to identify presenting problems, including the current intensity, frequency and severity, age of onset, duration, developmental history (pregnancy, milestones), family variables (psychopathology history), cultural considerations (SES, race/ethnicity), history of neglect/abuse, relevant medical history (TBI, hypothyroidism), impairment (academics, social), and prior assessment/treatment history (medications, school services).
• Observations: Include structured diagnostic assessments and informal data gathering (during interviews) and role play simulations (e.g., parent-child interactions).

IQ Testing

• Wechsler Intelligence Scale for Children (WISC): Full-scale IQ, M=100, SD=15 (average range 85-115), with 5 sub-indices (verbal comprehension, fluid reasoning, visual-spatial reasoning, working memory, processing speed).

Achievement Testing

• Examines academic knowledge: Reading, mathematics, written expression. Examples include Woodcock-Johnson and Wechsler Individual Achievement Test.

Functional Analysis of Behavior

• Antecedents: Child does not understand assignment, cannot read directions, does not know what to do.
• Behavior: Child leaves seat, talks with classmates, disrupts teachers.
• Consequences: Child is positively reinforced by teacher's attention/classmate's giggles, but negatively reinforced by avoiding assignment.

Social/Behavioral Functioning

• Self-report: Typical with depression (CDI) and anxiety (RCMAS), not optimal for ADHD/ODD/CD
• Parent/Teacher Report: Typical with ADHD/ODD/CD (e.g., ASEBRA CBCL).

Diagnoses

• DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition): Professional communication, prediction, treatment planning, and service acquisition. Disadvantages include overly simplified (parsimonious) approaches.

Research Domain Criteria (RDOC)

• Goal: Develop a diagnostic classification system based on underlying causes of symptoms.
• Domains: Positive/negative valence systems, cognitive systems, arousal/regulatory systems, social processes, and sensorimotor systems. May lead to more effective interventions targeting root causes of symptoms instead of symptoms directly.

Treating Children/Adolescents/Families

• Unique Features: Children do not refer themselves, parents/teachers do (so may be unmotivated to change). Treatment expectations/goals, and delivery methods need to consider cognitive, social emotional, and behavioral maturity. Not treating children like small adults. Ethical considerations regarding competency of minors and balance between confidentiality and parental rights.

Core Methods of Efficacious Psychosocial Therapy

• Behavior Therapy: Child/parent is client, theory of change is that behavior is driven by antecedents and consequences. Functional analyses are critical in altering how antecedents and consequences occur to encourage more adaptive behaviors.
• Cognitive Therapy: Child is client, theory of change is that distress is driven by cognitive biases and distortions/irrational beliefs; therapists help clients identify these errors and adopt more realistic ways of thinking. Combines cognitive and behavioral elements (CBT) and is an evidence-based treatment for many childhood disorders.
• Interpersonal Therapy: Child is client, theory of change (psychopathology) results from disruption in interpersonal relationships (e.g., transitions, loss of loved ones).

Family Systems Therapy

• Focus: Strengthening relationships with others may resolve mental health difficulties. Family is the client. Altering behavior of one member impacts alter behavior of the family. Structured family therapy helps strengthen relationships and boundaries between parents and children.

Evidence-Based Treatments and Practices (EBTs)

• Good News: Treatments are effective in controlled studies including 30,000 children. Average effect of treatment is considered moderate, 63% of youth receiving treatment fare better than control conditions.
• Bad News: Effects of therapies depend on the problem being treated and vary across populations (e.g., girls/boys, pre-adolescents/adolescents, anxiety/conduct/ADHD/depression).

Future Direction

• Translate and disseminate: Evidence-based assessment and treatment practices into real-world settings to improve access to treatment for mental health problems. Reduce individual, social, and economic costs of these problems.

This quiz covers the clinical and psychological assessment of childhood disorders, focusing on screening, diagnosis, and treatment planning. It highlights the importance of interviews, observations, and specific tools like the WISC for evaluating cognitive abilities in children. Aimed at students and professionals in psychology and mental health.