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Questions and Answers
A basic physical examination for a child usually includes an emphasis on the nervous system.
A basic physical examination for a child usually includes an emphasis on the nervous system.
True
Parents should not be informed about the assessment results during the ending of the assessment.
Parents should not be informed about the assessment results during the ending of the assessment.
False
Formulation usually starts with a brief statement of the child's developmental stages.
Formulation usually starts with a brief statement of the child's developmental stages.
False
The psychiatrist should seek consent to contact other people involved with the child, such as teachers and social workers.
The psychiatrist should seek consent to contact other people involved with the child, such as teachers and social workers.
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It is unnecessary to note the child's developmental stages if it has already been done in the multiaxial diagnostic system.
It is unnecessary to note the child's developmental stages if it has already been done in the multiaxial diagnostic system.
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Court reports prepared by psychiatrists often focus on the child’s psychiatric disorder.
Court reports prepared by psychiatrists often focus on the child’s psychiatric disorder.
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During a physical examination, a child’s appearance, coordination, and gait should only be observed during play.
During a physical examination, a child’s appearance, coordination, and gait should only be observed during play.
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Throughout the assessment process, the psychiatrist should discourage questions and discussion.
Throughout the assessment process, the psychiatrist should discourage questions and discussion.
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Children below the age of 3 years can produce an account that can be presented in a court of law.
Children below the age of 3 years can produce an account that can be presented in a court of law.
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Most children above the age of 6 years can use straightforward grammar and syntax adequately but may be confused by complicated questions.
Most children above the age of 6 years can use straightforward grammar and syntax adequately but may be confused by complicated questions.
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The writer's interpretation of the information from the interviews and written material should be included in the court report.
The writer's interpretation of the information from the interviews and written material should be included in the court report.
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Obtaining evidence from a child should be delayed until after any counseling has taken place.
Obtaining evidence from a child should be delayed until after any counseling has taken place.
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It is recommended to allow the child to talk freely and ask as few questions as possible when obtaining evidence.
It is recommended to allow the child to talk freely and ask as few questions as possible when obtaining evidence.
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Children of the age to be witnesses often have an accurate sense of the sequencing and timing of events.
Children of the age to be witnesses often have an accurate sense of the sequencing and timing of events.
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The qualifications of the writer are not necessary to include in the court report.
The qualifications of the writer are not necessary to include in the court report.
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Children above the age of 3 years may produce detailed and accurate memories with some prompting.
Children above the age of 3 years may produce detailed and accurate memories with some prompting.
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Study Notes
Physical Examination
- A physical examination may be necessary to complete the assessment, focusing on evidence of conditions that might affect the brain.
- The examination involves observing the child's appearance, coordination, and gait, at rest and during play.
- A basic physical examination may follow, with emphasis on the nervous system.
- If abnormalities are found or suspected, the opinion of a pediatrician or pediatric neurologist may be needed.
Ending the Assessment
- The psychiatrist should explain the assessment results to the parents and child, in terms appropriate to the child's age.
- The psychiatrist should explain how they propose to inform and work with the general practitioner, and seek consent to contact other people involved with the child.
- The psychiatrist should encourage questions and discussion throughout the process.
Formulation
- A formulation can help summarize key issues, starting with a brief statement of the current problem.
- The diagnosis and differential diagnosis are discussed, and recorded using the ICD-10 within a multiaxial framework.
- Aetiology is considered, including predisposing, precipitating, and perpetuating factors.
- The formulation should note the child's developmental stages, strengths, and achievements, as well as the family's problems and strengths.
- Any further assessments, treatment plans, and expected outcomes should be specified.
Court Reports
- Psychiatrists may be asked to prepare court reports about children, which should include:
- Qualifications of the writer and who commissioned the report
- Written information available and who was interviewed
- A summary of the findings from the interview
- The writer's interpretation of the information
- Comments on the options before the court
Principles for Obtaining Evidence from a Child
- Allow the child to talk freely, asking as few questions as possible.
- Obtain evidence as soon as possible after the event, and before any counseling has taken place.
- Try to complete the account on the first occasion, as subsequent accounts are likely to be less accurate.
- Be aware that the greater the pressure to remember, the less accurate the account is likely to be.
Understanding Children's Memory
- Memory varies with age, as do verbal skills required to describe what has been remembered.
- Children below 3 years seldom have the cognitive and other capacities to produce a reliable account for a court of law.
- Children above 3 years can produce detailed and accurate memories, but may not be able to describe them clearly without some prompting.
- Children above 6 years can use straightforward grammar and syntax adequately, but may be confused by complicated questions.
- Children may agree with leading questions or make up an answer in the hope that it will be correct.
- Children do not have an accurate sense of the sequencing and timing of events, and memories of frightening events are often incomplete.
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Description
Physical examination is a crucial step in assessing children's health, focusing on signs of conditions affecting the brain. This quiz covers the basics of physical examination in pediatric care.
