Working with Children and Adolescents Versus Adults Sample Essay Discussions
Developmental assessment is the process of mapping a child’s performance compared with children of similar age, while development is the process by which each child evolves from helpless infancy to independent adulthood. If a child has a developmental delay, it is essential to identify it early so that the child and family can receive needed intervention services and support. Working with Children and Adolescents Versus Adults Sample Essay Discussions. Healthcare providers play a critical role in monitoring children’s growth and development and identifying problems as early as possible (Bagner et al., 2015).
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The most widely used developmental screening test is the Denver Developmental Screening Test (DDST), which provides a pass/fail rating in four domains of developmental milestones: gross motor, fine motor, language, and personal-social. The original DDST was criticized for under-identification of children with developmental disabilities, particularity in language. The reissued DDST-II is a better assessment for language delays, which is important because of the strong link between language and overall cognitive development (Lippman, 2016). Also, the options for a traditional screening tool are the Behavioral and Emotional Screening System (BESS; for ages 3-18 years.) and the Ages and Stages Questionnaire-Social Emotional (ASQ-SE). The BESS collects information from three sources: parents, teachers, and youth (Lippman, 2016). These are assessments tools for children and adolescents only and cannot be used for adults and using the assessments tools for adults will result in inaccuracy. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Two treatment options for children and adolescents that may not be used when treating adults are treatment options for intellectual disabilities and developmental delays. No one treatment works for every child with a developmental delay. Children are unique; they learn and grow and develop in their own way, at their own pace, based on their strengths and weaknesses. Any treatment plan will take this uniqueness into account and be designed to focus on individual needs. Early intervention services are the central theme of treatment, but any underlying conditions that have led to developmental delay will need to be treated as well. Early intervention treatments or services might include speech and Language Therapy, Occupational Therapy, Physical Therapy, and Behavior Therapies, and such as those used to treat autism and behavioral issues (Haine-Schlagel, & Walsh, 2015). Also, it is crucial for all children with developmental delay to have their hearing and vision evaluated so that untreated visual or hearing impairments do not complicate the situation.
The role parents play in assessment and treatment is particularly important for child and family treatment given the critical role that parents, or any primary caregiver often play in obtaining and facilitating attendance at treatment. Furthermore, the significant influence of family context on children’s development and behavior often results in child treatment focusing on the family regardless of the underlying treatment approach or modality (Department of Health & Human Service, 2018). The role parents play includes sharing opinions, asking questions, and providing their point of view on a problem or solution, as well as participation in therapeutic activities such as games and role plays. Other role includes parent follow-through with home action plans referred to as homework, such as changing their parenting behavior, for example, increasing reinforcement of positive behaviors, serving as a “co-provider.” Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Bagner, D. M., Rodríguez, G. M., Blake, C. A., Linares, D., & Carter, A. S. (2015). Assessment
of Behavioral and Emotional Problems in Infancy: A Systematic Review. Clinical Child and Family Psychology Review, 15(2), 113–128. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476378/
Department of Health & Human Service. (2018). Developmental Monitoring and Screening for
Health Professionals. Retrieved from: https://www.cdc.gov/ncbddd/childdevelopment/screening-hcp.html
Haine-Schlagel, R., & Walsh, N. E. (2015). A Review of Parent Participation Engagement in
Child and Family Mental Health Treatment. Clinical Child and Family Psychology Review, 18(2), 133–150. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4433419/. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Lippman, L. (2016). Early childhood social and emotional development: Advancing the field of
measurement. Retrieved from: https://doi.org/10.1016/j.appdev.2016.02.002
Thorough assessment of a child or adolescent’s developmental history is important to the mental health professional for a number of reasons but particularly to reveal crucial clues to a client’s behavior or reason for a mental health consultation. Numerous factors need to be considered in a young client’s language and cognitive development, emotional and social development, and sexual development. An alteration in one or more of such domains can assist in leading to an appropriate diagnosis and treatment. Throughout all of the stages of human development – infancy stage, toddler period, preschool period, middle years, and adolescence – there are specific developmental markers and milestones that are assessed for. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Two assessments that are commonly utilized in child and adolescent psychiatry but not adult psychiatry is the Children’s Interview for Psychiatric Syndromes (ChIPS) and the Bayley Scales of Infant and Child Development (BSID). The ChIPS interview is highly structured and consists of questions written with an emphasis on simple, age-appropriate language which screens for twenty diagnoses; it uses a format the allows the interviewer to “skip out” of a section as soon as it is clear that the child does not meet diagnostic criteria for that diagnosis; in comparison to other assessment tools, the ChIPS is relatively short and can be completed in approximately 40 minutes (Young, Bell, and Fristad, 2016). The Bayley Scales of Infant and Childhood Development Third Edition (BSID-III) contains 325 items divided into 5 domains (cognitive, receptive communication, expressive communication, fine motor, and gross motor); items are approximately ordered by difficulty, and a child’s age determines the first item administered in each domain; the test continues until 5 consecutive items are missed (Veldhuizen, Bedard, Rodriguez, and Cairney, 2017). For both the ChIPS and BSID-III, adult utilization would not be realistic based on the language levels of the interviews as well as the functional assessments (e.g., stacking blocks or organizing by color as done in the BSID-III) would not be helpful in diagnosing an adult client. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Treatment modalities can be similar or very different when comparing the child and adolescent population with the adult population. One such difference is noted in the treatment of attention deficit hyperactivity disorder (ADHD). According to Sadock, Sadock, and Ruiz (2015), only the long-acting forms stimulants are Food and Drug Administration (FDA) approved in the treatment of ADHD in adults. This means that the more commonly known treatments for ADHD such as Ritalin and Adderall are not approved treatment options in their immediate release forms in adults, but they are highly popular in the school-aged population. Additionally, such stimulants are poor choices in the adult population due to the possibility of co-existing medical conditions, substance use disorders, and risk of diversion or illegal use (McGough, 2016). Another treatment difference between adults and the child population deals with treatment resistant depression. A currently popular option for treating adults with such depression is transcranial magnetic stimulation (TMS). Daily, repetitive, left prefrontal, high-frequency TMS is a standard, FDA-cleared treatment for major depressive disorder in adults (22 years of age or older) who have failed to improve with prior antidepressant treatment (Croarkin et al., 2018). Unfortunately, despite some promising trials in the adolescent age range, this has yet to be approved for adolescents or children.
Parental involvement can either be harmful or helpful in the treatment of children and adolescents. While it is assumed that all parents want the best for their children, sometimes preconceived notions, social stigma, and inaccurate beliefs can limit the mental health professional’s role in proper treatment. Essentially, up until the age of 18, parents are responsible for their children’s care, compliance, and decision-making. On the other hand, parents can provide a wealth of knowledge into past history, treatment success/ failures, and current insight in treatment responses. Attempting to maintain a good provider relationship with both the client and the parental system is crucial in all treatments. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Croarkin, P.E., Nakonezny, P.A., Deng, Z., Romanowicz, M., Voort, J.V., Camsari, D.D., & … Lewis, C.P. (2018). High-frequency repetitive TMS for suicidal ideation in adolescents with depression. Journal of Affective Disorders, 239282-290. doi:10.1016/j.jad.2018.06.048
McGough, J.J. (2016). Treatment controversies in adult ADHD. American Journal of Psychiatry, 173(10), 960-966. doi:10.1176/appi.ajp.2016.15091207
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.
Veldhuizen, S., Bedard, C., Rodriguez, C., & Cairney, J. (2017). Psychological distress and parent reporting on child health: The case of developmental delay. Research in Developmental Disabilities, 6311-17. doi:10.1016/j.ridd.2017.02.006
Young, M.E., Bell, Z.E., & Fristad, M.A. (2016). Validation of a brief structured interview: The Children’s Interview for Psychiatric Syndromes (ChIPS). Journal of Clinical Psychology in Medical Settings, 23(4), 327-340. doi:10.1007/s10880-016-9474-7
Explain why a developmental assessment of children and adolescents is important.
A developmental assessment is used to map a child’s progress by comparing them with children of similar age. According to Sadock, Sadock, and Ruiz (2014), the hypothesis of human development is based on the continuous interaction between genetics and environmental experiences. Benchmarks and standardized procedures are used to assess developmental milestones such as speech, movement, cognitive function, academic achievement, behavior, and emotions. A thorough assessment is used to determine developmental delays or other psychopathologies and assist clinical judgment for appropriate treatment planning. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Describe two assessment instruments and explain why they are used for children and adolescents but not adults.
From birth to adulthood, children are continuously developing and maturing through changes in emotions, behaviors, and intelligence. Due to the differences in the child and adult brain, many assessment instruments must be geared towards certain age groups. For example, the Children’s Apperception Test (CAT) is a personality test used in children ages three to 10 years (Bellak & Bellak, 1949). The CAT test uses pictures of animals in which the child can use to tell a story to assess possible relationship issues. It is believed that children of this age respond better to animals than humans, which is why they were used in this assessment tool. It is difficult for young children to express attitudes and feelings, therefore, projective techniques are often used for evaluation.
Other assessment tools that are specific for children are the Home Situations Questionnaire (HSQ-R) and School Situations Questionnaire (SSQ-R), used in ages six to 12 years old to assess Attention Deficit Hyperactivity Disorder (ADHD). These tools provide checklists and rating scales for teachers and parents to complete in response to a child’s behavior in the home and school setting (Adams & McCarthy, 1995). The use of these scales in the adult population would not be applicable. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Describe two treatment options for children and adolescents that may not be used when treating adults.
One treatment that is often used with children is Parent-Child Interaction Therapy (PCIT) for expressive language impairment (Sadock, Sadock, & Ruiz, 2014). Allen and Marshall (2011) discovered that the use of PCIT is also helpful for children with behavioral issues such as anger, aggression, and defiance. PCIT helps parents improve interactions with their children through bud in the ear training with skills such as praising positive behavior, reflecting and expanding on the child’s words to facilitate communication, and showing genuine enthusiasm in activities with their child. Research has shown PCIT to help in building self-esteem, reducing outbursts, and improving social skills and effective communication. Working with Children and Adolescents Versus Adults Sample Essay Discussions,
Another treatment that is specific to children is TEACH, which is used for autism spectrum disorder (ASD). Children with ASD have difficulty with perception, often hindering their learning in school. Developed in 1970, TEACH is a structured learning technique that uses a picture schedule and other visual aids to support the learning process. TEACH also helps children to develop more socially appropriate responses and foster autonomy (Sadock, Sadock, & Ruiz, 2014).
Explain the role parents play in assessment and treatment.
Interviewing children and adolescents in the psychiatric setting presents many challenges for the practitioner. Depending on a child’s developmental level, it can be difficult for them to create a timeline of their symptoms. According to Bellman, Byrne, and Sege (2013), parents serve as the best source of information, and their concerns about developmental and behavioral issues are usually correct. Typically, the parents are interviewed to obtain a chronological representation of the client’s growth and development. Parents can shed light on any stressors or major events in the child’s life along with prior psychiatric or medical illnesses. It is necessary for the interview with the parents to include information from their own development, viewpoint of family dynamics, marital history, and psychiatric history of the family (Sadock, Sadock, & Ruiz, 2014). In addition, the clinician can observe the interactions between the child and parent to assess any interpersonal issues that may be present. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Once all the information has been gathered, an appropriate treatment plan can be developed. Parents must consent to treatment for minor children under the age of 18. Sadock, Sadock, and Ruiz (2014) find that a child’s success in overcoming difficulties greatly depends on the psychological education and cooperation of the client’s family. Parents play an important role not only in the interview process but also as a catalyst for implementing effective treatment interventions. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Adams, C. D., & McCarthy, M. (1995). Adolescent versions of the Home and School Situations Questionnaires: Initial psychometric.. Journal Of Clinical Child Psychology, 24(4), 377.
Allen, J., & Marshall, C.R. (2011). Parent-child interaction therapy (PCIT) in school-aged children with specific language impairment. International Journal of Language and Communication Disorders, 46(4), 397-410. DOI: 10.3109/13682822.2010.517600
Bellak, L., & Bellak, S. S. (1949). Children’s Apperception Test.
Bellman, M., Byrne, O., & Sege, R. (2013). Developmental assessment of children. Bmj, 346, e8687.
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.
Developmental Assessment of Children
A developmental assessment is critical to personalize the treatment and support services for children. Developmental disorders can present significant challenges for the assessment and treatment, and a thorough evaluation may help in structuring therapy to best meet the client’s needs, may impact treatment goals, and impact behavioral/cognitive interventions in therapy and at school (Sadcock, Sadcock, & Ruiz, 2014). Therefore, understanding the development of the child is essential in developing the treatment plan. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
The Behavior Assessment System for Children, Second Ed., Parent Rating Scales (BASC-2) is often used for children in determining if the child falls within the autism spectrum disorder. The BASC-2 is formatted to evaluate children aged 2 years 6 months to 18 years and is used regularly in my current precepting location. Input is also gathered from the parents, the child’s assessment, and from the teacher. This specific version of the scale obtains parental input (Golden, Matson, Konst, & Adams, 2014). Working with Children and Adolescents Versus Adults Sample Essay Discussions’
Another scale often utilized in practice includes the Connors Abbreviated Parent-Teacher Rating Scale for ADHD. This scale should not be used alone. It is essential to obtain a careful developmental history for correct diagnosis of ADHD since children are prone to rapid and uneven developmental change (Sparrow & Erhardt, 2014). Some believe that ADHD is often misdiagnosed for bipolar disorder. It may be beneficial to also utilize The Child Bipolar Questionnaire- Version 2.0 to differentiate ADHD from bipolar disorder (Papolos & Papolos, 2006).
Some treatment options vary from those that are available for adults. Studies have shown that stimulant use for ADHD generally does not produce euphoria in children and children are less likely to abuse stimulant ADHD medication (Sareen & Trivedi, 2013). Considering this information and from my experience, pediatric providers are less fearful of prescribing stimulants to children for ADHD. In fact, my preceptor refuses to prescribe stimulants to adults without previous substantiated history of ADHD and stimulant prescription. Even then, she limits prescriptions to every 30 days and mandates drug screening for adults. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Trauma focused cognitive behavioral therapy (TF-CBT) is designed for children and adolescents and not validated for adults (Allen, 2018). Therapeutic methods that are endorsed by the Substance Abuse and Mental Health Services Administration (SAMHSA) for adults include CBT components of exposure and prolonged exposure therapy, cognitive restructuring, cognitive reprocessing and eye movement desensitization and reprocessing therapy (EMDR) (2017).Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Parental Role in Treatment
Parents are key to the success of pediatric psychiatric treatments. First, much of the pediatric history and assessment is obtained from the caregivers, especially with young children. Parents often oversee medication administration and are key to medication adherence and compliance. Also, pediatric treatments are more successful with parental participation and agreement (De Nadai et al, 2017). For example, TF-CBT includes the parents in treatment and is more successful if parents are included, but their participation is not essential for treatment (Allen, 2018). ,
Allen, B. (2018). Implementing trauma-focused cognitive-behavioral therapy (TF-CBT) with preteen children displaying problematic sexual behavior. Cognitive and Behavioral Practice, 25, 240-249. https://doi.org/10.1016/j.cbpra.2017.07.001
De Nadai, A.S., Karver, M.S., Murphy, T.K., Cavitt, M.A., Alvaro, J.L., Bengston, M., …Storch, E.A. (2017). Common factors in pediatric psychiatry: A review of essential and adjunctive mechanisms of treatment outcome. Journal of Child and Adolescent Psychopharmacology, 27(1), 10-18. doi: 10.1089/cap.2015.0263
Golden, R.L., Matson, J.L., Konst, M.J., & Adams, H.L. (2014). A comparison of children and adolescents with ASD, atypical development, and typical development on the Behavioral Assessment for Children, Second Edition (BASC-2). Research in Autism Spectrum Disorders, 8(8), 951-957. https://doi.org/10.1016/j.rasd.2014.04.005. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Papolos, D., & Papolos, J. (2006). The Bipolar Child: The Definitive and Reassuring Guide to Childhood’s Most Misunderstood Disorder. New York, New York: Broadway Books.
Sadcock, B. J., Sadcock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Sareen, H. & Trivedi, J.K. (2013). Child psychopharmacology: Is it more similar than different from adult psychopharmacology? Indian Journal of Psychiatry, 55(3), 301-304. doi: 10.4103/0019-5545.117158
Sparrow, E.P. & Erhardt, D. (2014). Essentials of ADHD Assessment for Children and Adolescents. Hoboken, New Jersey: Wiley.
Substance Abuse and Mental Health Services Administration (2017). Post-Traumatic Stress Disorder. Retrieved from https://www.samhsa.gov/treatment/mental-disorders/post-traumatic-stress-disorder#evidence-based-treatments
essay 5. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
The early years of a child’s life are crucial for his or her health and development. If a child has a developmental delay, it is essential to identify it early so that the child and family can receive needed intervention services and support (CDC, 2018). The purpose of this post is to review different types of assessment tools and treatment options for child and adolescent patients.
Why Developmental assessment of children and adolescent important
Developmental assessment is a part of comprehensive medical care, and it is a process of mapping a child’s performance compared with children of a similar age from a similar population (CDC, 2018). It is crucial because it helps to highlight the normal developmental pattern and timings. It also enables healthcare provider to identify areas of regression or areas of selected impairment that will warrant the provider to refer the child/adolescent to a specialist for evaluation (CDC, 2018). The American Academy of Pediatrics (AAP) recommends that health care providers should monitor the child’s development at each visit, periodically screen children with validated tools to identify any areas of concern that may require a further examination or evaluation, and ensure that more comprehensive developmental evaluations are completed if risks are identified (CDC, 2018). Working with Children and Adolescents Versus Adults Sample Essay Discussions.
The two-assessment instruments that are used specifically for children and adolescent are Pictorial Instrument for children and Adolescents (PICA-111-R), and Child and Adolescent Psychiatric Assessment. (CAPA). Both assessment tools can be used for diagnosis purposes per DSM-V standard.
The PICA-111-R assessment tool is used in children and adolescents between the ages of 6 and 16 years. This instrument is made up of 137 pictures which assess clients to rate how well the images relate to them (Sadock, Sadock, & Ruiz, 2014). The 137 pictures in this assessment tool are organized in modules and covers five diagnostic categories which include disorders of anxiety, mood, psychosis, disruptive behavior, and substance abuse. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
The other instrument CAPA assessment tool is used for children 9 to 17 years of age and focuses on symptoms occurring during the preceding three months period. It is useful in the assessment of a wide range of psychiatric disorders like sleep disorder, anxiety disorder, mood disorder eating disorder, disruptive disorder. Schizophrenia and Post Traumatic Stress Disorder (PTSD), etc. and takes about one hour to complete (Sadock et al., 2014). Working with Children and Adolescents Versus Adults Sample Essay Discussions.
The reason why these instruments are useful for children and adolescent and not adults have a lot to do with developmental stages and assessment parameters. The 137 pictures contained in PICA-111-R is helpful for children and adolescents than adults because children and adults may have a tougher time identifying their emotions than in adults.
Two Treatment Options for Children and Adolescents
Play Therapy is one of the treatment options used in children and adolescent and is not used in adults. Play Therapy uses toys, dolls, puppets, coloring and drawing, blocks, and games to help the child verbalize their feelings (Nichols, 2014). Playing allows the child to be comfortable with the therapist and gives them an opportunity to work out their conflicts, feelings, and behaviors (Nichols, 2014).
Another treatment option available is Triple P Positive Parenting Program. It is a form of parent training program that is designed to prevent severe behavioral, emotional, and developmental problems in children by promoting their knowledge, skills, and the confidence of parents (Aghebati, Gharraee, Hakim Shoshtari, & Gohari, 2014). Findings reveal that Triple P is a useful program in improving parenting style, mother-child relationship, and decreasing maternal depression, anxiety, stress, and children’s misbehavior (Aghebati et al., 2014). Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Role of Parents
The role parents play in the treatment and assessment of children and adolescents cannot be over emphasized. They are often present in the assessment sessions, and the observation of the child-parent interactions is an essential aspect of the assessment. They assist health care providers to make decisions and arrive at treatment plan. They serve as a co-provider to continue intervention at home. They also help to support the child’s behavior change efforts (e.g. providing reminders to the child to use coping strategies) (Haine-Schlagel, & Walsh, 2015). Research has proved that parent participation in the treatment and assessment of their children and adolescents have shown greater outcome in the improvement of their children (Haine-Schlagel, & Walsh, 2015). Working with Children and Adolescents Versus Adults Sample Essay Discussions.
It is crucial to note that assessment tools do not and cannot replace an actual assessment but rather serves as a means of helping providers to formulate an accurate diagnosis (Sadock et al., 2014). Without performing developmental assessments practitioners would have no way of knowing if a child is progressing through expected developmental stages. Also, if there is a breakdown in the progression this could lead to the development of a successful treatment plan for the child if it is known where and at what stage the breakdown occurred. Working with Children and Adolescents Versus Adults Sample Essay Discussions.
Aghebati, A., Gharraee, B., Hakim Shoshtari, M., & Gohari, M. R. (2014). Triple P-Positive Parenting Program for Mothers of ADHD Children. Iranian Journal of Psychiatry and Behavioral Sciences, 8(1), 59–65.
Center for Disease Control and Prevention (CDC) (2018). Developmental Monitoring and Screening. Retrieved from: https://www.cdc.gov/ncbddd/childdevelopment/facts.html
Haine-Schlagel, R., & Walsh, N. E. (2015). A Review of Parent Participation Engagement in Child and Family Mental Health Treatment. Clinical Child and Family Psychology Review, 18(2), 133–150. http://doi.org/10.1007/s10567-015-0182-x
Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson. Working with Children and Adolescents Versus Adults Sample Essay Discussions
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Working with Children and Adolescents Versus Adults Sample Essay Discussions.