Week 2: Working With Children and Adolescents versus Adults

Discussion: Working With Children and Adolescents Versus Adults

Post your answers to the following:

• Explain why a developmental assessment of children and adolescents is important.
• Describe two assessment instruments and explain why they are used for children and adolescents but not adults.
• Describe two treatment options for children and adolescents that may not be used when treating adults.
• Explain the role parents play in assessment and treatment.

Required Readings

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.

· Chapter 2, “Contributions of the Psychosocial Sciences” (pp. 93–130)

· Chapter 6, “Classification in Psychiatry” (pp. 290–299)

· Chapter 31, “Child Psychiatry” (pp. 1107–1152)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

· “Neurodevelopmental Disorders”

· “Intellectual Disabilities”

· “Communication Disorders”

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

· Chapter 2, “Diagnosis, Diagnostic Formulations, and Classification” (pp. 17–30)

Discussion: Working With Children and Adolescents Versus Adults

Pediatric Screening, Treatment, and Parents Role in Mental Health

The human brain is amazing. Our brains continue to grow as we age, learn, and interact with our environment. The human brain is not fully formed until one’s early 20’s (Giedd, 2004). This means the brain appears different on imaging during different stages of childhood and adolescents. A child could be developing on time, then start deteriorating and losing milestones it once had. An assessment would be needed to identify areas the child was no longer developing on par in. The assessment would identify what is wrong, give a diagnosis which could open means to fund treatment and get the child back on course. Children and adolescents think differently from each other and adults. It is important to speak to these kids at their level, which is impossible to do unless the provider does a brief assessment of where the client is intellectually and emotional and developmental age. Then the provider can alter their approach to meet the client where they are at. How these kids think influences the approach to treatment.

Pediatric Assessments and Screening Tools

The Vanderbilt Assessment Scale Parent Informant helps providers identify symptoms of ADHD. The questions listed address specific symptoms that occur in childhood ADHD, like climbing on things and running around when supposed to be sitting. If this tool was used on adults, adult ADHD could be missed because the Vanderbilt Assessment Scale Parent Informant does not target adult ADHD’s symptoms thus missing key symptoms of ADHD in adults. Adults might not climb on the furniture, but they may be forgetful and disorganized a lot.

CRAFFT is a screening tool for risky behaviors associated with substances. This tool addresses risky behavior teens may take part in. Alcohol is illegal for teens to consume, but adults can legally drink. What is considered a risky behavior for teens may not be for adults. CRAFFT is not ideal for adults. There are other assessment tools specific to the risky behaviors adult present. Leslie (2008) stressed the importance of routine screening for substances and risky behavior among teens. CRAFFT was found to be a valid screening tool to identify substance-related problems and disorders (Knight, Sherritt, Shrier, Harris, & Chang, 2002). Discussion: Working With Children and Adolescents Versus Adults

Pediatric Treatment Options

Play therapy is a type of therapy targeting the developmental age of the client. One large meta-analysis found play therapy to be efficacious and equally effective across ages, gender and presenting problems (Bratton, Ray, Rhine, & Jones, 2005). The greatest improvement was seen when parents were involved with play therapy (Bratton et al., 2005).

Many studies use elementary school as the medium or location to treat children. Prevention of negative outcomes is a common theme in schools. Children have little to no control over their home environment. So public schools have made changes to help students have higher chances of succeeding. Mental health problems prevention strategies can be implemented in schools. There is often a psychotherapist in the school and a free period at school to allow teens to make up homework that was not done at home. Tol, Komproe, Susanty, Jordans, … & De Jong (2008) conducted multiple control trials with interventions targeting mental health in schools for kids affected by political violence. The unique aspect of providing interventions and treatment in school is it is a safe, consistent, structured environment the child attends on a regular basis. And there are plenty of adults in the school that may be able to help with the interventions. Discussion: Working With Children and Adolescents Versus Adults

School is an ideal location to promote healthy development in children and provide prevention interventions to help children have positive outcomes. Adults are not treated like this. There is not one location nearly everyone goes to on a regular basis, which is a consistently safe environment. Adults work at different businesses and on different days. Often, mental health prevention is not addressed in adults to the degree it is in children and adolescents. Discussion: Working With Children and Adolescents Versus Adults

Parent’s Role in Treatment

Parents are vital when working with children and adolescents. When parents are involved and support their child, the child has better chances of succeeding and healing. One way parents can help is by providing information to practitioners in the form of screening and assessment dah data. Parents may need to give feedback because the client lacks insight, awareness, ability to express or even define complex feelings. The parent can provide assessment tools or screening tools to the child’s teacher, thus allowing for more data to be gathered in another environment the child is in.

Parents can also encourage teens to participate in the assessment. Parents may bring up symptoms or events the teen or child does not want to talk about, allowing for more data or an alternate perspective on their situation. Information gathered from parents of adolescents may or may not be accurate because teens often filter details of their lives to parents.

Parents can help children and teens follow through getting needed treatment, provide reminders and transportation to their children, and refill prescriptions.

Discussion: Working With Children and Adolescents Versus Adults References

Bratton, S. C., Ray, D., Rhine, T., & Jones, L. (2005). The efficacy of play therapy with children: A meta-analytic review of treatment outcomes. Professional Psychology: Research and Practice, 36(4), 376.

Giedd, J. N. (2004). Structural magnetic resonance imaging of the adolescent brain. Annals of the new york academy of sciences, 1021(1), 77-85.

Knight, J. R., Sherritt, L., Shrier, L. A., Harris, S. K., & Chang, G. (2002). Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Archives of pediatrics & adolescent medicine, 156(6), 607-614.

Tol, W. A., Komproe, I. H., Susanty, D., Jordans, M. J., Macy, R. D., & De Jong, J. T. (2008). School-based mental health intervention for children affected by political violence in Indonesia: a cluster randomized trial. Jama, 300(6), 655-662.Leslie, K. (2008). Youth substance use and abuse: challenges and strategies for identification and intervention. Cmaj, 178(2), 145-148. Discussion: Working With Children and Adolescents Versus Adults