1. Child Assessment

2. Goals and Objectives Collect accurate data – relevant and reliable
Presenting concerns and Sx
Daily and academic fx
Work/study habits
Interpersonal patterns
Personality
Temperament
Motor skills
Cognitive skills

3. Goals and Objectives Make Accurate Conclusions: Diagnosis
Guide the Treatment Plan
Assess effectiveness of current and previous coping styles and treatment attempts

4. Clinical Interview
Good Clinical Interview efficiently yields relevant and significant information and opens up clarity and insight into problem.
Key: Rapport with child and family
Join with the most accessible member
Join with the most powerful member
Join with the child

5. “Joining”
Keep in Mind: Parents come in extremely anxious and vulnerable and are desperate for help and clarification – be honest, objective, and empathic
Child- feels confused, pathologized, the “bad child”
Be clear with the child about who you are and what your purpose is: “I’m Dr. Saadia and I help boys and girls talk about their thoughts and feelings and find ways for them to feel better.”

6. Dimensions of a Clinical Interview
See my Child Intake Assessment Form
(handout)
- Go over Dimensions of Child Assessment

7. Theoretical Perspectives
Developmental
Normative Developmental
Assumption: Genetic, Environment interact in adaptive and nonadaptive ways. Explores Developmental Maturation and Environmental Fit for Child
Interview focuses on assessing child’s developmental maturation compared to peers.
Good to assess delays in cognitive and emotional development

8. Theoretical Perspectives
Cognitive-Behavioral
Humanistic-Phenomenological
Focuses on Child’s thoughts, assumptions, and perceptions
Problem-Solving Style
Environmental contingencies to maladaptive behavior, patterns of rewards and punishments
Assumption: Maladaptive behavior is a result of child’s experience of the world.
Every child strives for self-actualization if basic need for positive unconditional regard is present.

9. Theoretical Perspectives
Family Systems
Psychodynamic
Family Structure/Rigidity
Assigned Roles
Attachment/Closeness
Resources
Power
Dependency/Reliability
Availability of Resources
Child’s Object-Relations
Child’s differentiation/regression
Attachment pattern
Defenses/ Conflicts

10. Special Considerations
Child’s Verbal Ability, Insight
Child’s comfort with a Adult Stranger
Family interview vs Child Solo
What is appropriate to discuss?
Parent’s blocks to discussing concerns with child
Parent’s refusal to “label” ADHD and Asperger’s/Autism with child

11. Special Considerations
Duty to Protect Abused or Neglected Children
Child/Infant Mortality: Accidental Deaths
At Risk Factors:
Poverty
Low Birth Weight/Medical Illness
Lack of Child Proofing/supervision
Parent Drug and Alcohol use

12. Special Considerations
Parental Deception (conscious or uncons)
Parents taking control of interview
Parents dictating dx and tx
Parents who turn the interview into a therapy session for themselves
Child who is uncooperative or unresponsive

13. Assessing Strengths Resiliency Indicators:
Infant alert, eye contact, smiles, responsive and sociable
Child has healthy self-esteem, persistent w/goals
Secure Attachment, Warm Family environment
Strong, Cohesive, Extended Family Support
Middle/upper SES
Community with good schools, daycare, supportive social network

14. Consent and Confidentiality
What is consent?
Consent from child and parents
Explaining consent to child: Developmentally appropriate language
Divorced Parents: Who gives consent?
Confidentiality (ethics) vs Privilege (legal)
Child vs Adolescent

15. Case Discussion: “Emily”
Mother arrives with her 9 year old child concerned about separation anxiety. The child walked in with mother closely attached to her leg and sat next to her mother with face averted through out interview. Child ignored therapist attempts to engage with her. Mother stated that child only exhibit anxiety upon leaving for visits with her father. Parents are undergoing divorce. Mother asked that therapist not involve the father in the tx stating that she believes he is the cause of the child’s anxiety and hopes that she obtains sole custody for the sake of the child.
What ethical/ legal considerations must you address?
What hypothetical considerations do you have about the family dynamic?
What are your diagnostic concerns about the mother, child, attachment?
Given the possible issues here, what is the best approach to the initial assessment process?
What questions do you have as you proceed with your assessment?