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Symptom evaluation and treatment selection in the latency-aged child
Insights
Most children with behavioral disorders seen by physicians do not have severe psychiatric conditions. Evaluation involves assessing symptom significance and severity, guiding appropriate, time-efficient interventions for pediatric behavioral issues.
Area of Science:
- Child and Adolescent Psychiatry
- Behavioral Pediatrics
- Developmental Psychology
Background:
- Many children referred for behavioral disorders lack classical psychiatric diagnoses.
- Differentiating between reactive and internalized difficulties is crucial for accurate assessment.
Purpose of the Study:
- To provide a framework for evaluating behavioral disturbances in children.
- To guide non-psychiatric physicians in assessing and managing these cases effectively.
Main Methods:
- Assessment of parental objectivity and developmental knowledge.
- Evaluation of symptom significance and severity.
- Guidelines for history-taking and clinical examination.
Main Results:
- Criteria are provided to determine if a child's symptoms are significant and how disturbed the child is.
- Distinguishing between stress-reactive and internalized issues is emphasized.
- Findings help differentiate between mild and serious disturbances.
Conclusions:
- A systematic approach aids physicians in managing pediatric behavioral disorders.
- Time-efficient interventions are recommended unless intensive treatment is clearly indicated.
- Referral for psychiatric consultation is advised if significant improvement is not observed within six months.
Abstract:
Most latency children referred to the non-psychiatric physician with behaviour disorders do not suffer from classical neuroses, brain syndrome, retardation or psychoses. In evaluating the significance of disturbance two questions must be answered. I. Does the child have significant symptoms? This requires assessment of parental objectivity, knowledge of normal development, familiarity with developmental tasks of the period and ability to draw conclusions from observations of the child. II. How disturbed is the child? Here the basic questions are: 1. To what extent are the difficulties reactive to current stress rather than internalized? 2. How serious are the symptoms themselves? Criteria for answering these questions are provided. Comments are made on history-taking and a guide to the clinical examination is presented, together with findings indicating whether the disturbance is mild or serious. Principles for rational intervention are discussed and various treatment options are examined. Methods relatively economical of the physician's time are indicated unless clear reasons for more intensive treatment are present. If very definite improvement has not taken place within six months, psychiatric consultation should be sought.