Parents brought a four year old adopted daughter to see a psychiarist. The child was polite i greeting but did not smile and kept her gaze down as she took a seat. The parents explain their concerns. They described the child as quiet and who nows throws temper tamtrms, during which she is inconsolable. Her sleep and eating patterns have changed and she no longer wants to go to preschool.
What other information would we want to learn during the interview with te family? What questions would you need to ask?
In adition to clincical interview, what other clinical assessment tools whould be consider? Why
Although you need mor information to begin treatment, what factors might you take into cosideration in designing an effective intervention for this famil?
If you are preparing to diagnose the child would refer to DSM-IV classification system to evaluate her condition or five separate axis. What typeof information would go into each axis?
You are not to enter diagnosis, only describe the kind of information that would be entered in each axis.
Do you tink diagnosis would be beneficial or harmful? Explain why.
What was her behavior before (beside being quiet)? When did the behavior change? Is there any known event that might have precipitated the change? If preschool is the only activity she avoids, I might suspect that something occurred there.
I hope this helps you.
When conducting an interview with the family, you would want to gather more information to better understand the situation and the child's behavior. Here are some questions you might consider asking:
1. Developmental history: Ask about the child's early life experiences, her behavior in previous environments, any significant life events before or after adoption, and her relationship with her biological parents (if known).
2. Attachment and bonding: Inquire about the attachment relationship between the child and her adoptive parents, any disturbances in bonding, or any experiences that may affect her ability to trust and form secure attachments.
3. Trauma history: Explore whether the child has experienced any traumatic events, such as abuse, neglect, or witnessing violence, either prior to adoption or afterward.
4. Medical history: Collect information on the child's physical health, any past medical diagnoses, or current medications, as these may contribute to her behavioral changes.
5. Family dynamics: Assess the relationship dynamics within the family, including the parenting style, any recent changes or stressors within the family, and the presence of any sibling rivalry or conflict.
6. Social interactions: Investigate how the child interacts with peers, teachers, and other adults, as well as any significant changes in social behaviors or relationships.
In addition to the clinical interview, other clinical assessment tools that could be considered are:
1. Parent-report questionnaires: Tools such as the Child Behavior Checklist (CBCL) or the Strengths and Difficulties Questionnaire (SDQ) can provide standardized measures of the child's behavior, emotional well-being, and social functioning.
2. Observational assessments: Utilizing a structured observation method, such as the ADOS (Autism Diagnostic Observation Schedule), can help assess social communication skills and identify possible developmental disorders like autism.
3. Psychological testing: Depending on the specific concerns, psychological assessments like cognitive testing, temperament assessments, or projective measures might be useful.
When designing an effective intervention for this family, it is crucial to consider multiple factors, including:
1. Trauma-informed approach: Given the child's history and behavioral changes, it is essential to consider trauma as a potential factor influencing her behaviors. Integrating trauma-informed principles into the intervention can help address underlying trauma and support the child's healing process.
2. Attachment-based strategies: Strengthening the attachment relationship between the child and her adoptive parents can support her sense of security and help her regulate her emotions and behavior.
3. Parenting skills training: Assisting the parents in understanding and responding to the child's needs, managing challenging behaviors, and promoting positive parent-child interactions can be beneficial.
4. Early intervention support: Collaborating with preschool or early intervention professionals to create a supportive and inclusive environment for the child can help address her reluctance to attend preschool.
In the DSM-IV classification system, the diagnosis would consist of information entered into five separate axes:
1. Axis I: This axis would include clinical disorders, such as mood disorders, anxiety disorders, or developmental disorders like autism, which may be relevant to the child's current symptoms.
2. Axis II: This axis would cover personality disorders and intellectual disabilities that might be present.
3. Axis III: Here, you would include any relevant medical conditions that are impacting the child's behavior and functioning.
4. Axis IV: This axis would identify any psychosocial or environmental stressors that may be contributing to the child's difficulties, such as adoption-related issues, changes in family dynamics, or exposure to trauma.
5. Axis V: This axis would involve the Global Assessment of Functioning (GAF) scale, which provides an overall assessment of the child's psychological, social, and occupational functioning.
As for whether a diagnosis would be beneficial or harmful, it largely depends on how the diagnosis is used within the context of treatment. A diagnosis can help clinicians and parents understand the child's symptoms and access appropriate resources and interventions. However, it is essential to approach diagnosis with sensitivity, focusing on understanding the child's unique needs rather than stigmatizing or labeling them. A diagnosis should serve as a guide for treatment and support, not as a definition of the child's identity or potential.