Chapter 4- Assessment, Diagnosis, and Treatment Flashcards
what does that decision-making process begin with
clinical assessment
what is clinical assessment
systematic problem-solving strategies to understand children with disturbances and their family and school environments
Flexible, ongoing hypothesis testing assesses:
A child’s emotional, behavioral, and cognitive functioning; the role of environmental factors; nature, causes, and likely outcomes of the problem
what do Idiographic case formulation assessments focus on
obtaining detailed understanding of the child or family as a unique entity
what does the Nomothetic formulation emphasize
general inferences that apply to large groups of individuals
who are at the greatest risk of misdiagnosis
Ethnic minority youth
Cultural information is necessary to: -5
Establish relationship with child and family
Motivate family members to change
Obtain valid information
Arrive at accurate diagnosis
Develop meaningful treatment recommendations
what are culture-bound syndromes
Recurrent patterns of maladaptive behaviors and/or troubling experiences associated with different cultures or localities
more commonly reported problems among males
ADHD
ASD
childhood conduct disorder
Intellectual disability
Language disorder
Specific learning disorder
Enuresis
more commonly reported problems among females
anxiety disorders
eating disorders
sexual abuse
adolescent depression
equally reported problems among males and females
adolescent conduct disorder
childhood depression
feeding disorder
physical abuse and neglect
Basic information about child development norms is crucial in
understanding why a child may be referred to professionals
__ and __ typically define childhood disorders
Age inappropriateness and symptoms
____ in the child’s functioning is a key consideration
Impairment
what is the first step to description and diagnosis of assessment
clinical description summarizes the child’s unique behaviors, thoughts, and feelings that together make up the features of the child’s psychological disorder
a diagnosis involves analyzing ___
information and drawing conclusions about the nature or cause of the problem
what is a prognosis
the formulation of predictions about future behavior under specified conditions
what is important for a clinical assessment to work
methods need to be reliable, valid, cost-effective, and useful for treatment
a clinical assessment reveals ____
the child’s thoughts, feelings, and behaviors
a comprehensive assessment evaluates ___
a child’s strengths and weaknesses across many domains
clinical interviews provide
a large amount of information during a brief period and include a family history
a behavioral assessment evaluates the
child’s thoughts, feelings, and behaviors in specific settings
what are the “ABCs of assessment
observe the:
Antecedents
Behaviors
Consequences of the behaviors
example of the ABC of assessment
A: teased at school
B: refused to go to school
C: no teasing
Behavioral Assessments allow for a childs
behavior to be compared with a known reference group
Parents or other observers record ______ to provide information about behaviors in real-life settings
baseline data
clinician may set up ____ to observe children and their families
role-play simulation
psychological tests are ___ and the purpose is to
tasks given under standard conditions
assess some aspect of the child’s knowledge, skill, or personality
A child’s scores are compared with
a norm group
what is the code of fair testing practices
Guidelines which increase clinicians’ sensitivity to cultural factors
developmental tasks are used in ____
Screening, diagnosing, and evaluating infants and young children and identify those at risk
intelligence testing evaluates a child’s ___
intellectual and educational functioning
what is one of most frequently used intelligence scales
The Wechsler Intelligence Scale for Children (WISC-IV)
3 other commonly administered tests
Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R)
Stanford-Binet-5 (SB5)
Kaufman Assessment Battery for Children (K-ABC-II)
projective testing presents a child with ___
ambiguous stimuli and asking the child to describe what he or she sees
The child projects his or her own personality, including unconscious fears, needs, and inner conflicts, on the ambiguous stimuli
personality testing what are the central dimensions of personality- the big 5 factors
Timid or bold
Agreeable or disagreeable
Dependable or undependable
Tense or relaxed
Reflective or unreflective
Neuropsychological Assessment attempts to link
brain functioning with objective measures of behavior known to depend on an intact central nervous system
what is classification
system for representing the major categories or dimensions of child psychopathology
2 strategies for determining the best plan for a given individual
Ideographic strategies
Nomothetic strategies
Ideographic strategies highlight ___
a child’s unique situation
Nomothetic strategies are employed to
Benefit from all the information accumulated on a given problem or disorder
Determine the general category to which the problem belongs
Categorical classification systems are based primarily on
informed professional consensus
A “classical/pure” categorical approach: every diagnosis has a ___ and
clear underlying cause
each disorder is fundamentally different from other disorders
dimensional classification has
any independent dimensions that exist
The Diagnostic and Statistical Manual is
A multiaxial system consisting of five axes
what are the 5 axes that make up the DSM
Clinical disorders or conditions
Personality disorders and intellectual disability
General medical conditions
Psychosocial and environmental problems
Global assessment of functioning
3 criticisms to the DSM
- Fails to capture the complex adaptations, transactions, and setting influences crucial to understanding and treating child psychopathology
- Gives less attention to disorders of infancy/childhood
- Fails to capture the interrelationships and overlap known to exist among many childhood disorders
3 pros to diagnostic labels
- Help clinicians summarize and order observations
- Facilitate communication among professionals
- Aid parents by providing recognition and understanding of their child’s problem
3 cons to diagnostic labels
- Disagreement about effectiveness of labels to achieve their purposes
- Negative effects and stigmatization
- Can negatively influence children’s views of themselves and their behavior
interventions today are planned by combining ___
the most effective approaches to a particular problem
___ is needed to show that interventions work
data
Development of evidence-based interventions has led to a
growing awareness of children’s and families’ cultural contexts
the cultural compatibility hypothesis states that
Treatment is likely to be more effective when compatible with the cultural patterns of the child and family
4 outcomes related to child functioning- treatment goals
Reduce or eliminate symptoms
Reduce degree of impairment in functioning
Enhance social competence
Improve academic performance
4 outcomes related to family functioning
Reduce level of family dysfunction
Improve marital and sibling relationships
Reduce stress
Enhance family support
5 outcomes to societal importance
Improve child’s participation in school-related activities
Decrease involvement in juvenile justice system
Reduce need for special services
Reduce accidental injuries or substance abuse
Enhance physical and mental health
AACAP and APA ethical code provide
minimum ethical standards
what do the AACAP and APA do
Select treatment goals and procedures that are in the best interest of the client
Ensure participation is active and voluntary
Keep records to document treatment effectiveness
Protect confidentiality
Ensure therapist’s qualifications and competencies
more than 70% of clinicians use an ____
eclectic approach
Psychodynamic treatments view child psychopathology as determined by
underlying unconscious and conscious conflicts
Psychodynamic treatments focus on
helping the child develop an awareness of unconscious factors contributing to problems
behavioral treatments assume that ___ and focus on ____
behaviors are learned
re-educating the child
procedures of behavior treatments are- 4
Positive reinforcement or time-out
Modeling
Systematic desensitization
Changes in the child’s environment
cognitive treatments view abnormal behavior as the result of ___ and focus on
deficits and/or distortions in the child’s thinking\
changing faulty cognitions
client- centered treatments focus on ____
creating a therapeutic setting which provides unconditional acceptance of the child
family treatments view ___ and focus on ___
individual disorders as manifestations of disturbances in family relations
the family issues underlying children’s problematic behavior
biological treatments view child psychopathology as resulting from ___
psychobiological impairment or dysfunction
there are __ main approaches in developing best practice guidelines
two
The ____ approach derives guidelines from a review of current research findings
scientific
The _____ approach uses experts’ opinions to fill gaps in scientific literature
expert-consensus
fewer that __% of treatments demonstrate evidence for reducing impairment in life functioning
20
