Psychiatric Evaluation of the Child - Meiri

Question 1

What are the basic concepts in an invterview of infants and toddlers?

Answer 1

• Parents present
• Interview of parents
• Parent-infant
interaction
• Younger patients have more somatic symptoms: Irritability, eating disorder, FTT, developmental delay, social withdrawal (signs of problems)
• Diagnostic Classifications 0-3

• Parents – safety, stimulation, attunement.
• Child – Developmental level – motor, activity level, communication, play, problem solving, adaptation, social responsibility
• Interaction with play
• Symbolic play (test alertness)
• Puppets and dolls
• Observation in other situations

Question 2

What are the basic components of an interview of a school-aged child?

Answer 2

• Can tolerate 45 minutes
• Explore the child understanding
• Drawing (Winnicot’s squiggle- draw an abstract line and alternate with the child to continue it)
• Wishes
• Partially open-labeled questions
• Use of indirect commentary

Question 3

What are the components of the mental status examination of a child?

Answer 3

• Physical appearance
• Parent-child interaction
• Separation and reunion (reunion most important, seeing how child reacts after parent returns)
• Orientation
• Speech and language
• Mood
• Affect
• Thoughts process and content
• Social relatedness
• Motor behavior
• Cognition
• Memory (ask about vacations)
• Judgment and insight
• Neuropsychiatric examination
• Developmental, psychological, educational testing
• Formulation and summary (of tests and exams)
• DSM IV diagnosis (or other)
• Recommendations and treatment plan

Question 4

What are the axes of diagnostic classification?

Answer 4

• Axis I – Primary diagnosis
• Axis II – Relationship disorders
• Axis III – Medical and
Developmental conditions
• Axis IV – Psychosocial stressors
• Functional Emotional Developmental level