Clinical Reference Systems: Pediatric Advisor 10.0

Most children and adolescents with serious emotional and behavioral problems need a comprehensive evaluation by a psychiatrist.

Comprehensive psychiatric evaluations usually require several hours over one or more office visits for the child, parents, and family. With the parents' permission, the psychiatrist may contact other significant people, such as the child's physician, school personnel, or other relatives.

The comprehensive evaluation frequently includes the following:

• description of present problems and symptoms
• information about health, illness, and treatment (both physical and psychiatric)
• parent and family histories
• information about the child's development
• information about school and friends
• information about family relationships
• psychiatric interview of the child or adolescent
• if needed, laboratory studies such as blood tests, x- rays, or special assessments (for example, psychological, educational, and speech and language evaluations).

The psychiatrist then develops a formulation. The formulation describes the child's problems and explains them in terms that you and your child can understand. Biological, psychological, and social parts of the problem are combined in the formulation with the developmental needs, history, and strengths of the child or adolescent.

The psychiatrist will make time available to answer questions you or your child may have. Parents often come to such evaluations with many concerns, including:

• Is my child normal? Am I normal? Am I to blame?
• Am I silly to worry?
• Can you help us? Can you help my child?
• Does my child need treatment? Do I need treatment?
• What is wrong? What is the diagnosis?
• What are your recommendations? How can the family help?
• What will treatment cost and how long will it take?

Parents are often worried about how they will be viewed during the evaluation. The psychiatrist is there to support the family and to be a partner, not to judge or blame. He or she will listen to your concerns and help you and your child define the short-term and long-term goals of the evaluation. You should always ask for explanations of words or terms you do not understand.

When the psychiatrist identifies a treatable problem, he or she will make recommendations and develop a specific treatment plan.