An assessment by a child and adolescent psychiatrist and the clinical team, is appropriate for any child or adolescent with emotional or behavioural problems. Most children and adolescents with serious emotional and behavioural problems need a comprehensive psychiatric assessment.

Comprehensive psychiatric assessments usually require several hours over one or more office visits for the child, parents and family. With the parents’ permission, other significant people (such as the family physician, school personnel or other relatives) may be contacted for additional information.

Before you see a psychiatrist it is useful to have your paediatrician or family physician rule out physical problems such as vision, hearing, thyroid, diabetes, anemia and mononucleosis which may cause symptoms which are also found in neuropsychological disorders. The physician may also recommend further investigations.

The comprehensive assessment frequently includes the following:

Description of present problems and symptoms;
Information about health, illness and treatments (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/adolescent;
If needed, special assessments (psychological, educational, speech and language etc).

The child and adolescent psychiatrist then develops a general understanding and diagnosis of the child’s situation and diagnosis. The doctor will describe the child’s problems and explains them in terms that the parents and child can understand. Biological, psychological and social aspects of the problem are integrated with the developmental needs, history and strengths of the child or adolescent.
Time is made available to answer the parents’ and child’s questions.

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?
How much of the cost is covered by OHIP and private insurance plans?
Will my child end up mentally sick like one of my relatives?
Is this permanent?

Parents are often worried about how they will be viewed during the evaluation. The child and adolescent psychiatrist and the clincal team are there to support the family and to be a partner, not to judge or blame. They listen to concerns, and help the child or adolescent and his/her family define the short and long-term goals of the evaluation. Parents should always ask for explanations of words or terms they do not understand.
When a treatable problem is identified, recommendations are provided and a specific treatment/management plan is developed.

Taken in part from:
Facts for Families © is developed and distributed by the American Academy of Child and Adolescent Psychiatry.

Reviewed by Dr. Maged Kodsi M.D. Child and Family Psychiatrist.