PSYCH-333 Chapter Notes - Chapter 4-5: Clinical Formulation, Enuresis, Conduct Disorder
3 May 2018
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Department
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Psy 220
Chapter 4 Assessment, Diagnosis, and Treatment
Clinical assessment is directed at differentiating, defining ad easuig the hild’s ehaio,
cognitions, and emotions of concern, the environmental circumstances that may contribute to
these poles, ad the hild’s stegths ad opeteies
Use systematic problem-solving strategies to understand children with disturbances and
their family and school environment
Assessments are meaningful to the extent that they result in effective interventions; a close and
continuing partnership must exist between assessment and intervention (beginning of decision
making)
Childhood patterns for selected problems of childhood adolescence
More common in male
ADHD, childhood conduct disorder, IQ disability, autism, language disorder,
reading disorder, enuresis
More common in females
Anxiety, adolescent depression, eating disorder, sexual abuse
Equally distributed
Conduct disorder adolescence, childhood depression, feeding disorder,
physical abuse and neglect
Relational aggression- aggression indirectly (gossip, insults) shown in girls
Children who engage in forms of social aggression that are not typical of their sex are
significantly more maladjusted than children who engage in gender-normative forms of
aggression
Minority more likely to be misdiagnosed and less likely to receive treatment
The focus of clinical assessments is to obtain a detailed understanding of the individual
child or family as an entity- referred to idiographic case formulation
Nomothetic formulation- emphasizes broad general inferences that apply to large groups of
individuals
Age, gede, ad ultue ifluee ho hilde’s sptos ad ehaio ae epessed ad
recognized, and have implications for selecting the most appropriate methods of assessment
and treatment
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Biology and socialization interact to create different interests and behavior profiles of girls and
boys
Culture-bound syndrome- maladaptive behaviors associated with different cultures
Culture competence- matching children and families with clinicians of the same ethnicity and
customize treatment to Hispanics values, culture, and beliefs
Clinical description- desiig hild’s uiue behaviors
Include in clinical description
1) Intensity, frequency, and severity of problems
2) Age of onset and duration of difficulties
3) Know strength and resources, full range profiles
Diagnosis- analyzing information and drawing conclusions about the nature or cause of a
problem
Taxonomic diagnosis- formal assignment of cases to specific categories drawn from a system of
classification such as the DSM
Problem-solving analysis- inforatio that is used to udestad the atue of a idiidual’s
pole, it’s possile auses, teatet optios ad outoes
Prognosis- formulation of predictions about future behavior under specified conditions
Treatment of children focus on enhancing hild’s deelopet athe tha eel eoig
symptoms or restoring previous level of functioning
Treatment planning and evaluation- geeate a pla to addess the hild’s pole ad
evaluate its effictiveness
The age inappropriate and the pattern of symptoms, rather than individual symptoms, usually
define childhood disorders
Three purposes of assessment are 1) description and diagnosis that determine the nature and
auses of the hild’s pole, 2) pogosis that pedits futue ehaio ude speified
conditions and 3) treatment planning and evaluation
Assessing disorders
Clinical assessment relies on a multimethod assessment approach, which emphasizes obtaining
information from different informants in a variety of settings, using a variety of methods
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The clinical interview continues to be most universally used assessment procedure with parents
and children, flexible conservational style, study facial styles, body posture, voice, mannerisms
In unstructured interviews, interviewers use their preferred style and format to pursue various
questions in an informal and flexible manner. In contrast, semi structured interviews include
specific questions designed to elicit information in a relatively consistent manner regardless of
who is doing the interview
Developmental history/ family history- information is obtained from the parents regarding
developmental milestones, and historical events that might have bearing on current difficulties
Child’s ith ad elated eets, age of deelopetal ilestones, medical history,
fail haateistis, hild’s itepesoal skills, eduatioal histo, ok histo ad
relationships, description of presenting problems, parents expectations
Behaioal assesset ealuates the hild’s thoughts, feeligs, and behaviors in specific
settings and uses this information to formulate hypotheses about the nature of problem and
what can be done about it
Example- discover loss of energy- do you often feel tired?, decreased socialization- do you feel a
need to be alone?, sleep disturbances- do you have trouble sleeping?
Target behaviors- primary problems of concern, with the goal of then determining what specific
factors may be controlling or influencing these behaviors.
Framework for organizing findings in behavioral assesset ABC’s
A= antecedents, or the events that immediately precede a behavior
B= behavior of interest
C= consequences, or the events that follow a behavior
Behavioral analysis or functional analysis of behavior- general approach to organize using
assesset ifoatio i tes of A,B,C’s aoss a leels
Goal of functioning analysis is to identify as many factors as possible that could be contributing
to a hild’s pole ehaio ad thoughts ad to deelop a hpothesis fo the ost ipotant
factors and easily changed.
A= teased at school B= school refusal C= No teasing
Reports concerning child behavior and adjustment can be obtained using global checklists and
problem- focused atig sales. A idiidual hild’s soes a e opaed ith a ko
reference group of children of similar age and the same gender
Tests are tasks given under standard conditions with the purpose of assessing some aspect of
the hild’s koledge, skill, or personality, standardized on defined reference group
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Document Summary
Adhd, childhood conduct disorder, iq disability, autism, language disorder, reading disorder, enuresis. Use systematic problem-solving strategies to understand children with disturbances and their family and school environment. Clinical assessment is directed at differentiating, defining a(cid:374)d (cid:373)easu(cid:396)i(cid:374)g the (cid:272)hild"s (cid:271)eha(cid:448)io(cid:396), cognitions, and emotions of concern, the environmental circumstances that may contribute to these p(cid:396)o(cid:271)le(cid:373)s, a(cid:374)d the (cid:272)hild"s st(cid:396)e(cid:374)gths a(cid:374)d (cid:272)o(cid:373)pete(cid:374)(cid:272)ies. Assessments are meaningful to the extent that they result in effective interventions; a close and continuing partnership must exist between assessment and intervention (beginning of decision making) Childhood patterns for selected problems of childhood adolescence. Relational aggression- aggression indirectly (gossip, insults) shown in girls. Children who engage in forms of social aggression that are not typical of their sex are significantly more maladjusted than children who engage in gender-normative forms of aggression. Minority more likely to be misdiagnosed and less likely to receive treatment child or family as an entity- referred to idiographic case formulation.
