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Posted: July 17th, 2022

Colleagues response week 2 | NURS 6660 – Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent | Walden University

  

The Assignments

Respond to at least two of your colleagues by offering additional insights or alternative perspectives on their diagnosis or provide alternate next questions and why you selected those. Support your responses with evidence-based literature with at least two references in each colleague’s response with proper citation.

Colleagues Response # 1

Working With Children and Adolescents Versus Adults

           A practitioner must be versed in conducting an assessment of a child versus and adult. There is a difference when a child is not always able to deliver the information the practitioner seeks. More people need to be involved when gathering information regarding a child in comparison of an adult (Sadock, Sadock, and Ruiz, 2014).

Developmental Assessment

A developmental assessment seeks to uncover the history of development and meeting of milestones from pre-birth to current state. The developmental history helps paint the picture for the practitioner of the growth of the child, potential risks, and flags that warrant further investigation. A developmental assessment includes intellectual, academic, physical development, history of medical and mental health, family bonds, socioeconomic status, and other information the parent, teachers, and/or child may find important to share.

Assessment Instruments for Children and Adolescents

           One assessment tool is the SDQ, which is a screen that both a parent and other adult, such as a teacher, complete to identify areas of concern in emotional symptoms, conduct, hyperactivity-inattention, peer problems, prosocial behaviors, and caregiver stress in children ages 3-16 years of age (McSherry, Malet, & Weatherall, 2019). Another assessment instrument is the CATS screen, which a caregiver completes to identify trauma that has occurred in a child’s life. The screen is used in ages 3-6 years as well as 7-17 years; there are two separate screens depending on the age of the child. The CATS screen has been evaluated and recommended internationally as a valid screen for PTSD or other trauma in childhood (Sachser et al., 2017). A third instrument is the Wechsler Intelligence Scale for Children (WISC-III-R) use din children 6-17 years which highlights the “verbal IQ, a performance IQ, and a combined full-scale IQ” (Sadock, Sadock, & Ruiz, 2014). Neither of the first two assessment instruments mentioned would be valid for adults as both instruments require the caregiver to complete the screen. An adult is able to complete his or her own screen, so other instruments would be more efficient when seeking out information related to adults. Sadock, Sadock, and Ruiz (2014) highlight that there are different assessment tools used for children and adults due to the need for caregivers to give their feedback about symptoms. Although, it is important to note that the information shared by the caregiver may be distorted due to the caregiver stress, frustration, or mental health concerns that may be present (Sadock, Sadock, and Ruiz, 2014). The third instrument is based on the average scale of the age of the child and not intended for adults.

Treatment Options for Children and Adolescents

Treatment for children and adolescents include psychological education for the caregivers and educational treatment plans. Sadock, Sadock, and Ruiz (2014) highlight the importance of a combined effort from the caregiver, teachers, clinician, and the child to obtain positive results when treating mental health concerns. Psychological education for caregivers and educational treatment plans are not used in adulthood as the developmental stage is advanced past caregivers and teachers.

Parents Role in Assessment and Treatment

           According to Saddock, Saddock, and Ruiz (2014), the parental interview is an essential aspect pf the assessment and cooperation from the parents helps support the most successful testament plan. Parents are able to relay important information of developmental history, familial history, symptoms exhibited, strengths, and weaknesses. The treatment plan needs to be “consented” to by the parent including psychotherapy and psychopharmaceutic options. The child is not able to consent to treatment without the consent of the guardian in most cases.

Colleagues Response # 2

Working with Children and Adolescents Versus Adults

          Adolescent’s and children’s  assessment should be conducted routinely as they are very important. It should be conducted on a routine basis. The purpose of performing a routine assessment on children and adolescent is to evaluate various aspects of their functioning level, cognitive development, communication, behavior, social interaction, motor, and sensory functioning. The assessment is also important because it can help identify deficiencies in the early stage of growth. Studies have indicated that about 1 in 6 children between the ages of 3 to 17-year-old is born with abnormalities which include autism, ADHA, learning, and language disorder (Eileen Haebig, April 2019).

                                                                                  Assessment instruments used for evaluating children and adolescents

          Assessment instruments are tools use in gathering developmental information about the child and adolescent functional levels. However, I will be discussing different assessment instruments that can be used for children and adolescent’s Assessment. My first assessment tool will be the Denver Developmental Screening Test. It helps to assess various risk for developmental delay or functions which includes motor function, cognitive, adaptive skills, communication skill and social interaction (Sadock, 2014). The test is suitable for children in early school-age 6-year old. As stated above, it is imperative to begin the assessment in early child development to know how well the child or adolescent progressing without any abnormalities or delay. The screening tool is structured for the Assessment of a child’s development. It is also administered only by the evaluator directly with the child and does not require direct input from any other person. Furthermore, the Denver Developmental Screening Test is aimed for early identification of risk for developmental delays.

          My second assessment tool will be the ADHD Rating Scale. This Assessment tool can be completed by the child’s parent or teacher to help guide the clinician to diagnose the child or adolescent with attention deficit hyperactivity disorder. The ADHD Rating Scale consists of 18 test question that permits the teacher or parent to evaluate how many times the child behaviors change either at home or in school. According to (Overgaard, et al., 2019), states that screening purposes, the parent and teacher ECI-4 ADHD rating scale showed acceptable accuracy in identifying preschoolers at risk for ADHD.  There are many treatments available for children with ADHD and is supportive to the child which may include changes in the classroom and at home, academic and social skills training (Sadock, 2014).

                                                                                             Treatment options used for children and adolescents

          There are many treatments options available for children and adolescents. The applied behavior analysis (ABA) treatment is used to treat kids with social disorders like autism. This treatment has been proven to increase behaviors, learning/communication skills, and social skills in children with functional delays (Matson, 2012). Additional treatments are occupational therapy and therapeutic Horseback Riding.

                                                                                                         Roles parents play in assessment and treatment

          Every parent have a vital role to play in the treatment of his/her child. As a PMHNP, it is advisable to always involve the parent of the child or adolescent in the plan of care or medication management. This will permit the parents to have a vast understanding of the child or adolescent change in development. The parent participation is predominantly important for child growth and development.

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