QUESTION

Developmental assessment of children and adolescents is essential because it observes growth
and changes of the child over time. A developmental assessment allows the Psychiatric Mental
Health Nurse Practitioner (PMHNP) to compare developmental growth to expected
achievements of children of the same age and identify any delays in developmental milestones.
The identification of any abnormalities prompts a need to refer a child to the appropriate
clinician for further testing. The Centers for Disease Control and Prevention (2019) recognized
that early intervention could change a child’s developmental path and improve outcomes for not
only the child but families and communities as well. The earlier the detection of abnormal
development, the higher the chances the child has in reaching his or her best potential with
intervention (Centers for Disease Control and Prevention, 2019).
Assessment Instruments
Dominic-R- is a comprehensive child self-report screening tool that is used to diagnose common
mental health problems in children ages 6 to 11. The instrument provides instant results in
diagnosing “separation anxiety, generalized anxiety, depression and dysthymia, ADHD,
oppositional defiant disorder, conduct disorder, and specific phobia” (Sadock, Sadock, & Ruiz,
2014). The highly standardized test combines colorful pictures, text, and a voiceover with child
interaction. The instrument uses a child named “Dominic,” who experiences symptoms in
question, from the child’s point of view (Sadock et al., 2014). Dominic-R uses the combination of
auditory and visual symptoms to achieve a better understanding versus the use of traditional
questionnaires. According to Sadock, Sadock, and Ruiz (2014), “information gleaned from this
instrument can also be applied in conjunction with clinical information to the DSM-5” (p. 1111).
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Dominic-R is appropriate for children as young as the age of 6. Cognitive theories recommend
external data input through multiple sensory channels, achieves the enhancement of
information processing (Dominic Interaction, 2009). This assessment instrument is more
relatable to a child or adolescent versus an adult as it is driven towards limited comprehension
of abstract concepts that apply to this age group.
Reynolds Child Depression Scale- 2nd Edition (RCDS-2)- is an adolescent self-report screening
tool that measures the severity of depression in 11-20-year old. The RCDS-2 assesses for
dysphoric mood, anhedonia-negative affect, negative self-evaluation, and somatic complaints
(Ortuño-Sierra et al., 2017). This tool uses a 30-item questionnaire that uses a Likert scale to
assess the severity of the depression. The rationale that this assessment is used in adolescents
versus adults in the diagnosis of major depression disorder (MDD) in children and adolescence
can directly affect academic performance, increase the risk for attempted suicide and increase
the risk of suffering from depression as an adult (Ortuño-Sierra et al., 2017). Early intervention is
ideal.
Treatment Options
Pediatric Medical Dance/Movement Therapy- is a dance therapy designed for childhood and
adolescent with disorders such as ADHD, mental disability, anxiety, depression, and disordered
eating (Tortora, 2019). Pediatric medical DMT is practiced in both in-patient and out-patient
settings to engage children in dance/movement providing psychosocial support. The goals of
therapy are to improve experiences and address concerns related to medical illness (Tortora,
2019). DMT has been identified as successful in improving stress management, improving
quality of life, manages pain, reduces anxiety and depression, and improves body self-image
(Tortora, 2019).
Play Therapy- therapy used in children ages 3-12. Play therapy typically is a weekly 30 to a 60-
minute session that is used to assist children in addressing and resolving problems (Association
for Play Therapy, n.d.). Play therapy is designed to assist children in learning how to cope with
difficult emotions and find solutions to problems through natural play (Association for Play
Therapy, n.d.).
Parents Role
Parents play a significant role in the assessment and treatment of the child and adolescent as
they are likely the first to recognize a change. As clinicians, we rely on parents to keep the child
compliant with visits and keep us updated on treatment failures and successes. The
participation of the parent ultimately predicts the child or adolescent’s outcome. Negligence of
the parent failing to comply with treatment or lack of alerting clinicians of developmental delays
impacts the child’s care and ability to seek intervention, which ultimately decreases the likelihood
of the child successfully reaching his or her potential. Ignoring signs or symptoms of anxiety or
depression could lead to the worsening of symptoms as an adult or self-harm.
References
Centers for Disease Control and Prevention. (2019). Why act early if you’re concerned about
development? Retrieved from https://www.cdc.gov/ncbddd/actearly/whyActEarly.html
Dominic Interaction. (2009). Children ages 6 to 11. Retrieved from
http://www.dominicinteractive.com/21_en.jsp
Ortuño-Sierra, J., Aritio-Solana, R., Inchausti, F., Chocarro de Luis, E., Lucas Molina, B., Pérez
de Albéniz, A., & Fonseca-Pedrero, E. (2017). Screening for depressive symptoms in
adolescents at school: New validity evidences on the short form of the Reynolds
Depression Scale. PloS one, 12(2). https://doi.org/10.1371/journal.pone.0170950
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry:
Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Tortora, S. (2019). Children are born to dance! Pediatric medical dance/movement therapy:
The view from integrative pediatric oncology. Children (Basel, Switzerland), 6(1), 14.
doi:10.3390/children6010014