Psych · Child and adolescent psychiatry — developmental assessment
Developmental assessment in child psychiatry
Also known as Developmental history · Milestone assessment · Adaptive functioning assessment · Developmental surveillance · Developmental screening · Psychometric assessment CAP · Global developmental delay assessment · Intellectual disability assessment children
Exam-exhaustive fellowship reference on developmental assessment in CAP — structured history, domain milestones, adaptive function co-equal with IQ, screening versus diagnostic psychometrics, multi-source formulation, and multiagency early intervention. FRANZCP-primary, globally tagged.
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Red flags
- Developmental regression or progressive loss of skills — urgent medical/neurological pathway; do not only reassure
- Suspected neglect, abuse, or exploitation of a developmentally vulnerable child — safeguarding first under local law
- Language delay without documented hearing assessment — arrange hearing before complex labelling
- Failed screens or clear functional impairment with 'wait-and-see' delay of early intervention
- Acute behavioural crisis attributed to 'bad behaviour' in undiagnosed ID/ASD — rule out pain, medical cause, and unmet communication needs
- Request to medicate solely to suppress behaviour for incomplete assessment or school convenience — reformulate
Meet the patient
A 4-year-old is referred because "he's not talking like his sister was." He walked at 18 months, had a few words at 2 and then seemed to stall, and lines his cars in a row for an hour. His record shows no hearing test since the newborn screen. His mother has been told, twice, to "give it time."[1][3]
The registrar's instinct is to order an IQ test. The examiner's question is sharper: "what will you do today, before any score comes back?" That question is this whole topic.[1][15]
References18ShowHide
- [1]Lipkin PH, Macias MM Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening Pediatrics, 2020.PMID 31843861
- [2]Zubler JM, Wiggins LD, Macias MM, Whitaker TM, et al. Evidence-Informed Milestones for Developmental Surveillance Tools Pediatrics, 2022.PMID 35132439
- [3]Council on Children With Disabilities; Section on Developmental Behavioral Pediatrics; Bright Futures Steering Committee; Medical Home Initiatives for Children With Special Needs Project Advisory Committee Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening Pediatrics, 2006.PMID 16818591
- [4]Siegel M, McGuire K, Veenstra-VanderWeele J, Stratigos K, et al. Practice Parameter for the Assessment and Treatment of Psychiatric Disorders in Children and Adolescents With Intellectual Disability (Intellectual Developmental Disorder) J Am Acad Child Adolesc Psychiatry, 2020.PMID 33928910
- [5]Volkmar F, Siegel M, Woodbury-Smith M, King B, et al. Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder J Am Acad Child Adolesc Psychiatry, 2014.PMID 24472258
- [6]Moeschler JB, Shevell M; Committee on Genetics Comprehensive evaluation of the child with intellectual disability or global developmental delays Pediatrics, 2014.PMID 25157020
- [7]Robins DL, Casagrande K, Barton M, Chen CM, et al. Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F) Pediatrics, 2014.PMID 24366990
- [8]Winters NC, Hanson G, Stoyanova V The case formulation in child and adolescent psychiatry Child Adolesc Psychiatr Clin N Am, 2007.PMID 17141121
- [9]King RA; American Academy of Child and Adolescent Psychiatry Practice parameters for the psychiatric assessment of children and adolescents J Am Acad Child Adolesc Psychiatry, 1997.PMID 9606102
- [10]Achenbach TM, Ruffle TM The Child Behavior Checklist and related forms for assessing behavioral/emotional problems and competencies Pediatr Rev, 2000.PMID 10922023
- [11]Goodman R The Strengths and Difficulties Questionnaire: a research note J Child Psychol Psychiatry, 1997.PMID 9255702
- [12]Goodman A, Goodman R Strengths and difficulties questionnaire as a dimensional measure of child mental health J Am Acad Child Adolesc Psychiatry, 2009.PMID 19242383
- [13]Glascoe FP Parents' concerns about children's development: prescreening technique or screening test? Pediatrics, 1997.PMID 9093291
- [14]Glascoe FP Parents' evaluation of developmental status: how well do parents' concerns identify children with behavioral and emotional problems? Clin Pediatr (Phila), 2003.PMID 12659386
- [15]King TM, Tandon SD, Macias MM, Healy JA, et al. Implementing developmental screening and referrals: lessons learned from a national project Pediatrics, 2010.PMID 20100754
- [16]Noritz GH, Murphy NA; Neuromotor Screening Expert Panel Motor delays: early identification and evaluation Pediatrics, 2013.PMID 23713113
- [17]Tassé MJ, Luckasson R, Schalock RL The Relation Between Intellectual Functioning and Adaptive Behavior in the Diagnosis of Intellectual Disability Intellect Dev Disabil, 2016.PMID 27893317
- [18]Copeland WE, Shanahan L, Costello EJ, Angold A Childhood and adolescent psychiatric disorders as predictors of young adult disorders Arch Gen Psychiatry, 2009.PMID 19581568