How to diagnose mental health disorders in children and teens
What is a mental health evaluation?
Diagnosing pediatric mental health disorders can be difficult because many different factors can affect children's moods and behaviors, including physical health issues and experiences in their environment. For this reason, a mental health evaluation is often essential to understanding a child's difficulties and how help them become the best version of themselves.
A mental health evaluation (or assessment) is a process by which a professional gains detailed information about a child's difficulties in order to make an accurate diagnosis and provide recommendations for the most appropriate treatment.
The type of problem a child is experiencing will determine the type of evaluation needed and where it will be completed. Some evaluations take place in a child's school; others are completed at medical centers, community mental health centers or private outpatient offices.
How do you test for mental health or behavioral problems?
There are many types of evaluations or assessments to determine if your child needs mental health support. A mental health professional at CHoR will work with you to determine which might be the most beneficial, depending on the exact problems you are seeing in your child or teenager.
The types tests that mental health professionals can conduct, include:
Psychiatric evaluation
This is needed when:
- A child is showing serious emotional or behavioral problems
- To determine if symptoms have a physiological cause
- Medication is being considered as a treatment option
Who is it conducted by?
- Child and Adolescent Psychiatrist
Important things to know about the psychiatric evaluation
- A psychiatrist has specialized knowledge of medications for mental health problems and can give prescriptions if necessary
- If needed, laboratory studies such as blood tests, x-rays or physical examination are ordered to rule out physical health problems as a cause of symptoms
Psychological evaluation
This is needed when:
- A child is showing serious emotional or behavioral problems
- A child's diagnosis is unclear or needs clarification
Who conducts this mental health assessment?
What should I know about the psychological evaluation?
- A psychologist has specialized knowledge of children's mental health problems and treatment
- One-on-one testing with the child (i.e., intellectual, personality, information processing, memory and/or attention testing)
- Possible observation of the child's behavior at school
Psychoeducational evaluation
When is this needed?
- A child is having difficulty learning
- Eligibility for special education is being considered
Who conducts this evaluation?
- School, clinical or educational psychologist
What are the important things I should know about a psychoeducational evaluation?
- These professionals have specialized knowledge of how children learn and classroom interventions
- One-on-one testing with the child (i.e., intellectual, achievement, speech and language, information processing, attention and/or personality testing)
- Observation of the child's behavior in class
- Generally, this is not covered by insurance.
Developmental evaluation
When is this needed?
- A young child (birth to 7 years) is not showing age appropriate skills or is not meeting developmental milestones
- Eligibility for special education is being considered
Who is this conducted by?
- Usually by a team that could include a psychologist, physician, speech/language pathologist, physical therapist, occupational therapist or nurse
What are the important things to know about the development evaluation?
- These professionals have specialized knowledge of child development
- One-on-one testing with the child (i.e., motor skills, communication, pre-academic skills, adaptive functioning)
- Observation of the child's behavior in the office and/or school
Neuropsychological evaluation
Why might my child need this?
- Child is experiencing problems with memory, attention, problem-solving and/or visual-motor functioning
- Child has a medical condition that may affect brain functioning (e.g., brain tumor, brain injury, cancer, epilepsy, etc.)
What mental health professional conducts this assessment?
What should I know about this evaluation?
- A neuropsychologist has specialized knowledge of brain functioning
- One-on-one testing with the child (e.g., intellectual, achievement, speech and language, information processing, attention, visual-motor and/or personality testing)
Psychosexual evaluation
This evaluation may be needed if:
- Sexual abuse perpetration is alleged or suspected
- Information is needed regarding child's risk of re-offending, need for supervision and/or treatment recommendations
Who conducts this evaluation?
- Clinical psychologist, usually with specialized training in sex offender management
What are important things you should know about this evaluation?
- This psychologist has specialized knowledge of sexual development and issues related to sexual abuse perpetration
- Interviews with caregiver and child focus more on a child's sexual development, sexual attitudes, sexual interests, and sexual behaviors
- One-on-one testing with the child (i.e., personality testing)
ADHD testing
ADHD testing is usually conducted through surveys with caregivers and teachers.
ADHD testing is typically needed when:
- Several symptoms present before age 12
- Symptoms are present in multiple settings (home, school, work)
- Symptoms interfere with or reduce daily functioning
- Symptoms are not better explained by another mental health condition
Who is the test conducted by?
- May be conducted by Primary Care Physicians, Psychologist, or Psychiatrist
What are important things to know about ADHD testing?
- This may be done in conjunction with other testing or as "stand-alone" testing when ADHD is suspected.
Individualized Education Plan testing (IEP)
When is this needed?
- A Child Study referral has been made to the child's school with concerns regarding educational performance
Who conducts this?
- Usually conducted by personnel from the child's school district.
What should I know about IEP testing?
- Actual testing completed may vary, based on the referral and the need.
- Can include psychological (IQ) testing, social history, educational testing, speech and language evaluation, and/or occupational therapy evaluation.
- After testing is completed, a meeting is held to determine whether child is eligible to receive special education services. If so, then an IEP is developed.
For more information about special education services, check out the Virginia Dept of Education Guide to Special Education
How to prepare your child for a mental health assessment
For most children, participating in a mental health evaluation will be a new experience and they may feel nervous or confused about why they need to go. Preparing your child ahead of time by telling him or her what will happen and why the testing is important can alleviate some anxiety.
Here are five tips that can help to make the experience of a mental health evaluation a positive experience for your child:
- Talk to your child about testing: Some children may worry about what is "wrong" with them when they learn that they need to go for testing. It's important to let your child know that many children and teens go for evaluations at some point to understand how they think, learn, or experience and deal with their emotions. With older children, it may be helpful to encourage them to think about whether they have any questions of their own that they would like to talk with the professional about.
- Avoid telling your child that they will be playing "games": Children often find some of the tasks involved in evaluations fun, but some tasks may be challenging or boring to your child. A child may be disappointed or upset to find that the tasks are not what they would consider to be "games." Instead, you can tell your child that they will likely be asked to answer questions and complete tasks, some of which will be easy and some that might be more difficult.
- When possible, carefully schedule testing dates: Check your child's schedule to make sure that they will not be missing a field trip, sports game, or other special activity when testing; their disappointment or upset could affect their attitude towards testing. Also be aware of changes in family routine that might affect your child, such as a move or a caregiver being out of town.
- Make sure your child gets a good night's sleep before testing: A good night sleep is important to ensure that a child is able to perform their best at testing. A child's ability to pay attention and their level of effort can all be affected by a poor night's sleep.
- Make sure your child has eaten well before testing: Food is also essential to a child's ability to think and pay attention. If testing is taking place in the morning, make sure your child eats a good breakfast. If your child is testing in the afternoon, consider giving them a snack on the way. Also, you can ask the professional doing the testing if it is okay to bring a drink or snack for your child if testing will last a few hours.
Once an evaluation has been conducted, we will discuss the various treatment options available and develop a plan to help your kid become the best version of themselves.
Read about the different treatment options
