Infant psychiatry: Assessment
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Infant psychiatry is a crucial domain of psychiatry which yet not discussed as much as other sub specialties of psychiatry(Child, adult or geriatric). As a mental health professional, educator or health worker, one should have brief orientation of infant mental health (IMH) or infant psychiatry. This presentation will provide a brief idea about assessment of infancy and early childhood.
Infant psychiatry: Assessment
- 1. Infant Psychiatry-Assessment Dr Md Saleh Uddin Assistant Professor Department of Psychiatry, BSMMU 07.05.2020
- 2. Objectives Normal development Clinical models Clinical assessment
- 4. ICD, DSM, DC:0-5 DC:0-5 (Diagnostic Classification of Mental health and Developmental Disorders of Infancy and Early Childhood)
- 6. Axis-DC:0-3R 1. Clinical disorders 2. Relationship classification 3. Medical and developmental disorders 4. Psycho social stressors 5. Emotional and social functioning
- 7. Axis-DC:0-5 1. Clinical disorders 2. Relational context 3. Physical health conditions and considerations 4. Psycho social stressors 5. Developmental Competence
- 8. DC: 0-5 Disorders 1. Neuro developmental disorders 2. Sensory processing disorders 3. Anxiety disorders 4. Mood disorders 5. Obsessive Compulsive and Related disorders 6. Sleep, Eating and Crying Disorders 7. Trauma, Stress and Deprivation disorders 8. Relationship Disorders
- 13. Gap: Models and Assessment Standardized diagnostic interview (SDI): DISC (Diagnostic Interview Schedule for Children) K-SADS (Kiddle Schedule for Affective Disorders and Schizophrenia) DAWBA (39%match) Instruments for rating problems Official nosology based: Conners Rating Scale(CRS)
- 14. Models Vs Problems Top down Bottom up Expert Children, Parent, Teacher
- 15. Syndrome models: a. Somatic problems, Social problems etc b. Externalizing, Internalizing DSM oriented scale Cross informant comparisons Multicultural applications
- 18. Principals of assessment Assessment of risk Parent want the best Biopsychosoical framework Developmental context Relational approach Vulnerabilities and strengths Transactional model
- 19. Target of Assessment Accurate diagnosis and formulation Maximize child's developmental potential Intervention and management planning Research
- 20. Rating scales and questionnaire CBCL SDQ ASQ-3 PAPA PSI-SF
- 21. Assessing interaction Observation 1. Parental Sensitivity 2. Childs Responsiveness 3. Their Fit 4. Their Safety 5. Parents Capacity
- 22. Ideal communication: 1. Contingent-Responsive 2. Collaborative-Participatory 3. Emotionally attuned- Identify and response
- 23. Reflective or mentalising capacity Holding mind in mind PDI(Parent Development Interview) Play assessment Modified Crowell Procedure Instruments: 1. Neonatal Behavior assessment scale (NBAS) 2. Bayley Scales of Infant Development(BSID) 3. Wechler Preschool and Primary Scale of Intelligence (WPPSI) 4. Vineland Adaptive Behavior Scale
- 24. Assessing Risks Within or context Risk and protective factors Cumulative risks Observation, Interview, Examination and documents
- 25. Types: Immediate, Developmental, Indirect, Cumulative Greatest developmental risk: Neglect, Instability, Parental mental health and Hostility
- 27. Parenting and Parenting capacity Needs & Protection Boundaries Potentials Recognize the needs Meet developmentally appropriate way Accept responsibility
- 29. Parental Capacity determined by: 1. Parental factor 2. Child factor 3. Contextual sources of stress and support
- 30. Summary Models, Interview and Scales DC:0-3, Crosswalk Interaction assessment (observation and tools/play) Parenting and parenting capacity