Karen A. Frankel - Clinical Guide to Psychiatric Assessment of Infants and Young Children

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The validity and the importance of early childhood psychopathology have both become increasingly clear over the last two decades. An expanding body of empirical research on the manifestations, longitudinal outcomes, and neural correlates of psychopathology in young children, as well as the unique efficacy of early intervention, has catalyzed this field. Disorders of infants and preschoolers are now a widely accepted clinical phenomenon and of interest to groups beyond those with a specific focus on early childhood development and psychopathology, to those practicing in mainstream mental health. Based on this, the need for clear guidelines on developmentally sensitive and appropriate assessment techniques has taken on even greater importance and urgency. Innovations in this area have facilitated the clinical research providing the advances in our ability to detect and understand the etiology and course of early childhood psychopathology. Now, many of these methods and measures can be utilized in clinical settings and may serve as very useful tools for conducting an age-appropriate and clinically meaningful assessment as outlined in the following chapters.

The chapters contained in this volume outline developmentally sensitive principles and approaches to the clinical mental health assessment of young children. While these methods may be applied using a variety of adaptations and forms and in different clinical settings, it is important to note that such developmentally specific approaches are critical to obtaining a valid and clinically meaningful mental health assessment of a young child. Failure to utilize age-appropriate methods may result in both overdiagnosis and failure to detect symptoms and disorders of the young child. Several central principles underlying the unique features of the assessment of the young child are outlined in the book. First is the central importance of the dyad to the emotional and social functioning of young children and the related need to conduct the evaluation in the context of the caregiver-child relationship. Related to this, the assessment of parenting style and internal representations which impact parenting is also central and elaborated upon in several chapters. These issues while important in all child assessments are critical to the mental status exam and diagnostic formulation of the young child. The importance of the play setting and the use of play as the medium of expression is also a central theme. Several other principles are key, such as the need to consider behavior in context (including relationship context) and the need to assess the child with different caregivers and on more than one occasion to account for the significant effect of state on a young childs mental status. The reader can utilize the information in this volume to apply these methods and principles to conduct an age-appropriate mental health assessment of young children.

This volume also touches on diagnostic systems that can be applied in early childhood, reviewing the merits and limitations of both DSM 5 and DC:0-5. While it does not provide a review of empirically supported treatments for mental disorders in young children, it does touch on more global issues such as how to assess for the need to evaluate the potential use of psychopharmacology. The volume, while not prescriptive, provides a comprehensive overview of the key principles to be considered and numerous tools and approaches that can be utilized in the age-appropriate mental health assessment of the young child. Importantly, a true embrace of these principles and methods is nothing short of prerequisites for the appropriate and accurate mental health assessment of the young child. This comprehensive book provides a highly clinically useful review of these essential principles.

We are pleased to offer this volume as a hands-on guide to the assessment of very young children and their caregivers. Each of the editors (and most of the authors) has worked for decades in the area of infant and early childhood mental health, training and teaching new generations of providers. Joyce, Wanjiku, and I have longed for a single text that brought together resources describing the comprehensive process of evaluating infants, toddlers, preschoolers, and their caregivers. Infant and early childhood mental health is a complex subspecialty of child mental health which takes a unique lens toward assessmentone that is relationship-based, contextually grounded, culturally sensitive, and diversity-informed and requires competence in adult, child, and relationship assessment skills. Learning all of these domains can be daunting for trainees and seasoned professionals as well. We hope this volume will make the task more accessible and enticing!