Children's mental health assessment

Children's mental health assessment is by no means a verdict that a child has a "problem", nor is it an entertainment test without any reference value. It is essentially a set of standardized and verified behavioral signal identification tools. Only by cooperating with professionals' multi-dimensional assessment and avoiding fractional theory can we truly help parents understand their children's unspoken emotions, without delaying intervention opportunities or labeling children with lifelong negative labels.

Last week I met the mother of a third-grade boy at the child psychology clinic. She cried while clutching the evaluation report issued by the school. She said that the report showed that the child had hyperactivity tendencies. She had been suppressing the anger at home for three days and even dropped out of interest classes, so she was going to take the child for drug treatment. As a result, we played Lego with the child for 20 minutes and had a phone call with the class teacher to find out the truth: The child had just entered third grade and had a new math teacher, and the teaching progress was slow. He had already completed self-study of the math content for this semester. His inability to sit still in class was purely idle and had nothing to do with Attention Deficit and Hyperactivity Disorder (ADHD).

Interestingly, the academic controversy over children’s mental health assessment has actually lasted for nearly two decades, and both sides’ views are supported by solid cases. Scholars who do partial quantitative research believe that the commonly used Connors Behavior Scale and Rutter Child Behavior Questionnaire have been verified across populations for decades, and the accuracy of preliminary screening of common children's psychological problems can reach more than 80%. Especially for young children between 3 and 6 years old who cannot express emotions accurately, they are much more reliable than the subjective judgment of parents. I have been in contact with a 4-year-old girl before. Her mother always thought she was "too well-behaved and too introverted." As a result, the routine entrance test showed that the anxiety score was far above the threshold. After an in-depth interview, it was discovered that the child had been terrorized by the nanny at home for half a year and had already developed a stress reaction. If the parents had not discovered it on their own, it might have caused some problems.

However, consultants from the humanistic and family systems schools almost turn pale after hearing the test. The most common thing they say is: "There is no problem with the children, the problem is the environment." I have a deep understanding of this point of view. Last year, I received a first-grade case. The school evaluation said that the child had oppositional defiant disorder. The mother told everyone that "my child has mental problems." As a result, the child became more and more rebellious. He deliberately turned over the table in class and scolded his parents at home. Our first step in intervention was to tear up the evaluation report in front of the whole family and tell everyone, "This child just doesn't like to be labeled casually." Two months later, the child's performance was no different from that of ordinary children. Think about it, if everyone told you that you were a bad boy every day, would you be able to get better?

I have been working with children on the front line for six years, and I never dare to draw conclusions based on just one scale. A qualified children's mental health assessment should not only involve answering questions and scoring points. You must first choose the right tool. Children of different ages have completely different scales. If you use a depression scale for 12-year-olds on a 3-year-old child, it will be useless no matter how good-looking the results are. Not to mention those "Children's Emotional Intelligence Tests" on the Internet for 9 yuan and 9 free shipping. They don't even have basic reliability and validity. They are just a waste of time.

In addition to the scale, at least two dimensions of assessment must be added: one is interactive observation with the children. For younger children, we will do game therapy. For school-age children, we will talk about their favorite animations and games to see if there are really any abnormalities in his social reactions and emotional expressions.； The other is a parent interview of at least one hour. You need to ask clearly about the child's upbringing environment from birth to the present, whether there have been any family changes recently, and how his performance is at school. Only when the information in the three dimensions is consistent can it be said that the child may have some problems and require further intervention.

Many parents also have deep misunderstandings about assessments. They feel that assessments are just to check "whether there is a disease." In fact, many developmental assessments now do not screen for problems at all, but help you find your child's strengths. For example, some children are kinesthetic learners who find it uncomfortable to sit there and listen to a 10-minute class. They can sit for two hours doing hands-on experiments. After the evaluation is completed, it is much more effective for parents to adjust the way they accompany their children in learning than scolding their children for "can't sit still" every day.

By the way, there is another note that I repeat to parents every time: no matter what the assessment results are, don’t tell your children directly. Don't think that your child doesn't understand. If you tell him, "You have ADHD, so you can't sit still in class," he will only default to being a "sick child" and it will become increasingly difficult to change. You say it another way, "We found that you seem to prefer learning through hands-on play. Can you do more small games when your mother studies with you?" ”, the children’s acceptance is much higher.

To put it bluntly, the test is actually a thermometer for home use. You cannot use the thermometer as a fever reducer. If you detect a fever, you should go to a doctor to find out the cause, instead of scolding your child for having a fever at the thermometer.； But if you don't even believe the thermometer, and you insist that the child is just "a little hot" and still carries the fever to 39 degrees, the child will suffer in the end. To put it bluntly, the tools are never wrong, the fault is always the person using the tools.