The importance of a developmental assessment of children and adolescents Child and adolescent development is characterized as a continuous, predictable sequence of biological, psychological, and emotional changes that occur between birth and the end of adolescence (Choo et al., 2019). Specific developmental milestones are used as guidelines to gauge the child’s functioning level within their given age group. By performing a developmental assessment, clinicians can track growth and engagement patterns and identify developmental problems that will require the implementation of interventions to improve the child’s functioning. Determining the extent to which behaviors and experiences are appropriate for a child’s age and stage of development is critical in evaluating mental health conditions. Effective screening and assessment maximize the potential to direct patients and their families to the help they need before problems become entrenched (American Academy of Child & Adolescent Psychiatry [AACAP], n.d.). Awareness of a pediatric patient’s development enables caregivers and clinicians to perceive the world from their perspective. Individualized care is best achieved when the provider’s interaction is based on the patient’s developmental level. Description of two assessment instruments used for children and adolescents but not adults BASC-3 Behavioral and Emotional Screening System (BASC-3 BESS) The BASC-3 BESS is a quick and reliable, systematic tool to determine behavioral and emotional strengths and weaknesses of children and adolescents from preschool through high school (3 to 18 years) (Evidence-based Intervention Network, 2011). This assessment has three forms: parent and teacher forms (ages 3 to 18 years) and the student self-report form (ages 8 to 18 years). The screening tool uses a Likert scale to assess four dimensions of behavioral and emotional functioning, which includes internalizing problems, externalizing problems, school problems, and adaptive skills (Evidence-based Intervention Network, 2011). The tool has 25 to 30 items depending on the form in use. A T-score of 60 or below indicates normal risk level; 61 to 70 indicates elevated risk; and above 71 indicates extremely elevated risk level that may require support planning from a behavioral specialist (DiStefano et al., 2013). Ages and Stages Questionnaire-Social Emotional (ASQ-SE) The ASQ-SE is a highly reliable, parent-administered screening tool that assesses children's social and emotional development between 3 to 66 months. It looks at the domains of self-regulation, communication, autonomy, compliance, adaptive functioning, affect, and social interaction. The assessment results can determine if a referral for intervention services is necessary (California Evidence-based Clearinghouse for Child Welfare [CEBC], 2015). The test is broken down into age ranges, with cutoff scores varying by age. Scores above the cutoff for age indicates that a mental health assessment is warranted for the child (Squires & Bricker, 2009). Describe two assessment instruments used for children and adolescents but not adults Child-centered Play Therapy (CCPT) is an effective treatment option for children ages 3 to 10 years experiencing social, emotional, behavioral, and relational problems (CEBC, 2019). In the pediatric population, language development lags behind cognitive development. Play therapy is an effective intervention to allow children to communicate their awareness within their world. Emotionally significant experiences can be expressed through the symbolic representation toys provide. Anxieties, fears, fantasies, and guilt are transferred to objects rather than people (Wilson & Ray, 2018). Therapeutic interactions and a therapeutic environment that includes play and symbols allow the child to experience full acceptance, empathy, and understanding while processing inner feelings and experiences (CEBC, 2019). The goal of CCPT is to decrease symptomatic behaviors and improve the child’s overall functioning. Multisystemic Therapy (MST) was developed to address risk factors among children and adolescents with serious externalizing problems at-risk for out-of-home placement (Henggeler et al., 2009). Children and teens are conceptualized by their family, social, school, and community systems. MST uses a home-based model that limits treatment barriers, such as limited access to transportation, lack of childcare, or parent work hour restrictions. Young clients are treated within their real-world settings. The MST providers work with the client, their families, and the school community to encourage adherence to the nine core principles. Interventions are developed to eliminate drivers that influence undesirable behaviors and symptoms. Examples of effective interventions include reframing negative behaviors and family interactions, emphasizing familial strengths, and contingency management. The treatment duration is typically four to six months, in which the MST team is available to families on a 24-hour basis through an on-call rotation (Zajac, Randall, & Swenson, 2015). Explain the roles parents play in assessment and treatment According to Sadock, Sadock, and Ruiz (2014), it is necessary to involve parents in the assessment process to get a chronological picture of the child’s growth and development, details of stressors or important events, accurate family history, and their perspective of the family dynamic. Parents also help make informed decisions about goals and treatments. Many studies show that parent participation in treatment improves client outcomes. Empowered with information and strategies, parents increase compliance through assisting their child in treatment engagement, learning new skills, and becoming more independent (Haine-Schlagel & Walsh, 2015). Parent participation is needed to continue the intervention delivery within the home.

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The importance of a developmental assessment of children and adolescents cannot be overstated, as it plays a vital role in early identification of potential challenges and tailoring interventions to meet the unique needs of young individuals. Developmental assessments encompass a broad spectrum of biological, psychological, and emotional milestones that serve as benchmarks for normal growth and progression from birth through adolescence (Choo et al., 2019). By systematically evaluating these milestones, clinicians can monitor a child's developmental trajectory, identify concerns early, and implement appropriate interventions to support optimal functioning and mental health.

One of the primary reasons for conducting developmental assessments is to ensure children are developing within their expected age-related parameters. These assessments help differentiate typical developmental behaviors from those that may signal underlying issues, such as behavioral problems or emotional disturbances. Early detection is crucial because it allows timely intervention, which can prevent the escalation of problems and promote healthier developmental outcomes (American Academy of Child & Adolescent Psychiatry [AACAP], n.d.). For example, behavioral screening tools can reveal internalizing problems like anxiety or depression and externalizing issues such as aggression or defiance, which frequently co-occur with developmental delays or mental health disorders.

Two assessment instruments designed specifically for children and adolescents, but not applicable to adults, include the Behavior Assessment System for Children, Third Edition (BASC-3) Behavioral and Emotional Screening System (BESS) and the Ages & Stages Questionnaire-Social Emotional (ASQ-SE). The BASC-3 BESS is a rapid screening tool utilized to assess emotional and behavioral strengths and difficulties across various domains, including internalizing and externalizing problems, school-related issues, and adaptive skills (Evidence-based Intervention Network, 2011). It incorporates reports from parents, teachers, and the children themselves at age-appropriate levels. The scoring categorizes risk levels to identify children who may need further evaluation or targeted intervention, thus supporting early identification of emotional or behavioral difficulties (DiStefano et al., 2013). On the other hand, the ASQ-SE primarily targets social and emotional development from infancy to preschool age, covering children between 3 to 66 months (Squires & Bricker, 2009). This parent-administered tool evaluates critical areas like self-regulation, communication, and social interaction, with scores indicating whether further mental health assessments are necessary for the child—thus ensuring early support during formative years (California Evidence-based Clearinghouse for Child Welfare [CEBC], 2015).

When considering treatment options unique to children and adolescents, Child-centered Play Therapy (CCPT) and Multisystemic Therapy (MST) stand out as effective modalities. CCPT is tailored for children aged 3 to 10 years experiencing social, emotional, or behavioral issues. It leverages play—a natural medium of expression for children—to facilitate communication and emotional processing (CEBC, 2019). Through symbolic play, children can articulate fears, anxieties, and fantasies that might be difficult to express verbally. This therapeutic approach supports emotional healing and behavioral adjustment by providing a safe environment for children to explore their inner experiences with acceptance, empathy, and understanding (Wilson & Ray, 2018). The primary aim is to alleviate symptoms and improve overall functioning, fostering emotional resilience.

Multisystemic Therapy is a home-based, intensive intervention targeting adolescents with serious externalizing behaviors that may put them at risk for out-of-home placement. MST emphasizes the importance of the child's ecological system—family, school, community—and seeks to modify these interconnected influences. The therapy involves working collaboratively with families, school personnel, and community agencies to implement strategies that reinforce positive behaviors and eliminate drivers of problematic behaviors (Henggeler et al., 2009). Its flexible, 24-hour availability ensures that treatment remains accessible and contextually relevant, making it particularly effective for high-risk youth and their families (Zajac, Randall, & Swenson, 2015).

The role of parents in assessment and treatment is indispensable. Parental involvement provides comprehensive information about the child's developmental history, behavior patterns, and family dynamics, all of which are critical for accurate assessment (Sadock, Sadock, & Ruiz, 2014). Engaging parents also empowers them to make informed decisions about treatment goals and to reinforce therapeutic strategies within the home environment. Research indicates that active parent participation improves treatment adherence, enhances skill acquisition, and promotes generalization of successful strategies into daily life (Haine-Schlagel & Walsh, 2015). Therefore, a collaborative approach involving parents not only optimizes individual treatment outcomes but also ensures sustainable improvements in the child’s development and well-being.

References

• AACAP. (n.d.). Assessment of young children. Retrieved December 9, 2020, from https://www.aacap.org
• CEBC. (2015). Ages & stages questionnaire: Social-emotional (ASQ-SE). Retrieved from https://www.cebc4cw.org
• CEBC. (2019). Child-centered play therapy (CCPT). Retrieved from https://www.cebc4cw.org
• Choo, Y. Y., Yeleswarapu, S. P., How, C. H., & Agarwal, P. (2019). Developmental assessment: Practice tips for primary care physicians. Singapore Medical Journal, 60(2), 57-62.
• DiStefano, C., Greer, F. W., & Kamphaus, R. W. (2013). Multifactor modeling of emotional and behavioral risk of preschool-age children. Psychological Assessment, 25(2), 561-570.
• Evidence-based Intervention Network. (2011). Behavioral and emotional screening system (BESS). Retrieved from https://www.ebinstitute.org
• Haine-Schlagel, R., & Walsh, N. E. (2015). A review of parent participation engagement in child and family mental health treatment. Clinical Child and Family Psychology Review, 18(2), 165-185.
• Henggeler, S. W., Schoenwald, S. K., Borduin, C. M., Rowland, M. D., & Cunningham, P. B. (2009). Multisystemic therapy for antisocial behavior in children and adolescents (2nd ed.). Guilford Publications.
• Zajac, K., Randall, J., & Swenson, C. C. (2015). Multisystemic therapy for externalizing youth. Child and Adolescent Psychiatric Clinics of North America, 24(3), 631-649.