|Rapid Assessment of Youngsters|
This activity is useful when assessing the behavior, adjustment, and functioning of a young person. Importantly, it does not represent a thorough diagnostic evaluation and should not be seen as a substitute for careful, professional assessment when a specific youngster is experiencing serious or ongoing difficulties. It is, rather, only intended to point out those areas in which a child or adolescent is getting along fairly well and those areas where he/she may be having some mild, temporary difficulties.
Use a rating scale from five to one for each item on the list below. Five equals almost always, four equals usually, three equals sometimes, two equals seldom, and one equals almost never.
In this activity, each item needs to be evaluated and understood by itself. A normal, healthy young person would receive all fours and fives. Concern needs to be raised in any area suggested by an item where the young person's rating is three or below. Ratings of two or below or several ratings of three or below begin to suggest the need for more extensive assessment and more traditional therapeutic involvements.
The Young Person
1. Is energetic and interested in what is going on around him/her.
2. Feels attractive.
3. Is relaxed and comfortable with himself/herself.
4. Likes himself/herself.
5. Is self-confident.
6. Has a normal appetite and eating habits.
7. Stays away from drugs and alcohol.
8. Is happy and in a positive mood.
9. Manages his/her temper and anger responsibly.
10. Is honest and truthful.
11. Is a good student.
12. Feels successful.
13. Likes school.
14. Finishes projects, assignments, or other things for which he/she is responsible.
15. Is well behaved.
16. Is easy for parents, teachers, and other adults to deal with.
17. Is a responsible person.
18. Is a dependable person.
19. Has friends his/her age.
20. Makes good choices when it comes to friends.
21. Gets along well with his/her friends.
22. Follows the rules and goes along with what is expected of him/her at school and at home.
23. Makes friends easily.
24. Is adventurous and willing to try new things.
25. Handles day-to-day stresses and tensions well.
26. Is healthy.
27. Will talk about things with parents or other adults.
Understanding parent/child relationships and developing a parenting approach requires first that an assessment is done with and for the young person. Parenting is not a formula activity or something one does to a child. It is, rather, something one does with a child based on an understanding of and awareness of who that child is, his special problems and difficulties, and the child's unique personality. Further, good parenting depends on the style and personality of the parent, with the individuality of the parent combining with that of the child to develop an effective, on-going, on-growing relationship within which both the parent and the child may function successfully and effectively.
It is also important to understand that parenting is not an adequate response to many children and to their problems and difficulties. Parenting has the capacity to nurture and support the growth and development of relatively healthy, relatively normal children. When children begin developing problems and difficulties, however, parenting is frequently not an adequate response; and for children with special needs, parenting is simply not enough. For these children, a 'parenting plus' plan needs to be developed, with that plan providing healthy, positive parenting for the child and additionally providing those services and resources necessary to adequately respond to the special needs of the youngster.
In this activity, focus is on reasonably normal, reasonably healthy children. For them, effective parenting is usually an adequate response to their growth and development, an adequate response to the normal fluctuations in their behavior and adjustment. The activity includes a sample of factors associated with a child's being reasonably normal and healthy. If difficulties show up in the sample, however, it is critically important for the child that a more thorough medical, psychological, educational, and/or other specialized evaluation be done. In addition, it is important that a parenting plus plan be developed to respond to the special needs and difficulties of the youngster.
Normal children are energetic and interested in what is going on around them. No, they are not always energetic and not always interested. The point is that they are ordinarily people who have fairly high energy levels and who are interested in what is going on around them. They may not direct that energy to those things that parents would prefer the energy to be directed to and may not be interested in those things valued by parents. Nonetheless, their youthful energy and interest are obvious as one observes them over time.
When a youngster begins to show somewhat continuing low energy and disinterest, a problem is evident. First, the child needs to be evaluated medically, with the physician's attention directed specifically to the lethargy of the youngster. If no problems are found, the next procedure - psychosocial evaluation - needs to focus on the probability that the young person is depressed. If this is found to be the case, parents will need to bring more energy to their relationship with their youngster and will need to attend more closely to his needs and interests. It is likely, however, that this normal parenting response will not be adequate. A parenting plus plan will be necessary. In this plan, parents bring more energy to the relationship and attend more closely to the needs and interest of the youngster. They carefully involve themselves in healthy, positive parenting. In addition, though, the young person may need to be involved in counseling or therapy focusing on the continuing depression. This latter activity is the 'plus' in the parenting plus plan.
Normal, healthy children feel reasonably attractive in the sense that they see themselves as someone to whom others are attracted. In addition, they generally like themselves, are relatively self-confident, are ordinarily fairly happy and in a positive mood, and feel fairly successful in relation to those things valued by the youngster. Again, these feelings and perceptions are not present all the time and are not present in relation to all characteristics of the youngster or all aspects of his life. Here, attention is to the preponderance of the youngster's self-concept, his self-esteem. Also, it is important to evaluate these traits and characteristics over time, since on any particular day, a quite normal and healthy young person may feel ugly, incompetent and of little value. Even during these times, though, normal youngsters will ordinarily respond to the positive involvement and feedback of their parents.
For young people experiencing the set types of difficulties, good parenting lets the child know that the parents are attracted to him. How do parents show this attraction? They spend a little more time with the youngster, focus on positives instead of negatives, sincerely acknowledge the youngster's feelings and perceptions, and let the child know that he is cared about and loved. 'I enjoy spending time with you, talking with you, and having you as a member of our family. I can see that you do not like yourself very well today but want you to know that I like you and have faith in you and your abilities.' Good parenting responds to the successful, competent, attractive, valued young person. If this does not facilitate his moving to a more positive space, though, additional services are needed that help both the young person and the parent better understand the issues and concerns, the problems and difficulties.
Normal children are generally relaxed and comfortable with themselves, with who they are. Being relaxed should not here suggest necessarily being calm or 'laid back.' The young person may be very intense, very active, and very involved in a number of things at the same time. Nonetheless, the activity and involvement do not reflect anxiety, signs of tension or stress, continuing frustration, or any significant level of discomfort or displeasure with who he is. Yes, there may be periods of tension, self-doubt, anxiety, frustration, and other negative feelings and perceptions. Nonetheless, the predominant projection is one of being reasonably relaxed and comfortable.
If the young person's pattern of adjustment and self-management begins to show anxiety, tension, and other negative or uncomfortable elements, additional evaluating and assessment are needed. At the same time, though, parents will want to emphasize being calm and relaxed with the young person, being comfortable with who he is, and convey an atmosphere of acceptance and appreciation. Parenting may also extend to working with the youngster to better understand the problems and difficulties, the sources of the tension and stress. Here, parents can excise direct influence in terms of providing advice and guidance, managing and structuring the environment of the young person, and enabling the young person to use the adult perspective of the parent. If this is not enough, though - and at times it may not be - additional services and resources need to be incorporated into the parenting plus plan.
Healthy children reflect a normal appetite and eating habits. Generally, this is reflected through the youngster's eating when other people in the family eat, eating about the same foods other family members eat, and not reflecting any particular preoccupation with eating or eating patterns. For adolescents, however, dieting may become a mild preoccupation, although one should become concerned if the young person begins gaining or especially if the young person begins losing weight.
Does the young person look unusually heavy or unusually thin? If so, this needs evaluated by a physician on a fairly immediate basis. Also, it is important that children receive regular physical examinations, with the physician's evaluating the child's weight and eating habits as part of the examination. Here, good parenting comes first though setting a good example and encouraging good eating habits. If problems develop, however, parenting is not an adequate response to the needs of the young person. The parenting plus plan needs to include a thorough medical evaluation and may need to include specialized therapeutic services for the young person in those situations where eating disorders are suspected or confirmed. These types of difficulties are generally not manageable within the family as the only resource.
This latter point also applies to the misuse or abuse of alcohol or drugs. Normal children generally stay away from the use of alcohol or drugs; and any involvement that they do have is occasional and does not reflect any continuing problem of abuse or misuse. In fact, for normal youngsters, an especially negative experience with alcohol or drugs will decrease the likelihood of the young person's having a similar negative experience in the future. The idea is that normal children learn from bad experiences, adjusting their future behavior and involvement to avoid these negative experiences. If parents suspect a problem or know that the young person has had difficulties with alcohol or drugs on more than one or two occasions, it is very important that they seek out specialized and qualified resources to incorporate into the parenting plus plan.
Normal children are reasonably honest and truthful, fairly responsible, and usually people on whom others may depend. Of course, these qualities are not at issue until the young person has reached a developmental level to begin to reflect these qualities - generally around five or six years old. Even then it needs to be understood that honesty, dependability, and continuing responsibility are qualities that develop and become more dominant over time. Again, parenting best fosters these qualities by example. As you and the client assess the example being set by parents, you will want to help the client focus on small examples of honesty and truthfulness, small and large examples of responsibility, and various levels of dependability, especially as they relate to the child's being able to depend on or count on the parent. In this area, parenting is the most powerful resource available to the youngster. In fact, if these qualities are not present at a high level within the parent/child relationship the ability of outside resources to instill these qualities in the youngster is quite limited. In this area, Therapeutic Instruction is usually more effective than more traditional counseling and therapy approaches.
Normal children manage their emotions fairly well, with their ability to manage their emotions showing gradual improvement over time. By the time children are about six years old or so, they should be showing a pattern of experiencing, expressing, and managing emotions that enables them to function comfortably and smoothly within most situations. For example, the young person will experience anger and frustration and will be able to express those feelings. The expression of the anger and frustration, though, will be managed in ways that do not reflect temper tantrums, violence, destructiveness, or other negative outcomes. The emotional management will reflect an increasing pattern of positive, socialized expression that leads to healthy exercise of power, control, and influence on the part of the young person. Generally, this emotional management will reflect a primarily social, verbal pattern that is both responsible and serves over time the interest of the youngster.
The socioemotional styles of the young person's parents are as important here as they have been seen to be in other areas. Parents must be emotionally responsible and dependable if young people are expected to reflect these characteristics. In addition, though, good parenting assists the child in developing patterns of power, control, and influence that reflect positive personal style and do not have to fall back on unsocialized patterns of aggression and self-expression. If continuing problems develop, however, outside assistance is needed as part of the parenting plus plan. In addition to the child's having developed a pattern of ineffective or inappropriate emotional expression as a function of family experiences, these difficulties may also relate to medical problems, learning related difficulties, or other areas that may only be understood through competent professional evaluation and interventions. Above all, you need to focus specifically on any inclinations the parents may have to simply deal with the problems by over powering and controlling the young person.
Normal children are reasonably good students, usually like school, finish projects, assignments, or other things for which they are responsible, and deal fairly well with the school environment. This does not mean that they necessarily get all A's and B's, does not mean that they always do their homework, does not mean that they always feel good about school, and does not mean they never get into trouble at school. It means, rather, that they generally hang in there academically, passing their subjects and courses. They may not be particularly thrilled about homework or other assignments but usually make a reasonable effort to complete the requirements. They may not like particular teachers or particular classes but generally do enjoy the social interaction at school, some courses and assignments, and would generally prefer school to simply staying at home or getting a full-time job. If asked, most youngsters would indicate that they do not like school. Nonetheless, one finds that they get up and go to school voluntarily, generally enjoy themselves most of the time at school; and if they do get into trouble, those difficulties are ordinarily fairly mild and relatively inconsequential.
When children develop problems relative to these school-related areas, the most likely difficulty has to do with some type of learning problem or academically related issue. Generally, children do as well in school as they are capable of doing at the time, all things considered. When school is not going very well for them, then, it is very important for parents to first work with the youngster in terms of trying to understand the problems and difficulties and then in terms of helping the child with the problems. If this does not get the job done, it is important that the child be evaluated by professionals who understand children, understand the school environment, and understand the very complex nature of the learning process. This evaluation will likely lead to a specialized intervention plan that becomes the 'plus' in the parenting plus approach to the youngster.
You will want to work with the parent in terms of the parent's attitude toward the school, the attitude the parent is conveying toward the youngster, the parent's expectations, and how the parent is going about encouraging and facilitating the young person's school adjustment and academic achievement. For example, encouraging children to do their homework is a good idea. If homework becomes a battle or continuing hassle, though, the likelihood is that there are additional difficulties needing attention. It is unlikely that simply forcing the child to continue the uncomfortable, unpleasant homework activities will resolve the difficulties. In addition, this process does damage to the parent/child relationship that may have long-term negative effects. When children are having continuing difficulties in school, a parenting plus approach is essential.
Normal children are fairly well behaved, are relatively easy for parents and other adults to deal with, usually follow the rules, and usually do what is expected of them at school and at home. Children do not always behave, do not always do what is expected, do not always follow the rules, and do not always function as adults would like them to function. In fact, one would become equally concerned about a young person who never got into trouble, never broke the rules, never failed to meet expectations. The young person is adventurous, willing to and interested in trying new things, sometimes simply decide that his interest is better served by doing things his way, is sometimes overly impulsive and does not stop to think about what he is doing, and sometimes really did not understand the expectations or rules nearly as well as the adults thought he understood them. Nonetheless, the general pattern is to be reasonably conforming and cooperative.
When problems develop here, parents first need special assistance from you in terms of exercising reasonable and fair discipline, being consistent, following through with appropriate and proportional negative consequences, and being clear about what is expected. This is about as far as good parenting can go. If problems persist beyond these efforts, though, outside assistance is needed in terms of evaluation of the young person, the parent/child relationship, and the special needs and interest of the youngster. It really is true that the development and personality of some children are such that normal parenting is not an adequate response to their behavior and adjustment problems. They need additional services, unusually structured environments, special assistance with learning and school related difficulties, and an unusual level of sensitivity to their special needs and adaptational patterns. In addition to assuring that the needed resources and services are available, you will want to work closely with the parent to be sure that the parent is avoiding simply responding to the child's special problems by becoming increasingly frustrated and trying to simply overpower and control the youngster. Not only will these approaches be generally ineffective, they will tend over time to exacerbate or intensify the problems of the young person.
Normal children have friends their own age, make friends fairly easily, get along reasonably well with their friends, and show good choices in terms of picking friends. They are socially competent and responsible. As with areas already discussed, this area is not particularly at issue until children are about six years old or so.
This area may be the single most complex area related to the growth and development of youngsters and the parent/child relationship. First, children will tend to pick friends whom they perceive to be much like themselves. In fact, if a parent wants to know what the youngster thinks and feels about himself, one approach is to look at the friends with whom the young person associates. From the youngster's point of view, they are like him. This begins to show that the peer involvements of young people are very dependent on their levels of self-esteem, their self-concepts, their self-perceptions. This, of course, relates back to the earlier portion of this discussion related to these self-perception factors.
If a youngster is experiencing friendship related difficulties, the first level of understanding needs to be developed in terms of the parent/child relationships within which the young person is involved. Are those relationships open, accepting, warm, stable, and representative of a positive interpersonal style? Next, do the parents encourage and facilitate positive peer relationships for the youngster? Are people at home relatively spontaneous and approach-oriented in their relationships with each other? The idea is that helping young people with peer relationships starts, at a parenting level, with attention to relationships at home. Beyond that, though, peer relationships are very dependent on a young person's school adjustment, how accepted he is within the school environment, the level of physical and social skills the young person has, and the absence or presence of other physical, emotional, moral, social, sexual, or intellectual difficulties. When young people are experiencing continuing social adjustment difficulties, parenting is central to assisting with those difficulties. At the same time, though, the 'plus' needs to come through additional assessments and evaluations along with additional intervention that both understands and responds to the special needs and interest of the child. Generally, this is best accomplished through counseling and ordinarily through group-level interventions emphasizing relationship development and peer interaction.
Three additional variables conclude the rapid assessment process. Normal children generally handle day-to-day stresses and tensions reasonably well. When they do not, parenting needs to focus in the areas already discussed. If this does not seem to smooth out the management process for the youngster, additional assessment and intervention - parenting plus - are required.
Normal children are reasonably healthy. This is an important but sometimes overlooked area and needs medical attention if any problems or concerns develop. You will want to assist the parent in looking at minor to major health-related issues including low energy, frequent colds or infections, headaches, or other signs that the young person is not feeling well or is not functioning well physically.
Finally, normal youngsters talk about things with parents and with other adults. This includes talking about positive experiences, things that are going well, parts of their world with which they are comfortable. In addition, though, normal children seek out and talk with trusted adults when they are having difficulties, when things are not working out very well, when their lives are not going smoothly for them. Attention in this area starts within the family and emphasizes the priorities and processes discussed in earlier activities. Beyond that, though, the 'plus' in the parenting plan needs to include interaction between you and the youngster and the possible inclusion of counseling and ongoing guidance for the child and the family. When people are not talking with each other, the family system is shutting down. It becomes the responsibility of each member of the family and especially of the parents to assure that talking and listening are and continue to be the central aspect of family life.
As will have been noted, the activity as presented most appropriately applies to school-age children. You will want to use the same sampling approach for the rapid assessment of younger children. In these cases, you should first drop those variables from the above activity that apply less clearly to younger children. You will want to simply draw on his experience, knowledge, and expertise to select those variables in the original activity that are appropriate for the specific child and are to be retained. In addition, the variables selected below may be included especially for children in the age ranges indicated. The effect is modifying the activity to correspond with the child developmentally.
Birth to Two Years Old:
1. The child responds to familiar adults and other children.
2. The child seeks out familiar adults when under stress and when she is afraid.- Seeks out with eyes, by reaching, by moving toward the adult.
3. The child becomes more comfortable with people as more time is spent with them.
4. The child has regular sleeping habits and patterns.
5. The child relates to his caretaker comfortably and easily.
Two Years to Six Years:
1. The child handles new experiences fairly well.
2. The child shows an increasing ability to use language to communicate.
3. The child shows increasing social participation.
4. The child is showing an increasing ability to delay gratification.
5. The child is reflecting increasing gross and fine motor skills and coordination.
6. The child is reflecting increasing activities and interest outside of the family.
7. The child is reflecting increasing initiative and self-control.
8. The child is reflecting increasing friendship and playmate involvements.
The following additional variables may be useful when assessing elementary school youngsters.
1. The youngster is usually more interested in spending time with peers than with parents or other adults or by herself.
2. The child is able to adjust to or adapt to changes or disappointments.
3. The youngster reflects increasing frustration tolerance.
4. The youngster is able to entertain or occupy himself.
5. The youngster is content with her gender.
The following variables may be useful when assessing adolescents.
1. The young person reflects appropriate sexual behavior and interest.
2. The young person develops and maintains appropriate relationships with opposite sex peers.
3. The young person reflects good group level skills.
4. The judgment and decision making of the young person are consistent with his short-term and long-term self-interest.
5. The young person reflects increasingly independent judgment.
6. The young person has good driving habits.
7. The young person has a positive sense of her future.
8. The young person reflects good personal habits.
The chart in this section may be used as a convenient way of helping parents understand the nature of the problems and difficulties experienced by their children and those times when a parenting plus plan is needed. You may first assist the parents in determining the primary dimension within which the problem or difficulty is present. Of course, many problems and difficulties may reflect issues in more than one dimension. Generally, though, you should first encourage the parent to assign the problem or difficulty to the dimension in which it fits furthest from the bottom of the chart.
Next, you may help the parent understand the type of problem being experienced by the youngster. Real problems are those that are generally understood as illnesses, diseases, conditions, or problems experienced by the young person that are unrelated to external factors or events. Real problems would be seen as problems for any child, at any time, in any situation. This may be more easily understood in comparison to relative problems. Here, the functioning of the youngster is problematic mostly in terms of how that functioning compares to the functioning of other children. Relative to other children, the youngster's functioning is somewhat delayed or problematic.
Situational problems are those problems seen in youngsters whose functioning is generally free from real or relative difficulties. The particular problem comes up in relatively definable situations but is relatively absent in other situations. For example, the youngster may experience difficulties with emotional control at home but not at school, may have relationship difficulties at school but not with siblings or other children in the neighborhood, may be relatively well behaved in some situations but not in others. The problems are primarily situational.
Value based problems are perhaps the most common area of difficulty experienced between parents and children. Here, things like keeping rooms clean, good table manners, curfews, language usage, and similar value based conflicts develop. Basically, the problem is one of values and what is and is not valued. As can be seen, these types of difficulties are quite different from real problems, relative problems, and - to a lesser extent - situational problems.
When a problem or issue comes up between a parent and a child, you may first assist the parent in defining the problem in very clear and specific terms. The parent may then - with your assistance - select the cell on the chart that most commonly relates to the specific problem type. Once this is done, you may assist the parent in selecting other cells that 'may' relate to the problem. Parenting will first respond to the first cell selected. Additional assessment and evaluation will relate to the other 'possibility cells' developed by you and the parent.
As a general principle, real problems and relative problems require parenting plus plans. Situational problems and value problems are ordinarily quite appropriate for and responsive to good parenting. In addition, problems in the top three rows are more common to early elementary age and preschool-age children, while problems in the bottom three rows are more common to older grade school age children and adolescents.
Problem Dimension and Type
What is the definition of the problem?
|By Gary A. Crow, Ph.D. March 23, 2017|