INFORMATION FOR PARENTS/CAREGIVERS

Psychoeducation is a fundamental step that provides both information and support to enable an individual (parent/family member) understand and cope with mental illness.

Educating Parents and Caregivers:

Disruptive and Aggressive behavior: though an inappropriate form of communication, a child who is unable to effectively communicate verbally may use behavior instead.

Self-help strategies for parents, caregivers and patients:

Sleep hygiene: Most sleep problems can be resolved by changing sleep habits that affect sleep. Use your bed for sleep (not for playing video game) to avoid the brain from associating your bed with sleeplessness.
Time out: may not 'work' in all situations. In most cases it works when parents/caregivers have 'adopted' a culture of praise or acknowledge good/positive behavior and also if the child is motivated to maintain being in the 'good' books for the parent/caregiver.
Functional behavior analysis: it is very helpful in more ways than one to identify why a particular negative behavior occurs frequently and what can be done to decrease the number of times it occurs.
Planning after a crisis: Seek professional help when you 'sense' something is 'off'. Parents/caregivers/patients should trust your 'instincts' and seek for help sooner than later. Always identify triggers, and safety concerns. Always LOCK UP ALL potential weapons. These include: medications/pills (both over the counter and prescriptions. Dispense pills daily; sharps (knives/blades), and Guns. Call 911 if you 'sense' that your child and or others are not safe due to his/her behavior. You can also call suicide hot line 1-800-273-8255 for help.
Behavior activation: The act of 'self-motivation' to do things that make one happy to improve their mood. If a child/adolescent is noticed to become withdrawn, and shows a decreased interest in previously enjoyable activities, it is 'time' to reengage them. This should be interpreted with 'caution.' Ask questions about bullying. It affects both the perpetrator and victim (www.stopbullying.gov)

Rating Scales:

Can be both helpful and useful for a Clinician and patient.
Unfortunately, are inherently 'imperfect' because questions can be misinterpreted or answered wrongly.
Should never be used solely to make a diagnosis. Interpret results in the context of a patient's situation

Academic Performance Problems: Assessment for possible cause could identify challenges in the following areas such as impairing mental health concerns; life distraction ( family and peers problems); Ability; School environment and Effort put into school work

Autism Spectrum Disorder:

Diagnosis can occur before, and after the age of 3 years old.
Not smiling in response to being smiled at
Not sharing attention with others
Lack of interest in other children
Not responding to his or her name by the age of 1 year
Not making eye contact
Mainstay of treatment involves socially focused interventions that encourage communication as early as possible.
Medication management primarily targets irritability and aggressive behavior.

A Brief version of DSM-5
Abbreviated DSM-5 criteria for common diagnoses
Diagnosis Criteria/Time Symptoms
Neurodevelopmental disorders

Excerpt from DSM-5® Pocket Guide for Child and Adolescent Mental Health, | Robert J. Hilt and Abraham M. Nussbaum, https://ebooks.appi.org/epubreader/dsm5-pocket-guide-for-child-adolescent-mental-health." Source. American Psychiatric Association 2013."

Attention-deficit/hyperactivity disorder

≥6 for ≥6 months:

Inattention: makes careless mistakes; cannot sustain attention; does not seem to listen; often does not follow through; struggles to organize tasks; dislikes mental effort; loses objects necessary for tasks; distractible; forgetful

≥6 for ≥6 months:

Hyperactivity/impulsivity: fidgets; leaves seat; runs or climbs; unable to remain quiet; on the go as if driven by a motor; talks excessively; blurts out answers; cannot wait turn; interrupts or intrudes without thinking.

Intellectual disability

Beginning in early childhood:

Deficits in intellectual functions confirmed by standardized intelligence testing; deficits in adaptive functioning

Autism spectrum disorder

Beginning in early childhood:

Deficits in social-emotional reciprocity; deficits in nonverbal communicative behaviors; deficits in developing and maintaining relationships

Stereotyped or repetitive speech, motor movements, or use of objects; excessive adherence to routines or excessive resistance to change; restricted interests of abnormal intensity or focus; hyperreactivity or hyporeactivity to sensory input

Specific learning disorder

Beginning during childhood DESPITE interventions to reduce difficulties:

Inaccurate word reading; impaired reading comprehension; spelling difficulties; difficulties with written expression; difficulties with numbers; difficulties with mathematics."

Initial visit at Unity Clinics:

Consultation with the doctor for psychiatric evaluation. This usually lasts 90 minutes. This involves discussing concerns that prompted the visit (history of present illness- mood,psychotic, and manic symptoms, .) A detailed history also includes the following- past psychiatric history of medications, inpatient admission(s), self injurious behavior (cutting self ); and suicide attempts. Also, important is developmental history as well as history of trauma, abuse, sleep, and appetite. Other information needed are social, medical and family histories. Information about school performance will also be asked about.

Discussion of diagnosis and plan
Baseline lab tests will be ordered. This can be done at your primary doctor's office or laboratory of preference. The results will be faxed to the clinic if done elsewhere other than at Lab Corp.

Bring with you the following (as it applies to you):

Most recent lab results/EKG if available
Most recent physical exam
Discharge summary from the hospital

Individual Educational Plan (IEP) report from school
Physician referral letter

Laboratory:

Lab Corp (closest to you) or Other lab of your choice

Psychological/Psychoeducational testing Referral will be done if indicated.