How a Psychiatric Evaluation Works for a Child

What is a child's psychiatric evaluation for?

An evaluation helps clarify your child's emotions, behavior and current situation. From there, a mental health professional can decide whether your child would benefit from treatment or other support, and what might work best. It also helps sort out whether what you are seeing is related to changes or stress at home or school, or may point to a condition that calls for treatment.

It is not a test your child can fail, and you do not need to have a suspected diagnosis in mind. Parents usually come because something has been hard for a while. Grades may have dropped, mornings have turned into battles, or a teacher has raised a concern. If you are still deciding whether to seek help, our guide to ADHD signs in children may be useful.

What questions will the provider ask?

The American Academy of Child and Adolescent Psychiatry describes what a comprehensive evaluation frequently covers. Many parents find it helps to think through these topics ahead of time.

• The present problems: what you see, when it began, how often it happens and what makes it better or worse
• Health, illness and treatment, both physical and mental, including current medications
• Your child's development, such as early milestones and temperament
• School: how your child is doing with learning, behavior and friendships
• Family relationships and what has been happening at home
• Parent and family health and mental health history
• Interests, abilities and strengths, which matter as much as the problems

Who talks to whom during an evaluation?

Children often behave differently from one place to another, so a provider needs more than one point of view. This is the usual pattern, and it varies by child, age and clinic.

Will I be in the room, and will my child get to speak?

At DanShalom Behavioral Clinic, a parent or guardian must be present at appointments for patients under 18. A young person also gets room to speak for themselves. In general, providers may want an older child or teen to have some private time, since teens may struggle to share how they feel in front of family, even in supportive families. How that works here, and what would and would not be shared with you, is a good thing to ask us before the visit.

Mental Health America suggests asking any provider to explain what information will stay private and when they would need to share something for safety reasons. Knowing the answer can also help you explain it to your child.

What role does school information play?

School information is often central, particularly when attention or behavior is the concern. Children spend many of their waking hours at school, and a teacher sees them in a setting that a parent does not. The National Institute of Mental Health lists information from the child's school, such as standardized test scores and reports on behavior, capabilities and difficulties, as part of a comprehensive evaluation.

For an ADHD question, this matters even more, because symptoms have to appear in more than one setting. The American Academy of Pediatrics says a provider may want to see report cards, standardized tests and samples of schoolwork. Bring what you already have. Ask us what school information would be helpful for your child, and whether teacher forms are part of the process.

Are parents being judged?

Many parents worry about this. The American Academy of Child and Adolescent Psychiatry lists the worries parents commonly bring: Am I to blame? Am I silly to worry? Is my child normal? Its guidance is that providers are there to support families and be a partner, not to judge or blame.

Be as open as you can about hard things, including family stress, past treatment and mental health history in relatives. These details can change what a provider recommends. If you do not understand a word or term, ask for an explanation. You should not leave wondering what was said.

What comes out of an evaluation?

By the end, you should understand how the provider sees the problem, explained in terms that you and your child can follow. Sometimes the picture is clear after one visit. A comprehensive evaluation may take more than one, and sometimes more information is needed first, such as school records or a medical check. Our psychiatric evaluation page explains how we share impressions and next steps.

The result may be a diagnosis, such as ADHD, or a different explanation, or no diagnosis at all. Recommendations may include therapy, parent training or support, changes at home or school, or medication. If additional assessment would help, such as psychological or educational testing, ask us. A referral may be needed.

What does this look like at DanShalom Behavioral Clinic?

We see patients ages 5 to 65. You will meet with Victor Onodjacha, MSN, PMHNP-BC, a board-certified psychiatric-mental health nurse practitioner, in person in Sugar Land or by secure video if you are physically in Texas, Idaho, Arizona or Maryland at the time. You complete intake forms in a secure patient portal before the first visit, which lasts about 60 minutes. Follow-ups are about 30 minutes, with the same provider each time.

The next step, if you are ready, is the request form. We check coverage before the first visit, and the insurance page covers plans, self-pay and the sliding scale. Our guide to preparing a child for a first visit covers what to gather and how to explain the visit.

We are not an emergency service. If your child talks about suicide or self-harm, or cannot stay safe, call or text 988, call 911, or go to the nearest emergency department.