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Seven Clinical Problem Modules Social-Emotional Modules
or Patterns of Behavior Addressing
The following behavioral modules can be used as steps toward sorting
out confusing symptoms and behaviors, and in establishing a formal
diagnoses. Effort here has been made to condense multiple conditions,
as well as to separate them into several areas. A multi-risk child’s
problems may fit under more than one area or module. The screeners
are designed to help organize the direction of inquiry Although a diagnosis may be required either for services or a treatment course at a later time, it is believed that these several unifying patterns establish an empirical cause and effect on a continuum or spectrum and overlap. They thus require a multi-modal approach, which differs from the medical model in its single treatment management. This affords early intervention as well as ways to build protective factors promoting contextual resources such as have been developed in the Family Health Promotion Plan discussed under Our Practices - Part III. Many of these behaviors can be screened for early detection, using the Pediatric Screening Checklist available on public domain at http://psc.partners.org/. Other conditions can be screened from both of these sites: www.schoolpsychiatry.org and www.smhp.psych.ucla.edu. ORGANIZING MY THINKING ABOUT THE CHILD'S BEHAVIOR
1. Physical Health and Bodily System Problems: Conditions, such as poor sleeping, eating, toileting, low stamina, and sensory/motor sensitivities are some of these bodily system problems. It is likely that these biological and physiological features actually combine with environmental events that are conditioned by sensory and emotional features to form some of the problem behaviors below.
2. A Child’s Mal Temperament and Poor Goodness of Fit: Before a clinical condition should be pursued, one should check if there are constitutional or familial factors present which may determine biological styles of perceiving and responding which may become maladaptive when demands of the environment exceed the ability of the child. Understanding the temperament of the slow to warm child can take guilt away from the parent and offer a source of clarity to match with the child’s style.
3. Acting-out Behaviors: Such dys-regulatory and disruptive behaviors as tantrums, being mad or defiant, not paying attention, and hyperactivity are all forms of acting-out behaviors. Some of these have a strong genetic and neurobiological basis, while others may represent social and emotional expressions. Regardless, there are psychological and social impacts of these externalized adaptations that must also be managed. We believe that ADHD represents a prototype for disruptive behaviors, even though hyperactive, impulse and inattention can stem from a variety of such causes as medical sources, sleep apnea, mood, anxiety, environmental stress and abuse, and temperament. (Surprisingly, many children who may present with ADHD are predominantly the inattentive type.) We believe that by defining these behaviors, it’s possible to structure an early response including differentiating these other possibilities which may lead to further diagnosis later on, if necessary.
4. Acting-in Behaviors: Turning feelings inward, being worried, scared, sad, anxious, in despair, or crying: These hypersensitivities are most common in our species, and can be situational, or may be a genetic trait. Feelings may be expressed overtly or they may lie dormant and are apart of all of these dimensions and need to be sorted out. Those children who are more nonverbal from language and cognitive delays may express themselves more emotionally.
5. Cycles of Acting In and Out: 6. Disorganized Information Processing Affecting Learning, Memory, Language and Development: Severe learning disabilities and/or developmental retardation best describe this dimension. These atypical features of receiving information and processing it with a compromised adaptive response overlaps with normal variation often describing inter and intra-individual diversity and “goodness of fit” in determining the adaptive outcome. Families and society generally determine the acceptable limits and boundaries of social expectation. Richard L. Evans once qu oted, “Language is the dress of thought: every time you talk, your mind is on parade.” Although there are many categories, as with people, we generally feel that expressing life stories generally functions in achieving wants and needs through both cognitive reality processing and adequate language use, and that both require understanding and intervention. We also suggest that many of the above concerns regarding a child’s behaviors, feelings, moods and social expression will depend on these learning functions as well as determine his or her learning capacities. It’s important to see the impact of these styles on daily function to determine their severity. We use one of several adaptive behavior assessments. See “Assessment.”
7. Regulation of Social, Emotional and Sensory Communication:
Transition Statement to Next Topic _______________________________________________________ If the problem cannot be resolved, determine current teams that are operating and available, such as an IEP team, the Child Study Team, a DCFS Service Team, a Student Assistance Team, or a Child Guidance Team, and see if the child qualifies. A first-level problem-solving approach using many of the above ideas, will likely lead to more easily-resolved problems. Another level of awareness comes from combining knowledge already gained into the following context-based solution-findings in the World of the Child. This level is for more complex or unresolved situations requiring a greater understanding of both the breadth of challenges, as well as a possible multi-source range of solutions.
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not
necessarily to establish formal diagnoses. If conditions are responded
to before there is a diagnosis, then more everyday sorts of solution
may be started. There is a screener for most areas included along
with favorite web sites and other literature to help in the exploration.