This leading text and clinical guide offers best-practice recommendations for assessing a comprehensive array of child and adolescent mental health problems and health risks. Prominent authorities present evidence-based approaches that can be used in planning, implementing, and evaluating real-world clinical services. Coverage encompasses behavior disorders, mood disorders, anxiety disorders, developmental disorders, maltreatment, and adolescent problems. The volume emphasizes the need to evaluate clients' strengths as well as their deficits, and to take into account the developmental, biological, familial, and cultural contexts of problem behavior.
|Publisher:||Guilford Publications, Inc.|
|Edition description:||Fourth Edition|
|Product dimensions:||6.80(w) x 9.90(h) x 1.80(d)|
|Age Range:||3 - 18 Years|
About the Author
Eric J. Mash, PhD, is Professor of Psychology in the Department of Psychology and Program in Clinical Psychology at the University of Calgary. He has served as an editor, editorial board member, and editorial consultant for many scientific and professional journals; and has published numerous books and journal articles.Russell A. Barkley, PhD, ABPP, ABCN, is Clinical Professor of Psychiatry at the Virginia Treatment Center for Children and Virginia Commonwealth University School of Medicine. Dr. Barkley has worked with children, adolescents, and families since the 1970s and is the author of numerous bestselling books for both professionals and the public, including Taking Charge of ADHD and Your Defiant Child. He has also published five assessment scales and more than 275 scientific articles and book chapters on ADHD, executive functioning, and childhood defiance, and is editor of the newsletter The ADHD Report. A frequent conference presenter and speaker who is widely cited in the national media, Dr. Barkley is past president of the Section on Clinical Child Psychology (the former Division 12) of the American Psychological Association (APA), and of the International Society for Research in Child and Adolescent Psychopathology. He is a recipient of awards from the American Academy of Pediatrics and the APA, among other honors. His website is www.russellbarkley.org.
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Assessment of Childhood Disorders
The Guilford PressCopyright © 2001 The Guilford Press
All right reserved.
Chapter OneASSESSMENT OF CHILD AND FAMILY DISTURBANCE: A BEHAVIORAL-SYSTEMS APPROACH
Eric J. Mash Leif G. Terdal
Almost from the time of their conception, children in North American society are assessed, evaluated, and labeled with respect to their physical condition, behavior, cognitive status, educational achievement, social competence, mood, and personality. These assessments are guided by the implicit assumptions about child development and behavior held by significant others and by society. Parents, teachers, physicians, siblings, peers, and community members all participate in this ongoing process, as do the children themselves. For most children, these evaluations occur during everyday social transactions and, to a lesser degree, during periodic formal evaluations best characterized as "routine" (e.g., regular medical checkups). As a result of these assessments, some children are identified as deviating from a normal course of development with regard to their behavior, physical condition, or violation of social norms and expectations (Kagan, 1983; Mash & Dozois, 1996). When a negative valence is assigned to these deviations, a child is likely to be informally labeled as belonging to a group of children who display similar characteristics (e.g., "difficult," "shy," "overactive"). Such childrenand their families then come to the attention of society's professional assessors, who utilize special strategies to build upon the informal assessments that led to the referrals (Kamphaus, 1993; Kamphaus & Frick, 1996; Mash & Terdal, 1988a; Messick, 1983; Ollendick & Hersen, 1993b; Reynolds & Kamphaus, 1990a, 1990b; Sattler, 1992, 1997).
Although there is much agreement concerning the need for systematic assessments of children-particularly children exhibiting problems, or at risk for later problems-there has been and continues to be considerable disagreement regarding how childhood disorders should be defined; what child characteristics, adaptations, and contexts should be assessed; by whom and in what situations children should be assessed; what methods should be employed; and how the outcomes of assessments should be integrated, interpreted, and utilized. Despite such disagreement, there exists a general consensus on the need for the development of assessment strategies not as an endpoint, but rather as a prerequisite for designing and evaluating effective and efficient services for children (Mash & Terdal, 1988b). Such a functional/utilitarian approach to the assessment of children and families is a major theme underlying this volume-one that transcends many of the conceptual and methodological differences and preferences that emerge in the current discussion.
This volume describes current approaches to the behavioral-systems assessment (BSA) of child and family disorders. BSA evolved from the concepts and methods of child behavioral assessment (Bornstein, Bornstein, & Dawson, 1984; Cone, 1987; Cone & Hoier, 1986; Evans & Nelson, 1977; Nay, 1979; Nelson & Hayes, 1979; Ollendick & Hersen, 1984), and continues to embrace many of its fundamental ideas, principles, and methods (Cone, 1993; Hayes & Follette, 1993; Mash & Hunsley, 1990; Mash & Terdal, 1988b; Ollendick & Hersen, 1993a). Among these are the importance of context in assessment; the view of assessment as an ongoing process; the use of multimethod strategies, including direct observations of behavior; the use of multiple informants; an emphasis on assessment information that will lead to the design of effective interventions; the use of empirically justifiable assessment methods; and the ongoing evaluation of treatment outcomes as an integral part of the assessment process. The purpose of this introductory chapter is to present the current concepts and practices of BSA with disturbed children and families, and to discuss some of the broader issues and implications surrounding their development and use.
In the introductory chapter to the first edition of Behavioral Assessment of Childhood Disorders, we stated (Mash & Terdal, 1981b): "Recognizing the likelihood of ongoing and future changes in assessment strategies related to new empirical findings, emergent ideas, practical concerns, and shifts in the broader sociocultural milieu in which assessments are carried out, this chapter-indeed, this book-should be viewed as a working framework for understanding current behavioral approaches to the assessment of children" (p. 4).
As reflected throughout the present volume, behavioral approaches to the assessment of child and family disorders have changed dramatically over the last two decades. Some of the more notable developments are as follows:
1. An increased emphasis on incorporating developmental considerations into the design, conduct, and interpretation of assessments (Peterson, Burbach, & Chaney, 1989; Yule, 1993); into the implementation of treatments (Kendall, Lerner, & Craighead, 1984; McMahon & Peters, 1985); and into the study of child and family psychopathology more generally (e.g., Cicchetti & Cohen, 1995a, 1995b; Hersen & Ammerman, 1995; Lewis & Miller, 1990; Mash & Barkley, 1996).
2. A heightened interest in issues related to diagnosis and classification, with concomitant efforts to integrate extant diagnostic practices with BSA strategies (Barlow, 1986; Harris & Powers, 1984; Kazdin, 1983; Last & Hersen, 1989; Mash & Terdal, 1988a).
3. An elaborated view of BSA as an ongoing decision-making process (Adelman & Taylor, 1988; Evans & Meyer, 1985; Kanfer & Schefft, 1988; La Greca & Lemanek, 1996). This view has generated interest in the judgmental heuristics that influence this complex information-processing task (Evans, 1985; Kanfer, 1985: Kanfer & Busemeyer, 1982; Tabachnik & Alloy, 1988), and has spawned efforts to develop both clinically and empirically derived decision-making models for specific clinical problems and populations (Herbert, 1981; Loeber, Dishion, & Patterson, 1984; Nezu & Nezu, 1993; Sanders & Lawton, 1993).
4. A growing attention to prevention-oriented and socially relevant assessments for high-risk populations. Such attention has emanated from current social issues and concerns, such as divorce (Emery, 1982; Hetherington, Law, & O'Connor, 1993), single-parent families and stepfamilies (Santrock & Sitterle, 1987; Santrock, Sitterle, & Warshak, 1988; Stevenson, Colbert, & Roach, 1986), working mothers (Cotterell, 1986), unemployment (Kates, 1986), children in day care (Molnar, 1985), poverty (Duncan, Brooks-Gunn, & Klebanov, 1994), accidental injuries (Peterson & Brown, 1994), child abductions (Flanagan, 1986), sexual abuse (Finkelhor & Associates, 1986; Wolfe & Birt, Chapter 12, this volume), family violence (Azar, 1986; Goldstein, Keller, & Erne, 1985; Kelly, 1983; Neidig & Friedman, 1984), teen delinquency and violence (Hinshaw & Anderson, 1996), substance use problems (Vik, Brown, & Myers, Chapter 15, this volume), and adolescent suicide (Petersen & Compas, 1993).
5. An increasing emphasis on understanding the interrelated influences of child and family cognitions (Crick & Dodge, 1994), affects (Dix, 1991; Gottman & Levenson, 1986), and behavior, as assessed within the context of ongoing social interactions (e.g., Bradbury & Fincham, 1987; Gottman, Katz, & Hooven, 1996; Gottman & Levenson, 1985; Hops et al., 1987).
6. The extension and assimilation of BSA concepts and practices into health care settings (Karoly, 1985; Strosahl, 1996) within the general frameworks of behavioral-developmental pediatrics (Gross & Drabman, 1990), pediatric behavioral medicine (Hobbs, Beck, & Wansley, 1984), and pediatric psychology (La Greca, 1994; Roberts, 1995).
7. A growing recognition of the need for empirically driven theoretical models as the basis for organizing and implementing assessment strategies with children and families (Mash & Barkley, 1996; McFall, 1986; Patterson, 1986; Patterson & Bank, 1986).
8. The introduction of technological advances, including the use of computers, the Internet, and the World Wide Web (WWW) during both the data-gathering and decision-making phases of assessment (Ager, 1991; Ancill, Carr, & Rogers, 1985; Carr & Ghosh, 1983; Farrell, 1991; Romanczyk, 1986). Suggested computer and WWW applications have included collecting interview, self-monitoring, and observational data; psychophysiological recording; training; organizing, synthesizing, and analyzing behavioral assessment data; utilization review; monitoring treatment appropriateness; and supporting decision making (Dow, Kearns, & Thornton, 1996; Farrell, 1991). Technological advances have led to a heightened interest in the utility and feasibility of using actuarial models in clinical decision making (Achenbach, 1985; Dow et al., 1996; Mash, 1985; Rachman, 1983; Wiggins, 1981).
9. Conceptual and methodological convergence on an ecologically oriented systems model (Belsky, Lerner, & Spanier, 1984; Bronfenbrenner, 1986; Hartup, 1986) as the appropriate framework for organizing and understanding assessment information derived from children and families (Evans, 1985; Wasik, 1984). This has led to a heightened interest in the assessment of whole-family variables (Forman & Hagan, 1984; Holman, 1983; Mash & Johnston, 1996a; Rodick, Henggeler, & Hanson, 1986) and the relationships between family systems and the broader sociocultural milieu (Barling, 1986; Dunst & Trivette, 1985, 1986; Parke, MacDonald, Beital, & Bhavnagri, 1988).
10. Increased recognition of the growing cultural diversity in North America and the need to consider culture, ethnicity, and religious beliefs in the assessment and treatment of children and families (Forehand & Kotchick, 1996; Foster & Martinez, 1995; Rowan, 1996; Tharp, 1991).
11. Further attention to accountability in assessment and to the development of cost-effective assessment strategies (Hayes, 1996; Hayes, Follette, Dawes, & Grady, 1995). Such attention has been fueled by the growing concern for reducing costs within changing health care systems (Mash & Hunsley, 1993a; Strosahl, 1994).
12. Increased emphasis on the evaluation functions of behavioral assessment in light of a growing concern for empirically validated treatments (Hibbs & Jensen, 1996). This concern has focused attention on the need to develop meaningful and practical outcome measures for use in clinical practice (Clement, 1996; Mash & Hunsley, 1993b; Nelson-Gray, 1996; Ogles, Lambert, & Masters, 1996), and to develop methods for the analysis of change (Gottman, 1995; Gottman & Rush, 1993).
It is apparent from this brief and selective overview of recent developments that current behavioral-systems approaches to child and family assessment are complex and varied. These approaches are best conceptualized within a broad assessment framework that examines a child's functioning in the context of the social systems and decisional processes in which the child and family are typically embedded. The current view of BSA extends well beyond earlier views of child behavior assessment as being synonymous with the direct observation of target behaviors.
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Table of Contents
1. Assessment of Child and Family Disturbance: A Developmental–Systems Approach, Eric J. Mash and John Hunsley
II. Behavior Disorders
2. Attention-Deficit/Hyperactivity Disorder, Bradley H. Smith, Russell A. Barkley, and Cheri J. Shapiro
3. Conduct and Oppositional Disorders, Robert J. McMahon and Paul J. Frick
4. Adolescent Substance Use and Abuse, Ken C. Winters, Tamara Fahnhorst, and Andria Botzet
III. Mood Disorders and Suicide Risk
5. Child and Adolescent Depression, Karen D. Rudolph and Sharon F. Lambert
6. Pediatric Bipolar Disorder, Eric Youngstrom
7. Adolescent Suicidal and Nonsuicidal Self-Harm Behaviors and Risk, David B. Goldston and Jill S. Compton
IV. Anxiety Disorders
8. Anxiety in Children and Adolescents, Michael A. Southam-Gerow and Bruce F. Chorpita
9. Posttraumatic Stress Disorder, Kenneth E. Fletcher
V. Developmental Disorders
10. Autism Spectrum Disorders, Sally Ozonoff, Beth L. Goodlin-Jones, and Marjorie Solomon
11. Early-Onset Schizophrenia, Michael G. McDonell and Jon M. McClellan
12. Intellectual Disability (Mental Retardation), Benjamin L. Handen
13. Learning Disabilities, Deborah L. Speece and Sara J. Hines
VI. Children at Risk
14. Child Abuse and Neglect, Claire V. Crooks and David A. Wolfe
15. Child Sexual Abuse, Vicky Veitch Wolfe
VII. Problems of Adolescence
16. Eating Disorders, Eric Stice and Carol B. Peterson
17. Personality Disorders, Rebecca L. Shiner
Practitioners, researchers, and students in child clinical psychology and related fields. Serves as a core text for advanced undergraduate- and graduate-level courses in child assessment, child psychopathology, and child therapy.