Articles from prior issues of The Advocate

September/October, 1998

Assessing Common Psychiatric and Neurological Impairments in Children
by Bob Perry, SSA

ARLENE REED-DELANEY, MD, CLINICAL Associate Professor of Psychiatry, Albany Medical College, Disability Review Psychiatrist with Albany DDS spoke on assessing neuropsychiatric impairments in children. Ms. Delaney stated that some common sources able to provide information pertaining to children are: parents, teachers, speech therapists, relatives, hospitals, and other agencies. It is important that the DDS adjudicator know how each of these people sees these children and how they report to the DDS regarding the child. In some instances special education teachers may present the child as doing better than they actually are, because in that setting (special education class) they may appear to be normal when compared to the other children. Some common presenting factors for these children are: attention problems, social problems, aggression; withdrawn behavior; anxiety and/or depression; thought problems; and delinquency. Children with Attention Deficit Hyperactivity Disorder (ADHD) usually do not play well with others. They present themselves as a problem. They often display hyperactivity and impulsivity as well as high levels of non-compliance. These children can be treated with medication. Ritalin has been shown to yield a 70% response rate in some cases. It is important for adjudicators to know the time that medication was administered as the medication usually causes a behavior modification. Other common impairments and their characteristics that are found in these children are:

Oppositional Defiant Behavior This condition usually presents itself as a loss of temper, tendency to argue with adults, easily upset, blames others, etc. An approach to treating this condition is finding out the underlying problem (e.g. is the child being treated differently than other?, is he/she depressed, etc.).

Conduct Disorder This condition is usually demonstrated by physical aggressiveness with peers, setting fires, swearing, cruelty to animals, etc.

Post Traumatic Stress Syndrome The child is afraid to leave the parent or experience nightmares. This is usually the result of the child having experienced intense fear, or witnessed or experienced a horrible act such as murder, sexual abuse by an adult, etc. These children are often angry, irritable, have difficulty concentrating and are uncooperative.

Autism These children usually are not able to develop relationships with people and they are difficult to communicate with. Autistic children tend to stay with one task indefinitely.

Mental Retardation This is another impairment commonly found in these children. This condition can be caused by prenatal situations or situations occurring after birth.

DDS adjudicators must access as much information as needed in order to resolve conflictive information when adjudicating these childhood cases. They should use the IEP and the Consultative Examiner when necessary.