The measurement of obsessive compulsive disorder in children and young people in clinical practice

Bennett, S.D. et al. Child and Adolescent Mental Health. 22(2) pp.100–112

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Background: If left untreated, obsessive compulsive disorder (OCD) can cause significant distress and impact on functioning throughout the lifespan. Despite the severity of the disorder, there is often a significant delay between the onset of symptoms and successful treatment. This is in part due to delays in recognising OCD symptoms in young people, particularly if the symptom forms are less common. Once OCD is accurately diagnosed, cognitive behavioural therapy (CBT) is known to be an efficacious treatment, sometimes in combination with medication, producing good long-term prognosis. It is therefore important to accurately detect OCD in children and young people so that they can be offered timely intervention. Use of the best tools in clinical and research settings improves detection and diagnosis, as well as enabling the tracking of progress through treatment. The aim of this current paper was to review measurement tools for OCD in young people with a focus on the practicalities of using tools in busy child mental health clinical settings.

Conclusions: There are several measurement tools with good psychometric properties that are useful for initial screening/identification of OCD, as well as formal diagnosis, symptom tracking and treatment evaluation. With the availability of brief screens, as well as online diagnostic measures, such tools should not be a burden on clinical practice, but rather a helpful aid to support clinicians’ assessment and treatment of OCD.

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Frequent interactions with grandparents lowers the age of autism diagnosis

Children who have older siblings or frequent interaction with grandparents are diagnosed with autism spectrum disorders (ASD) earlier than those who do not, according to new research | ScienceDaily

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Study results show that approximately 50 percent of friends and family members reported that they had suspected a child to have a serious condition before they were aware that either parent was concerned. Maternal grandmothers and teachers were the two most common relationship categories to first raise concerns

While interactions with grandparents and friends played an important role, family structure also impacted the age of diagnosis. Children with no siblings were diagnosed 6 to 8 months earlier than children with siblings. Among children with siblings, children with older siblings were diagnosed approximately 10 months earlier than those without older siblings, suggesting that older siblings may serve as a reference point, helping parents calibrate whether younger siblings are on target developmentally.

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Improving Early Identification and Intervention for Children at Risk for Autism Spectrum Disorder

Rotholz, D. et al. (2017) Pediatrics. 139(2)

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Objectives: To provide an example of a successful, novel statewide effort to increase early identification of young children at risk for autism spectrum disorder (ASD) using a 2-tiered screening process with enhanced quality assessment, interagency policy collaboration and coordination.

Conclusions: Improvements in early identification and intervention are feasible through collaborative policy change. The South Carolina Act Early Team and its key stakeholders committed to improving outcomes for this population used existing tools and methods in new ways to improve early identification of children with ASD and to make available evidence-based intervention services. This example should be replicable in other states with key stakeholders working collaboratively for the benefit of young children with

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Development and validation of brief scales to measure emotional and behavioural problems

Shen, M. et al. (2017) BMJ Open. 7:e012961

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Objectives: To develop and validate brief scales to measure common emotional and behavioural problems among adolescents in the examination-oriented education system and collectivistic culture of China.

 

Conclusions: Four brief scales were developed and validated among adolescents in middle schools of China. The scales have good psychometric properties with minor differential item functioning. They can be used in middle school settings, and will help school officials to assess the students’ emotional/behavioural problems.

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Automated assessment of early autism

ScienceDaily | Published online: 3 November 2016

anatomy-1751201_960_720Autism Spectrum Disorder is usually diagnosed in early childhood, but genetic detection of this brain disorder could mean more timely interventions that improve life for the patient and their carers. Research suggests that machine learning might be used to analyze genetic data that points to an ASD diagnosis before symptoms become obvious.

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Diagnosis and treatment of ADHD in Primary Care

Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder During Adolescence in the Primary Care Setting: A Concise Review

Attention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder with a worldwide prevalence of about 5% in school-age children. This review is intended to assist primary care providers (PCPs) in diagnosing and treating ADHD in adolescents.

PubMed, PsychInfo, and Science Citation Index databases were searched from March 1990 to 2015 with the keywords: ADHD, primary care/pediatrics and children/adolescents, abstracts addressing diagnosis and/or treatment with 105 citations identified including supplementary treatment guidelines/books.

Adolescent ADHD presents with significant disturbances in attention, academic performance, and family relationships with unique issues associated with this developmental period. Diagnostic challenges include the variable symptom presentation during adolescence, complex differential diagnosis, and limited training and time for PCPs to conduct thorough evaluations.

The evidence base for treatments in adolescence in comparison to those in children or adults with ADHD is relatively weak. Providers should be cognizant of prevention, early identification, and treatment of conditions associated with ADHD that emerge during adolescence as substance use disorders.

Adolescent ADHD management for the PCP is complex, requires further research, and perhaps new primary care psychiatric models, to assist in determining the optimal care for patients at this critical period.

Full reference: Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder During Adolescence in the Primary Care Setting: A Concise Review. Journal of Adolescent Health. Published Online:May 18, 2016