A Psychiatric Assessment Was Recommended for My Child. What Now?

There can be a lot of mental health stigma in our culture, and some parents may worry that a child psychiatric assessment means they’re a bad parent. In truth, it’s the opposite—it’s an act of love. Overcoming a difficult decision to have your child be evaluated by strangers is a sign of love and care. It means you’re an advocate for your child, showing up to help support your child despite any worries or concerns you may have. My job as a psychiatrist is to offer companionship in that journey—for both the child and the parents.

A psychiatric assessment may be recommended for a child when a parent, pediatrician, teacher, or therapist has concerns about the child’s behavior, emotions, or well-being. For example, angry outbursts, inattention, inability to follow instructions, sadness, or anxiety may all be reasons for psychiatric evaluation. This type of evaluation could also be helpful for children who have experienced an unexpected event, like a car accident, community violence, or a death in the family.

The purpose of a child psychiatric assessment is to help a child thrive. That may require changes to the child’s education, parenting, socialization, or medications. Sometimes, a child psychiatric assessment can help diagnose a child with a specific condition. Having that specific diagnosis helps parents advocate for that child within the school system—it may be much easier, for example, to persuade the school to provide the child with extra time for exams, extra breaks during the day, or preferential seating in class. 

An assessment can also give parents and schools a better idea of a child’s capabilities, which can help them tailor a child’s learning experiences to their needs. Results may also help a parent understand why their child is behaving in a certain way and what changes may be made to help both the child and the parents thrive. We, as psychiatrists, want parents to be able to support their child rather than feeling lost and frustrated.

At the actual assessment, a psychiatrist will typically evaluate a child’s functioning, capabilities, behaviors, and developmental milestones. They’ll ask the child some questions within an interview and may also use written tests or questionnaires to evaluate the child. They’ll also observe how the child interacts with their surroundings and, in some cases, how the child plays.

The assessment considers more than just the child’s responses. Psychiatrists are trying to understand that child’s whole journey, so we will also ask the parents or guardians questions about the child’s development, social interactions, and academic history. The child’s medical history is important, as well. For example, certain events and exposures in a child’s early life can increase their chances of behavioral conditions, such as attention deficit hyperactivity disorder. The psychiatrist may also want to speak with the child’s school or therapist, as they can provide valuable insight.

Sometimes, an assessment reveals that medication may help. I meet a lot of parents who are very hesitant to allow their children to take medication. That also comes from a place of care and love. I like to remind those parents that medication can be extremely helpful for some children, but that the parents ultimately make the decisions about whether their child takes medication. They’re the expert on their child, and I’m an expert on the science of child development, psychiatric conditions, treatment, and its potential impacts on a child’s future. The hope is for us to collaborate together in medical and psychiatric decision making. 

It’s important that a child is prepared for a psychiatric assessment and not surprised by it. Talk to them a few days before the appointment and again the night before and the morning of the appointment. Also, let them know that there aren’t going to be any shots, there’s not going to be anything that will hurt them, and we’re just going to talk. 

Tell your child that there may also be fun things to do at the appointment, as a lot of child psychiatrists have toys in their offices that are used as part of the assessment. You can also make a trip out of it—if you have to drive to another city, for example, make a stop at a children’s museum, park, or aquarium. We want this to be a stress-free and even fun bonding experience for both the child and the parents.

Neha Sharma is an associate professor at Tufts University School of Medicine and a psychiatrist at Tufts Medical Center who specializes in treating children and adolescents.