The psychiatric diagnostic evaluation provided at the center meets the AACAP standards for assessment of an attachment disorder.
- Serial observations of the child interacting with his or her primary caregivers and history (as available) of the child’s patterns of attachment behavior with these caregivers. Given the association between a diagnosis of RAD and a history of maltreatment, the clinician should also gather a comprehensive history of the child’s early care giving environment,
- A relatively structured observation should be conducted and generally involves some combination play, teaching, and separation/reunion with careful observations of how the child behaves with the primary caretaker. The caregiver–child relationship forms both the basis of the assessment of RAD symptoms and the nexus for treatment of RAD.
- Screening of developmental delays, untreated medical conditions and speech and language assessment should be provided.
- Although the diagnosis of RAD is based on symptoms displayed by the child, assessing the caregiver’s attitudes toward and perceptions about the child is important for treatment selection.
And recommendations from The National Child Traumatic Stress Network on trauma assessment of young children:
Assessment of trauma in young children must focus on the presenting problem in the context of the child's overall development. This information can be gathered through interviews with the parents/significant caregivers in the child's life, observation of the parent/caregiver-child interaction, and standardized assessment tools. Clinical assessment should include review of the specifics of the traumatic experience(s) including:
- Reactions of the child and parents/caregivers
- Changes in the child's behavior
- Resources in the environment to stabilize the child and family
- Quality of the child's primary attachment relationships
- Ability of parents/caregivers to facilitate the child's healthy social, emotional, psychological, physical and cognitive development.
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