Gathering Detailed Information
One local parent was told by a teacher “your son spends a lot of time in his own world”. It was not until later that this parent understood that for her child, this was an early warning sign of an emerging mental health problem.
Typically, neither parents nor school and child care providers are trained mental health professionals and, as such, should not attempt to diagnose mental health disorders. However, because of the amount of time that children and youth spend at home and in school, it is most likely the adults in these places who will notice the signs and symptoms that signal the need for help.
When making a referral to a pediatrician or mental health professional, the more specific and detailed information you can provide, the more useful the information will be in accurately assessing the child. The following list of questions can help you obtain information that is detailed and clear from the adults who spend the most time with the child.
INFORMATION GATHERING QUESTIONS
WHAT IS THE PROBLEM? Ask detailed questions about the specific behaviors that indicate a problem is present. Probe until you feel confident that you understand what the concern LOOKS like in the school and/or at home.
HOW INTENSE IS THE PROBLEM? Ask questions to help you understand how BIG of a problem this seems to be. It may be useful to ask for the intensity to be rated on a scale of 1-10. This can also help you to measure changes in the problem over time.
HOW LONG HAS THE PROBLEM BEEN HAPPENING? Ask questions to clarify when the problem was first observed.
HOW FREQUENTLY DOES THE PROBLEM OCCUR? Probe for specific details about how often the problem is occurring, especially when you hear generalities such as “the problem is happening all of the time.”
WHEN AND WHERE (TIMING AND SETTING) DOES THE PROBLEM OCCUR? Does it seem that the symptoms are only happening in school? At home? Do they occur most often before lunch or at recess? Are there times or places that the symptoms seem worse? Information about timing and the settings where the problem occurs can give valuable clues about the problem itself.
ARE THERE SPECIFIC THINGS OR PEOPLE THAT SEEM TO TRIGGER THE SYMPTOMS? Probe deeply to undertsand if there seem to be specific things that lead to the symptoms occurring or getting worse. Understanding these triggers can be invaluable in preventing and accurately assessing and treating potential mental health issues.
HAVE THERE BEEN CHANGES IN THE SYMPTOMS OVER TIME? Has the problem stayed the same over the course of 3 months? Is it getting steadily worse? By asking detailed questions about the concerning symptoms, it is easier to understand if this is a worsening problem or perhaps a problem that is slowly improving.
HOW IS THIS IMPACTING THE CHILD’S DAILY FUNCTIONING? One of the most important pieces of information to gather about a young person’s symptoms is the impact they are having on daily functioning. Changes in a child or adolescent’s emotional functioning present concern when his or her thoughts, feelings, or behavior become too difficult to manage and/or get int the way of the ability to cope with the everyday demands of home, school, and/or relationships. Awareness of the impact of the symptoms on every day life can guide the development of effective intervention strategies.
ARE/HAVE THERE BEEN ANY SIGNIFICANT CHANGES THAT HAVE OCCURED IN THE CHILD OR ADOLESCENT’S LIFE? Significant changes in a child or adolescent’s life are important to track as they may have a short- and/or long-term impact on his or her functioning. Examples of changes include things such as divorce or separation of parents, loss of a loved one, changes in family finances or jobs, a recent move, family health issues.
Click here to view a sample information gathering conversation between a parent and a concerned teacher. While this is only an excerpt of a longer conversation, it does illustrate how probing questions can help to clarify the issues of concern.
In addition to gathering detailed information from others, it is helpful for you to document your own observations. When you notice signs or symptoms that concern or puzzle you, document them in detail. Write down specifically what you see, how often it occurs, when, where and in what context you notice it, any triggers or factors that seem to make the problem better or worse, how the child responds to intervention, etc. This information will be a great help when making a mental health referral or when tracking the effectiveness of interventions or treatment over time.
An Observation/Recording of Symptoms Chart (opens in PDF format) is one tool for organizing information you observe about a child’s presenting symptoms. A filled out example and a printable blank chart are included for your use.