Assessment to Intervention
The primary task of the child clinician is to identify and treat those children who suffer from emotional and/or behavioral problems that significantly interfere with their development or functioning and are likely to persist without intervention. The first step in accomplishing this complex task is a careful assessment of the presenting problem. The assessment process helps the clinician determine which problems are clinically significant and might benefit from treatment, and which are only annoying and/or transient. The second step, intervention, is necessarily dependent on the quality of the assessment. In addition to determining whether particular behaviors are clinically significant, the assessment process must determine what factors contribute to the problem and what the target areas for intervention should be. Furthermore, a careful assessment informs the clinician about which treatment methods are developmentally appropriate for each child and family. In order to accomplish this task, the clinician must take into account the developmental level of the child; the potential biological influences on the child's functioning; and the broader ecological factors (familial, social, and cultural) that interact with children's characteristics. Moreover, the clinician must have knowledge of empirically validated treatment approaches, as well as of ways to document treatment progress for individual cases. In this chapter, we focus on the assessment-to-intervention process in general. First, we discuss issues of diagnostic classification, and review estimates of prevalence for childhood problems. Next, we present a comprehensive assessment-to-intervention system that is adapted to specific problems as they are covered in later chapters. Methods of assessment that we have found most useful in clinical practice are also discussed. Finally, issues central to the treatment process are covered.
Assessment and diagnostic classification are parts of a single process. Assessment identifies the distinguishing features of an individual case, whereas classification groups cases according to these features (Kamphaus & Frick, 1996). Some of the benefits of classification systems include (1) promotion of communication among professionals, since each system of classification defines the rules for distinguishing a particular disorder from normal functioning and facilitates reporting of data; (2) translation of research into practice, since classification allows