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    History in Child and Adol

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    sanjibanipanigrahi
    This document provides guidelines for obtaining a thorough history from children and adolescents. It outlines important domains of information to cover, including school, social, home, and social media. Key areas of history include demographic details, informants, presenting complaints, history of present illness, predisposing factors, and personal history covering prenatal, natal, neonatal, developmental, family, and other relevant areas. The guidelines emphasize a developmental and systemic approach to understanding the child in the context of their family and environment.

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    History in Child and Adol

    Uploaded by

    sanjibanipanigrahi
    16 views32 pages
    This document provides guidelines for obtaining a thorough history from children and adolescents. It outlines important domains of information to cover, including school, social, home, and social media. Key areas of history include demographic details, informants, presenting complaints, history of present illness, predisposing factors, and personal history covering prenatal, natal, neonatal, developmental, family, and other relevant areas. The guidelines emphasize a developmental and systemic approach to understanding the child in the context of their family and environment.

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    This document provides guidelines for obtaining a thorough history from children and adolescents. It outlines important domains of information to cover, including school, social, home, and social media. Key areas of history include demographic details, informants, presenting complaints, history of present illness, predisposing factors, and personal history covering prenatal, natal, neonatal, developmental, family, and other relevant areas. The guidelines emphasize a developmental and systemic approach to understanding the child in the context of their family and environment.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    16 views32 pages

    History in Child and Adol

    Uploaded by

    sanjibanipanigrahi
    This document provides guidelines for obtaining a thorough history from children and adolescents. It outlines important domains of information to cover, including school, social, home, and social media. Key areas of history include demographic details, informants, presenting complaints, history of present illness, predisposing factors, and personal history covering prenatal, natal, neonatal, developmental, family, and other relevant areas. The guidelines emphasize a developmental and systemic approach to understanding the child in the context of their family and environment.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 32

    HISTORY TAKING IN CHILDREN AND

    ADOLESCENTS

    PRESENTED BY: DR NEETU GARG


    MODERATOR: DR. SANJIBANI PANIGRAHI
    DEPARTMENT OF PSYCHIATRY
    Getting history from child and adolescents is difficult.

    Information Domains:

    SCHOOL ( TEACHERS / CLASSMATES)

    SOCIAL (FRIENDS/ NEIGHBOURS)

    HOME (PARENTS/ SIBS/ RELATIVES)

    SOCIAL MEDIA
    “child” will be used for all children
    between 0 and 12 years of age and
    the term “adolescent” for those
    between 13 and 18 years of age.

    “infant” will be used for children


    0–12 months of age and “toddler”
    for children between 12 and 36
    months of age.
    NAME

    S/O, D/O:

    DATE OF BIRTH :

    Demographic AGE, SEX , RELIGION, ADDRESS


    details EDUCATION

    IDENTIFICATION MARK

    BROUGHT BY:
    INFORMANTS: ( INCLUDE PATIENT’S AS WELL IF SATISFACTORY
    INFORMATION IS AVAILABLE FROM THE PATIENT

    NAME, RELATIONSHIP,INTIMACY, LENGTH OF CONTACT,


    CONSISTENCY.

    RELIABILITY: RELIABLE, PARTIALLY RELIABLE, UNRELIABLE

    ADEQUACY: ADEQUATE/ INADEQUATE

    PRESENTING COMPLAINTS ( NATURE AND DURATION IN


    CHRONOLOGICAL ORDER)
    MODE OF ONSET:

    ABRUPT- SUDDEN APPEARANCE OF SIGNS AND SYMPTOMS WITHIN 48 HOURS

    HISTORY ACUTE: RAPID ONSET OF SIGNS AND SYMPTOMS WITHIN 2 WEEKS


    Insidious- Onset of signs and symptoms takes more than 2 weeks

    OF COURSE OF ILLNESS:

    PRESENT Continuous- Characterised by uninterrupted change without breaks or with steps infinitely

    ILLNESS small and thus not detectable e.g. Schizophrenia.

    Episodic- An illness can be said episodic when it has an onset and an offset of signs and
    symptoms of the disease with periods of recovery inbetween at least for a period of 2
    months e.g. affective illness, non affective remitting psychosis

    Fluctuating- When the course is waxing and waning especially under the effect of
    treatment. e.g. Obsessive compulsive disorder, Schizophrenia
    Progress of illness- To what extend has the
    patient’s symptomatology represented an
    evolution over time

    Improving- Improving from the date of onset


    e.g. Depression (with treatment)

    Deteriorating-Condition is getting worse by time


    e.g. Schizophrenia

    Static- Condition remains same no change


    happens e.g. Dysthymia
    Predisposing factors- Factors operating from early life that
    determines a person’s vulnerability to develop a disorder or
    likelihood that person will develop certain symptoms under
    given stress conditions.

    ! Biological (delayed milestones, head injury, family history of


    psychiatric illness)

    ! Psychological (impaired premorbid personality)

    ! Social (home atmosphere in childhood, neglect, abuse, low


    education level)
    Precipitating factors- Events that occur shortly before the
    onset of a disorder and act as physical or psychosocial
    stressors and lead to the onset of disorder in a person
    who may be predisposed to develop the disorder

    ! Biological (fever, accident, onset of severe medical


    illness)

    ! Psychological (stress intolerance, poor impulse control)


    ! Social (trauma, loss of job/partner)
    Perpetuating factors- Factors due to which
    the disorder is maintained or aggravated.

    ! Biological (chronic medical illness,


    substance use)
    ! Psychological factors (poor insight, poor
    impulse control, low intelligence)
    ! Social (social isolation, unemployment,
    ongoing expressed emotions in family)
    • Limiting factors- Factors which limit the illness from an extensive progress
    and may include factors such as good social support or treatment during the
    course of illness.
    • Modifying factors- Factors which modify natural or expected course of the
    illness. This includes factors such as use of substance by a patient with
    Schizophrenia which may lead to affective colouring of illness, use of
    antidepressants causing a manic switch in patient with depressive illness.
    • Age at which problem was recognised:
    • Persistent and Pervasive mood
    • Biological functions
    • Impact of illness in role functioning , activities of daily living, personal care
    and overall attitude
    ( interpersonal relation with parents , other adults, peers, interest in work/
    studies, play behaviour
    • Important negative history (rule out any childhood disorder)
    • Course of current episode and relevant treatment history(details of
    pharmacological/ psychological interventions, faith healing)
    • Past illness ( Physical / Mental Health related)
    • Family history (Nucler, joint, intact, broken)
    • Family Genogram( at least 3 generations)
    • Family history of Mental and Medical illness
    Personal History
    Prenatal History:
    • Planned/unplanned conception; wanted/unwanted child; attempted
    but failed abortion/threatened abortion/ bleeding during late
    pregnancy, RH incompatibility/ Trauma
    • History of gestational diabetes/ hypertension/jaundice
    • X-ray exposure, potentially harmful medications or substance abuse/
    infection/ fever/rash
    • Nutritional status of mother during pregnancy
    • Fetal movement
    Natal and NEONATAL HISTORY( BIRTH
    TO 28 DAYS)
    Delivery Delivery Head injury
    Term
    place type during birth

    Prolapsed Birth Color of


    Birth cry
    cord weight baby

    Congenital
    anomaly
    Postnatal History ( upto 6 weeks)
    • Infections
    • Jaundice
    • Feeding problems
    • Failure to thrive
    • Injury
    • Convulsions
    Feeding history
    Breast feeding
    Weaning age
    Immunization history
    HOME ENVIRONMENT
    • Physical environment (accomodation, no. of rooms)
    • Emotional environment at home (disturbed, broken home, step parents,
    adopted siblings, patients attitude towards parents)
    • Patterns of paternal functioning
    Permissiveness/ rigidity
    consistency/ inconsistence
    strictness of discipline/ liberal(any appropriate supervision)
    protectiveness/ non protectiveness (over protectiveness)
    Expectations from child ( any pressure)
    Pattern Of family dynamics

    (patients relationship with family members, interpersonal relationship with


    family members, decision making process, interaction pattern and family
    support system

    Reasons for the condition of child as perceived by family(including knowledge


    regarding illness, misconceptions , if any)
    Scholastic History

    • Type of school: normal school, special school, at


    home, religious schools
    • Age of entry
    • Schooling details ( mention changes in school,
    duration with reasons)
    • Scholastic Perfomances
    • Disciplinary actions
    • Attendance : regular/ irregular
    • Peer group adjustment
    • Relation with authorities
    • Play History
    • Play Behaviour : enjoys, not interested
    • Play preferences : Plays alone, with older, younger, peer group, animals
    • Behaviour while playing in group situations

    Sexual, Menstrual and marital History (in adolescent, if relevant)


    • Attained menarche: (age)
    • Details of menstruation( duration of cycle, regular, irregular
    • Gained sexual knowledge
    • Sexual activities ( child sexual abuse if any)
    • Marital History
    Temperament
    Information should be obtained regarding child’s temperament before
    the onset of symptoms if he has illness or when the child has been his
    most usual self if he has no illness.
    • Activity level: How active is your child? Do you find him so active that
    he runs rather than walks or is he inactive that he hardly moves?
    While eating does he eat staying still or does he keep moving about?
    • Are there periods when the child can sit still, or fidgetiness is there?
    (completely still/ very little movement/ always on the move)
    • ADHD
    • Attention span and persistence: If you try to interrupt your child’s
    activity, does he try to go back to it or does he forget it?
    • Is the child able to concentrate on the activity he or she is doing ?
    • Is the child easily distracted by say someone coming into the room or
    some noise outside the room?
    If your child finds a game or piece of work difficult, does he turn into
    another activity or keep on trying until he learns it? ( no persistence /
    continues till he achieves what he sets out to)
    • ADHD
    • Approach to or withdrawl from novel stimuli : what is your child’s first
    reaction when he meets children of his age for the first time? If he is
    given a new food or placed in a new situation , what is his first
    reaction?
    ( feels frightened, cries, withdraws physically, goes spontaneously)
    • Adaptability: If your child has been shy with some children , how long
    does it take him to mix and get friendly? Does he settle back in school
    routine quickly after a long holiday? ( No adaptability/ initial reaction
    of withdrawl is only momentary)
    • CHILDHOOD DISORDERS:
    HYPERACTIVITY
    ATTENTION DEFICITS
    IMPULSIVITY
    DISOBEDIENCE
    LYING
    STEALING
    EATING DIFFICULTIES
    • FEAR
    • SLEEP DISORDERS
    • SOMATIZATION
    • TEMPER TANTRUM
    • ATTENTION SEEKING BEHAVIOUR
    • ENURESIS, ENCOPRESIS
    • TICS
    • DISTURBED SOCIAL RELATION WITH PEERS, ELDERS
    THREE WISH TEST
    • It is a window test to know the Emotional condition of the child.
    If you could make three wishes, any three wishes in the whole world, what could they be?
    REFERENCES
    • IPS CPG GUIDELINES.
    • RUTTERS CHILD AND ADOLESCENTS PSYCHIATRY.
    THANK YOU !

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