Child and Adolescent Psychiatry: Development and Context
Core concepts
Developmental stage is central: symptoms must be interpreted against expected milestones and age-appropriate behaviour. Know the features of autism spectrum disorder (social communication deficits, restricted and repetitive behaviours, early onset), ADHD (inattention, hyperactivity, impulsivity across settings), and the anxiety and mood disorders of childhood. Understand attachment theory, separation anxiety, and the impact of family, school, and trauma. Recognise that children often present with behavioural rather than verbal symptoms.
Traps
Questions test whether a symptom is deviant for the child's developmental stage, and whether it occurs across settings (a key criterion for ADHD). Beware over-diagnosing normal developmental variation, and remember that consent and confidentiality involve parents and the young person differently depending on age and capacity.
Worked example
A 7-year-old is restless at school and at home, with academic underachievement and symptoms present before age 12. The rule of thumb: establish cross-setting presence, early onset, and functional impairment; exclude hearing, sleep, and psychosocial contributors before diagnosing ADHD.
Key points for revision
Always interpret symptoms against developmental norms.