Infant psychiatry is a crucial domain of psychiatry which yet not discussed as much as other sub specialties of psychiatry(Child, adult or geriatric). As a mental health professional, educator or health worker, one should have brief orientation of infant mental health (IMH) or infant psychiatry. This presentation will provide a brief idea about assessment of infancy and early childhood.

1. Infant Psychiatry-”Assessment”
Dr Md Saleh Uddin
Assistant Professor
Department of Psychiatry, BSMMU
07.05.2020

2. Objectives
• Normal development
• Clinical models
• Clinical assessment

3. Clinical models

4. • ICD, DSM, DC:0-5
• DC:0-5 (Diagnostic Classification of Mental
health and Developmental Disorders of
Infancy and Early Childhood)

5. 1994 2005
2016

6. Axis-DC:0-3R
1. Clinical disorders
2. Relationship classification
3. Medical and developmental disorders
4. Psycho social stressors
5. Emotional and social functioning

7. Axis-DC:0-5
1. Clinical disorders
2. Relational context
3. Physical health conditions and considerations
4. Psycho social stressors
5. Developmental Competence

8. DC: 0-5 Disorders
1. Neuro developmental disorders
2. Sensory processing disorders
3. Anxiety disorders
4. Mood disorders
5. Obsessive Compulsive and Related disorders
6. Sleep, Eating and Crying Disorders
7. Trauma, Stress and Deprivation disorders
8. Relationship Disorders

9. Crosswalk
DC:0-5 DSM5 ICD10

13. Gap: Models and Assessment
• Standardized diagnostic interview (SDI):
DISC (Diagnostic Interview Schedule for Children)
K-SADS (Kiddle Schedule for Affective Disorders and
Schizophrenia)
DAWBA
(39%match)
• Instruments for rating problems
Official nosology based: Conners Rating
Scale(CRS)

14. “Models” Vs “Problems”
• Top down
• Bottom up
Expert
Children, Parent, Teacher

15. • Syndrome models:
a. Somatic problems, Social problems etc
b. Externalizing, Internalizing
• DSM oriented scale
• Cross informant comparisons
• Multicultural applications

17. Clinical Assessment

18. Principals of assessment
• Assessment of risk
• Parent want the best
• Biopsychosoical framework
• Developmental context
• Relational approach
• Vulnerabilities and strengths
• Transactional model

19. Target of Assessment
• Accurate diagnosis and formulation
• Maximize child's developmental potential
• Intervention and management planning
• Research

20. Rating scales and questionnaire
• CBCL
• SDQ
• ASQ-3
• PAPA
• PSI-SF

21. Assessing interaction
Observation
1. Parental Sensitivity
2. Childs Responsiveness
3. Their Fit
4. Their Safety
5. Parents’ Capacity

22. Ideal communication:
1. Contingent-Responsive
2. Collaborative-Participatory
3. Emotionally attuned- Identify and response

23. • Reflective or mentalising capacity
“Holding mind in mind”
PDI(Parent Development Interview)
• Play assessment
Modified Crowell Procedure
• Instruments:
1. Neonatal Behavior assessment scale (NBAS)
2. Bayley Scales of Infant Development(BSID)
3. Wechler Preschool and Primary Scale of Intelligence (WPPSI)
4. Vineland Adaptive Behavior Scale

24. Assessing Risks
• Within or context
• Risk and protective factors
• Cumulative risks
• Observation, Interview, Examination and
documents

25. • Types: Immediate, Developmental, Indirect,
Cumulative
• Greatest developmental risk: Neglect, Instability,
Parental mental health and Hostility

27. Parenting and Parenting capacity
• Needs & Protection
• Boundaries
• Potentials
• Recognize the needs
• Meet developmentally appropriate way
• Accept responsibility

28. CARE
CONTROL
DEVELOPE
MENT
CORE
PARENTING
ELEMENT

29. Parental Capacity determined by:
1. Parental factor
2. Child factor
3. Contextual sources of stress and support

30. Summary
• Models, Interview and Scales
• DC:0-3, Crosswalk
• Interaction assessment (observation and
tools/play)
• Parenting and parenting capacity

31. Reference
• https://iacapap.org/content/uploads/A.4-
Infant-assessment-2017.pdf