Children's Mental Health Questionnaire

The core positioning of the Children's Mental Health Questionnaire is an auxiliary tool for screening children's psychological risks. It cannot be directly equivalent to a diagnostic conclusion, and there is no universal version suitable for all children. Its core reference value depends on the matching between the questionnaire and the child's age and growth scene, as well as the professionalism of the interpretation of the results.

Last week at a child psychology free clinic in the community, I met a mother who was so anxious that she was crying. She was holding a screenshot of the assessment on her phone and said that her third-grade son was "moderately depressed" and asked me if I wanted to drop out of school. I took it over and took a look. What she was looking for was a self-rating depression scale for teenagers over 14 years old. There were several questions in it asking "Have you ever had thoughts of self-harm?"

Regarding the adaptation standards for children's questionnaires, there have been two different voices in the academic community. Researchers in the school of developmental psychology accept the truth and believe that it is necessary to strictly limit the biological age range. For example, the commonly used Strengths and Difficulties Questionnaire (SDQ) is officially divided into three versions: 3-4 years old, 5-10 years old, and 11-17 years old. It is not recommended to cross the age range if there is a difference of half a year. The reason is that children's cognitive and emotional expression abilities develop according to stages. A 6-year-old child cannot accurately distinguish the difference between "occasionally unhappy" and "always sad". The error in cross-age test results can reach more than 60%, which is no different from being blind. But most clinical consultants don’t think so, and I myself prefer this direction - after all, the growth environment of each child is very different. Children with precocious intelligence, children who have been left behind or have had traumatic experiences often have a mental age that is several years older than their biological age, so hard-coding the age will miss the risk. Two years ago, I followed up on a 6-year-old left-behind girl who usually lived with her grandma and was very silent. The teacher said she never played with children. I used the 5-10-year-old version of the SDQ to fill out her parents and teachers' evaluation papers. The emotional score reached the critical value. Follow-up follow-up found that she had severe separation anxiety. I intervened for more than half a year in advance, and now she is willing to take the initiative to say hello to others.

The first requirement of many parents when looking for a questionnaire is "accuracy". It is best to answer more than a dozen questions to know whether the child has any problems. In fact, this itself is a misunderstanding. To put it bluntly, the Children's Mental Health Questionnaire is of the same nature as the thermometer and blood pressure monitor you have at home. If you measure a fever at home, you can't just prescribe antipyretics for yourself, right? You must go to the hospital and let the doctor check whether it is a bacterial infection or a viral infection, right? What the questionnaire measures are only "risk signals". For example, if the score of inattention is high, it may be ADHD, or it may just be that he has not slept well recently, or he has already mastered the content of the class and feels bored. What the problem is can only be judged by professionals through interviews and daily observations. Don't just label the child with "ADHD" or "depression" based on the results of the questionnaire.

Oh, by the way, there is another very important point when choosing a questionnaire. Younger children must give priority to him to mark the questionnaire, that is, the kind that parents and teachers fill in. Do not let the children answer the questions themselves. A child between the ages of 3 and 6 does not even have a complete vocabulary for emotions. If you ask him "Do you often feel anxious?" he will not know what anxiety means, and the answer he gives will not be of reference at all. When the children reach third or fourth grade and their cognitive ability is sufficient, they can slowly add self-assessment papers. Comparing the two results, the accuracy rate will be much higher. Nowadays, many Internet celebrity questionnaires are for the sake of traffic. Children no matter how old they are are asked to fill in the questionnaires themselves, and the whole cool evaluation report looks very professional, but in fact it is of no use and can easily mislead people.

Nowadays, many people in the education sector are opposed to conducting large-scale mental health questionnaires on children. This worry is really not unnecessary. Two years ago, there was news that a school directly asked "Have you ever had thoughts of suicide" in a questionnaire to primary school students? Many parents protested, saying that their children had not had such thoughts in the first place, but became curious after being asked. Formal child questionnaires will blur such sensitive questions, such as changing them to "I feel like nothing is interesting in anything I do recently" and "I feel like no one likes me." They must be done under the guidance of professionals and will not directly throw pointed questions to children. After all, there is nothing wrong with the tools themselves, it is the people who misuse them that are wrong.

I have been working on child psychology for almost 8 years, and I have used no less than 20 standardized questionnaires. I still don’t think any questionnaire can replace daily companionship and observation. Last time, a mother came to me with a full score evaluation result and said that her child was fine, but she always felt something was wrong. She said that her child had been hiding in her room recently when she came home from school and would not talk to her about school. Later, after chatting for a long time, I found out that my child was bullied at school. I was afraid that my mother would scold him if I told him, so I deliberately chose all the positive options during the assessment. You see, scores can be faked, but the child's subconsciously evasive eyes, tightly clenched clothes, and little secrets that he is unwilling to share cannot be faked. Instead of looking for reliable questionnaires everywhere, it is better to spend more time squatting down and asking him if he encountered anything interesting at school today and if he was wronged - this is the most accurate "mental health questionnaire", right?