Children's Mental Health Assessment Scale

The Children's Mental Health Assessment Scale is a set of assessment tools that have been verified for standardized reliability and validity and are designed for children's cognition, emotion, behavior, social adaptation and other multi-dimensional psychological states. The core value is to assist in identifying children's psychological risks, rather than labeling children with "problem labels". Any single assessment result that is separated from clinical interviews and daily observations will not have diagnostic validity.

Last week, I was on duty at the psychological service point of the street social worker station, and I met a mother who was crying with her mobile phone. Last week, her second-grade son was criticized by the teacher for forgetting to bring his homework. He was bored at home for two days. She searched the so-called "Children's Depression Screening Form" online and filled it out for her son. The test showed "moderate depression" and she was paralyzed on the spot. We conducted a formal Children's Depression Inventory (CDI) assessment on the child, combined with interviews with the child and the class teacher, and found that it was a normal low mood, not even emotional distress. I watched two episodes of my favorite cartoon at home, and went to school jumping up and down the next day.

In the clinical assessment circle, practitioners with different backgrounds have quite different preferences for using scales. Psychiatrists with a medical background pay more attention to the "hard indicators" of the scale, such as whether the norm covers children of the same age in different regions across the country, and whether the reliability and validity have been repeatedly verified for more than ten years. The commonly used Rutter Children's Behavior Scale and Conners Hyperactivity Symptom Scale are mature tools that have been iterated over several generations, and their accuracy in screening the risk of developmental disorders and emotional disorders is indeed very high. But most psychology teachers in schools don’t think so. I have talked with many full-time and part-time psychology teachers in the district. They prefer to use the scale as a "stepping stone" - for example, if a child's hyperactivity index is measured to be high, they will not directly send the results to the parents. Instead, they will first look at the child's classroom performance records for a month, ask his deskmate if he really can't sit still, and even deliberately ask the child to come to the office to chat twice to confirm that it is not because the course is too simple or the child has already learned it. Then he will communicate with the parents about the follow-up observation plan.

What’s even more interesting is that most of the humanistic counselors are particularly wary of the “authoritativeness” of the scale. I attended a supervision meeting before, and a counselor said that he had encountered parents who took Conners’ assessment results and said in front of their children, “You need to see a doctor.” "Every student said you have ADHD. If you move around in class from now on, I will take you to take medicine." Originally, the child just couldn't sit still and had more energy than other children. Later, he really labeled himself "ADHD" and deliberately caused trouble in class, saying, "I'm sick anyway." They feel that the biggest side effect of the scale is that it easily turns "dynamic emotional states" into "fixed identity labels", which in turn harms children.

To be honest, I have been doing children's assessment for 6 years, and I have seen more "fake results" than real abnormal results. Last year, there was a 10-year-old boy whose score on the Screening Scale for Children's Anxious Emotional Disorders (SCARED) was almost twice the critical value, but his score on the validity scale was extremely high. I took him alone for 10 minutes and handed him an orange. Only then did I realize that he had filled out the test in a serious way on purpose. His parents forced him to enroll in three Mathematical Olympiad classes. He heard his classmates say, "If you have mental problems, you don't need to go to cram school." That's why he acted like this on purpose. You see, if you only look at the score on the scale, you might label this child as having an "anxiety disorder."

Many parents ask me, can they evaluate their children at home? In fact, it's not impossible, but you have to step on a few pitfalls. You must first choose the right applicable age. Children between 3 and 6 years old have not even fully developed their self-awareness and cannot make self-assessment scales at all. Those "depression self-assessments" for preschoolers on the Internet are all nonsense. Most of them use self-assessment scales for this age group, which must be filled out by parents and teachers, and combined with daily observations. Also, don’t worry too much about the score. For example, if your child has recently experienced a transfer to another school, a quarrel at home, or the death of a pet, it is normal for the emotional score to be high. If you take the test again after half a month, it may fall back to the normal range.

To put it bluntly, the Children's Mental Health Assessment Scale is like a thermometer at home. If the temperature is high, it does not necessarily mean that you have pneumonia. It may just be that you have worn too much clothes or just ran. But if the temperature is high repeatedly, you should be careful and go to the hospital. It is never a verdict that convicts the child, it just helps us see the unspoken emotions of the child earlier. If you really find that something is wrong with your child recently, don't blindly take a scale by yourself on the Internet. Go to a regular psychiatric department or psychological institution. The trinity of scale + interview + observation is the most reliable assessment.