Blog Detail

4 Important Signs to Consider Before Booking a Behavioural Assessment

4 Important Signs to Consider Before Booking a Behavioural Assessment

Behavioural Assessments at a Child Specialist Clinic

behavioural assessment - child clinic malaysia
Behavioural Assessments

What is a behavioural assessment? Should I make an appointment?

A behavioural assessment is typically conducted to identify the risks of your child developing developmental disorders. If you’re worried that your child is exhibiting challenging behaviours that fall out of the age-appropriate range, you may want to consider making an appointment with your paediatrician for a behavioural assessment.

Challenging behaviours may include hyperactivity, impulsivity, aggression, difficulty sustaining attention and disruptions in learning. Concerns regarding a child’s speech development, emotional regulation, gross and fine motor skills can also be addressed at a behavioural assessment.

challenging behaviours
Figure 1: Examples of ‘challenging behaviours’

During the assessment, the paediatrician can identify whether your child is at risk of having a developmental disorder. They may then refer your child to a specialist, who can help to provide a definite diagnosis and a treatment plan. You may be referred to a child psychiatrist, a speech therapist, clinical psychologist or a child psychologist, depending on the outcome of the assessment.

Some of the main developmental delays or behavioural disorders that can be identified at a clinic include ADHD, autism, speech delays, dyslexia and learning difficulties.

Why should I visit a paediatrician if I can just go see a specialist directly?

Normally, booking an appointment to see a child psychiatrist, psychologist or even a developmental specialist takes time, as parents would be placed on a waiting list. On the other hand, seeing a paediatrician for a screening would usually be faster. More importantly, once the paediatrician has notified you that your child is at risk of having a developmental disorder, you can then start thinking about starting intervention and/or therapy.

Remember – It is a good thing to act quickly in seeking intervention for your child. Support provided earlier in life is likely to be more effective. It can also prevent any difficulties the child is facing from turning into more challenging behaviours.

early intervention 1
Figure 2: Early intervention is important and likely to be more effective

What happens during a behavioural assessment?

Here at FirstStep Child Specialist Clinic, the doctor will usually interview the parents before assessing the child. The doctor may ask about your family history, your child’s birth history, any health complications your child has faced, and their progress in school.

Different factors interact with one another to influence the overall development of the child. This is why it is important to share as much you can about the child’s background and history. Any previous health scares and notable incidents affecting the child’s physical, social and emotional well-being can help to inform the doctor before making a diagnosis.  

When appropriate, the specialist may use the M-Chat-R, which is an assessment tool (usually used in autism screening) that includes questions about the child’s behaviour.

dr assessment
Figure 3: The doctor may test the child by asking them to follow certain instructions

Based on the results of the assessment, the doctor will advise parents on whether any further evaluations are needed.

Should I be worried about my child’s development?

Understandably, some parents are uncertain on whether their child should be brought for a behavioural assessment. As a parent, you know your child best. If you are worried about your child’s speech, learning, play and movement, or if you think your child is not meeting the milestones for their age group, talk to a paediatrician and let them know your concerns.

Generally, if your child’s behavioural challenges interrupt their daily routine, or if they face issues that come up on a regular basis, you may want to consider getting advice from a specialist. At the same time, it is also important to assess the frequency and severity of the behaviours that are of concern. Remember, it is normal for children to have meltdowns and outbursts once in a while. Everyone has their bad days! 

Signs to look out for

Here are some indicators that it may be time to book an appointment for a behavioural assessment and seek advice from a professional:

1. Sudden, drastic changes in behaviour

bh changes
Figure 4: Drastic changes in eating, sleeping and studying can be indicative of a larger problem

Although it is considered normal for children to go through different phases, such as a new interest in different music and clothing, drastic changes to their usual behaviours might be a sign of psychological distress. 

For instance, if your child is sleeping too much, or not sleeping at all, it may be a warning sign. Changes in their eating habits or a deterioration in their academic performance also tend to be warning signs. 

2. Display of regressive behaviours

Regressive behaviours include throwing tantrums, bedwetting, being clingy or even being excessively frightened of strangers and new surroundings. Typically, these types of behaviours can be seen in children facing major life changes such as a parents’ divorce, a new sibling or moving houses. However, if your child is seen expressing these kinds of behaviours without it relating to any major life changes, it may be a cause for concern. 

3. Issues with social relationships

Another reason that may urge you to book a behavioural assessment is if the child is having issues with forming new relationships or struggling with their current friendships and family relationships. If they show a lack of enthusiasm or interest in participating in leisure activities and prefer their own companionship, it is possible that they may benefit from a behavioural assessment. 

changes in behaviours
Figure 5: Children that are struggling with social relationships may be a sign of a developmental disorder

Do note that if your child has always had a shy temperament or a more introverted personality, then this type of behaviour may not be indicative of a developmental disorder. However, if the change in their personality is significant, you may consider seeking advice from a professional. 

4. Expressing self-destructive behaviours / violent behaviours

Self-destructive or self-harming behaviours are when an individual behaves with the intention of physically causing harm to themselves. Children, in general, tend to scratch, hit or bite themselves. They may also pull out their hair or dig their nails into their skin. However, children usually are unaware of the harmful consequences of their self-destructive behaviours.

self harming behaviours
Figure 6: nail-biting and hair pulling are some ways that children can harm themselves when they are upset

Usually, self-harming behaviours are concealing deeper feelings that the child is unable to communicate. The child can benefit from seeing a child psychologist who can help to introduce the child to other different ways they can cope and manage their emotions.

Common Misconceptions regarding Developmental Disorders

Despite the rise in the number of clinics and centers that offer behavioural assessment services, some parents still remain hesitant to book an appointment. Furthermore, most people still have a lack of understanding of developmental disorders.

Let’s take a look at some reasons why parents may avoid behavioural assessments, and address some common misconceptions about developmental disorders in general. 

1. Stigma surrounding developmental disorders

Some people believe that informing children of their weaknesses may do more harm than good when in fact, it can do the opposite! When handled appropriately, helping children to understand their true learning styles can help to develop their self-esteem. Self-awareness will help them to identify when to seek help, which, in turn, will help them to become more successful. 

2. The belief that their child’s diagnosis would hold them back from excelling academically

Some parents believe that a diagnosis wouldn’t help their child to perform well in their academics. However, most children with learning difficulties or developmental disorders can actually learn very well and even enjoy learning! The point is that they require different environments or different teaching styles to stay engaged. They way some children process information differs from a typical student in a traditional school setting. A diagnosis from a specialist would be beneficial as it would help in finding the right special needs educator that can help your child to excel academically. 

teaching styles 1
Figure 7: Different teaching methods that children can learn from

3. The parent’s denial of the diagnosis

Certain parents refuse to acknowledge that their child has a disability. Instead, they may blame the child’s difficulties on the teachers, spouse and other environmental factors. Usually, this denial is indicative of the parent’s own fear that their child will struggle later on in life. Accepting the child’s diagnosis is most beneficial, as it will encourage parents to form a plan to address the issues and help the child progress.  

Key Points to Remember:

  • Behavioural assessments are not the same as a diagnosis. A paediatrician will usually help to identify (not diagnose!) any risk of developing developmental disorders
  • Early intervention is important in preventing more challenging behaviours
  • All children are expected to act out to some extent – consider the severity, frequency and duration of the child’s challenging behaviours. If it disrupts their ability to get through the day, it is a cause for concern

Thank you for reading our article on behavioural assessments!

If you have any questions, feel free to contact us! We are happy to answer any of your questions.

References

C. D. C. (2022). Why Act Early if You’re Concerned about Development?. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/whyActEarly.html

Childpsychologist.com.au. (2022). Child Behaviour Assessments | Child Behaviour Management. https://www.childpsychologist.com.au/mental-health-care/behaviour-assessments

Bird & Associates Psychological Services Inc. (2022). 5 Signs Your Child May Benefit From a Psychological Assessment. https://birdpsychological.com/children-adolescents/5-signs-your-child-may-benefit-from-a-psychological-assessment/

ACC Institute of Human Services. (2022). Developmental Disabilities – Myths vs. Facts. https://acc.edu.sg/en/developmental-disabilities-myths-vs-facts/