Ballou Education, Special Education Advocate
Bipolar disorder was not seen as a condition that was common in children or adolescents until recently. However, the past few years has seen a steady increase in the number of children who are being diagnosed, creating a need for researchers and experts to come up with assessment tools that were effective for children with bipolar disorder.
There is controversy over the subject of children who are being diagnosed, with some people being concerned that the label is being given too freely to children that may have another condition. There is concern that perhaps the child is being given the diagnosis due to pressure to find the reasons behind certain behaviors that perhaps could be treated.
Diagnosing bipolar disorder in children is very difficult, because no two children with the condition will exhibit the same symptoms. Also, many of the symptoms mimic other conditions, such as attention deficit hyperactivity disorder (ADHD) and other conduct disorders, and in some cases even just normal, childhood behavior that is misunderstood.
It is important to distinguish and recognize the correct diagnosis, because the treatments for conditions are going to be different. As an example, the medication that is used for children with ADHD acts as a stimulant. This could trigger manic episodes in children with bipolar disorder.
One assessment tool that has been used in the past to diagnose bipolar disorder in children younger than 18 years is the Kiddie-Schedule for Affective Disorders and the Schizophrenia-Epidemiological version (K-SADS-E).
These evaluative tools involve an interview process that is conducted by a clinician that is trained in its use. Normally, the age range for this assessment is 6-18 years old. In cases with younger children, generally the parent will go through the interview, and the interview will be repeated with the child. In the cases with teenagers, it is recommended that they be interviewed first.
The adult version of the scale, Schizophrenia and Affective Disorder Scales, is the assessment tool which is revised with children in mind. Questions will cover school issues and other issues related to children and adolescents.
The interview is assessed by taking into consideration interviews from parents, the child and other factors and sources of information. In cases of discrepancies between results of answers by parents and the child, it will be up to the trained clinician to evaluate the differences.
Symptoms are rated for current episodes and past cases of most severe episodes. The interview consists of an introductory process, and then the more in-depth screening section. The whole interview will take about 90-120 minutes to complete.
Since it is very difficult to be able to diagnose a condition as serious as bipolar disorder in children, it is crucial that all factors are taken into consideration before labeling a child with a condition such as this. It is important for all involved to come up with effective assessment tools for children with bipolar disorder to ensure that they are being given the proper treatment, so that they can learn to live and function with their condition.
RESOURCES
Child and Adolescent Psychiatry: The Assessment of Bipolar Disorder in Children and Adolescents
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915577/
The Journal of CHild Psychology and Psychiatry: Practitioner Review: The Assessment of Biplar Disorder in Children and Adolescents
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2786990/
American Academy of Child and Adolescent Psychiatry: Bipolar Disorder
https://www.aacap.org/aacap/Families_and_Youth/Resource_Centers/Bipolar_Disorder_Resource_Center/Home.aspx
Juvenile Bipolar Research Foundation: The Child Bipolar Questionnaire
http://www.jbrf.org/the-child-bipolar-questionnaire-for-families-use/
American Psychological Association: PSychological Science and Bipolar Disorder in Children and Adolescents
http://www.apa.org/science/about/psa/2006/07/youngstrom.aspx
Sacramento State: Assessment and Intervention for Bipolar Disorder
https://www.csus.edu/indiv/b/brocks/Workshops/NASP/BIPOLAR%20Summer%20NASP%2007.pdf
University of Maryland Medical Center: Biopolar Disorder
https://www.umms.org/ummc/patients-visitors/health-library/in-depth-patient-education-reports/articles/bipolar-disorder
MayoClinic: Bipolar Disorder
http://www.mayoclinic.com/health/bipolar-disorder/DS00356/DSECTION=tests-and-diagnosis
Eastern AHEC: Bipolar Disorder in Children and Adolescents
http://www.eahec.ecu.edu/brochures/E37876.pdf