What ongoing assessments are needed for a child with an anxiety disorder?

From the Guidelines

Ongoing assessment for a child with anxiety disorder should include regular monitoring of symptom severity, functional impairment, treatment response, and potential side effects of interventions, as recommended by the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1. The assessment should be comprehensive and include the use of standardized rating scales such as the Screen for Child Anxiety Related Emotional Disorders (SCARED) or the Multidimensional Anxiety Scale for Children (MASC) to track anxiety symptoms objectively over time. Some key points to consider in the ongoing assessment include:

• Regular monitoring of symptom severity and functional impairment
• Evaluation of treatment response and potential side effects of interventions
• Use of standardized rating scales to track anxiety symptoms
• Assessment of the child's academic performance, social functioning, family dynamics, and the presence of comorbid conditions
• Regular communication with parents, teachers, and other caregivers to gather information about the child's functioning across different settings. As noted in the clinical practice guideline, anxiety disorders are among the most common psychiatric disorders in children and adolescents, and the course of anxiety tends to be chronic, often with waxing and waning, and exhibits both homotypic and heterotypic continuity 1. Therefore, the assessment should occur at regular intervals, typically every 2-4 weeks during initial treatment and then every 1-3 months during maintenance phases, to ensure that interventions remain appropriate as the child develops and their circumstances change. For children on medication such as SSRIs, monitoring should include evaluation of therapeutic effects and potential adverse reactions, particularly during the first month of treatment, as highlighted in the guideline 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Ongoing Assessment for Children with Anxiety Disorder

Ongoing assessment is crucial for children with anxiety disorders to monitor their symptoms, adjust treatment plans, and evaluate the effectiveness of interventions. The following aspects should be considered:

• Baseline somatic symptoms: Evaluating the child's physical symptoms, such as headaches or stomachaches, to understand how they relate to their anxiety 2.
• Severity and impairment ratings: Assessing the severity of the child's anxiety and its impact on their daily life, including social and academic functioning 2, 3.
• Multimethod approach: Using a combination of assessment tools, such as semistructured interviews, questionnaires, and behavioral observations, to gather a comprehensive understanding of the child's anxiety 3.
• Differential diagnosis: Considering other potential diagnoses, such as depression or attention-deficit/hyperactivity disorder, to ensure accurate diagnosis and treatment 3.
• Treatment response: Monitoring the child's response to treatment, including cognitive-behavioral therapy (CBT) and medication, to adjust the treatment plan as needed 2, 3, 4.
• Combination treatment: Considering the use of combination treatment, such as CBT and selective serotonin reuptake inhibitors (SSRIs), which has been shown to be effective in treating anxiety disorders in children and adolescents 2, 3, 4.

Assessment Tools and Techniques

Various assessment tools and techniques can be used to evaluate children with anxiety disorders, including:

• Semistructured interviews: Standardized interviews that allow clinicians to gather detailed information about the child's symptoms and experiences 3.
• Child and informant questionnaires: Questionnaires completed by the child and their parents or teachers to gather information about the child's symptoms and behavior 3.
• Behavioral observations: Observing the child's behavior in different settings to understand how their anxiety affects their daily life 3.
• Cognitive-behavioral therapy (CBT): A type of therapy that helps children identify and change negative thought patterns and behaviors that contribute to their anxiety 2, 3, 4.