4.1 Severe Emotional Disorders Diagnoses Summary
This information listed here is pulled directly from the Diagnoses
Page. This provides the screener an opportunity to confirm that they have
selected the following mental health conditions for the child. The rest of
the questions on this page refer to symptoms or needs directly related to
these mental health diagnoses.
This question reflects long-standing policy to avoid cost shifting from the Department of Justice to the Family Support Program. If a child is an adjudicated delinquent, then the justice system is responsible for providing whatever assistance the child and family needs, and the child is not eligible for the Family Support Program. This includes youth being tried as adults.
"Adjudicated delinquent" means that a child-currently or within the past year-is or has been under supervision of the juvenile justice system because they violated the law, misbehaved, or posed a threat to others due to their conduct (Chapter 938 of Wisconsin State Statute). This does not include court orders for treatment, or a Child in Need of Protective Services (CHIPS) petition (Chapter 48 of Wisconsin State Statute).
The expanded clarifications below further define the applicability of "adjudicated delinquent" to the Family Support Program:
If item 1 is true, then the child is an "adjudicated
delinquent." If item 2 is true, then the child is not an
"adjudicated delinquent." When meeting with the family, ask to
see documents related to the crime and subsequent decision.
If the child has a clinical diagnosis of an emotional disability, has the diagnosis, or symptoms related to that diagnosis, persisted for at least six months?
If the child has a clinical diagnosis of an emotional disability, is the disability expected to last a year or longer?
Many of the questions on this CLTS FS page reflect current duration requirements for a Psychiatric Level of Care (LOC). Note that the Autism Spectrum Disorders are Mental Health diagnoses; the screener may check this box for children with those diagnoses. These include Asperger's, Autism and Pervasive Developmental Disability. Likewise, ADHD (Attention Deficit Hyperactivity Disorder) and ADD (Attention Deficit Disorder) are Mental Health diagnoses. All of these are diagnoses of an emotional disability and you must answer this question on this page for children with these diagnoses from a qualified professional (MD or Psychologist). Many people identify these diagnoses as developmental in nature. However, they are also considered a clinical mental health diagnosis and you must therefore answer this question accurately. Answering this question correctly will increase the likelihood of an appropriate functional eligibility determination for these children.
Regardless of the answer to these questions, complete the Mental Health
section for every child who has a mental health diagnoses. In addition, if
a child does not have a mental health diagnosis but is exhibiting mental
health symptoms or receiving mental health services, the screener can
indicate that on this page. Every question on this page relate directly to
mental health issues or concerns.
The minimal frequency of mental health and behavioral symptoms is lower than the criterion used for ADLs and IADLs. For the mental health symptoms, the screener should check the box if:
Does child have any of the following symptoms? (Check all that apply and enter notes below)
For Anorexia/Bulimia - Life-threatening Syptomology the effects of the eating disorders must include at least one of the following:
For Anorexia or Bulimia and Psychosis, there should be a corresponding diagnosis in the Diagnosis table of the CLTS FS.
Psychosis occurs only with severe mental conditions resulting in loss of contact with reality through delusions or hallucinations. A delusion is defined to be a belief that is pathological (the result of an illness or illness process) and is held despite evidence to the contrary. A hallucination, in the broadest sense of the word, is a perception in the absence of a stimulus. Hallucinations can occur in any sensory modality - visual, auditory, olfactory, tactile, and many others.
Violence is defined as life threatening acts that endanger another person's life. This life-threatening act must result in one of the following:
If the behavior does not meet this requirement, the screener may be able to
check one of the behaviors listed under the category: Aggressive or Offensive Behaviors on the Behavior Page of the CLTS
Does child currently require services from any of the following? (Check all that apply.)
"Require" is based on the qualified, treating professional's
recommendation that a specific service is essential to address the child's
identified mental health need. The professional recommendation must be
made within the past year. It cannot be solely based on parental desire
for services. Most children who require these services will be receiving
them, but on occasion a parent or child cannot, or will not, participate
in recommended services or the recommended services are not available. If
the parent or child has refused to access recommended services for over 12
months, then this recommendation is considered no longer valid.
These three conditions are rare and extreme and usually don't cause physical harm to the child or others. They are directly associated with mental health disorders and the child's ability to function throughout their day, every day, all day and night. They are usually not considered overt behaviors and are often better described as a lack of behavior or action. There are limited interventions because the condition appears to be a direct result of their mental health status. They are a measure of the severity of a child's mental health condition. Consideration needs to be given to these rare and extreme conditions as the severity of these circumstances is significant. The following three questions address these unique situations.
This question will only be answered in the affirmative in extremely rare situations. It is imperative that the screener confirm that the frequency of this disruptive behavior occurs "every 3 minutes or more often" all day, every day. The redirection must be for a disruptive behavior not simply lack of focus or off task behaviors. The disruptive behavior must be a direct result of their mental health condition. If a child has been removed from the regular classroom due to this behavior, check "no" unless they exhibit disruptive behaviors of this same intense frequency in alternative classrooms or school settings as well.
All children may have nightmares or even the occasional night terror. This question is intended for the child who has these intense experiences at least 4 nights a week, for months. If the condition does not meet this frequency, then check "no" and describe the situation in the note section.
In general, this question will be most appropriately answered in the
affirmative if the child has a diagnosis of a severe Obsessive Compulsive
Disorder or a severe Anxiety Disorder. Again, this is only going to be
answered "yes" in rare and extreme cases. This does not apply to
a child with sensory needs that cause them to engage in repetitive
behaviors. Keep in mind that the question indicates that the child must
be aware of the obsession but not be able to control the influence of
their own thought pattern. They would be able to express their awareness
of their own behavior and their desire to stop this behavior but an
inability to due to their mental health condition.
February 28, 2014