Children Exposed to Maltreatment: Assessment and the Role of Psychotropic Medication
Keeshin, Brooks ; Forkey, Heather ; Fouras, George ; MacMillan, Harriet L.
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Abstract
Pediatricians regularly care for children who have experienced child maltreatment. Child maltreatment is a risk factor for a broad range of mental health problems. Issues specific to child maltreatment make addressing emotional and behavioral challenges among maltreated children difficult. This clinical report focuses on 2 key issues necessary for the care of maltreated children and adolescents in pediatric settings: trauma-informed assessments and the role of pharmacotherapy in maltreated children and adolescents. Specific to assessment, current or past involvement of the child in the child welfare system can hinder obtaining necessary information or access to appropriate treatments. Furthermore, trauma-informed assessments can help identify the need for specific interventions. Finally, it is important to take both child welfare system and trauma-informed assessment approaches into account when considering the use of psychotropic agents because there are critical diagnostic and systemic issues that affect the prescribing and discontinuing of psychiatric medications among children with a history of child maltreatment.
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Keeshin B, Forkey HC, Fouras G, MacMillan HL; AMERICAN ACADEMY OF PEDIATRICS, COUNCIL ON CHILD ABUSE AND NEGLECT, COUNCIL ON FOSTER CARE, ADOPTION, AND KINSHIP CARE, AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, COMMITTEE ON CHILD MALTREATMENT AND VIOLENCE, COMMITTEE ON ADOPTION AND FOSTER CARE. Children Exposed to Maltreatment: Assessment and the Role of Psychotropic Medication. Pediatrics. 2020 Feb;145(2):e20193751. doi: 10.1542/peds.2019-3751. Epub 2020 Jan 21. PMID: 31964760. Link to article on publisher's site