Diagnosis

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Because the symptoms of adjustment disorders may resemble other medical problems or psychiatric conditions, the child's physician should always be consulted for a correct diagnosis. A child psychiatrist or child psychologist usually makes the diagnosis after a comprehensive psychiatric evaluation and interview with the child and parents, including a detailed personal history describing development, life events, emotions, behaviors, and the identified stress. Early diagnosis and treatment can reduce the severity of symptoms, enhance the child's growth and development, and improve the quality of life.

Treatment

Individual psychotherapy uses cognitive-behavioral approaches to improve problem-solving skills, communication skills, impulse control, anger management skills, and stress management skills. Family therapy is often focused on making changes within the family system, such as improving communication skills and family interactions, as well as increasing family support among family members. Peer group therapy is often focused on developing and using social skills and interpersonal skills.

While medication has very little value in the treatment of adjustment disorders, it may be considered on a short-term basis if a specific symptom is severe and known to be responsive to medication.

adolescent immunization Experts recommend that all adolescents should have measles, mumps, rubella (german) measles, tetanus, polio, and diphtheria immunizations. Teenagers with diabetes or chronic heart, lung, liver, or kidney disorders need protection against influenza and pneumonia. chicken pox vaccine is recommended for those not previously vaccinated who have no reliable history of the disease. hepatitis B vaccine is indicated for all adolescents up to age 18 who have not been vaccinated before. Hepatitis A vaccine is recommended for adolescents traveling to or working in countries where the disease is common, and for those living in communities with outbreaks of the disease. It is also recommended for adolescents who have chronic liver disease or clotting-factor disorders, use illegal injection drugs, or are male homosexuals.

Adolescents not previously vaccinated against measles, mumps, and rubella with two doses of mmr vaccine require these. During childhood, teens should have received the DTap vaccine against tetanus, diphtheria, and polio. Immunization against tetanus and diphtheria (Td vaccine) should be supplemented with a booster shot at age 11 or 12, and every 10 years thereafter. One dose of chicken pox vaccine is recommended for adolescents 11 or 12 years of age (or two doses for those 13 or older) if there is no proof of prior chicken pox disease or immunization.

The flu shot or nasal spray should be given each year to all adolescents—especially those at high risk for complications associated with influenza. High-risk teens should not be given the nasal spray version of the vaccine, however. Immunization against pneumococcal disease is recommended for adolescents with certain chronic diseases who are at increased risk for pneumonia or its complications; a booster dose is recommended 10 years after the initial dose for this group.

As with any medicine, there are very small risks that serious problems could occur after getting a vaccine. However, the potential risks associated with the diseases that these vaccines prevent are much greater than the potential risks associated with the vaccines themselves.

adoption Nearly 70,000 children are adopted in the united states each year, including 8,000 international children and 10,000 children with special emotional or physical needs.

Adoptions may be arranged independently or through an adoption agency. An independent adoption usually requires the participation of an adoption attorney or counselor, physician, or minister. Adoption laws vary significantly from state to state. Adopting between states or from a foreign country also is possible, but it is more complex. Many prospective Caucasian parents want to adopt healthy babies who come from a similar background, but in the united states there are very few healthy Caucasian infants available. Most Caucasian infants are placed through agencies and independent adoptions.

African-American, Hispanic, and mixed-race infants are available both through public and private adoption agencies. However, the adoption of Native American children of all ages by non-Indians is strictly limited by the Federal Indian Child Welfare Act (P.L.95-608).

Many children with special needs are available for adoption. These children may be older; they may have physical, emotional, or mental disabilities; or they may have brothers and sisters who should be adopted together. Usually children like these are being cared for by the state and are placed in foster care. Both public agencies and some private agencies place children with special needs.

Families can get help in adopting a child with special needs from national, regional, and state adoption exchanges. Adoption exchanges and agencies usually have photo listings and descriptions of available children, and many now provide information about waiting children on the Internet. In many cases, adoption subsidies are available to help parents pay for the legal, medical, and other costs that can occur when caring for a child with special needs.

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