Clinical Child
Psychology
Clinical Child Psychology
vs.
Pediatric Psychology
• Considerable overlap, but…
• Clinical Child Psychologists – typically work
with children and adolescents once
psychological systems have developed
– Usually in private practice settings or
outpatient clinics
– Diverse in orientation
– Traditional training (assessment, developmental
processes, family therapy)
Pediatric Psychology
• AKA child health psychology
• Usually practiced in medical settings
• Frequently intervene before psychopathology
develops
• More likely to adopt a cognitive-behavioral
orientation
• More short-term interventions
• Tend to emphasize medical and biological issues in
training, research and service delivery
History
• Remember – Clinical Psychology has
its roots in the assessment and
treatment of childhood disorders –
Witmer, Binet
• However, through the 20th century,
study of childhood psychopathology
was largely ignored – “adultmorphism”
• Neither Psychoanalysis or
Behaviorism recognized the unique
nature of childhood disorders
DSM-III
• The first version of the DSM to
make specific recommendations
concerning developmental
considerations in the diagnostic
criteria for childhood disorders
Nowadays
• DSM-IV: Over 2 dozen Axis I disorders specific
to children
• Several major journals concerned with children:
Journal of Abnormal Child Psychology, Journal of
Clinical Child Psychology
• Division 53 – Clinical Child and Adolescent
Psychology
• Division 54 – Pediatric Psychology
• New field of study: Developmental
Psychopathology – the study of childhood
disorders from a developmental perspective
Why the recent attention?
• Psychopathology relatively common in
childhood (8 – 22% of children diagnosed with
a behavioral, emotional or learning disorder)
• Many childhood disorders have lifelong
consequences
• Most adult disorders have their roots in
childhood disorders
• By studying childhood disorders, may be
better able to develop effective early
interventions
• Media attention to high-profile, child-related
problems (school violence, misuse/over-use of
meds, child abuse, etc.)
Issues Unique to Clinical
Child Psychology
• 1. Referral Issues
• 2. Developmental Considerations
– Rapid physical, social, cognitive and behavioral
changes
• 3. Infant Temperament (Thomas, Chess,
etc.)
• 4. Early Attachment (Object Relations
theory, Bowlby, Ainsworth)
Childhood Stressors
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Maladaptive parenting
Birth of a sibling
Exposure to poverty
Starting school
Parental conflict and divorce
Child abuse
Classification Issues
• Greater emphasis on empirically
derived classification
• Based more on research and use of
clinical rating scales
Assessment Issues
• As with adults, continued concern with
psychometric properties of the instruments
• Many of same techniques used
• However:
– More information supplied by adult referral services
– Cognitive maturation limits usefulness of self-report data
– Majority of referrals from schools, having to do with
school-based problems
– Almost always include concerns with behavior within the
family setting
– Issues of confidentiality
Treatment
• Talk therapy not really an option for
younger children – verbal skills, insight
• Play therapy
• Behavior therapy – especially operant
procedures
• Cognitive-Behavioral Interventions
• Biological Interventions – medication,
dietary modifications