Interview with Centro TAP: the detection of needs in children

Isabel Rodero and Victoria Jariego, from Centro TAP, talk about needs assessment in children.

Childhood is a stage in which we are able to adapt surprisingly well to many situations that present us with new challenges, but at the same time, it is also a phase of life in which we are psychologically vulnerable.

For example, something as simple as having problems following primary education classes can give rise to a set of complexes, gaps in knowledge and emotional imbalances that accumulate very quickly and, if not treated, can even take shape in adulthood.

That is why it is very important to have psychological and psycho-pedagogical help at the first signs that a child suffers from problems in some aspect of his or her daily life. In this case, we interviewed two professional experts in this field, Isabel Rodero López, pedagogue, and Victoria Jariego Cordero, psychologist, from Centro TAP..

Interview with Centro TAP: how is the accompaniment and evaluation in the detection of children's needs?

Isabel Rodero López and Victoria Jariego Cordero are part of the team of professionals at Centro TAP, an entity specialized in psychological and psycho-pedagogical care and whose facilities are located in Madrid. Throughout this interview, they explain the keys to detecting children's needs from their perspective as professionals in child care.

Are parents who take their children to the psychologist for the first time usually very confused about what the problem is affecting their children, or do they usually arrive having already made their own hypothesis about what is going on?

When families come to the center, it is usual that they come with a specific request, which may come from themselves, because they have detected that there is something that worries them at behavioral, social or school level, or in other cases they come for consultation at the suggestion of the tutor or the guidance department of the school.

Generally, the demands that come from the school have to do with learning difficulties and disruptive behavior in the classroom. And family demands have more to do with maladaptive behaviors, relational difficulties or difficulties in emotional management.

In some cases, the initial request does not correspond to the real problem of the case. In fact, in most cases, whether they involve children and adolescents or adults, the demand is usually based on what we call the symptom, which is only the tip of the iceberg. It is under this symptom where the problem of what is really happening lies.

It may be that we receive the case of a child with disruptive behavior in the classroom or with his family and what underlies this misbehavior is a destructuring of the family nucleus, a grief, a superior ability or a learning difficulty not detected in time, etc.

What are the first tasks performed in the psychology office to detect possible disorders in children?

Once we receive the family and the child, the reception takes on special importance. The child needs to feel the therapeutic context as a space of protection and care, where his or her privacy and that of his or her family is respected.

Therefore, one of the first tasks is to create an environment as warm as possible, which provides security and tranquility to the child and the family. Once we are in a safe environment, we can begin to take the first steps to make a proper diagnosis and subsequent intervention.

In some cases, at the request of the parents or because we have certain indications that there may be a problem related to high abilities, developmental disorder, attention deficit, dyslexia, autism spectrum disorder, etc., we conduct a comprehensive assessment with specific questionnaires.

This, in addition to helping us detect the existence of a disorder or associated difficulty, also allows us to assess the level of development of the child with respect to the average of the population of the same age and with its own average, that is, to know the strengths and weaknesses of the person, in order to implement an appropriate psycho-pedagogical intervention.

What role do families play in the process of diagnosing, for example, learning disorders in a child? What kind of valuable information do they usually provide?

The family is the close environment where the child develops. Parental educational models, socioeconomic level, social relationships, parents' level of education, can be risk or protective factors depending on the characteristics of the case.

If we focus on learning disorders, the information that the family can offer is related to several aspects that influence both the diagnosis and the treatment and prognosis: the genetic basis, the development of the basic evolutionary milestones, biopsychosocial development, etc.

In a first interview, we collect all the information related to the evolutionary, psychophysiological and social development of the child, since it is important to understand the social, family and personal aspects that may be influencing the specific case.

On the other hand, observation both in structured contexts (the office and the classroom) and in their natural environment, where the family acquires special relevance, are key for an adequate diagnosis and intervention.

Is it often the case that until the child goes to the psychologist the belief is maintained that the child has a problem of bad behavior, when in fact what is happening is that he/she has developed a psychological or neurodevelopmental disorder?

Disruptive behavior is the main reason for consultation in the child population since it is when conflicts are explicitly generated in the family and/or school context and, therefore, it is considered that there is a difficulty in the management of their behavior. However, when we evaluate the situation of the child in question, on many occasions, the misbehavior is the indicator that he/she is having other types of difficulties that have not been detected.

For example, in the clinic we find that, behind the misbehavior there may be low self-esteem, learning difficulties, low frustration tolerance, need for more attention from the family, jealousy, social skills deficits, hyperactivity and/or impulsivity, among other psychological factors.

Therefore, it is essential to carry out a complete assessment of the child to differentiate what his/her real needs are and, based on this, to carry out an individualized intervention to achieve a favorable evolution in his/her development, as well as to accompany the family to understand their child and offer them management guidelines in the natural context.

From what you have seen, do families need a lot of advice and constant supervision to understand what they should do at home so as not to slow down the progress of the therapy between sessions and do their part in consolidating it? Do they find it difficult to adopt new ways of relating to their son or daughter?

Families need counseling to understand what is happening to their child and how they can accompany them in their day to day life. In fact, at Centro TAP we consider that it is essential to work together with the family in order to generalize the tools and strategies that their children are learning in the sessions in their natural context.

From our clinical experience we can say that there is diversity in the involvement of the families in the therapies, observing that this influences the evolution of the children.

Some families are very involved, coordinating between parents to be aware of the progress of their child and carrying out the guidelines we offer to change the family relationship. While others give more responsibility to the work done by the children, so we do need to supervise with the parents the importance of their accompaniment in the therapeutic process to achieve the goals set more effectively.

Families that are less involved usually have more difficulty in adopting new ways of relating to their son or daughter.

How does a psychology center like yours work to motivate children to achieve the goals of the therapy?

At Centro TAP we believe that in order to work with children, it is essential to use a didactic methodology that includes games, stories, manual activities, drawings, videos, etc.

In addition, we adapt to the individual needs of each child, adjusting the dynamics to the interests of the children so that meeting the objectives is more attractive and they can be motivated in the process of learning and change. Of course, it is very important to adapt both the language and the activities to their evolutionary stage.

And how do you help these children to be fully aware of their progress?

On many occasions, children detect that they are feeling better or have evolved favorably but they do not know how they have achieved it, having the feeling that "they have done nothing".

Therefore, what we do in consultation is to assess with them what we wanted to achieve and how they are achieving it, specifying what tool they are using to achieve the goal. In addition, in each session we review what has been the evolution and we use positive reinforcement in each achievement to reinforce the strategy learned.