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Child & Youth Mental Health Algorithm - GPSC

Child & Youth Mental Health Algorithm - GPSC

Current Functioning at

Current Functioning at Home (depending on age, some may not apply). Give frequency and/or details:Family/patient strengthsStressors within the familyPast:Present:Family atmosphereMorning routineAttitudes towards chores(adult: doing housework)Attitudes towards rules(adult: able to set/follow rules)Engagement in family funDiscipline in the family(adult: parenting abilities)Relationship to siblings(adult: partner relationship)Parent/spouse frustrationsSocial Functioning (depending on age, some may not apply). Give frequency and/or details:Patient's strengths:Hobbies, activitiesFriends (e.g. play dates,parties, social events)Social skills (e.g. social cuescompassion, empathy)HumourAnger management(e.g. aggression, bullying)Emotional intelligence (e.g.emotional control, awareness)Sexual identityCADDRA ADHD ASSESSMENT FORM 7/1293

Functioning at School (if not at school, indicate where academic history took place and if there were difficulties)School name English Second Language Individual Education Plan Specialized ClassSpecialized Designation Details:Kindergarten to Grade 8High SchoolReport card gradesReport card commentsBehaviour problemsPeer relationsTeacher-child relationshipsTeacher-parent relationshipsHomework attitudesOrganizational skillsAchieving potential/difficultiesWritten outputAccommodationsTutoring and/orLearning assistanceAssistive TechnologyCollege/UniversityAccommodationsAchieving potential/difficultiesFunctioning at Work (depending on the subject’s age, some may not apply) Frequency and/or details:Current employment status: FT PT Unemployed Self-employed Contract DisabilityVocational Assessment: No Yes If yes, suitable jobs:# of past jobs: Length of longest employment:Work strengths:Work weaknesses:Complaints:Workplace accommodations:Other information about work:94 Version: January 2011. Refer to www.caddra.ca for latest updates.CADDRA ADHD ASSESSMENT FORM 8/12

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