This issue of Child Psychology and Psychiatry Review is devoted to consideration of the new Needs Assessment Framework for children and families who are the concern of Social Services Departments, the new Youth Justice Assessment for children and young people who break the law, and the processes for the assessment of special educational needs. The new frameworks provide different professional approaches to children and should have a significant impact on the work of all professionals involved with children and families. In many cases the processes of all three areas should overlap and be integrated.

This paper highlights the many complex psychological needs of paediatric patients in intensive care. The literature on the experience of children in intensive care and their relatives is reviewed and related to the work of a paediatric psychologist. Case examples are given of direct work with children and suggestions are made of ways in which the psychologist can work in a consultation/liaison capacity. The personal impact of this work is addressed, as is the need to disseminate information to other health professionals. Further research is called for, both on the child's experience and on the development of appropriate psychological interventions.

Although research has demonstrated the differential influence of schools on children's psychosocial adjustment, the influence of radical legislative changes since 1979 is less clear. Evidence of a sharp rise in exclusions and in referral for special educational needs is contrasted with evidence that behaviour in most schools is good, and with data showing a steep reduction in the number of pupils leaving school with no qualifications. It is argued that these reforms have improved overall standards and may thereby have contributed positively to the mental health of many vulnerable children. However, the way they have been implemented has undermined teachers in some schools and, as a result, pupils there experience education as an additional source of stress rather than of stability and support.

Obsessive-compulsive disorder (OCD) is estimated to affect between 0.5% and 2% of children and adolescents. The majority of clinical cases has both obsessions and compulsions. Depression, anxiety and tic disorders are common comorbid diagnoses, and assessment can therefore be complex. Several theories have been proposed for the aetiology and maintenance of the disorder, including cognitive-behavioural and neuropsychiatric theories. Cognitive-behavioural and pharmacological treatments are both probably efficacious therapies for children and adolescents but further research is needed to compare these treatments with each other, and to examine the use of combination therapies in controlled trials.

Professionals working in child and adolescent mental health services are increasingly encouraged to examine the evidence underlying their clinical practice. Embracing evidence-based practice can present difficulties, as barriers to changing practice exist. These difficulties are examined, along with the meaning of evidence-based practice in a multidisciplinary speciality, and the potential benefits that develop from it.

The establishment, operation and theoretical basis of a multi-disciplinary, Tier 3, risk assessment team based in a Child and Adolescent Mental Health Service (CAMHS) is described. The work is based on the premise that a multi-disciplinary team, with a degree of statutory independence, assessing forensic issues within a systemic and developmental context, offers a useful contribution to the comprehensive assessment of risk and provides a valuable and valued service to statutory agencies and the courts. The team is used by Social Services Departments and the courts as an independent assessor of the risk parents and potential carers pose to children. An evaluation of 39 referrals, carried out over the last 3 years of operation of the parenting risk assessment team, is given.

The Framework for the assessment of children in need and their families (Department of Health et al., 2000) has been developed to provide a systematic way of analysing, understanding and recording what is happening to children and young people within their families and the wider context of the community in which they live. From such an understanding of what are inevitably complex issues and inter-relationships, clear professional judgements can be made. These judgements include whether the child being assessed is in need, whether the child is suffering or likely to suffer significant harm, what actions must be taken, and which services would best meet the needs of this particular child and family. The Assessment Framework was issued jointly by the Department of Health, Department for Education and Employment and Home Office. It was issued as Section 7 Guidance under the Local Authority Social Services Act 1970, which means it must be complied with unless local authorities can justify why not.

This study set out to evaluate the use of a video based parent training programme (The Webster–Stratton Programme) in the management of children referred to child mental health services for treatment of behaviour problems. Following diagnostic assessment children were assigned to one of two groups: parents of both groups completed the parenting programme and, in addition, in the second group the child received an intervention appropriate to his/her clinical presentation. The waiting list control group waited 3 months prior to allocation to either treatment group. Standardised rating scales were administered pre-treatment, post-treatment and at 6-month follow-up to both treatment groups, and at an interval of 3 months to the control group. Improvement was significantly greater in both the treatment groups than in the control group. Parenting training programmes are an effective intervention in the management of clinic-referred children with behaviour disorders.

The argument for evidence-based child and adolescent mental health services is irresistible. Indeed, I have yet to meet a mental health practitioner who has told me that his or her work was not based on evidence. The exam question, however, is ‘what is the best evidence?’ In a helpful contribution to the current debate about evidence-based practice, Ramchandani, Joughin and Zwi point out that the answer depends on what the question was in the first place. They argue that while some clinical questions are best tackled using quantitative methods such as randomised trials, other questions are better answered using different techniques. Traditional hierarchies of evidence that give primacy to randomised trials may not always be appropriate to child mental health practice.

This study reports on a nation-wide survey of a randomly selected group of child psychiatrists and examines their prescribing practices for a wide range of psychotropic medication in a wide range of disorders. Despite 98% of the sample valuing medication as a treatment modality, one third of clinicians prescribed rarely or not at all. More than three-quarters felt insufficiently competent in this area, a finding which was significantly associated with less frequent or no prescribing. Half of the sample believed that if they were better informed they would prescribe more and 91% requested regular psychopharmacology seminars.

The Framework for the Assessment of Children in Need and their Families signifies a major achievement in the development of a coherent approach to promoting the welfare of children while safeguarding them from harm. In this article, the aspirations of the Framework are considered, with particular focus on the challenges posed by the Framework, not only to the practice of social workers but also to the status of the social work profession. The area of professional judgement making is discussed, along with the threats to the effective implementation of the Framework. The author concludes that the Framework could bring about not only a better deal for children and families service users, but a new era of professional respect for social workers.

The model outlined in the paper by Partridge, Casswell and Richardson is an interesting one. Its strengths are particularly the multidisciplinary nature of the assessment and its extension over a period of time, allowing for the assessment to be also a therapeutic process. It stands in contrast to many single-handed expert assessments carried out as a cross sectional view of the family at one particular point.

The decision not to meet with the children is understandable on the basis that the children may well have been seen by other professionals. However, since parenting is a dyadic interaction it can only be observed by meeting with both parents and children together. The notion of risk and assessment of risk is broader than the risk posed by an adult or parent to a generic child. Beyond a capacity to injure and physically or sexually abuse, risk extends to emotional abuse or injury and emotional neglect, insensitivity or inability to meet the child's developmental needs. An assessment of these capacities is best related to the needs of particular children and includes issues of attachment. These can only be assessed by meeting with the children and/or the children and parents together.

The addition to the team of an adult psychiatrist with a particular interest in personality and the influence of early experiences on adult functioning has been found to be of great value.

An alternative model is the multi-family intensive assessment process, during which several families attend together for a short period of time and during which intra-family interactions as well as group processes are observed.

Reviews of the literature on attention-deficit/hyperactivity disorder (ADHD) typically begin early in the twentieth century with the descriptions provided by paediatrician George Still. Physician Alexander Crichton, however, described all of the essential features of the Inattentive subtype of ADHD more than a century earlier than Still. This article presents a short biography of Crichton, looks at his 1798 publication describing attentional disorders in otherwise healthy individuals, contrasts his medical writing with the moralism of Still, and shows how his thoughts and observations are very much in accord with DSM-IV criteria for the Inattentive subtype of ADHD.

Through a questionnaire survey, the present study investigated the coping strategies of Year 7 (11–12 years old) and Year 9 (13–14 years old) pupils (N = 324) to find out what strategies they have used to overcome the difficulties of being bullied by peers. Fifty-one UK secondary schools, in each of which an anti-bullying peer support system had been in place for at least a year, participated. The coping strategies of those pupils who said that they had told someone (N = 279) about being bullied were compared with those who said that they had not (N = 45). These coping strategies differ, not only according to whether or not they report the bullying, but also according to their age and gender. Implications of the findings for professionals who work with children and adolescents are suggested.

This article reviews research conducted over the past 20 years on the social competence of children with Attention Deficit Hyperactivity Disorder (ADHD). A substantial body of research suggests that children with ADHD experience significant interpersonal difficulties. The social competence of ADHD children is considered using three indices: typical social behaviours or social functioning, internal cognitive structures relating to the behaviours, and the products or outcomes of their social functioning. Possible mechanisms underlying their interpersonal difficulties are discussed. The article concludes by outlining the significance of these difficulties for later life outcomes, and emphasising the importance of uncovering the mechanisms by which these difficulties arise.

A scheme is described that involves close collaboration and joint working arrangements across agencies in achieving a tightly organised multi-agency specialist assessment of families in severe difficulties. It is presented as one model of multi-agency assessment work that fits with concepts in the new Framework document.

Despite agreement that children's social functioning may be the best indicator of current and future behavioural and emotional problems, its measurement is under-developed. Measures of social functioning and psychopathology remain entangled, although this may be less critical clinically than in research. Confusion in terminology and definition is highlighted and clarified by tracing diverse but converging areas of research. Current measurement needs and approaches are presented along with six measures—each suited to different assessment needs. It is suggested that the next generation of instrument developers make use of findings from studies of social competence and motivation, focusing not only on social skills and deficits but also on beliefs and goals that lead to adaptive and maladaptive functioning.

This article analyses assessment procedures for young offenders aged 10 to 17 years who receive a police Final Warning or appear before Youth Courts in England and Wales. Members of Youth Justice Teams (YOTs) use detailed ‘Asset’ forms to collate information about the background, education, life-style and personal characteristics of the young people. The replies are scored to indicate the risk of further offending and the YOTs make their recommendations for intervention. The author points out that punishment has to be proportional to the crime but many young people and their families require long-term help if they are to be diverted from crime.

The Revised Children's Manifest Anxiety Scale is a widely used assessment tool, but it is questionable whether the North American norms are applicable to a British population. The scale was administered to 575 English children aged 8–12 years. Means were computed by age and gender and compared to the published North American norms. English males reported less anxiety than American males in most age groups, while 8-year-old English girls reported less anxiety than 8-year-old American girls. The language used in the Scale caused some difficulties, suggesting that the Scale might be better used in a structured interview rather than as a self-completion questionnaire.

This review outlines some of the difficulties involved in assessing preschool children's language development. Language is a sensitive indicator of a range of developmental difficulties yet the accurate identification of children who are experiencing delays or disorders is problematic. A range of different approaches are used to identify and assess language problems including norm-referenced assessments, questionnaires and language samples. Each of these is critically evaluated. In particular the reliability and validity of the measures and their ability to discriminate atypical patterns of development is considered. It is concluded that there are no simple assessment tools that identify and assess language development. Moreover, the use of single measures is considered inadequate for determining whether a child at any age has typical or delayed language. Ways to circumvent the limitations of the assessment tools are considered.