1. Define the child guidance clinic.

2. Underline the objectives of the child guidance clinic.

3. Illustrate the principles of child guidance treatment.

4. Explain the services at a child guidance clinic. 

5. Enlist the stages of evaluation.

6. Discuss the role of the nurse of the child guidance clinic.

The child guidance clinic was started in 1909 in Chicago to deal with the problem of Juvenile
delinquency. At present, it deals with all children or adolescents who one reason or other are
not fully adjusted to their environment.

The first CGC was started in India in 1939 at the TATA institute Mumbai. The CGC in Delhi
was started in 1955 at RAK con, simultaneously with madras, thereafter there has been a slow
growth. As per WHO, there should be CGC for every 1 lakh child. Today we have around 120 CGC
as against 9,500.

The child guidance clinic (CGC), is a multidisciplinary team of professionals (psychiatrists,
physicians, educational psychologists, social workers, special educator, and language pathologists)
working together towards the cause of children with developmental disabilities.

DEFINITION

1. Stevenson and Smith defined Child Guidance as  “attempts to marshal the resources of the

community on behalf of children, who are in distress because of unsatisfied inner needs or

are seriously at outs with there environment children whose development is thrown out of

balance by difficulties which revile themselves in unhealthy traits, unacceptable behavior,

or an inability to cope with social and scholastic exploitations”. community on behalf of children,

who are in distress because of unsatisfied inner needs or are seriously at outs with there

environment children whose development is thrown out of balance by difficulties which revile

themselves in unhealthy traits, unacceptable behavior, or inability to cope with social and

scholastic exploitations”.

2. “Child guidance clinic is one of the medico-social amenities and may be best defined as a    
      center for the organized and scientific study and treatment of maladjustment in children”.

OBJECTIVE

“To prevent children from the possibility of becoming neurotics and psychotics in later life.”

PRINCIPLES OF CHILD GUIDANCE TREATMENT

1. The treatment of the child is carried out not by one person but by a team of workers.

The team of staff members is constituted of a psychiatrist, a pediatrician, a PHN, and educational

psychiatric social worker and playroom workers.

2. The child is treated as a whole and the personality has many aspects, viz., physical, intellectual,

educational, emotional, social, and economies etc. each of these aspects is studied by the

respective staff member who has specialized in that particular field.

3. Thus, by working together they formulate a plan of treatment and reintegrate the personality

and bring about lasting benefit to the individual.

The treatment can be divided broadly as

1.  TREATMENT OF THE CHILD HIMSELF

A. Treatment of any physical illness if it is present

B. Psychotherapy which includes:

a) Suggestion and persuasion

b) Hypnosis 

c) Re-education

d) Psychoanalysis 

C. Play therapy and other forms of expressive therapies

D. Change of environment as a treatment:

a) Fosters home placement

b) Institutional placement

c) School’s part in changing the child’s behavior

2. FAMILY ATTITUDES AS A FOCUS OF TREATMENT

A. Attitude therapy to the parents

B. Treatment of psychoneurosis or psychosis in parents, if and when necessary

Child Guidance Center is dedicated to meeting the mental health needs of children and their
families in the Lincoln area and surrounding communities through effective and flexible
therapeutic partnerships and a commitment to advocacy and positive social change.

GUIDING PHILOSOPHY

Child Guidance Center has a philosophy that emphasizes understanding the unique qualities and
experiences of each child as influenced by emotional and cognitive development, family situation,
social environment, and personality.

BENEFICIARIES

Treatment is available to youth ages 1-19 and their families who seek care for a wide range of
mental, emotional, and behavioral issues. Therapists work with clients who experience varying
degrees of difficulty, but often see youth who are depressed or suicidal, engaged in high-risk
behaviors, or have suffered physical/sexual abuse and neglect.

TEAM

Most children tend to have a combination of problems: developmental, neurological, academic
and emotional. Hence it is imperative that a team of specialists from the related fields is available
to evaluate these children. A dedicated team of child psychiatrists, educational psychologists,
medical social workers, special educators, and language pathologists offer appropriate
assessment, guidance, and treatment.

SETTING

CGC team works in the open setting of CGC, which encourages children and their parents to seek
help for learning difficulties, emotional or behavior problems without stigma and fear. The need
of the hour is for schools to have access to an authentic resource center with various specialists,
where they can confidently seek expert opinion about the child’s performance in order to help
them.

NEUROBEHAVIOURAL CLINIC

Autism Services are provided for children and adolescents (between 5-19 years old) with autism.
Cases may be referred to us from other hospitals, polyclinics, general practitioners, or schools or
they may be self-referred.

ADHD Services offers specialized multi-disciplinary assessment and therapy for children and
youth with ADHD and mental health comorbidities. Through parent education and workshops,
this team seeks to work collaboratively with parents and caregivers in supporting their children’s
needs.

THE MOOD & ANXIETY CLINIC (MAC)

It provides comprehensive assessment, treatment planning, and intervention for children with
mood, anxiety, and other related emotional conditions that may require clinical attention.

FORENSIC REHABILITATION, INTERVENTION, EVALUATION & NETWORK DEVELOPMENT
SERVICES (FRIENDS)

Provides comprehensive and integrated multi-disciplinary assessment and intervention services
targeted at the following groups facing mental health issues:

-Young offenders

-Youth at risk of committing offenses

-Victims of child abuse

-Children and parents involved in complex custody and access disputes

SERVICES AT CGC

CGC services include professional evaluation for:

•Poor school performance and learning disorders

•Levels of intelligence and types of intelligence

•Special skills and abilities

•Academic skill deficits in reading, writing, spelling, math, etc.

•Speech and language disorders: stuttering, aphasias, etc.

Motor skill deficits, poor handwriting, clumsiness, etc.

•Attention deficit hyperactivity disorders

•Defiant/oppositional behavior, conduct disorders

•Addiction to TV/ internet, disorganized routines.

•Tics/ Tourette disorder, ‘silent’ epilepsy

•Obsessive behaviour/ disorders, obsessive slowness/ procrastination, etc

Anxiety, school phobia, exam phobia and various fears in the child

•Depression, social withdrawal, loss of interest

•Developmental neurological disorders

•‘Functional’ symptoms like headache, breathlessness, stomachache, frequent sickness, absenteeism
from school, etc.

          These are some of the difficulties that need to be checked out by a team of specialists. Such as
the facility is provided in one single center as the CGC. 

STAGES OF EVALUATION: PROTOCOL

1. INTAKE INTERVIEW
2. PHYSICAL AND NEUROLOGICAL EXAMINATION
3. ASSESSMENT OF POOR SCHOOL PERFORMANCE
4. ASSESSING OVERLAPPING DISORDERS
5. MULTIDISCIPLINARY DIAGNOSIS AND DOCUMENTATION

1. INTAKE INTERVIEW:

           This is a major step in the diagnosis, with information from parents, child, and report from
teacher and samples from the child’s problems and to determine which other special needs to
examine the child, if necessary.

2.  PHYSICAL/NEUROLOGICAL EXAMINATION: 

          This is done to rule out soft neurological signs and sensory deficits. Tests like EEG or other
investigations may be done for the same.

3. 3. ASSESSMENT OF POOR SCHOOL PERFORMANCE (LEARNING DISORDERS): 

           The basic sets of assessment include Tests of general intelligence (IQ) and types of intelligence,
assessment of academic skills-reading, writing, spelling, math and language, assessment of pre-academic
skills (for children below 6 years), tests of speech and language, identification of special abilities/
aptitude testing, neurological assessment, and EEG etc. 

4. ASSESSING OVERLAPPING DISORDERS: 

          A significant part of the evaluation includes identifying other coexisting disorders.
This is done by focused evaluation and multi-axial diagnosis.

5. MULTIDISCIPLINARY DIAGNOSIS AND DOCUMENTATION:

           After completion of assessments, a multidisciplinary diagnosis is made. Counseling and

guidance is offered for the child and parent or guardians. Follow-up sessions are planned, remedial

therapy is given and medical intervention if any is suggested.

OUTREACH PROGRAMMES

The CGC outreach programs include the following:

•Workshop on “Learning Strategies” for children.

•Workshop on “Life Skills” for children.

•Workshop / Sensitization modules for Schools, Teachers, and Parents.

•Consultation and Liaison for Resource Room Services in Schools.

•Training Programmes for Counselors, Social Workers, and Special Educators.

ROLE OF NURSE

The nurse can help prevent by identifying risk cases in the community.

1. Educating the public.
2. Not only encouraging but also undertaking research studies herself.
3. Provide holistic nursing care.
4. Lobby for child rights.

CONCLUSION

Child health clinic is very important in our clinical area as well as in our life to prevent children from
the possibility of becoming neurotics and psychotics in later life.