house fire A clinician has been asked to assess a four-year-old girl who has been having nightmares since a house across the street from hers burned down two months earlier. One of the BEST ways to get information from the client is:

A. Have the child undergo a sleep study.

B.  Avoid an interview with the child, which might prove too traumatizing. Instead, the clinician should speak with the child's parents and other family members.

C. Watch or engage the child in several sessions of play.

D. Ask the child gentle questions about the fire.


Since this question is from an old bonus exam that's no longer used on the site, there are explanations for each answer.

For A: Since the sleep issues the child is having appear to be anxiety-related, no sleep study is indicated.

B: The family should be interviewed as a part of the assessment process, but this should not take the place of meeting with the child.

C: Four-year-olds often express their concerns and fears through play. Watching or engaging in play is the best way to assess a child this age.

D: The child is too young to be able to understand or formulate a verbal response to anything but simple questions.

So you have your answer.

The longer rationale: A four-year-old child is too young to put her feelings and thoughts into words and might be intimidated by a stranger asking questions. While interviewing the client's family is a valuable source of information, it cannot be used in place of assessing the child directly. In this case, there's little reason for a sleep study. The best way to proceed is to watch and interact naturally with the child while she is playing.

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November 1, 2019
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