Reply from Stacy Weiner
Module 1 Discussion
Stacy Weiner
St. Thomas University
NUR-630-AP3.25/FL2
Dr. Wilson-Romans
10/23/2025
Module 1 Discussion
As a future Psychiatric-Mental Health Nurse Practitioner (PMHNP), I believe that
diagnosing children with psychological disorders is appropriate and necessary when done
thoughtfully and with sensitivity to each child’s stage of development. Early identification can
help children and families access care before symptoms become more serious or disruptive.
Brinley et al. (2024) noted that earlier screening interventions for behavioral and emotional
concerns allows providers to identify disorders and to create treatment plans that help support
overall outcomes. The Centers for Disease Control and Prevention (CDC, 2025), found that
nearly one in five U.S. children has been diagnosed with a mental, emotional, or behavioral
condition. These statistics highlight that mental health concerns among children are not rare or
exaggerated—they are real, widespread, and often undertreated. A clear diagnosis helps guide
treatment, ensures coordination between healthcare providers and schools, and gives families the
structure and validation they often need to move forward. However, diagnosing children must be
approached carefully. Labels can carry significant weight for kids and sometimes influence how
they see themselves or how others perceive them. Diagnosis should never define a child; it
should guide the care plan. Kumar et al. (2023) emphasized that screening and diagnosis must
always lead to action—such as therapy, counseling, or school-based interventions—rather than
simply being documented in a chart. When a diagnosis is combined with treatment and
consistent follow-up, it becomes a powerful tool for healing rather than a mark of limitation. For
PMHNPs, the focus should not be on diagnosing quickly, but on diagnosing responsibly and
supporting families throughout the process.
A major challenge in diagnosing children is that their emotions, behaviors, and abilities
change rapidly as they grow. What looks like hyperactivity, defiance, or withdrawal at a younger
age could look very different at an older age. Factors such as stress, trauma, or cultural norms
could also influence how symptoms present. Gathering information from multiple sources like
parents, teachers, caregivers, and the child themselves is so important and this shows why.
Laraque-Arena and Stein (2021) emphasize that mental health care for children should include
developmental context, family dynamics, and community resources. By combining clinical
observations with standardized assessments and family input, PMHNPs can make more accurate
and compassionate decisions about diagnosis and treatment.
Families also need reassurance that a diagnosis is not permanent. It should be explained as
a way to understand what the child is going through right now—not a label that will follow them
for life. When families feel heard and supported, they are more likely to stay proactive in
treatment and advocate for their child’s well-being. Open communication and re-evaluation over
time help ensure that care stays relevant as the child grows and changes. Refusing to diagnose
children out of fear of labeling can do more harm than good. So many children go without the
care they need because no one formally recognized what they were struggling with. As
PMHNPs, we must balance empathy with evidence and use diagnosis as a tool to open doors to
support our patients. When handled with care, collaboration, and cultural understanding,
diagnosis becomes not a label—but a bridge toward healing, growth, and resilience.
Reply from Leeann Chang
Module 1 Discussion
Leeann Chang
St. Thomas University
NUR-630-AP3.25/FL2
Dr. Wilson-Romans
10/23/2025
Module 1 Discussion
Yes—but carefully, developmentally, and transparently. A formal diagnosis in childhood
should be made when credible, multi-informant evidence shows clinically significant impairment
and the DSM-5-TR criteria are met. Diagnosis opens doors to evidence-based care, insurance
coverage, and school supports (e.g., 504/IEP), and it anchors measurement-based follow-up. The
American Academy of Pediatrics (AAP) now recommends routine mental, emotional, and
behavioral screening starting in infancy and continuing annually, to help with earlier
identification and referral—steps that typically culminate in a diagnosis when warranted (AAP,
2025). This is critical because U.S. treatment rates for common youth disorders (especially
depression and anxiety) remain low; without a shared diagnostic language, children often miss
timely intervention (Wang et al., 2023).
At the same time, “labeling” is not benign. A growing literature documents mixed
downstream effects: some families experience validation and access to services, but others
encounter stigma, expectancy effects in classrooms, and self-concept shifts (Sims et al., 2021).
Diagnostic error is also a real risk in mental health—especially when clinicians rely on brief
visits, single informants, or culturally insensitive tools (Bradford et al., 2024). DSM-5-TR itself
underscores that diagnoses are constructs—best used as working hypotheses to guide care and
revised as new data comes about (First et al., 2023). Taken together, these realities argue not
against diagnosing, but against premature or “checklist-only” diagnosing.
A balanced approach for child mental health practice includes:
1. Developmentally sensitive assessment. Use longitudinal history, multi-informant reports
(caregivers, teachers), standardized rating scales, and functional data from home and
school. Rule out medical, neurodevelopmental, and environmental drivers; revisit
differential diagnoses over time.
2. Staged or provisional diagnoses when appropriate. Communicate uncertainty
(“provisional,” “other specified”) and pair with active monitoring. This supports access to
care without prematurely “fixing” an identity around a label.
3. Dimensional tracking. Combine DSM categories with symptom severity scales and
impairment metrics to guide step-up/step-down treatment and to decide whether a
diagnosis should be confirmed, revised, or removed (First et al., 2023).
4. Family-centered, culturally responsive communication. Discuss benefits and risks of
diagnosis plainly: how labels facilitate services, what stigma can look like, and how
you’ll mitigate it (e.g., confidential documentation, school messaging focused on
supports rather than identity). Evidence shows labels can both help and harm; naming
that duality builds trust (Sims et al., 2021).
5. Active linkage to care. Screening without pathways is insufficient. Health-system
studies highlight persistent gaps between problem identification and treatment initiation;
programs that streamline referral and follow-up improve engagement (Karcher et al.,
2023; Wang et al., 2023).
In sum, diagnosing children is ethically and clinically justified when it improves
functioning and access to care. The alternative—avoiding diagnoses to sidestep stigma—often
perpetuates under-treatment and inequity. As PMHNPs, our charge is to diagnose well: use
rigorous, iterative assessment; communicate honestly about uncertainty; and pair every diagnosis
with a concrete, family-centered care plan and ongoing review.
