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Diagnosis and treatment As most of these disorders are highly complex, their diagnostic evaluation should be carried out by specialists (physicians, psychologists, etc.) and interdisciplinary teams that are experienced with patients in this age group (e45) (Boxes 5, 6). The evaluation should include an assessment of potential disorders along three axes��biological, social, and psychological. Once the evaluation has been concluded, a definite treatment plan should be developed, with the goal not only of treating the current problem but also of preventing its recurrence at a later age. Box 5 Standards for psychiatric evaluation* Family interview Observation of mother�Cfather�Cchild interactions Assessment of cognitive, social, and emotional developmental functions Assessment of parental sensitivity, affective responsiveness, and ability for self-regulation Use of standardized observation instruments Interdisciplinary findings Diagnostic formulation including symptom diagnosis, relationship diagnosis, degree of severity, and prognosis Multiple follow-up evaluations in the long term *(modified from [e45]) Box 6 Methods of parent�Cchild psychotherapy Interactional guidance (McDonough) Parent�Cchild interactions are www.selleckchem.com/products/PLX-4720.html recorded on video, and the parents are then instructed, with the aid of video feedback, on how to improve their interactive competence. Child-centered psychotherapy (��watch, wait, and wonder��) (Cohen) Mothers are helped, in non-directive fashion, to open themselves to the opportunities for forming a relationship with their children, and to establish an interaction with them. Psychoanalytic-psychodynamic child�Cparent psychotherapy (multiple proponents, including Cramer, Cierpka, Salomonsson) During the therapeutic sessions, parent�Cchild interactions are observed, the observations are verbally described, and unconscious conflicts in the parents��internal world are discussed and interpreted. Treatment planning Once the evaluation has been concluded, a definite treatment plan should be developed, with the goal not only of treating the current problem, but also of preventing its recurrence. Extended treatment Motor abnormalities, linguistic deficits, and other specific developmental impairments must be recognized and treated appropriately, e.g., with speech therapy, physiotherapy, or ergotherapy. Harmful substances Disorders of regulation may be caused or exacerbated by biological factors, such as intrauterine exposure to nicotine or other harmful substances.