Whenever a person in the community is contacted to get a better idea of how a patient behaves outside of the healthcare setting, that is called collecting collateral information.
Child psychiatrists try to collect collateral information from anyone who has significant contact with the patient. These information sources are typically contacted only with the permission of the child's legal guardians. This is part of the reason why guardianship is so carefully explored when learning more about why a pediatric patient is presenting for care.
Several common sources of collateral include:
Their school teachers
Regular caregivers, like a babysitter, nanny, or daycare worker
Extended family
Their pediatrician
Many guardians have, over time, learned how to help their children through numerous challenges. However, when a child moves from their home to school or to daycare or to an extracurricular activity, it can lead to different behavior from what is seen in the home.
The most frequently contacted sources of collateral are teachers and caregivers.
Teachers are often contacted because they spend an enormous amount of time with their students on a regular basis. They usually are very familiar with what subjects are challenging for a patient and where the patient's educational strengths lie. Additionally, teachers also are present when the patient interacts with other children from different backgrounds or with different strengths.
Similarly, ancillary caregivers like daycare workers or babysitters also spend significant time with a child. However, they are not typically the patient's parent-figure. It can be incredibly useful to learn more about how a child interacts with a familiar adult who is not their primary caregiver.
Frequently, child psychiatrists will provide screeners or questionnaires for collateral sources to fill out. Other physicians may, with the permission of a guardian, schedule a phone call or appointment with a collateral source. Both of these approaches help the physician learn more about how the child acts when moving through their average day.
While somewhat more challenging to coordinate, a child psychiatrist may also reach out to the child's other physicians. This is especially important with children who have complicated medical histories and there is a need to make sure that any new psychiatric medications will not interfere with medications for other conditions.
Finally, it is very common for a child psychiatrist to ask a guardian to sign a form called a release of information, which will act as documentation that a child's guardian has given permission, usually for one year at a time, to reach out to a specific person for collateral information. This release of information can be revoked by the child's legal guardian at any time.
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