What Happens in a Child Psychiatric Evaluation?

By Sukhmani Kaur Sadana, MD · Double board-certified in general psychiatry and child & adolescent psychiatry · Last reviewed October 22, 2026

Many parents feel nervous before their child's first psychiatric appointment. They picture something clinical or intimidating, or they worry their child will be labeled after one conversation.

In reality, a psychiatric evaluation is a structured medical conversation. Its purpose is to understand your child's emotional, behavioral, and developmental health well enough to give you a clear picture and a plan. The goal is clarity, not judgment.

Here is what an evaluation with my practice looks like, step by step.

Before the visit

After you reach out through our secure contact form, you will receive access to a secure patient portal. There you will complete intake forms about your child's history and current concerns, and you will receive a Good Faith Estimate of costs before the first visit.

Most important is a list of your child's current medications. It also helps to gather anything else that adds context, such as report cards, teacher comments, and previous evaluations or testing.

Because I am licensed in Tennessee, your child must be physically located in Tennessee during each video visit.

Step 1: Understanding your child's history

The evaluation begins with a detailed history. Depending on your child's age and concerns, this may include:

• Pregnancy, birth, and early development

• Developmental milestones (speech, motor skills, social development)

• Medical history, current medications, and allergies

• School performance and any learning concerns

• Family mental health history

• What prompted you to seek help now

This context matters. The same symptom, such as trouble concentrating, can come from very different causes, including anxiety, a learning difference, poor sleep, or ADHD.

Step 2: Hearing from parents

Parents often see patterns that children cannot describe themselves. I will ask about mood, behavior at home, sleep, appetite, friendships, and how your child handles stress and transitions.

With your permission, I may also ask for input from teachers or other caregivers, for example through standard rating forms. Seeing how a child functions in more than one setting is an important part of an accurate assessment.

Step 3: Speaking with your child or teen

Children and adolescents usually also have time to talk with me on their own. Teens in particular often share more when a parent is not in the room, whether about stress, friendships, school, or feelings they have not yet put into words.

Building trust is central to child psychiatry, so this part of the visit is unhurried.

Step 4: The mental status examination

Throughout the conversation, I am also performing what physicians call a mental status examination. I observe mood, thought process, attention, speech, and how your child is coping, and I look for signs of anxiety, depression, or other conditions. It is the psychiatric counterpart of the physical exam other specialists perform, and it works well over secure video.

Some things cannot be done by video, such as a physical exam, vital signs, or lab draws. If any of these are needed, I will coordinate with your pediatrician or a local lab.

Step 5: Diagnostic impression and a plan

At the end of the evaluation, I share what I am seeing and what I recommend. Depending on the situation, that may include:

• A diagnostic impression, or a clear explanation of what still needs clarifying

• Recommendations for therapy, which I coordinate with your child's therapist or help you find one

• Practical strategies for home and school

• A discussion of medication, if appropriate. Medication is never automatic.

• Coordination with your child's school or pediatrician, with your permission

You should leave knowing what happens next and why. Sometimes the most useful outcome is reassurance that what you are seeing is within the range of normal development, together with guidance on what to watch for.

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Frequently asked questions

How long does the first evaluation take?

The initial evaluation is a 60-minute video visit. Follow-up visits are shorter. Fees are listed on our Fees & Refund Policy page.

Will my child get a diagnosis at the first visit?

Sometimes. Other times I need more information, such as school input, records, or a second conversation, before giving a diagnosis. I would rather take the time to be accurate than rush.

Does every child end up on medication?

No. Many children benefit from therapy, behavioral strategies, or school support without medication. When medication is a reasonable option, we discuss the benefits, risks, and alternatives together, and the decision is yours.

Should parents attend the whole appointment?

Parents are central to the evaluation, especially for younger children. For older children and teens, part of the visit is usually one-on-one.

Is what my child says confidential?

I keep what your child tells me private and share only what parents need to know to support them. Safety always comes first: if your child is at risk of harm, I will tell you.

What if my child is in crisis?

This practice does not provide emergency care. If your child is in immediate danger, call or text 988 (Suicide & Crisis Lifeline), call 911, or go to the nearest emergency room.

If you are in Tennessee

If you are worried about your child and unsure where to start, an evaluation is a good first step. You can reach us through our secure contact form.

This is general education, not medical advice. Talk to your own clinician about your child.

Sources

• American Academy of Child & Adolescent Psychiatry, Facts for Families: Comprehensive Psychiatric Evaluation: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Comprehensive-Psychiatric-Evaluation-052.aspx

• 988 Suicide & Crisis Lifeline: https://988lifeline.org/