Mild: Overall good functioning in school, home and with peers. If symptoms are present, they are transient and may be a result of developmental state or expectable reaction to external stress (e.g. anxiety, sadness, or behavioral difficulty related to introduction to new situations, losses or changes in the child’s environment). Ability to communicate needs and understand rules as well as consequences of behavior (depends on developmental stage). Possible use of substances. Child does not require medication or therapeutic mediation at this time, but may benefit from counseling in dealing with emotions and behaviors that may be causing difficulty.
Moderate: Symptoms are present but child is able to function with some assistance in school, home and with peers. Anxiety, depression, behavioral problems that can be mediated by medication, behavior therapy or counseling as needed e.g. occasional panic attacks or severe anxiety that is not precipitated by external stess, sexually inappropriate behavior (does not include sexual abuse of others); episodic use of substances; some conflict with teachers; peers or others in authority; fighting, occasional theft or lying; depressed mood without suicidal ideation; encopresis (soiling) or enuresis (bedwetting); poor judgement or impulse control; hard to manage behaviors that are not destructive or violent; isolating behavior; difficulty maintaining friendships. Difficulty in communicating needs in an appropriate fashion and sometimes loses sight of consequences of behavior (depends on developmental stage).
Severe: Serious impairment in social academic functioning. Some persistent danger of severely hurting self or other; recurrent violence that appears unprecipitated; a pattern of cruelty to animals and fire setting behaviors; inability to maintain personal hygiene; sexual abuse of others; gross impairment in ability to communicate (largely incoherent); inability to see consequences of actions or show empathy for others; significant destruction of property; gross impairment in reality testing, judgement, and thinking. Persistent use of substances. Self mutilating behavior; presence of hallucinations or delusions (that are not related to substance abuse or organic difficulty). May require repeated psychiatric hospitalizations or 24-hour monitoring. Medication and consistent psychiatric assistance is needed. Serious impairment in social and academic functioning. Prognosis may be considered poor for adult level of functioning.