Challenges in the Assessment and Diagnosis of Eating Disorders in Childhood and Adolescence Given Current Diagnostic and Assessment Instruments

The diagnosis and assessment of children and adolescents with eating disorders is fraught with challenges. This chapter reviews the problems inherent within the most widely used classification systems and assessment instruments currently available. The greatest challenge is that these systems and measures have typically been designed for adult populations, and thus, are often developmentally inappropriate for youth. It is recommended that future diagnostic criteria and assessment instruments be specifically designed at inception for youth, taking their developmental stages into account. Further, norm-referenced tests for different ages and genders are needed. Other essential elements of a multimethod assessment should be included in the assessment and diagnosis of youth with eating disorders, particularly collateral information, especially from parents, and both formal and informal observations. These elements are particularly important given the denial, minimization, shame, and guilt associated with eating disorders, which are perhaps even more prominent in children and adolescents.