Pathology is operationally defined by a set of rating scales which addresses the dimension at issue. In psychiatry, many dimensions are measured with rating scales e.g. anxiety, depression, hyperactivity, impulsivity, inattention, aggressiveness, extroversion, introversion, and emotional liability. The diagnostician's job is first to connect the symptoms/problems with which the patient presents with possible disorders that might be responsible for the symptoms/problems. For parents who consider medication treatment as the court of last resort, it may be sensible to recommend a trial of psychologic treatment with a time period built in such that continuation of problems after x number of weeks warrants reconsideration of medication. It is important to target psychosocial functioning separately from change in psychopathology. Other issues that complicate treatment include the presence of multiple disorders, which is the rule rather than the exception for children requiring medication treatment.

Child and adolescent psychopharmacology is a leading edge of pediatric psychiatry and is rapidly developing. Attention-deficit/hyperactivity disorder (ADHD) has become the psychiatric model or prototype disorder for the medication treatment of children. Psychostimulants remain the treatment of choice for ADHD, partially because of their solid effectiveness in treating the behavioral symptoms and especially because of their unmatched effectiveness in ameliorating the cognitive symptoms. In the 1990s, child and adolescent psychopharmacologic treatment entered everyday psychiatric practice. Its speedy expansion led drug treatment, alongside and integrated with psychosocial interventions, to become the prevailing approach in child psychiatry by mid 1990s. The preoccupation of child psychiatry with psychoanalysis has given way to a more eclectic and empirical clinical methodology. Therapeutic empiricism has become the watchword by which clinicians decide when to treat and when to delay the use of medication and psychosocial treatments.