Can standardized diagnostic assessment be a useful adjunct to clinical assessment in child mental health services? A randomized controlled trial of disclosure of the Development and Well-Being Assessment to practitioners

Ford, Tamsin; Henley, William; Norman, Shelley; Guglani, Sacha; Kelesidi, Katerina; Martin, Anne‐Marie; Paulina, Moran,; Latham-Cork, Harriett; Goodman, Robert

doi:10.1007/s00127-012-0564-z

Cited by 26 publications

(44 citation statements)

References 26 publications

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“…These less severe difficulties may contribute to diagnostic uncertainty and suggest subclinical levels of problems that might never-the-less contribute to impairment and to diagnostic confusion. As reported above, two trials of standardised assessment have been conducted to date [31, 33], which may not have been adequately powered to detect a difference in the detection of ASCs between the trial conditions (disclosure or not of the assessment to the clinical team). Our findings suggest that disagreement was mainly between the research diagnosis and practitioner reports of a possible ASC, with a remarkable level of fluctuation in practitioner-reported diagnoses over time.…”

Section: Discussionmentioning

confidence: 99%

“…As part of a wider randomised control trial (RCT) nested into this cohort study [31], the unrated DAWBA assessments were disclosed to approximately half of the practitioners (43%) before they conducted their first assessment with the child. The DAWBA RCT found no statistically significant effect of disclosure of the DAWBA upon diagnostic agreement between practitioners and the DAWBA, but the levels of agreement found in this secondary analysis will be stratified by DAWBA disclosure to account for the increased level of information available to some practitioners about some children.…”

Section: Clinical Settingmentioning

confidence: 99%

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The agreement between the referrer, practitioner and research diagnosis of autistic spectrum conditions among children attending child and adolescent mental health services

Ford

Kenchington

Norman

et al. 2019

Eur Child Adolesc Psychiatry

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We aimed to explore the levels of agreement about the diagnoses of Autistic Spectrum Conditions between the referrer, CAMHS practitioner and a research diagnosis, as well as the stability of the practitioner’s diagnosis over time in a secondary analysis of data from 302 children attending two Child and Adolescent Mental Health Services over two years. Kappa coefficient was used to assess the agreement between the referrer and research diagnosis. Kendall’s tau b coefficient was used to assess the agreement between the practitioner and the research diagnosis assigned using the Development and Well-Being Assessment, as well as the agreement between the referrer’s indication of presenting problems and the practitioner diagnosis. Diagnostic stability was explored in children with and without a research diagnosis of Autistic Spectrum Condition. There was a moderate level of agreement between the referrer and research diagnosis (Kappa = 0.51) and between practitioner’s and research diagnosis (Kendall’s tau = 0.60) at baseline, which reduced over the subsequent two years. Agreement between the referrer and practitioner’s diagnosis at baseline was fair (Kendall’s tau = 0.36).The greatest diagnostic instability occurred among children who practitioners considered to have possible Autistic Spectrum Conditions but who did not meet research diagnostic criteria. Further studies could explore the approaches used by practitioners to reach diagnoses and the impact these may have on diagnostic stability in Autistic Spectrum Conditions. Standardised assessment using a clinically rated diagnostic framework has a potential role as an adjunct to standard clinical care and might be particularly useful where practitioners are uncertain.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Settingmentioning

confidence: 99%

The agreement between the referrer, practitioner and research diagnosis of autistic spectrum conditions among children attending child and adolescent mental health services

Ford

Kenchington

Norman

et al. 2019

Eur Child Adolesc Psychiatry

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“…A computerized algorithm provides the probability of a child having any psychiatric disorder based on responses to structured questions, but clinical raters can review the symptoms, damage and qualitative information in parallel to these probabilities in their own assessment [33]. The clinical judgments were made by a child psychiatrist (SP), rater on this study, supervised by another child psychiatrist (BFB), who translated and validated the DAWBA for use in the Brazilian population [11].…”

Section: Methodsmentioning

confidence: 99%

Prevalence and comorbidity of psychiatric disorders among 6-year-old children: 2004 Pelotas Birth Cohort

Benetti

Anselmi

Santos

et al. 2014

Soc Psychiatry Psychiatr Epidemiol

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PurposeMost studies published on the prevalence of psychiatric disorders in children were conducted in high-income countries despite the fact that nearly 90 % of the world’s population aged under 18 live in low- and middle-income countries. The study aimed to assess the prevalence of psychiatric disorders among children of 6 years of age, to examine the distribution of psychiatric disorders by gender and socioeconomic status and to evaluate the occurrence of psychiatric comorbidities.MethodsThe 2004 Pelotas Birth Cohort originally comprised 4,231 live births from Pelotas, southern Brazil. A total of 3,585 (84.7 % of 4,231 births) children aged 6 years were assessed using the Development and Well-Being Assessment (DAWBA).ResultsNearly 13 % of the children presented a psychiatric diagnosis according to DSM-IV, being more prevalent among males than females (14.7 and 11.7 %, respectively, p = 0.009). Anxiety disorders were the most prevalent of all disorders (8.8 %) and specific phobias (5.4 %) and separation anxiety disorder (3.2 %) were the most common subtypes. Attention deficit hyperactivity disorder (2.6 %), oppositional defiant disorder/conduct disorder (2.6 %), and depression (1.3 %) were also diagnosed. More than one psychiatric disorder was presented by 17 % of children. Socioeconomically disadvantaged children had a higher prevalence of psychiatric disorders.ConclusionOur findings underline the early onset of psychiatric disorders among children and the frequent occurrence of psychiatric comorbidity. Early prevention is needed in the field of mental health in Brazil and should start during infancy.

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“…Conducting a cognitive assessment needs to be administered by a trained professional, which is costly and time consuming [5]. Using a static questionnaire to gather the data does not allow for the user to ask clarification questions if any of the wording is ambiguous.…”

Section: Resultsmentioning

confidence: 99%

Using an intelligent interviewer to perform cognitive assessments

Weaver

Komlódi

Duffy

2013

CHI '13 Extended Abstracts on Human Factors in Computing Systems

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Intelligent Virtual Agents (IVAs) are computer systems that have specifically designed capabilities ranging from simple conversation agents to complex systems that can accomplish activities on our behalf. As a result, state of the art Computerized Conversation Agents (CCAs) have been developed to have a fluid dialog with humans using natural language, offering advanced intelligent tutors, museum guides, and virtual patients. These CCAs monitor the user's interactions and build a user model in order to adjust current and future interactions to meet the needs of the individual user. We explore using an Intelligent Interviewer to conduct a cognitive assessment of a user. The results could be offered to existing CCAs allowing the interaction to be individualized from the initial point of interaction. In addition, educators, psychologists and medical professions can replace existing methods of conducting cognitive assessments with an Intelligent Interviewer.

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Can standardized diagnostic assessment be a useful adjunct to clinical assessment in child mental health services? A randomized controlled trial of disclosure of the Development and Well-Being Assessment to practitioners

Cited by 26 publications

References 26 publications

The agreement between the referrer, practitioner and research diagnosis of autistic spectrum conditions among children attending child and adolescent mental health services

The agreement between the referrer, practitioner and research diagnosis of autistic spectrum conditions among children attending child and adolescent mental health services

Prevalence and comorbidity of psychiatric disorders among 6-year-old children: 2004 Pelotas Birth Cohort

Using an intelligent interviewer to perform cognitive assessments

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