The Zero‐to‐Three diagnostic classification: A contribution to the validation of this classification from a sample of 85 under‐threes

Abstract

The goal of this article is to contribute to the validity of the Zero-to-Three diagnostic classification (DC: 0-3) by studying the range, the indices of consistency, the interjudge reliability, and the issue of comorbidity on Axis I. Eighty-five consecutive children under three years of age and their families were assessed in six mental health centers with clinical interviews and developmental testing. Diagnoses on the five axes of the classification system were made after clinical consensus. The Task Force data record DC: 0-3 was completed for each subject. The use of the classification on a sample of 85 children showed good consistency between the different axes, moderate interjudge reliability, and a high percentage of associated diagnoses on Axis I. The DC: 0-3 appears to help the clinician catch the complexity of the clinical situation in planning the therapeutic strategy. However, the objectivity of the diagnostic criteria must be improved if this system is to be used in research settings. • N. Guédeney et al.Cero a Tres (DC: 0-3) por medio del estudio del alcance, los índices de consistencia, la fiabilidad de la evaluación o juicio de diferentes evaluadores, así como el asunto de la presencia de dos trastornos como depresión y enfermedad mental en la categoría I. Ochenta y cinco niños y sus familias fueron evaluados consecutivamente en 6 centros de salud mental, por medio de entrevistas clínicas y exámenes acerca del desarrollo. Los diagnósticos en las 5 categorías del sistema de clasificación se hicieron después de un consenso clínico. En cada caso se completó la tarea de toma de datos según el DC: 0-3. El uso de esta clasificación en un grupo muestra de 85 niños mostró buena consistencia entre las diferentes categorías, una moderada fiabilidad en cuanto al criterio de los evaluadors, y un alto porcentaje de los diagnósticos asociados de la categoría I. El DC: 0-3 parece ayudar a los especialistas clínicos a atrapar la complejidad de la situación clínica a través del planeamiento de una estrategia terapéutica. Sin embargo, la objetividad de los criterios de diagnóstico debe mejorarse si el sistema va a ser usado en situaciones de investigación.RÉ SUMÉ : Le but de cet article est de contribuer à la validité de la classification diagnostique 0-3 (DC:0-3) en utilisant la gamme, les indices de cohérence, la fiabilité inter juge et le problème de co-morbidité sur l'Axe I. Quatre-vingt cinq enfants consécutifs de moins de 3 ans et leurs familles ont été évalués dans 6 centres de santé mentale avec des entretiens cliniques et des tests du développement. Les diagnostics sur les cinq axes du système de classification ont été faits après un concensus clinique. Le compte-rendu de données du Groupe de Travail (Task Force data record DC: 0-3) a été rempli pour chaque sujet. L'utilisation de la classification sur un échantillon de 85 enfants a démontré une bonne cohérence entre les différents axes, une fiabilité inter juge modérée et un haut pourcentage de diagnostics associés sur l'Axe I. La classification ...

Comparison of ICD-10 and DC: 0-3R Diagnoses in Infants, Toddlers and Preschoolers

“…The distribution of diagnoses varies widely across clinical studies [20,21,35], which may be due to factors such as age of children, referral biases or specialization of institution. In the present study, the most frequent diagnoses were ODD, HKD and 'Other Disorders' as well as Sleep and Feeding Behavior Disorders.…”

Assessment of Behavioral and Emotional Problems in Infancy: A Systematic Review

“…The original DC: 0–3, published in 1994, consisted of five axes: primary diagnosis, relationship disorder classification, medical and developmental disorders and conditions, psychosocial stressors, and functional emotional developmental levels. In a study of 85 0- to 36-month-olds, Guédeney and colleagues (2003) demonstrated inter-rater reliability of .73 between two child psychiatrists with comparable clinical experience. Two studies demonstrated some differences between the DC: 0–3 and the DSM, providing preliminary support for divergent validity (Dunitz et al 1996; Minde and Tidmarsh 1997).…”

“…Two studies demonstrated some differences between the DC: 0–3 and the DSM, providing preliminary support for divergent validity (Dunitz et al 1996; Minde and Tidmarsh 1997). In response to the lack of psychometric evidence, Gueédeney et al (2003) recommended changes to the DC: 0–3 to promote reliability and empirical studies validating the proposed diagnostic categories.…”

“…The revision addressed Guédeney et al’s (2003) recommendation by including specific criteria for all of the diagnostic categories, as well as some modifications to the diagnostic categories to reflect recent research (Zero to Three 2005). There have been some descriptive reports of the DC: 0–3R (Loeb et al 2011).…”

Basler interdisziplinäre Sprechstunde für Eltern von Säuglingen und Kleinkindern: Konzept und empirische Ergebnisse

“…4). Der Behandlungserfolg bezüglich der Beziehung Eltern-Kind ist etwas weniger deutlich: in 39 % (Guédeney et al, 2003) oder fehlende altersbezogene Kriterien für die Diagnosen (Keren, Feldman, Tyano, 2003). Spezifisch für Regulationsstörungen haben Tirosh et al (2003) (Whiffen u. Gotlib, 1989).…”