For an individual child, the constructs to be assessed will differ from case to case and depend on the referral question. In this book we have focused on measuring psychological constructs that emphasize a child's emotional, behavioral, and social functioning.
Basic Issues
Historical Trends
Traits
The Big Five Personality Traits (Factors)
Given the amount of research and development in this area, the Big Five personality factors may ultimately have a significant impact on the field of child and adolescent personality assessment. With some notable exceptions (e.g., Lynam et al., 2005), the Big Five research has largely focused on adult populations.
Temperament
Behavior
As we suggested in the preface, we believe that it is premature to reify any of these approaches as the ultimate method for assessing children's psychological adjustment. Clearly, some questions aimed at psychologists are trait-based, while others require the measurement of various behaviors.
Robert S. Woodworth
The most popular theory after World War I was the psychodynamic theory of personality as advocated by Sigmund Freud (1936) and others. Psychodynamic personality theory has provided a useful theoretical framework for the development of projective assessment measures because of the concepts of suppression, projection, and other constructs that are fully consistent with the use of atypical test stimuli to identify personality traits (see Chapter 10 for a more extended discussion of the basic assumptions of the projective technique). .
Association Techniques
These early methods of word association laid the groundwork for the development of other associational (projective) techniques, such as the thematic apperception technique and the Rorschach test, which used pictures instead of word lists to elicit associations.
Thematic Apperception Test
The Rorschach
However, Rorschach was not interested in the content of the subject's responses to the inkblots. The legacy of the Rorschach, his original inkblots, and many of the associated scoring criteria remain influential as the test continues to enjoy popularity.
Sentence Completion Techniques
Some interesting features included number of responses, perception of color or motion, and perception of the whole versus. Several scoring systems have been offered for the Rorschach, including the Exner Comprehensive System (Exner. & Weiner, 1982). that contribute most to the continued use of the instrument.
Projective Techniques for Children
Due to the lack of data to support the projective hypothesis, psychologists have focused on using psychometric methods to assess the reliability of the results obtained and the validity of the results. This shift toward accumulating psychometric evidence for measures is best reflected in the work of Exner.
Objective Tests
In the 1960s, John Exner began a research program designed to make the most of the Rorschach scoring systems and integrate their features into a comprehensive system (Exner & Weiner, 1982). Furthermore, a standard method of scoring the test responses has led to scores that have proven reliable and, as a result, has paved the way for direct tests of the validity of various interpretations that can be made from them.
Minnesota Multiphasic Personality Inventory (MMPI)
In the case of the MMPI, items were selected if they could routinely differentiate clinical groups from samples. The original version of the MMPI consisted of 550 statements printed on separate cards.
The “Children’s MMPI”
The first MMPI clinical scales were linked to the main diagnostic nosology of the time (Kleinmuntz, 1967), which is another factor that contributed to its popularity. Indeed, some of the scale names (eg, Psychasthenia) had fallen out of use around the time of original publication (Kleinmuntz, 1967).
Rating Scales
Thus, the PIC, like the MMPI, was developed with a heavy emphasis on empirical methods (see Chapter 6). In the 1960s, empirical methods of test development were also applied to the development of other types of child assessment devices.
Internalizing and Externalizing Dimensions
The most obvious connection is between the different editions of the Diagnostic and Statistical Manual of Mental Disorders (currently DSM-IV-TR; before the development of the DSM-III, the system was based primarily on the expert judgment of a relatively small number of doctors.
Constructs (Dimensions) vs. Categories
Two trends of the past few decades continue; relatively less emphasis on training in projective methods (Belter & . Piotrowski, 1999) and increased use of rating scales (Archer & Newsom, 2000). The most recent edition of the manual, the DSM-IV-TR, is based on a more comprehensive research base than any of its predecessors.
Measurement Issues
Most of the measures discussed in this book fit into the first notion of standardization because they are norm-related. Furthermore, the principle of administrative structure or consistency applies to all measures in this text.
Types of Tests
The final part of the chapter introduces measurement issues specific to the use and interpretation of personality tests and similar instruments. The primary purpose of the assessment (e.g., diagnostic clarification vs. identifying areas of behavioral, social, or emotional problems) should guide the selection of diagnostic schedules and/or behavioral rating scales.
Types of Scores
With a normal distribution (an often untenable assumption in personality and behavior assessment, as shown in a later section), the normalized standard score divides equal parts of the normal curve. It is important to remember that the ordinal properties of the scale are due to the fact that the percentile rank merely places the score in a distribution.
Norm Development
This approach accomplishes the objectives outlined by the developers, but relies on the assumption that the bias of the MMPI-2 clinical scales is similar. However, there is evidence that some MMPI-2 clinical scales (eg, hypochondriasis and schizophrenia) are much more skewed than others (see Tellegen & Ben-Porath).
Local Norms
An example of a diagnostic question is, "Does Frank have enough symptoms of depression to warrant a diagnosis?" The DSM-IV diagnostic criteria do not have different thresholds for boys, so a gender norm would be inappropriate. A clear description of the sample will allow the clinician to determine whether the clinical norm group has the potential to answer questions of interest.
Test–Retest Method
In other words, a reliability coefficient is not squared, as is the case with correlation coefficients, to account for the amount of reliable variance (Anastasi & Urbina, 1998). For example, the reliable variance of a test with a reliability coefficient of 0.90 is 90%, an extremely easy calculation.
Internal Consistency Coefficients
Variables that Affect Reliability
Reliable Specific Variance
If the reliable specific variance exceeds the error variance by 0.20 or more, the scale is considered to have adequate specificity for interpretation purposes. If the reliable specific variance does not exceed the error variance, then the interpretation of the scale is inappropriate.
Standard Error of Measurement
Validity is defined as "the extent to which accumulated evidence and theory support specific interpretations of test scores implied by proposed uses of a test" (AERA, APA, NCME, 1999, p. 184). That is, validity is essentially an issue related to the uses of a test and the interpretations one wishes to make from test results.
Content Validity
Virtually every aspect of a test either contributes to or detracts from its ability to measure the construct of personality or behavior, or in other words, its construct validity. By doing so, we believe that clinicians will be better able to judge the implications of test content for interpretation.
Criterion-Related Validity
Selected factor loadings for the factor analysis of the MMPI-A standardization sample (Butcher et al., 1992) are shown in Table 2.2. In exploratory factor analysis, the number of factors to be extracted is usually dictated by the characteristics of the intercorrelation matrix.
Sensitivity and Specificity
Tests must now demonstrate the ability to discriminate between diagnostic categories—not just between a diagnostic group and normality. More recent work has focused on developing an evidence base that will improve problem specificity, or the ability to distinguish particular problems from one another (Mash & Hunsley, 2005).
Threats to Validity
Clinicians routinely face this task, which is also often considered "differential diagnosis." The requirement for a larger, more robust evidence base also raises awareness of positive predictive power (ie, the ability of an item to correctly identify a child with a particular problem) and negative predictive power (ie, the ability of an item to correctly identify a child with a particular problem) identify a child without a problem; Pelham, Fabiano, & Massetti, 2005). Validity, including incremental validity (ie, the improved assessment decision as a result of adding a measure), is a necessary condition for utility, and establishing such validity evidence for an assessment tool, and especially an entire assessment battery, is difficult.
Classification and Developmental Psychopathology
There are many areas of basic research that improve a rater's ability to perform psychological evaluations, but we have selected two that we feel are the most critical to the clinical assessment of children and youth. The following discussion highlights some of the issues in both areas that we believe are most relevant to the assessment process.
The Need for Classification Systems
Because of this imperfection, many experts have argued against the need for a formal classification system. Documentation of service needs Classification systems enable the documentation of service needs.
Dangers of Classification
This includes documenting the need for special educational services for a child, determining the need for mental health services within a given catchment area, attempting to determine appropriate staffing patterns within an institution, or documenting the need for services to third parties. payers (eg insurance companies). The solution is not to eliminate the classification systems, but rather (1) to develop better classification systems that more directly predict the need for services and (2) to educate other professionals about the limitations of the classification systems so that they may be more appropriately used to document the need for services.
Evaluating Classification Systems
Furthermore, when using such terms, great care should be taken to clearly define the meaning of the term in order to avoid misinterpretation. And finally, the terms should be designed to emphasize the classification of the psychological construct rather than the classification of the person.
Models of Classification
The clinical assessor should be aware of the issues involved in classification in general, and the advantages and disadvantages of these two classification models specifically, to aid in the interpretation of assessment measures. In the following section, we provide an overview of one of the most commonly used classification systems, the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.
Diagnostic and Statistical Manual of Mental Disorders,
One of the major changes in DSM-IV from its predecessors is the emphasis on users having access to the basic research underlying the various diagnostic categories. Box 3.2 provides a summary of the Axis I and Axis II diagnoses most relevant to children and adolescents.
Developmental Norms
Developmental Processes
Comparing a child's behavioral or emotional functioning with the developmental norms can help determine whether the child's functioning is deviant compared to other children who experience similar developmental demands. However, simply comparing a child's behavior to developmental norms and determining whether the child's functioning is deviant compared to other children of the same age does not allow the assessor to determine whether (1) the child's problems as a should not be considered an exaggeration of the normal. maturational processes operating at that developmental stage or (2) the child's problems should be considered a qualitative deviation from normal development (i.e. not in accordance with the specific demands of that developmental stage), with the latter often indicative of a more serious pathological process.
Stability and Continuity
First, there is clearly some continuity in children's behavior, and the degree of stability (or instability) appears to depend on the domain of behavior being assessed. Furthermore, aggregates of behaviors (behavioral domains) tend to be more stable than individual behaviors.
Situational Stability
Therefore, interpretations of behavioral stability must depend on the behavioral dimension of interest. Because of the importance of comorbidity, most clinical evaluations of children and adolescents should be comprehensive.
Standards and Fairness
Use and Misuse
One of the vital points presented by the testing standards is that it is incorrect to use the phrase "test validity" because it cannot be concluded that a particular test is valid for all children under all assessment situations (AERA, APA, NCME, 1999 ). A small sample of some of the important aspects of psychological test use and validation is given in the following excerpts from the test standards.
Evidence-Based Interpretation
If experts are used in test design, their roles and credentials should be described in detail. First, the interpretation must be evidence-based and, when it is not, the fact must be made known to all consumers of the results.
BIAS and Cultural Competence
One of the typical procedures in this research literature is to compare predictive validity coefficients between groups. While psychometric evidence of test bias can be found, little convincing evidence of test bias has been found for various groups residing in the United States (Figueroa, 1990).
Fairness
Cultural plurality has challenged assessment and diagnostic practice since the early days of mental testing. The testing movement was forced early on to change testing and testing practices in the United States due to the massive influx of new immigrants.
Emic Versus Etic Perspectives
They evaluated the effects of physician language and ethnicity on diagnostic decision making, using Spanish-dominant adult patients of Puerto Rican and Dominican descent. However, it is possible that poor parents may be very familiar with the culture of poverty and may seek control, not for its own sake, but rather to ensure that their child or adolescent does not fall prey to negative consequences. the behavior associated with that culture (Inclan & Herron, 1989).
Guidelines for Assessing Children from Diverse
This client may not actually be pathologically shy; instead, she may adhere to the prohibition of eye contact with a man because of cultural values that suggest that this is sexually seductive behavior (or a sign of a lack of respect) that she finds inappropriate (Hasegawa, 1989). Some may assume that Vietnamese and Chinese children share similar values due to early Chinese dominance and the inculcation of Vietnamese culture with Confucian ethics.
Backgrounds
In this case, the clinician simply ignored relevant data, and the clinician's lack of knowledge of the child's culture resulted in an erroneous interpretation. They note that some poor parents of youth may be judged by a therapist as being too rigid and controlling of their youth at a time when parents should be giving their children more freedom.
Assessing Acculturation
Guideline 6a suggests that a cascade of three options apply to the examiner faced with such a case: (1) Refer the child to a clinician who can communicate in the client's preferred language; (2) if this is not possible, use an interpreter who also possesses professional training; and, finally, (3) it is advisable to use a paraprofessional from the community to interpret. Continuous professional development is particularly important to achieve fairness in the evaluation process.
Planning the Evaluation and Rapport Building
Many of the topics discussed involve clinical skills that are difficult to teach but often require refinement based on practical experience testing children and adolescents. Within these basic frameworks, however, evaluations must be tailored to the needs of the individual case.
Purpose of testing
However, sufficient information to determine eligibility should be part of the assessment if this is the primary referral issue. However, Martin (1988) provides a concise and practical analysis of the specific goals involved in diagnosis.
Description of Referral Problems
However, Martin (1988) discusses several issues when planning an assessment battery that can maximize the reliability of the information obtained. If you add unreliable tests to a battery, aggregation actually reduces the battery's reliability.
Developmental considerations
Secondly, it is important for the psychologist to decide on the developmental stage of the child to be assessed when designing an assessment battery. In addition to specific tests, some testing methods may be more or less appropriate depending on the child's developmental level.
Determining the Relevant Psychological Domains
For example, when selecting tests for a battery, it is important to determine whether the tests provide good norm-referenced scores for the developmental stage of the child or adolescent being assessed. For example, in the chapter on structured interviews, we discuss research that suggests that the child self-report format on these interviews may be unreliable before age 9.
Screening of Important contexts
Furthermore, from research on ADHD it is known that approximately 30% of children with this disorder have a co-occurring learning disability (Frick . & Kimonis, 2008). Based on this piece of information, one may decide not to conduct an intensive evaluation of a possible learning disability unless, during the evaluation, some evidence of learning problems is discovered.
Practical considerations in Designing an Evaluation
Alternatively, the evaluator may have personal issues related to the referral problem that may prevent him from being able to competently perform the evaluation. While the importance of rapport is not limited to the psychological assessment of children and adolescents, there are several unique aspects to youth assessment that make rapport building a complex process in this context.
Informed consent
I'm going to ask you to take some pictures for me and tell me about it. Second, the child may have been told implicitly or explicitly that the reason for testing is to see “what is wrong with you.” the explanation of testing in this age group must be sensitive to these issues.
Building Rapport with the child
Clearly, the potential benefits of testing should be discussed with the adolescent in an effort to improve motivation. I work with a lot of people your age who don't want to be here at first but end up getting a lot out of the experience.
Building Rapport with the Parent
When greeting the child, the evaluator should (1) use a warm, friendly, and engaging tone, (2) be sure to greet the child by name (not just the child's parents), and (3) introduce yourself using your title (e.g., Dr., Mrs., sir). If parents are immediately asked to complete rating scales or complete a structured interview as part of a standard evaluation, they often develop the impression that the evaluator is more interested in administering tests than actually understanding the child's needs.
Building Rapport with teachers
As you would expect, such an impression is very detrimental to the development of a relationship. A thorough and sensitive informed consent process can play an important role in showing respect for the child client and their parents, and thus can greatly assist in building a relationship.
Assessment Methods
Self-Report Inventories
Unfortunately, the entire complexity of using and interpreting omnibus self-reports cannot be summarized in one chapter. This chapter is in no way an exhaustive overview of the available self-report inventories.
Behavior Assessment System for Children Self-Report of
Whether or not a self-report inventory has a place in a psychological assessment will depend on many factors, including the client's developmental level, the presenting problem, and the purpose of the assessment. In addition, although the appropriate uses of self-report measures are highlighted, there are limitations to any assessment technique.
Personality (BASC-2-SRP;
However, as with any assessment tool, there are limitations to the reliability, validity, and utility of any self-report measure, and these limitations must be considered when designing an assessment battery and interpreting its results. What has become clearer in recent research is that, despite their relative lack of validity for assessing very young children, self-report inventories can provide invaluable information about an adolescent's perception of his or her own functioning and the factors that improve or impair it. overcome his/her problems.
Reynolds & Kamphaus, 2004)
Notably, correlations between the adolescent version of the BASC-2 and the MMPI-A have not yet been investigated. Lack of research into this version of the BASC and its improvements over the original BASC-SRP 2.
Achenbach System of Empirically Based Assessment
Youth Self-Report (YSR;
Achenbach & Rescorla, 2001)
However, the previous version of the YSR enjoys a lot of validity evidence from independent researchers. More validity studies exist for various cultural groups on the previous version of the YSR.
Minnesota Multiphasic Personality Inventory-
Content scales are a relatively unique feature of the MMPI that were developed differently from the original clinical scales. All the clinical cases were taken from the Minneapolis area (Butcher et al., 1992).
Conners, 3rd Edition, Self- Report (Conners-3 SR;
Conners, 2008a)
It should be noted that the above information pertains specifically to the Conners-3 SR Long Form. Conners (2008a) provides a clear recommended approach to interpreting the SR and other scales in the Conners-3 family.
Personality Inventory for Youth (PIY; Lachar & Gruber, 1994)
The scale is labeled “Psychological Discomfort.” The lack of clear operational definitions for psychological distress, cognitive impairment, dyscontrol, and other scales and subscales hinders interpretation, and the clinician must pay close attention to the content of the items within the scales and subscales when making interpretations. These data allow evaluation of the criterion-related validity of the PIY psychological distress scale and its constituent subscales.
Parent and Teacher Rating Scales
Parental ratings of child behavior have additional advantages, including conciseness and cost-effectiveness (Hart & Lahey, 1999). The time-efficient nature of parent assessments facilitates the collection of additional information about children's behavior.
Factors Influencing Parent Ratings
However, teachers can provide useful perspectives of the young child's social, academic, and behavioral functioning. Based on these considerations, there is a growing interest in assessing a child's behavioral and emotional functioning in the school environment.
Factors Influencing Teacher Ratings
This broad overview of the various scales is not intended to replace the information provided in the technical manuals accompanying these instruments, which can be reviewed by any user of the scales. The parent and teacher rating scales discussed in this chapter are highlighted in Tables 7.1 and 7.2 respectively.
Parent Rating Scale (PRS)
The median reliability coefficients in the manual suggest good evidence for the reliability of the individual scales and composites. Some secondary loadings for the scales may also have implications for interpretation.
Teacher Rating Scale (TRS)
The TrS is closely, but not precisely, matched to the item content of the PrS. The BaSC-2 manual provides factor analytic support for the construct validity of the scales and composites of the TrS.
Parent Report: child Behavior checklist (cBcL)
Forty percent of respondents were from the southern United States (see Achenbach and Rescorla, 2001). On the preschool version of the CBCL, internal consistency coefficients for syndrome scales and composites ranged from 0.66 to 0.95.
Teacher Report: Teacher Report Form (TRF)
There is relatively limited validity information available for the current versions of the TrF. The TrF remains one of the most widely used of the teacher-administered behavior rating scales.
Parent and Teacher Report checklists
There is increasing evidence for the validity of the CSI-4 as a screening test for DSM-IV diagnoses in school-aged children. It should be noted that research on the parent and teacher forms of the CSI-4 far outstrips the research available on their companion measures, the eSI-4 and aSI-4.
Parent Rating Scale
Internal consistency coefficients for the content and DSM scales of the Conners-3-P are all 0.80 and above, and many are 0.90 and above for the overall sample. 6, Conners (2008a) provides a clear step-by-step approach to interpreting ratings on the different forms of the Conners-3.
Teacher Rating Scale
The same four-point response scale used for the self-report and parent-report versions of the Conners-3 is also used for the teacher-report scale. The grading process for Conners-3-T was essentially the same as that used for Conners-3-P and Conners-3 Sr.
Parent Report PIC-2
The normative sample is not as diverse as that for the parent and self-report forms of the Conners-3, but is still diverse in terms of race/ethnicity. The scale contents were also better articulated with those of the PIY to improve score comparisons.
Teacher Report: The Student Behavior Survey
One of the unique features of the SBS is that, in addition to the usual educational norm sample on which T-score conversa-. The information provided in the manual (Lachar et al., 2000) on the reliability of the SMT is exemplary.
This information, however, typically describes performance in terms of problem severity and/or problem frequency.
Questionnaire (SSQ)
However, the criterion validity evidence associated with the HSQ and SSQ is more difficult to operationalize because these measures have a different focus than symptom or problem ratings. Nevertheless, the situations in which a child is experiencing difficulties, as indicated on the HSQ and SSQ, can help the clinician to plan and prioritize intervention strategies accordingly.
Therefore, rating scales such as those discussed in this chapter may not be appropriate for assessing change—at least not in the short term. The eCBI is an excellent example of a scale that has some value only in the hands of a knowledgeable clinician who uses the scale only in circumstances where it has empirical power.
Behavioral Observations
In the previous example of a child being observed for a period of 20 minutes in a playground, it cannot be determined how typical a child's behavior was during this observation period. In the next section, we discuss basic issues in the development and use of observation systems.
Defining target Behaviors
The sound quality of the word or phrase is the main distinguishing element for coding the complaint. each complained sentence constitutes a separate complaint. Source: Adapted from the Dyadic Parent-Child Interaction Coding System manual (eyberg & robinson, 1983) with permission of the authors.
Setting
