Clinical Tools

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Clinical Assessment Tools for Children

Assessment and Screening for Immigrant and Refugee Children New to Canada
These tools from Kids New to Canada, developed by the Canadian Paediatric Society include screening and assessment tools directed at health care providers working with immigrant and refugee children include:

Kids New to Canada helps health professionals provide appropriate care to immigrant and refugee children, youth and families. The site contains a number of key resources to help health professionals learn more about working with newcomer families. – See more tools at  essentials for providing health care to children and youth new to Canada.

The Achenbach System of Empirically Based Assessment (ASEBA)
The ASEBA assesses competencies, adaptive functioning, and behavioral, emotional, and social problems from age 1½ to over 90 years (specifics of the assessment tools vary depending on the age of the patient). This instrument has been translated into over 85 languages and has been culturally validated in many different studies. This is not an open-access document, but can be purchased from the website for varying prices, depending on the exact instrument and whether it will be used for training purposes. Information about the reliability and validity of the instrument can be found here.

Pediatric Symptom Checklist
This is a brief screening questionnaire that is used by pediatricians and other health professionals to improve the recognition and treatment of psychosocial problems in children. In addition to the original 35 item parent report form of the PSC, there are now many other validated forms including a youth self report, a pictorial version, and a briefer 17 item version for both the parent and youth forms. In a number of validity studies, PSC case classifications agreed with case classifications on the Child Behavior Checklist (CBCL), Children’s Global Assessment Scale (CGAS) ratings of impairment, and the presence of psychiatric disorder in a variety of pediatric and subspecialty settings representing diverse socioeconomic backgrounds. This tool is available in over a dozen languages from the website. There is no cost associated with using this tool. This is an open-access document.

Jellinek, M., Evans, N., & Knight, R.B. (1979). Use of a behavior checklist on a pediatric inpatient unit. Journal of Pediatrics94(1): p. 156-8.

Strength and Difficulties Questionnaire (SDQ)

Open SDQ

The Strengths and Difficulties Questionnaire (SDQ) is a brief behavioral screening questionnaire about 3 to 16-year-olds. It exists in several versions to meet the needs of researchers, clinicians, and educationalists. It can be used as part of the initial assessment, by asking parents, teachers and young people over the age of 11 to complete questionnaires prior to the first clinical assessment. Each version includes between one and three of the following components:

A) 25 items on psychological attributes

All versions of the SDQ ask about 25 attributes, some positive and others negative.  These 25 items are divided between 5 scales:

1) emotional symptoms (5 items)
2) conduct problems (5 items)
3) hyperactivity/inattention (5 items)
4) peer relationship problems (5 items)
5) prosocial behaviour (5 items)

(1) to 4) added together to generate a total difficulties score (based on 20 items)

  • The same 25 items are included in questionnaires for completion by the parents or teachers of 4-16 year olds (Goodman, 1997).
  • A slightly modified informant-rated version for the parents or nursery teachers of 3 (and 4) year olds. 22 items are identical, the item on reflectiveness is softened, and 2 items on antisocial behaviour are replaced by items on oppositionality.
  • Questionnaires for self-completion by adolescents ask about the same 25 traits, though the wording is slightly different (Goodman et al, 1998). This self-report version is suitable for young people aged around 11-16, depending on their level of understanding and literacy.

In low-risk or general population samples, it may be better to use an alternative three-subscale division of the SDQ into ‘internalising problems’ (emotional+peer symptoms, 10 items), ‘externalising problems’ (conduct+hyperactivity symptoms, 10 items) and the prosocial scale (5 items) ( Goodman et al, 2010).

B) An impact supplement

Several two-sided versions of the SDQ are available with the 25 items on strengths and difficulties on the front of the page and an impact supplement on the back. These extended versions of the SDQ ask whether the respondent thinks the young person has a problem, and if so, inquire further about chronicity, distress, social impairment, and burden to others.  This provides useful additional information for clinicians and researchers with an interest in psychiatric caseness and the determinants of service use (Goodman, 1999).

C) Follow-up questions

The follow-up versions of the SDQ include not only the 25 basic items and the impact question but also two additional follow-up questions for use after an intervention. Has the intervention reduced problems? Has the intervention helped in other ways, e.g. making the problems more bearable? To increase the chance of detecting change, the follow-up versions of the SDQ ask about ‘the last month’, as opposed to ‘the last six months or this school year’, which is the reference period for the standard versions. Follow-up versions also omit the question about the chronicity of problems.

Goodman R (1997) The Strengths and Difficulties Questionnaire: A Research Note. Journal of Child Psychology and Psychiatry, 38, 581-586.