A group of Dutch researchers tested the predictive value
of parent, teacher, and clinician ratings of child psychopathology over
a 3-year period (Ferdinand et al., 2003). Parent and teacher ratings
were obtained with the CBCL and TRF. Clinician ratings were obtained
with the Semi-structured Clinical Interview for Children and Adolescents
(SCICA). Ninety six children referred for mental health services were
initially evaluated at ages 6 to 12 and were evaluated again after a
mean interval of 3.2 years. The initial CBCL, TRF and SCICA scale scores
were tested as predictors of the following measures of poor outcomes:
school problems, police/judicial contacts, parent's wish for help, need
for outpatient treatment, and need for inpatient treatment. The cross-informant
correlations of SCICA scores with CBCL and TRF scores were low to moderate,
as is typically found for assessment of psychopathology. All measures
of poor child outcomes were significantly predicted by CBCL, TRF, and
SCICA scores. On the whole, CBCL and TRF scores tended to be better
predictors of poor outcomes than clinicians' ratings. Nevertheless,
after all other scores were partialed out, the SCICA Attention Problems
scale, based solely on clinicians' observations during the interview,
significantly predicted need for inpatient treatment, which is an especially
compelling sign of poor outcomes. This was evidently the first study
to systematically compare the predictive value of parent, teacher, and
clinician ratings of poor outcomes for children referred for mental
health services. The findings suggest that the predictive power of clinical
assessment can be enhanced by the integration of reports provided by
multiple informants. Exclusive reliance on clinicians' ratings of child
psychopathology may limit the predictive power of clinical assessment.
Nevertheless, clinician ratings can add important predictive power to
parent and teacher ratings.
Reference:
Ferdinand, R. F., Hoogerheide, K. N., van der Ende, J., Heijmens Visser,
J. H., Koot, H. M., Kasius, M. C., & Verhulst, F. C. (2003). The
role of the clinician: three-year predictive value of parents', teachers',
and clinicians' judgment of childhood psychopathology. Journal of Child
Psychology and Psychiatry, 44, 1-10.