Measuring Serious Emotional Disturbance in Children Workshop Summary (2016) / Chapter Skim
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2 Existing Measures and Data
2 Existing Measures and Data
Pages 7-26
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From page 7... ...
, the perceived causal mechanisms of mental disorders, and the social and other contextual factors that influence mental disorders and treatment strategies. When it was first published in 1999,1 the report brought national attention to the public health relevance of mental disorders and also led to several initiatives by NIMH that focused on collecting data on the prevalence and magnitude of mental disorders, as well as on associated impairments in both adults and children.
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From page 8... ...
In the case of children under 16, a parent interview was also conducted. Although the DISC can measure a large number of disorders, only a subset of the disorders were selected for inclusion in the NHANES: generalized anxiety disorder, panic disorder, eating disorder, elimination disorder, major depression, dysthymic disorder, attention deficit hyperactivity disorder (ADHD)
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From page 9... ...
, conduct disorder, and eating disorder. NCS-A, National Comorbidity Survey Replication Adolescent Supplement; R02945 NHANES, National Health and Nutrition Examination Survey.
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Teachers are also likely to underestimate mood disorders or anxiety disorders, particularly social anxiety. Another consideration, Merikangas noted, is the large proportion of children with more than one disorder.
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Merikangas pointed out that although the nationally representative surveys sometimes lack depth of information, there are several regional studies that have collected rich, comprehensive data, including in the Northwest, the Smoky Mountain region, New York state, and Puerto Rico. Thinking about SAMHSA's mandate to produce prevalence estimates of children with serious emotional disturbance, Merikangas said that there are several challenges that are particularly important to consider.
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From page 12... ...
She proposed defining impairment on the basis of the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) , which describes disabilities as negative functional outcomes resulting from health conditions, involving significant deviation from or loss of "normal" or "expected" function.
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Canino summarized the characteristics of an impairment measure that are best suited in her view to measure child serious emotional disturbance as follows: • has scoring that is suitable to determine severity or significant impairment; • able to assess functioning in a variety of contexts, such as school, family, friends (multidimensional) ; • suitable for use with a wide range of ages; • available for both parent and child reports; • has good psychometric properties for the U.S.
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From page 14... ...
One of the disadvantages of the ICF-CY is that its applicability to children with serious emotional disturbance is limited, due to the operationalization challenges discussed. The WHO-DAS for adults was used successfully with adolescents in the NCS-A, but further research would be needed on the psychometric properties of the instrument, based on that study.
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From page 15... ...
administration; good applicable for children younger scores psychometric properties in than 7; three items confounded English and Spanish; short with symptoms C-GAS Yes 5 4-16 P, C Good psychometric Not applicable for children properties in English and younger than 4; dependent on Spanish; short; prior knowledge of the child severity cutoffs and what interviewer/parent thinks is normal functioning; confounded with symptoms SDQ-Impact Yesb 2 2-17 P, C, T Good psychometrics Not tested in children younger (5 items) and predictive validity than 5; of five items, only in several languages, three refer to impact; difficulty including Spanish; used in disentangling impact from large national survey by the symptoms; all items refer to Centers for Disease Control difficulties with emotions, and Prevention; wide age concentration, behavior, or range; short getting along with others; measures outcome, not impairment aCIS, Columbia Impairment Scale; C-GAS, Child Global Assessment Scale; SDQ, Strengths and Difficulties Questionnaire.
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From page 16... ...
on strengths; used mostly child; has not been tested for placing children and in populations other than treatment goals whites; no Spanish version aCAFAS, Child and Adolescent Functional Assessment Scale; PECFAS, Preschool and Early Childhood Functional Assessment Scale; BIS, Brief Impairment Scale; BERS, Behavioral and Emotional Rating Scale. bGlobal cutoff refers to results of receiver operating characteristic (ROC)
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From page 17... ...
With this initiative, the CDC wanted to contribute its expertise in the area of surveillance to an issue that is important to many agencies. The surveillance systems reviewed are as follows: • Autism and Developmental Disabilities Monitoring Network • National Health and Nutrition Examination Survey • National Health Interview Survey • National Survey of Children's Health • National Survey on Drug Use and Health • National Violent Death Reporting System • National Vital Statistics System • National Youth Risk Behavior Survey • School-Associated Violent Death Surveillance Study • National Comorbidity Survey Replication Adolescent Supplement Centers for Disease Control and Prevention.
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From page 18... ...
The 2005-2010 NHANES data show that 8.3 percent of 12- to 17-year-olds reported 14 or more mentally unhealthy days in the past month. An advantage of having national surveys that include these types of indicators is that they provide population estimates that help in understanding the relative sizes of the groups with various disorders, which helps with resource planning: see Figure 2-3.
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From page 19... ...
NOTE: The data cover children aged 3-17 except as follows: for Tourette syndrome, they cover children aged 6-17, and for illicit drug use disorder, alcohol use disorder, and cigarette dependence, they cover children aged 12-17. SOURCE: Workshop presentation by Susanna Visser, June 2015, based on Centers for Disease Control and Prevention, available: http://www.cdc.gov/media/ dpk/2013/docs/Child_menatal_health/Child_menatal_health_infographic.pdf [October 2015]
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The main limitations of these surveys are declining response rates, coverage bias, recall bias, and reporting bias. Data from community-based studies that involve either direct assessments of children or some other type of active surveillance case assessment tend to have more depth and breadth than data from the national surveys.
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. The impact of case definition on attention deficit hyperactivity disorder prevalence estimates in community-based samples of school-aged children.
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8.5 (8.0–9.0) NOTES: ADHD, attention deficit hyperactivity disorder; CI, confidence interval; FPL, federal poverty level; NHIS, National Health Interview Survey; NSCH, National Survey of Children's Health.
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6.8 (6.4–7.2) cFPL is based on family income and family size and composition using federal poverty thresholds that are updated annually by the U.S.
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Leveraging partnerships among agencies will also be important in developing better estimates. IMPAIRMENT DATA FROM THE MEDICAL EXPENDITURE PANEL SURVEY Benjamin Druss (Emory University)
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, conducted using data from the Medical Expenditure Panel Survey (MEPS) .5 The MEPS is primarily a service use survey, rather than an epi demiological survey, and it has included the Columbia Impairment Scale since the 1990s.
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From page 26... ...
SOURCE: Workshop presentation by Benjamin Druss, June 2015. Data from the Medical Expenditure Panel Survey.
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