Development, preliminary validation and reliability of the colourful 'My Feelings Form' self-report for young children.

BACKGROUND: Patient-reported outcome measures place the patient at the centre of his/her care. There are calls to introduce child-reported outcome measures to mental health services. We aimed to (a) develop an age-appropriate patient-reported outcome measure for children's mental health, and (b) validate this in a primary school and Child and Adolescent Mental Health Service (CAMHS). METHODS: A list of items to measure children's mental health was proposed (Draft 1) and revised to 14 items following focus group and user consultation (Draft 2). A colourful, cartoon and emoji version was created in consultation with children (Draft 3); a professional cartoon artist created the final 'My Feelings Form' (MFF), with usability feedback (Draft 4). The MFF was tested by 317 children aged 4-13 years from one mixed-gender primary school at two time points in 1 day, and 25 children aged 4-13 years from CAMHS. Results were analysed using test-retest reliability and exploratory factor analysis; a receiver operator characteristic curve was constructed. RESULTS: The CAMHS group scored significantly higher than the school group for the mean total score (23.5 ± 11.3 vs. 16.1 ± 6.2) and for 10 items. Test-retest reliability was acceptable (correlation = 0.74, p < .001). Exploratory factor analysis using 10 informative items identified two factors - emotional factor (Cronbach's alpha = 0.74) and function factor (Cronbach's alpha = 0.59). The revised 10-item form has a Cronbach's alpha of 0.77; a cut-off of 12 has a sensitivity of 80% and specificity of 60%, indicating that it correctly identified 80% of those who were attending CAMHS and gave 60% of the schoolchildren a negative result. CONCLUSIONS: The colourful MFF was co-produced with children, and preliminary data suggest that it is a useful patient-reported outcome measure for children's mental health.

COVID-19 and mental health of primary school children: Comparison of 2019 and 2020.

INTRODUCTION: It is believed that the COVID-19 pandemic and associated global school closures may have an adverse effect on children's mental health. METHODS: We performed repeated measures of the mental health of children attending one primary school in Ireland before and during the quarantine phase of the first wave of the pandemic. We used the 'My Feelings Form', which is a 14-item colourful self-report measure which was completed in the classroom in 2019 and via postal survey in 2020. RESULTS: We had an 87% response rate in 2019 and a 35% response rate via postal return in 2020. We found no evidence of a change in mean measures of mental health between 2019 and 2020, in the 35% who responded in 2020. CONCLUSION: There is a cohort of children who were not adversely affected by the first wave of COVID-19 pandemic and associated school closures in Ireland.