Data-Informed Communication: How Measurement-Based Care Can Optimize Child Psychotherapy.

Measurement-based care (MBC) research and practice, including clinical workflows and systems to support MBC, are grounded in adult-serving mental health systems. MBC research evidence is building in child and adolescent services, but MBC practice is inherently more complex due to identified client age, the family system and the need to involve multiple reporters. This paper seeks to address a gap in the literature by providing practical guidance for youth-serving clinicians implementing MBC with children and their families. We focus on MBC as a data-informed, client-centered communication process, and present three key strategies to enhance usual care child and adolescent psychotherapy via developmentally-appropriate MBC. These strategies include (1) go beyond standardized measures; (2) lean into discrepancies; and (3) get curious together. Case-based examples drawn from various child-serving settings illustrate these key strategies of MBC in child psychotherapy.

El ajuste psicológico de los niños, niñas y adolescentes en acogimiento residencial con Familias Colaboradoras: Una evaluación multi-informante / Psychological adjustment of children and adolescents in residential care with Collaborating Families: A multi-informant assessme

En el marco del acogimiento residencial, se ha desarrollado el programa Familias Colaboradoras con el fin de que los niños, niñas y adolescentes tutelados puedan disfrutar de períodos de convivencia en un ambiente familiar positivo, que les genere beneficios y complemente su atención residencial. En este trabajo, a través del instrumento Strengths and Difficulties Questionnaire (SDQ), estudiamos el ajuste psicológico de 37 menores de edad en acogimiento residencial con familias colaboradoras, contrastando las valoraciones de 185 informantes: los propios menores de edad, sus familias colaboradoras, los profesionales de referencia del centro, así como un grupo de comparación de iguales sin familias colaboradoras y sus profesionales de referencia. Además, analizamos si el ajuste psicológico de estas personas menores se relaciona con variables personales y la valoración que hacen de la colaboración familiar. Los resultados mostraron diferencias significativas entre el ajuste psicológico valorado por los distintos informantes. Además, los menores de edad con familias colaboradoras tendieron a mostrar un mejor ajuste psicológico frente al grupo de comparación, con tamaños de efecto considerables. Se encontraron también relaciones significativas entre el ajuste psicológico y la valoración de los menores sobre la colaboración familiar. Finalmente, se discuten algunas implicaciones prácticas para el desarrollo del programa.(AU)

In residential care, programs such as Collaborating Families have been developed so that children and adolescents can experience periods of cohabitation in a positive family environment, which generates benefits for them and complements their residential care. The present study used the Strengths and Difficulties Questionnaire(SDQ) to study the psychological ad-justment of 37 children and adolescents in residential care with collaborat-ing families, comparing the assessments of 185 informants: the children themselves, their collaborating families, their caregivers at the protection center, as well as a comparison group of peers without collaborating fami-lies and their caregivers. In addition, this study analyzed whether the psy-chological adjustment of these children is related to some of their personal variables and their experience in family collaboration. The results showed significant differences between the psychological adjustment assessed by the different informants. Also, children with collaborating families tended to present a better psychological adjustment compared to the comparison group, with considerable effect sizes. Moreover, significant relationships were found between psychological adjustment and the children’s ratings about their family collaboration. Finally, some practical implications for the development of the program are discussed.(AU)

Discrepancias entre padres y maestros de estudiantes con trastorno de espectro autista (TEA) en funcionamiento ejecutivo según el BRIEF / Discrepancies between parents and teachers of students with autism spectrum disorder (ASD) in executive functioning according to the BRIEF

Uno de los puntos críticos en la evaluación del trastorno del espectro autista es la manifestación del comportamiento en varios contextos del desarrollo, por lo que la valoración por parte de diferentes informantes es un aspecto clave. El objetivo de este estudio fue analizar la existencia de discrepancias entre padres y maestros en la evaluación del funionamiento ejecutivo en una muestra de 43 niños con un trastorno del espectro autista de nivel de gravedad 2. Para ello se compararon las puntuaciones obtenidas en las subescalas del BRIEF entre padres y maestros, y se analizó la relación entre tales puntuaciones. Los resultados obtenidos indicaron, en primer lugar, diferencias estadísticamente significativas entre padres y maestros en todas las escalas, siendo los maestros quienes informaron de una mayor disfunción ejecutiva, y en segundo lugar, la ausencia de correlaciones estadísticamente significativas entre las puntuaciones otorgadas por ambos informantes en casi todas las escalas. Se puede concluir que existen diferencias en cuanto a la percepción que tienen padres y maestros con respecto a las funciones ejecutivas de los niños con TEA, lo que puede estar en consonancia con la relevancia o el papel que tienen estas funciones en el contexto en el que son evaluadas.(AU)

One of the critical issues in the assessment of autism spectrum disorder is the behavior exhibited in various developmental contexts, and so the assessment by different informants is important in understanding this disorder. The aim of this study was to analyze parent-teacher agree-ment on executive functioning assessment in a sample of 43 children with autism spectrum disorder with level 2 severity. For this purpose, scores given by parents and teachers on the BRIEF subscales were compared, and the relationship between these scores was analyzed. The results obtained indicated, first, statistically significant differences between parents and teachers on all the subscales, with teachers reporting greater executive dys-function in all cases. Second, there were no statistically significant correla-tions between the scores given by the two informants on almost all the subscales. Overall, these results point to the different perceptions of par-ents and teachers regarding the executive functioning of children with ASD, which may reflect the relevance or role of these functions in the con-text where they are assessed.(AU)

Multi-Informant Assessment of Adolescents' Social-Emotional Skills: Patterns of Agreement and Discrepancy among Teachers, Parents, and Students.

OBJECTIVES: This study explores the patterns of agreement and discrepancy among informants (teachers, parents, and students) in the domains of the Social Emotional Skills Scale Assessment System-Social Skills Scales (SESAS-SS), which is a translation of the Social Skills Improvement System-Rating Scales (SSIS-RS) for use in Spain. METHODS: The sample is composed of students, 88 teachers, and 98 parents from Spanish secondary schools. Inter-rater agreements have been assessed, calculating the Pearson correlation coefficients among pairs of raters, effect size indices, and intraclass correlation coefficients at the subscale and total scale level. RESULTS: The convergent validity coefficients were stronger than the divergent ones, with the highest level of agreement between teachers and parents in social skills, particularly for total social skills, engagement, empathy, and communication. The patterns of discrepancies confirmed weaker agreements between teachers and parents in self-control and between parents and students in empathy. Significant differences were also found in students' estimates depending on gender. CONCLUSIONS: The SESAS-SS provides support for previous studies on inter-rater agreements for SS, extending the focus on the degree of agreement in the estimate of dyads of raters when considering the students' gender.

Multi-informant reports of depressive symptoms and suicidal ideation among adolescent inpatients.

OBJECTIVE: Suicide is a leading cause of death among adolescents, and suicidal thoughts represent key predictors to suicidal behavior. Yet, suicidal thoughts can be challenging to accurately assess. Symptoms that commonly co-occur with suicidal thoughts, such as depressive symptoms, may provide valuable information for predicting these thoughts. Although clinicians commonly collect multi-informant reports about adolescent depressive symptoms, these reports often yield discrepant findings as individual predictors of adolescents' suicidal thoughts. METHOD: We tested the ability of specific patterns of multi-informant reports to predict adolescents' suicidal thoughts. Ninety adolescent inpatients and their parents (i.e., "dyads") reported on adolescent depressive symptoms, and adolescents completed self-report assessments of suicidal thoughts at baseline and three-month follow-up. RESULTS: Dyads displayed variability in reporting patterns, and these patterns uniquely predicted suicidal thoughts. Adolescents reporting elevated depressive symptoms displayed increased concurrent suicidal thoughts relative to adolescents reporting subthreshold depressive symptoms, regardless of parent report. Yet, only adolescents who reported elevated depressive symptoms and whose parents reported subthreshold adolescent depressive symptoms displayed increased future suicidal thoughts. CONCLUSIONS: Identifying patterns of multiple informants' reports about adolescent depressive symptoms may improve the prediction of suicidal thoughts. These findings have important implications for assessing adolescents at risk for suicide.

Social Emotional Competence, Learning Outcomes, Emotional and Behavioral Difficulties of Preschool Children: Parent and Teacher Evaluations.

This paper addresses the role of social emotional competence in the emotional and behavioral problems and learning outcomes of preschool children based on their parents' and teachers' evaluations. In this study, we compared the perceptions of teachers and parents when evaluating the same child using the multi-informant assessment. First, the associations and differences between both the informant evaluations were investigated. Second, the correlation of the social emotional competence and emotional, and behavioral difficulties among preschool children was analyzed, separately addressing their parents' and teachers' evaluations. Third, the role of the preschool children's social emotional competence in their emotional and behavioral problems, and learning outcomes was investigated building the regression and mediation models. The sample consisted of 507 preschool children (3-6 years, mean age 4.85 years, SD 0.82) and their parents and teachers. Both informants completed the Strengths and Difficulties Questionnaire and Social Skills Improvement System Social-Emotional Learning Brief Scales, and teachers reported on each child's learning outcomes (by completing a three-item Learning outcomes measure). When comparing both informants' evaluations, positive associations were found between teacher and parental evaluations of prosocial behavior and emotional, and behavioral difficulties of preschool children, as well as self-management. Parents evaluated their children higher than teachers in conduct problems, hyperactivity, prosocial behavior, and total difficulty, while teachers evaluated children higher than parents in social emotional competence. According to teachers, the social emotional competence of preschool children was negatively correlated to all difficulty scales, and positively related to the prosocial behavior scale. The demographic variables, as well as parental socioeconomic status and children's belonging to a vulnerable group were not found to be significantly associated with the preschool children's learning outcomes. However, social emotional competence remains a significant variable in teacher-rated learning outcomes of preschool children even if sociodemographic variables are controlled. Our findings indicate that a higher level of social emotional competence and lower levels of social, emotional, and behavioral difficulties are related to a higher preschoolers' academic learning in their teachers' evaluation. This suggests the importance of early facilitation of social emotional competence as a key factor for academic success and more positive behavioral outcomes.

Family Functioning among Rural Teens and Caregivers: Interactive Influence on Teen Dating Violence.

Multi-informant assessment of family functioning is considered best practice in research and clinical settings. However, in the area of teen dating violence, multi-informant assessment of family functioning has received limited attention. The current study investigated whether and to what extent caregiver and adolescent perceptions of family functioning interact in their influence on adolescent dating violence. Participants were 493 adolescents and their primary caregivers from a rural southeastern community in the United States. As hypothesized, a paired-samples t test showed that adolescents' scores on the family functioning measure were significantly lower than their caregivers' scores. Logistic regressions revealed that adolescents' positive views of family functioning were significantly associated with a lower likelihood of dating violence victimization but not perpetration and that caregivers' views on family functioning moderated the impact of adolescent-reported family functioning on both dating violence outcomes. Post hoc analyses showed that adolescents with negative perceptions of family environment were most likely to be victims and perpetrators of dating violence when their parents also reported more negative views of family environment. The article concludes with a discussion of how these findings can: (a) advance our understanding of the impact of family functioning on teen dating relationships and (b) inform practical efforts aimed at preventing dating aggression among teens.

La evaluación multiinformante del funcionamiento familiar se considera una práctica adecuada en la investigación y en los entornos clínicos. Sin embargo, en el área de la violencia de parejas adolescentes, la evaluación multiinformante del funcionamiento familiar ha recibido escasa atención. En el presente estudio se investigó si y hasta qué punto las percepciones que tienen los cuidadores y los adolescentes del funcionamiento familiar interactúan en su influencia en la violencia de parejas adolescentes. Los participantes fueron 493 adolescentes y sus principales cuidadores de una comunidad rural del sureste de los Estados Unidos. Como se hipotetizó, una prueba de T para muestras apareadas demostró que los puntajes de los adolescentes en la medida del funcionamiento familiar fueron considerablemente más bajos que los puntajes de sus cuidadores. Las regresiones logísticas revelaron que las perspectivas positivas de los adolescentes con respecto al funcionamiento familiar estuvieron asociadas considerablemente con una menor probabilidad de victimización por violencia en la pareja pero no de perpetración, y que las perspectivas de los cuidadores con respecto al funcionamiento familiar moderaron el efecto del funcionamiento familiar informado por los adolescentes en ambos resultados de la violencia de pareja. Los análisis retrospectivos demostraron que los adolescentes con percepciones negativas del entorno familiar fueron más propensos a ser víctimas y perpetradores de violencia en la pareja cuando sus padres también informaron perspectivas más negativas del entorno familiar. El artículo finaliza con un debate de cómo estos hallazgos pueden: (a) promover nuestra comprensión del efecto del funcionamiento familiar en las relaciones de parejas adolescentes y (b) respaldar efectos prácticos orientados a prevenir la agresión en las parejas de adolescentes.

Multi-informant universal screening: Evaluation of rater, item, and construct variance using a trifactor model.

Universal screening is a proactive method for identifying student risk, yet remains under-utilized in school systems. Instead, many schools rely on teacher reports and referrals without accounting for different informant perspectives. In the current study, multi-informant universal screening in evaluated using a trifactor model. The study utilized the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS), specifically the teacher (SAEBRS-TRS) and student (mySAEBRS) self-report forms, with items indicating risk for social, academic, and emotional behavior. Data from a national sample of over 24,000 K-12 teacher-student dyads were used to examine the extent and variance of discrepant reports between students and teachers of common, perspective, and item factors. Results demonstrated that informant perspective factors were a strong predictor for student and teacher emotional behavior item ratings. Whereas age had a positive effect on younger student reports of risk on the behavior items compared to older student reports, teachers showed the opposite effect. The teacherperspective of social and emotional behaviors of students was predicted by gender. Implications and directions for future research are further discussed.

Assessing ADHD Through the Multi-Informant Approach: The Contribution of the Conners' 3 Scales.

OBJECTIVE: Symptoms of ADHD need to be present in at least two different settings to suggest a diagnosis, so multi-informant assessment approaches are usually adopted. The Conners' Rating Scales offer three versions, completed by parents (Conners 3-P), teachers (Conners 3-T), and youth (Conners 3-SR). Nonetheless, there is a lack of studies examining the psychometric properties of the Parent and Teacher versions and the relation between each version of the Conners 3 scales. METHOD: The present work examined the psychometric properties of the Parent and Teacher scales in terms of the structural validity and reliability of their Content scales in an Italian sample. Moreover, to support the need to administer all Conners 3 scales together and to exclude their potential redundancy, cross-informant agreement between parents, teachers, and children was assessed. RESULTS: Results supported the Conners 3 scales as reliable and valid tools to assess ADHD and provided evidence for their non-redundancy. CONCLUSION: The non-redundancy of the Conners 3 may promote clinicians to adopt a multi-informant perspective.