How We Measure
Screening Measures
All screening measures used by the LINK are evidenced based tools recommended by CORC (Child Outcomes Research Consortium) and are used nationally in child and adolescent mental health services.
RCADS
The Revised Children’s Anxiety and Depression Scale (RCADS) and the RCADS - Parent Version (RCADS-P) are 47-item questionnaires that measure the reported frequency of various symptoms of anxiety and low mood. They produce a total anxiety and low mood score and separate scores for each of the following sub-scales: separation anxiety; social phobia; generalised anxiety; panic; obsessive compulsive total anxiety; and low mood.
RCADS and the RCADS-P can be used for tracking symptoms as well as providing additional information for assessment. The tool can be useful in highlighting specific issues, such as separation anxiety or obsessive compulsive disorder, where the initial difficulty seems to be a more general one, such as generalised anxiety or low mood.
The RCADS can be completed by young people aged from 8 to 18 years and the RCADS-P can also be completed by the parent or carer of young people aged across the same age groups. Clinical experience indicates that RCADS is too developmentally advanced for use with young people with learning disabilities, but has been found to be useful for some CYP with mild learning difficulties (Law & Wolpert, 2014).
SDQs
The Strengths and Difficulties Questionnaire (SDQ) is a brief emotional and behavioural screening questionnaire for children and young people. The tool can capture the perspective of children and young people, their parents and teachers. There are currently three versions of the SDQ: a short form, a longer form with an impact supplement (which assesses the impact of difficulties on the child's life) and a follow-up form. The 25 items in the SDQ comprise 5 scales of 5 items each. The scales include:
Emotional symptoms subscale
Conduct problems subscale
Hyperactivity/inattention subscale
Peer relationships problem subscale
Prosocial behaviour subscale
The SDQ can be used for various purposes, including clinical assessment, evaluation of outcomes, research and screening. The SDQ can be completed by children and young people aged 11-17 years old. The parent and teacher versions can be completed by the parent or teacher of CYP aged 2-17 years old. Clinical experience indicates that the SDQ may be appropriate to use with CYP with mild learning difficulties, but not with more severe learning difficulties (Law & Wolpert, 2014).
SRS
The Session Rating Scale (SRS) is a simple, four-item visual analogue scale designed to assess key dimensions of effective therapeutic relationships. The SRS is administered, scored and discussed at the end of each session to get real time alliance feedback from young people and carers to that alliance problems can be identified and addressed (Miller, Duncan, & Johnson, 2002). The SRS translates what is known about the alliance into four visual analogue scales each 10CM long to assess the client's perceptions of:
Respect and understanding
Relevance of the goals and topics
Client-practitioner fit
Overall alliance
The SRS is used with young people ages 13 to adults. The Child Session Rating Scale (CSRS) is for young people aged 6 - 12 (Duncan, et al. 2003). There is also a Group Session Rating Scale (GSRS) for ages 13 to adults, and a Child Group Session Rating Scale (CGSRS) for ages 6 - 12. For children 5 or under there is also the Younger Child Session Rating Scale (YCSRS), which has no psychometric properties, but can be a useful way of engaging small children regarding their assessment of the alliance.
ORS
The Outcome Rating Scale (ORS) and Child Outcome Rating Scale (CORS) are measures that can be used to monitor children’s, young people and their families or carers feedback on progress.
The ORS is a simple, four-item session-by-session measure designed to assess areas of life functioning known to change as a result of therapeutic intervention. These include: symptom distress, interpersonal well-being, social role, and overall well-being. The ORS translates these four dimensions of functioning into four visual analogue scales which are 10cm lines, with instructions to place a mark on each line with low estimate to the left hand to the right.
The ORS is designed to be accessible to a child with a 13-year-old’s reading level, making it feasible for adolescents and adults.
The CORS was developed for children aged 6 - 12. It has the same format as the ORS but with more child friendly language and smiley and frowny faces to facilitate the child's understanding when completing the scales (Duncan et al., 2003). For children 5 or under there is also the Young Child Outcome Rating Scale (YCORS), which has no psychometric properties, but can be a useful way of engaging young children regarding their assessment of how they are doing.
The ORS can be completed by children aged 13-18 years old and the CORS can be completed by children aged 6-12 years old. Parents/carers can also complete the ORS/CORS. If the young person is 13 or over and fills out the ORS, the carer fills out the ORS on how they perceive the young person doing. Similarly, if the young person is 12 and under and fills out the CORS, than the carer fills out the CORS on the young person.