Parent Report Form Research Articles

The German version of the Centre for Epidemiological Studies Depression Scale for Children: psychometric evaluation in a population-based survey of 7 to 17 years old children and adolescents – results of the BELLA study

To examine the psychometric properties and test the theoretical quality of the German version of the Centre for Epidemiological Studies depression scale for children (CES-DC), a 20-item screening instrument measuring the frequency of parent- and self-reported depressive symptoms in children and adolescents. Using a population-based, representative sample of n=2,863 7 to 17-year-old German children and adolescents, factorial validity were determined by means of linear structural equation modelling. Cross-sectional coefficients of reliability, inter-rater agreement as well as descriptive statistics of the scales were calculated. In a population-based German sample, the four-factor version of the CES-DC following Radloff (Appl Psychol Meas 1:385-401, 1977) is considered to have good factorial validity and stability across age and informant versions. The main problems of the questionnaire are the high item difficulties, strong floor effects of the scales and low cross-sectional reliability, which are acceptable only for screening purposes. The low inter-rater agreement indicates that parental assessment can replace self-assessment only to a limited degree. The strengths and weaknesses of the CES-DC are discussed taking previous data and comparable tests into consideration. Particular advantages are the existence of the parent-report form and the adult version, as well as its multifactorial structure. Parental assessment should be supplemented by self-report data whenever possible.

Factors related to Health-Related Quality of Life (HRQoL) among children with ADHD in Europe at entry into treatment

To describe the associations between a range of baseline factors (demographic, family and clinical) and parent-reported health-related quality of life (HRQoL) of children with ADHD taking part in the ADORE study. HRQoL was rated using the Parent Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE). Forward-stepwise linear regression models were used to investigate associations with 26 independent variables. Separate models were fitted for each of the five CHIP-CE domains (Satisfaction, Comfort, Resilience, Risk Avoidance and Achievement) and two subdomains of Achievement (Academic Performance and Peer Relations). CHIP-CE domain mean scores were lower than community norms, especially for Risk Avoidance and Achievement, indicating a low level of HRQoL. Clinical factors significantly associated with a poorer HRQoL included ADHD symptoms (inattention, hyperactivity-impulsivity), conduct problems, peer relationship problems, having asthma, multiple other somatic symptoms and co-ordination problems. Family factors, such as having a parent with a health or mental health problem possibly caused by the child's illness, child not living with both parents and maternal smoking during pregnancy were also associated with a worse HRQoL in some CHIP-CE domains/subdomains. Numerous factors independently impact on the HRQoL of children with ADHD.

Validity of the health-related quality of life assessment in the ADORE study: Parent Report Form of the CHIP-Child Edition.

To examine the cross-sectional reliability and validity of the Parent Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE), a generic measure of health-related quality of life (HRQoL), in children with ADHD in the pan-European ADHD Observational Research in Europe (ADORE) study. Parents of children with ADHD (aged 6-18 years) in 10 European countries completed the CHIP-CE at the baseline visit (n=1,477; data missing for one patient). Analyses included determination of internal consistency reliability, ceiling and floor effects, factor analysis, and Pearson's correlations between CHIP-CE and other scales used to measure ADHD severity, problems and family strain. Internal consistency reliability was good-to-excellent (Chronbach's alpha>0.70) for all CHIP-CE domains and subdomains, and almost no ceiling and floor effects were observed. Factor analysis of the subdomains yielded a 12-factor solution. The domainlevel factor analysis identified six factors, the four domains of Satisfaction, Comfort, Resilience and Risk Avoidance. The two subdomains of Achievement domain, Peer Relations and Academic Performance, were separate factors in this sample. There were moderate-to-high correlations between the CHIP-CE scales and measures of ADHD and family factors. The HRQoL of children in ADORE was dramatically lower than that of community youth,with mean CHIP-CE scores almost 2 standard deviations below community norms. The validity and reliability of CHIP-CE to measure HRQoL in children with ADHD across Europe was confirmed.

Perceived health status and use of healthcare services among children and adolescents

The aim of the present study was to analyse the use of healthcare services according to health status in a population of children and adolescents, taking into account family socio-demographic characteristics and characteristics of the proxy respondent. A total of 836 interviews of proxy respondents for children aged 5-14 years from the Barcelona Health Interview Survey carried out in 2000 were included. Dependent variables were visits to a healthcare professional, visits to the emergency room, and hospitalization. Independent variables were: report of medical conditions, health status of the child measured by the Child Health and Illness Profile-Child Edition, Parent Report Form (CHIP-CE/PRF), the educational level of the head of household, social class, child's healthcare coverage, and proxy-related variables [mental health status by means of the General Health Questionnaire-12 items version (GHQ-12), and other]. Logistic regression analysis was used to estimate prevalence ratio (PR) to compare the use of healthcare services among different categories of independent variables. Children having worse health status were more likely to have visited a healthcare professional [PR = 1.68; 95% confidence interval (95% CI) = 1.09-3.83], whereas children with a reported medical condition were more likely to have made a visit to the emergency service (PR = 1.47; 95% CI = 1.27-2.55) and were hospitalized more frequently (PR = 2.50; 95% CI = 1.12-5.57). Higher likelihood of visits to the emergency room was associated with children having both public and private coverage and a proxy respondent scoring 3 or higher on the GHQ-12. Use of healthcare services differed by health needs but not by social class. Double healthcare coverage and mental distress of the proxy respondent influenced the use of emergency services.

Emotional and behavioral problems after pediatric liver transplantation: A quantitative assessment

Several uncertainties regarding psychological problems in children who underwent liver transplantation and the need to differentiate these disturbances from those related to the underlying previous chronic liver disease itself exist. This background triggered the present pilot study to investigate, using quantitative assessment methods, the incidence and the type of emotional and behavioral disturbances after liver transplantation. Sixteen liver transplant recipients (aged 5.7-14.4 yr) and 12 age-matched controls with stable chronic liver disease were assessed through the parent report form of Child Behavior Checklist/ 4-18. The mean time elapsed since transplantation was 8.1 yr. No patient or family had received psychological support during chronic liver disease or at any phase of the transplantation process. Transplanted children scored within borderline range for Internalizing and Total Behavioral Problems and within pathological range for Competences, except for the Activity Scale. Transplanted children showed more Total Behavioral (p = 0.005) and Externalizing Problems (p = 0.0005) than controls. Both groups scored within the pathological range for Total Competences with no significant differences between the two groups. Our findings suggest that in the absence of support programs a psychological risk does exist for a long period of time, after transplantation. Regarding Total Behavioral Problems and Externalizing Problems, this risk is higher than in children with chronic liver disease.

Child Adjustment of Single-Parent Adoption from China

A sample of 126 single-mother adoptive families was compared with 415 dual-parent adoptive families on their adopted Chinese daughters' internalizing and externalizing problem behaviors as measured by the Child Behavior Checklist (CBCL) parent report form. The single-mother families included 110 preschool (1.5–5 yrs) and 34 school-aged adoptees (6–11 yrs). The dual-parent families included 378 preschool and 131 school-aged adoptees. No group difference was found between adoptees from the two types of families on either the internalizing or the externalizing problem scale. The preschool adoptees from both single-and dual-parent families scored significantly lower than the U.S. norms on the internalizing and externalizing problem scale. The school-aged Chinese adoptees from both types of families also scored significantly lower than the U.S. norms on the externalizing problem scale. For both preschool and school-aged adoptees, family type did not predict any group difference in the problem behaviors. Overall, there was no evidence that single parenting was a risk factor for the Chinese adoptees' adjustment.

The Parent Report Form of the CHIP-Child Edition: reliability and validity.

Valid, comprehensive instruments to describe, monitor, and evaluate health from childhood through adolescence are almost nonexistent, but are critical for health resource planning, evaluation of policy, preventive, and clinical interventions, and understanding trajectories of health during this important period of life. The objectives of this study were to describe the development, testing, and final versions of the Parent Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE/PRF), designed to measure the health of children 6 to 11 years old from the caregiver perspective. Parents (N=1049) completed a version of the CHIP-CE/PRF in 4 locations in the United States, either in clinic waiting rooms or their homes. They differed in race/ethnicity, socioeconomic level, and native language. The Parent CHIP-CE is feasible; parents with a 5th-grade reading level complete the 76-item PRF in 20 minutes. Its domains (Satisfaction, Comfort, Risk Avoidance, Resilience, and Achievement) measure structurally distinct, interrelated aspects of health. Domain reliability is high: internal consistency=0.79-0.88; retest reliability (ICC)=0.71-0.85. Validity is supported. The scale scores are sensitive to predicted age, gender, and socioeconomic status differences in health. The CHIP-Child Edition/Parent Report Form is a psychometrically sound, conceptually based measure of child health that works well in diverse populations. It produces scores that parallel those of children on the CHIP-CE/CRF and adolescents on the CHIP-AE and allows health to be consistently assessed from childhood through adolescence. It should meet many needs for describing, monitoring, and understanding child health and evaluating outcomes of interventions.

Versión española del perfil de salud infantil, cuestionario para padres y madres: Child Health and Illness Profile-Child Edition Parent Report Form (CHIP-CE/PRF)

ObjectivesTo analyze the reliability and validity of the domains of the Child Health and Illness Profile-Child Edition Parent Report Form (CHIP-CE/PRF) included in the Barcelona Health Survey conducted in 2000 and to obtain populationbased reference values. MethodsData were obtained from proxy-respondent interviews of children aged 5-14 years old (n = 836) participating in the Barcelona Health Survey 2000. The 4 subdomains of the parent version of the CHIP-PRF included in the health survey were: «satisfaction with health», and physical discomfort, emotional discomfort, and limitation of activities of the «discomfort domain». Internal consistency was assessed using Cronbach's alpha coefficients. An exploratory factor analysis was carried out and analysis of covariance was performed to assess the construct validity of the subdomains. ResultsIn all the subdomains assessed, Cronbach's alpha was above 0.70 (range, 0.76-0.98). In the factorial analysis, almost all the items (31/35) presented the highest load in their corresponding subdomain. Most of the expected mean differences among groups were confirmed. Girls aged 10-14 years old scored the lowest, both in «satisfaction with health» (48.93; 95% confidence interval [CI 95%], 47.40-50.47) and in «discomfort » (48.87; CI 95%, 47.51-50.22). No differences were found according to the social class of the head of the family. ConclusionsThe present study provides a useful measure of perceived health status in a child health survey.

Sibling-based association analyses of the serotonin transporter polymorphism and internalizing behavior problems in children.

Childhood internalizing problems are often precursors in the development of more serious psychiatric syndromes including anxiety and depressive disorders. Twin studies of the etiology of these disorders suggest that the genetic risk factors underlying anxiety and depression are highly correlated. However, the specific genetic mechanisms responsible for this risk have not yet been identified. We examined the association between childhood internalizing problems and a functional polymorphism in the serotonin transporter gene (5-HTTLPR) in 711 children participating in a longitudinal twin study of behavioral and emotional development. Internalizing problems were measured at ages 4, 7, 9, 10, 11 and 12 years using the Child Behavior Checklist (CBCL) parent report form. We applied a sibling-based methodology for estimating allelic association with quantitative traits, while controlling for population stratification. No associations were found for CBCL Internalizing problems at any age, including the subscales for Somatic Complaints, Withdrawn and Anxiety/Depression. Thus, although our results did not support the hypothesis that the 5-HTTLPR contributes to a dimensional expression of internalizing behavior problems, this does not rule out the possibility that it is an interesting polymorphism to pursue in the search for genetic risk factors related to major depressive and/or anxiety disorders.

Association of bullying with adolescent health-related quality of life.

To examine the relationship between being bullied and health-related quality of life (HR-QOL) in adolescence. Subjects were a cohort of 805 adolescents with a mean age of 13.6 years (standard deviation 0.2 years). An adolescent questionnaire elicited the frequency of being bullied. HR-QOL was measured using the Child Health Questionnaire - Parent Report Form (CHQ-PF50) and Dartmouth COOP Functional Health Assessment Charts for Adolescents. Thirty-six per cent of boys and 38 per cent of girls reported being bullied at least weekly. Adolescent psychosocial HR-QOL was inversely related to frequency of being bullied, while physical HR-QOL was not related. Peer bullying is an important determinant of adolescent HR-QOL with a negative impact on psychosocial well-being.

A psychometric evaluation of the parent report form of the State-Trait Anxiety Inventory for Children—Trait Version

We examined the psychometric characteristics of the State-Trait Anxiety Inventory for Children–Parent Report—Trait Version (STAIC-P-T) [Strauss, C. (1987). Modification of trait portion of State-Trait Anxiety Inventory for Children–Parent Form. Gainesville, FL: University of Florida], a brief, parent report paper-and-pencil measure of child chronic anxiety, in a large clinic-referred sample. Internal consistency coefficients were high and retest reliability coefficients were in the moderate range. Convergent validity evidence was mixed in its support for the measure, with evidence most supportive within reporter and within parental dyad. Divergent validity evidence provided less support for the measure, but was largely consistent with past research. Regression analyses indicated that parent reports on the STAIC-P-T were not significantly related to a parent’s own level of symptomatology. Overall, the study provides mixed support for the psychometrics of the STAIC-P-T.

Exposure to Violence

Inner-city children are frequently exposed to violence; however, there are few data regarding the psychological and academic correlates of such exposure in young children at school entry. To document exposure to violence in inner-city children aged 7 years; assess their feelings of distress; and evaluate the relationships of exposure to violence with school performance, behavior, and self-esteem. A study center in an inner-city hospital. One hundred nineteen inner-city children evaluated at age 7 years; 119 caregivers (biological and foster). As part of a longitudinal study, children were administered the following by a masked examiner: Things I Have Seen and Heard (TISH) to assess exposure to violence; Levonn, a cartoon-based interview for assessing children's distress symptoms; and the Culture-Free Self-Esteem Inventory, Second Edition. School performance was assessed by school reports and child behavior by the Child Behavior Checklist (CBCL), the Parent Report Form, and the Teacher Report Form. Caregivers for children were administered the parent report version of the Checklist of Children's Distress Symptoms (CCDS-PRV) as well as the CBCL Parent Report Form. Exposure to violence (TISH); feelings of distress (Levonn); school performance; behavior (CBCL Parent Report Form and CBCL Teacher Report Form); and self-esteem (Culture-Free Self-Esteem Inventory). We found that these children were frequently exposed to violence. For example, 75% had heard gun shots, 60% had seen drug deals, 18% had seen a dead body outside, and 10% had seen a shooting or stabbing in the home (TISH). Many showed signs of depression and anxiety; eg, 61% worried some or a lot of the time that they might get killed or die and 19% sometimes wished they were dead (Levonn). Higher exposure to violence (TISH Total Violence score) was correlated with higher Levonn composite scores for depression and anxiety and with lower self-esteem (P< or =.04), and was also associated with lower grade point average and more days of school absence (P< or =.02). Caregiver assessment of child anxiety correlated poorly with child report of anxiety (P =.58). Young inner-city children have a high exposure to violence by age 7 years; many show signs of distress that frequently are not recognized by caregivers. Further, higher exposure to violence in children correlates with poorer performance in school, symptoms of anxiety and depression, and lower self-esteem.

Social-Behavioral Assessment of At-Risk Early Adolescent Students: Psychometric Characteristics and Validity of a Parent Report Form of the School Social Behavior Scales

The purposes of this investigation were to examine the validity of the Home and Community Social Behavior Scales (HCSBS) for differentiating at-risk and non-at-risk stu dents in grades 6 through 9 and to evaluate psychometric characteristics of this instru ment. Parent ratings of social competence and antisocial behavior on the HCSBS for a group of 160 students who were part of an at-risk pre vention project were compared with those of 107 typical non-at-risk students. These students were all in grades 6 through 9, and the groups were relatively similar in terms of demographic characteristics. The at-risk group was rated as having significantly lower social competence and significantly higher rates of antisocial behavior than the non-at-risk group (p &lt; .0001). Power analyses indicated that these group differences ranged from approximately 1½ to 1 3/4 standard deviations. Item level HCSBS scores were also shown to correctly clas sify the students into their respective groups with a great deal of accuracy (92.37% overall). Internal consistency coefficients of the two HCSBS scales were uniformly high (in the mid .90 range). These results provide new and use ful evidence regarding the significant social behavior problems exhibited by at-risk stu dents, as well as preliminary evidence of the validity and usefulness of the HCSBS. Implications for further research and psychoe ducational assessment practice are discussed.

The Pediatric Cancer Quality of Life Inventory: a modular approach to measuring health-related quality of life in children with cancer.

Measurement of pediatric cancer patients' health-related quality of life (HRQL) in phase III randomized, controlled clinical trials is being recognized increasingly as an essential component in evaluating the comprehensive health outcomes of modern anti-neoplastic treatment protocols. Use of a brief core measure of HRQL plus disease-specific symptom modules is a way to assess specific HRQL outcomes with a minimum of subject burden. Demonstrating a measure's feasibility, reliability and validity also represents children's ability to provide reliable and valid responses to HRQL questions. The Pediatric Cancer Quality of Life Inventory (PCQL) Modular Approach consists of a 15-item core measure of HRQL and 2 specific symptom modules: pain and nausea. To validate a patient-report form and a parent-report form, the PCQL was administered to 291 pediatric cancer patients and to their parents. Feasibility and range of measurement, as well as patient-parent concordance, were assessed. Internal consistency reliability was assessed via Cronbach's alpha. Validity was determined by the known-groups approach and by correlating PCQL scores with days missed from school. Patients had minimal missing data, and the range of measurement for the items was good. Patient-parent concordance was large but not perfect. For both patient and parent forms, internal consistency reliability of the PCQL core scale (0.83 and 0. 86, respectively) was strong. The internal consistency reliabilities of the 2 symptom modules for both patient and parent forms were in the acceptable range for group comparisons. Regarding clinical validity, the core scale and the 2 symptom modules distinguished between patients on and off treatment for both patient and parent reports. Further, both patient and parent reports correlated with days of missed school in the past 6 and 12 months. The PCQL Modular Approach has demonstrated acceptable internal consistency reliability and clinical validity for both patient-report and parent-report forms. By implication, children are capable of providing reliable and valid responses to these HRQL questions.

Scores on the MacArthur Communicative Development Inventory of children from lowand middle-income families

AbstractThis study compared the language skills in a group of very low-income toddlers with those of a middle-income sample matched on age and sex. The assessment instrument was the MacArthur Communicative Development Inventory (CDI) for toddlers, a parent report form. The scores for the low-income group were strikingly lower on the three key indices evaluated: size of expressive vocabulary, age of appearance of word combinations, and complexity of utterances. The entire lowincome distribution was shifted about 30% toward the lower end of the middle-income distribution for both productive vocabulary and grammatical development. The magnitude of these income/ social class effects was larger than reported in most prior reports for children in this age range. This finding underscores the cautionary note issued by the CDI developers, which states that the published CDI norms, based on a middle-class sample, may not be directly applicable to low-income samples.

The pediatric cancer quality of life inventory-32 (PCQL-32): I. Reliability and validity.

Multidimensional measurement of pediatric cancer patients' health-related quality of life (HRQOL) in Phase III randomized controlled clinical trials is being recognized increasingly as an essential component in evaluating the comprehensive health outcomes of modern antineoplastic treatment protocols. The Pediatric Cancer Quality of Life Inventory-32 (PCQL-32) is a standardized patient self-report and parent proxy-report assessment instrument designed to assess systematically pediatric cancer patients' HRQOL outcomes. To validate a patient-report form and a parent-report form, the PCQL-32 was administered to 291 pediatric cancer patients and to their parents. Both forms yield a total score and five a priori multidimensional scales. Clinical validity was determined by the known-groups approach by comparing patients classified as either on or off treatment. To determine construct validity, a battery of standardized psychosocial measures was administered and a multitrait-multimethod matrix was constructed. For both patient and parent forms, internal consistency reliability of the PCQL-32 total scale was high (0.91 and 0.92, respectively). The internal consistency reliabilities of the five component scales for both patient and parent forms were in the acceptable range for group comparisons. With regard to clinical validity, the PCQL-32 total scale and the disease/treatment and physical functioning scales of the PCQL-32 distinguished between patients on and off treatment for both patient- and parent-report. The results of the multitrait-multimethod matrix approach were consistent with hypotheses and lent evidence for the construct validity of the patient and parent forms of the PCQL-32 total scale and the psychological functioning, social functioning, cognitive functioning, physical functioning, and disease/treatment scales. The PCQL-32 has demonstrated acceptable internal consistency reliability, clinical validity, and construct validity for both patient-report and parent-report forms. Further field testing of the PCQL-32 will determine its practicality and utility in multisite pediatric cancer randomized controlled clinical trials.

Diagnosing ADHD (predominantly inattentive and combine type subtypes): Discriminant validity of the behavior assessment system for children and the Achenbach parent and teacher rating scales

Compared the effectiveness of discriminating attention deficit/hyperactivity disorder (ADHD) subtypes using the Parent Rating Scale (PRS) and Teacher Rating Scale (TRS) of the Behavior Assessment System for Children (BASC) and the Parent Report Form and Teacher Report Form (TRE) of the Achenbach Child Behavior Checklist (CBCL). To determine the extent to which these scales measured similar behaviors, Pearson Product-Moment Correlations were computed for the parent scales (PRS and CBCL) and for the teacher scales (TRS and TRF). Results indicated that correlations were significant for a number of scales. Discriminant analysis does not suggest a strong advantage of either measure in differentiating children with ADHD from those who do not meet criteria for ADHD, except for the BASC TRS which has better predictive ability for children who do not meet ADHD criteria. For subtypes of ADHD, and specifically the ADHD: Predominantly Inattentive subtype, however, results would favor the use of the BASC PRS and TRS.

Cross-language synonyms in the lexicons of bilingual infants: one language or two?

This study tests the widely-cited claim from Volterra & Taeschner (1978), which is reinforced by Clark's PRINCIPLE OF CONTRAST (1987), that young simultaneous bilingual children reject cross-language synonyms in their earliest lexicons. The rejection of translation equivalents is taken by Volterra & Taeschner as support for the idea that the bilingual child possesses a single-language system which includes elements from both languages. We examine first the accuracy of the empirical claim and then its adequacy as support for the argument that bilingual children do not have independent lexical systems in each language. The vocabularies of 27 developing bilinguals were recorded at varying intervals between ages 0;8 and 2;6 using the MacArthur CDI, a standardized parent report form in English and Spanish. The two single-language vocabularies of each bilingual child were compared to determine how many pairs of translation equivalents (TEs) were reported for each child at different stages of development. TEs were observed for all children but one, with an average of 30% of all words coded in the two languages, both at early stages (in vocabularies of 2-12 words) and later (up to 500 words). Thus, Volterra & Taeschner's empirical claim was not upheld. Further, the number of TEs in the bilinguals' two lexicons was shown to be similar to the number of lexical items which co-occurred in the monolingual lexicons of two different children, as observed in 34 random pairings for between-child comparisons. It remains to be shown, therefore, that the bilinguals' lexicons are not composed of two independent systems at a very early age. Furthermore, the results appear to rule out the operation of a strong principle of contrast across languages in early bilingualism.

Lexical Development in Bilingual Infants and Toddlers: Comparison to Monolingual Norms

This study compares lexical development in a sample of 25 simultaneous bilingual and 35 monolingual children for whom semilongitudinal data were collected between the ages of 8 and 30 months. A standardized parent report form, the MacArthur Communicative Development Inventory (1989), was used to assess the children's receptive and productive vocabulary in English and/or Spanish. A methodology was devised to assess the degree of overlap between the bilingual children's lexical knowledge in one language and their knowledge in the other. Using the measures presented here, there was no statistical basis for concluding that the bilingual children were slower to develop early vocabulary than was the monolingual comparison group. The wide range of vocabulary sizes observed at these ages in normally developing children (Fenson et al., 1991) was observed in these bilingual children as well. The close correspondence of the pattern of the bilinguals' growth in two languages at once to monolinguals' growth in one suggests that norms for lexical development in bilinguals should be made with reference to the children's performance in two languages together.