We are doing research assessments on all the children participating in the study as they come into foster care, 15 months and 2.5 years later.  The primary outcome measure is the Strengths and Difficulties Questionnaire (SDQ) at 2.5 years after entry to care.  Secondary outcome measures are child quality of life (PEDS-QL) and parent/carer-child relationship functioning (PIR-GAS).  Because infant mental health is multi-faceted, we have a range of additional mental health outcome measures, plus measures of cognition, foster carer commitment and child placement outcomes.  These are listed alphabetically below:

Development And Well-Being Assessment (DAWBA) 

The DAWBA is a package of interviews, questionnaires and rating techniques designed to generate ICD-10 and DSM-IV psychiatric diagnoses on 5-17 year olds.

The DAWBA covers the common emotional, behavioural and hyperactivity disorders, without neglecting less but sometimes more severe disorders.  click here for more information 

Disturbances of Attachment Interview (DAI)

This is a semistructured interview designed to be administered by clinicians to caregivers who know the child and the child’s behaviour well.  If possible, it should be administered to the child’s primary caregiver.  Specific probes are designed to elicit more information; they are not intended to be exhaustive.  Clinicians should feel free to probe further.  The scoring is completed at the close of the interview based upon responses provided.    

Infant Toddler Social Emotional Assessment (ITSEA) 

The ITSEA assesses for social or emotional problems and competencies in infants and toddlers and was designed to identify children with deficits or delays in these areas. It provides a comprehensive profile of problems and competencies with scores on 4 domains: 1) Externalizing, 2) Internalizing, 3) Dysregulation, 4) Competence. Each domain is comprised of a number of subscales (see sample items). The ITSEA also yields scores on three clusters that include atypical behaviours: Maladaptive, Social Relatedness, and Atypical. There are two versions, a Parent Form and a Childcare Provider Form; both are reviewed in this database. 

Parent-Infant Relationshiip Global Assessment (PIR-GAS) 

The PIR-GAS is a research-based rating instrument covering the full range of parent/infant relationships used for research purposes to describe the strengths of a relationship as well as to capture the severity of a disorder. A clinical interview with the parent coupled with observed behaviour patterns allows the clinician to place the relationship into one of nine categories, ranging from well adapted (100-91) to grossly impaired (10 and under). Relationship difficulties are assessed based on the intensity, frequency, and duration of maladaptive interactions and a score below 40 marks a disordered relationship. Three aspects of the parent/infant relationship are evaluated in order to classify a disordered relationship: the behavioural quality of interactions, affective tone, and psychological involvement.

The PIR-GAS is influenced by developmental, psychodynamic, family systems, relationship, and attachment theories, as well as clinical case studies, observation in naturalistic settings, and assessments based on attachment theory. 

Pediatric Quality of Life Inventory (PedsQL) 

The PedsQL (Children's Hospital and Health Center, San Diego, California) is a modular instrument for measuring health-related quality of life (HRQOL) in children and adolescents ages 2 to 18. The PedsQL 4.0 Generic Core Scales are multidimensional child self-report and parent proxy-report scales developed as the generic core measure to be integrated with the PedsQL Disease-Specific Modules. The PedsQL 4.0 Generic Core Scales consist of 23 items applicable for healthy school and community populations, as well as pediatric populations with acute and chronic health conditions. click here for more information 

Relationship Problem Questionnaire (RPQ) 


Strength and Difficulties Questionnaire (SDQ)

The SDQ is a brief behavioural screening questionnaire about 3-16 year olds. It exists in several versions to meet the needs of researchers, clinicians and educationalists.  It is a self-report inventory behavioral screening questionnaire for children and adolescents ages 2 through 17 years old, developed by United Kingdom Child Psychiatrist Robert N. Goodman.  The SDQ is available online, and has been translated into more than 80 languages, including Spanish, Chinese, Russian and Portuguese.  The PhenX Toolkit uses SDQ as its child protocol for General Psychiatric Assessment and for Broad Psychopathology.  click here for more information 

This Is My Baby (TIMB) 

Investigates the carers’ long-term view of their relationship with the child 

Waiting Room Observation (WRO)

The WRO is a brief standardised observational schedule for Reactive Attachment Disorder (RAD) in school-age children to aid clinician recognition of these behaviours. Design: A new structured observational schedule for symptoms of RAD was developed using unstructured observation of children in a clinic waiting room setting. The measure's ability to discriminate between a sample of children with RAD and a normative sample was established by comparing scores in these two groups. Method: Children aged 5-8 years (n = 77 [38 RAD cases and 39 controls]) were observed with their primary caregiver in a standardised waiting room setting. A structured observational tool was developed that tested the reliability, sensitivity and specificity of each item. Results: The schedule has good internal consistency (0.75). The individual items on the observational schedule were predominantly highly discriminatory between cases and comparisons, showing both reasonable sensitivity and excellent specificity. Certain questions were dropped due to poor discrimination and/or poor inter-rater reliability. Conclusion: The 10-item observational schedule for RAD in school-age children provides a promising tool for assessment, although further research will be required to evaluate its ability to discriminate between RAD and other disorders. 

Wechsler Preschool and Primary Scale of Intelligence (WPPSI)

WPPSI is an IQ test for preschool and early elementary-aged children to determine their intelligence quotient. An IQ score established by this exam can help with preschool and kindergarten admission determinations, as well as with psychological and general academic evaluations. The test can be administered to discover if a child has any particular strengths or weaknesses or to help determine how a child might benefit from academic support.

The test is similar to the other Wechsler scales developed by David Wechsler for children and adults, but this scale is specifically-targeted for children ages two-and-a-half through seven years and three months.  The third, and most recent, edition of WPPSI, the WPPSI III, was redesigned to be shorter and more game-like with bold, colorful images to capture and hold a young child's attention. Originally created in 1967, the updated WPPSI III was redeveloped in 2002.

The exam includes two scoring systems, one for children ages two years, six months through three years, eleven months, and one for children ages four years through seven years and three months.  

The WPPSI is comprised of fourteen subtests.  click here for more information


Feasibility indicators

  1. Are parents of children recently diagnosed with ADHD willing to be randomised to Parents InC or Incredible Years?
  2. Can sufficient numbers of families be (a) recruited and (b) retained such that a full-scale RCT is likely to be feasible?
  3. Are research procedures and measures feasible and acceptable to participating families?

Primary efficacy outcome measure

Parental Sense of Competence Scale (PSOC) is a 17-item questionnaire showing good validity across several studies and widely used as a measure of parenting self-esteem14. It will be collected at baseline and at 12-months post-randomisation.

Secondary efficacy outcome measures

  • Eyberg Child Behaviour Inventory (ECBI): measure of behaviour problems of children aged 2-16 to be completed by parents or carers.
  • Strength and Difficulties Questionnaire (SDQ): self-report measure of behaviour of children aged 2-17 to be completed by parents/carers/children aged 11yrs or older.
  • General Health Questionnaire (GHQ): self-report measure of common psychiatric conditions to be completed by parents or carers.
  • ADHD Symptom Rating Scale-version 1 (ASRSv1): symptom checklist consisting of 18 DSM-iV criteria to be completed by practitioners with regards parents.
  • Parenting Daily Hassles Scale (PDHS): 18-item self-report measure of the frequency and intensity of 20 potential parenting ‘hassles’ to indicate parents stress.
  • Goal Based Outcomes (GBO) from the Child Outcomes Research Consortium (CORC):
  • EQ-5D_5L: a self-report measure of parent quality of life.
  • PedsQL: a self-report measure of child quality of life.
  • Participant service use (diary and questionnaire).