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This is an original manuscript/preprint of an article published by Taylor & Francis in Journal of Mental Health Research in Intellectual Disabilities on 04/07/2019, available online: http://www.tandfonline.com/https://doi.org/10.1080/19315864.2019.1630872. Introduction: Although the Aberrant Behavior Checklist (ABC) is one of the most widely used behavioral rating scales among people with developmental disabilities, very few studies have examined the factor structure of the non-English versions. Methods: The construct validity of the Norwegian ABC was examined in a clinical sample of children and adolescents with neurological and neurodevelopmental disorders (N= 339). Diagnoses were obtained from direct interdisciplinary assessments in our neuropediatric clinics. Results: In an exploratory factor analysis, 46 of the 58 items (79%) loaded most heavily on four of the five original factors in the English version. Confirmatory factor analysis revealed less-than-optimal fit indices for the five-factor solution. Internal consistency was adequate to excellent for all subscales (α range = .76–.95). The ABC showed meaningful overlap and differentiation with the Strengths and Difficulties Questionnaire, the Behavior Rating Inventory of Executive Function, the Vineland Adaptive Behavior Scales, and full scale IQ. There were positive correlations between several of the ABC subscales and diagnoses of attention deficit/hyperactivity disorder, autism spectrum disorder, oppositional defiant disorder, and emotional disorder. Conclusion: Satisfactory psychometric properties were found for the ABC, with the exception of the Inappropriate Speech factor, in a mixed sample of higher functioning children and adolescents with neurodevelopmental and neurological disorders.

It has been suggested that the structure of psychiatric phenomena can be reduced to a few symptom dimensions. These proposals, mainly based on epidemiological samples, may not apply to clinical populations. We tested the structure of psychiatric symptoms across two pediatric clinical samples from England (N = 8434) and Norway (N = 5866). Confirmatory factor analyses of the parent-reported Strengths and Difficulties Questionnaire (SDQ) evaluated the relative fit of several models, including a first-order model, a second-order model with the widely-established broad symptom dimensions of internalizing-externalizing, and two bi-factor models capturing a general psychopathology factor. Predictive value of the SDQ subscales for psychiatric disorders was examined. A first-order five-factor solution better fit the data. The expected SDQ subscale(s) related best to the corresponding psychiatric diagnosis. In pediatric clinical samples, a granular approach to psychiatric symptoms where several dimensions are considered seems to fit the data better than models based on lumping symptoms into internalizing/externalizing dimensions. Electronic supplementary material The online version of this article (10.1007/s10578-017-0777-1) contains supplementary material, which is available to authorized users.

This is a Submitted Manuscript of an article published by Taylor & Francis in Child Neuropsychology on 15 August 2018, available online: http://www.tandfonline.com/doi/full/10.1080/09297049.2018.1508564. The construct validity of the 9-scale version of the Behavior Rating Inventory of Executive Function (BRIEF) parent form was examined in a clinical sample of children and adolescents with neurological and neurodevelopmental disorders (N = 281). Confirmatory factor analysis supported a three-factor model separating the inhibitory behavioral control dimension from the emotional control and metacognitive problem-solving dimensions. The Metacognitive factor was also related to a diagnosis of attention deficit/hyperactivity disorder (ADHD) after controlling for age, gender, IQ, adaptive functioning, and a conventional behavioral rating scale, which included inattention-hyperactivity symptoms. The Emotional Regulation factor was related to a diagnosis of oppositional defiant disorder. Correlational analyses indicated that child comorbid emotional and behavioral problems may exacerbate parental BRIEF reporting. Accordingly, when assessing executive function among children with neurological and neurodevelopmental disorders, the BRIEF should be complemented with assessments of mental health problems.

Source at https://doi.org/10.1016/j.ridd.2018.11.005. Most research does not address the overlap between neurodevelopmental disorders when investigating concomitant mental health problems. The purpose of the present study was to examine the association of intellectual disability (ID), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) with the presence of behavioural and emotional problems after controlling for other well-known correlates and risk factors. The sample included 4- to 18-year-old children who attended neuropaediatric clinics (N = 331). After controlling for adversity, age, gender, other developmental/neurological disorders, parental emotional problems, and parenting strategies, the presence of ADHD but not ASD or ID was uniquely associated with behaviour problems. Neither ADHD nor ASD nor ID was significantly associated with emotional problems after controlling for other risk factors. However, ADHD, ASD and behavioural/emotional disorders but not ID were significantly associated with functional impairment in everyday activities after controlling for other risk factors. Because children with neurodevelopmental disorders have complex needs, a holistic approach to diagnosis and interventions is highly warranted, including the assessment and treatment of behavioural and emotional disorders.

Objective: This study examined the agreement between diagnoses and severity ratings assigned by clinicians using a structured web-based interview within a child and adolescent mental health outpatient setting. Method: Information on 100 youths was obtained from multiple informants through a web-based Development and Well-Being Assessment (DAWBA). Based on this information, four experienced clinicians independently diagnosed (according to the International Classification of Diseases Revision 10) and rated the severity of mental health problems according to the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the Children’s Global Assessment Scale (C-GAS). Results: Agreement for diagnosis was κ=0.69-0.82. Intra-class correlation for single measures was 0.78 for HoNOSCA and 0.74 for C-GAS, and 0.93 and 0.92, respectively for average measures. Conclusions: Agreement was good to excellent for all diagnostic categories. Agreement for severity was moderate, but improved to substantial when the average of the ratings given by all clinicians was considered. Therefore, we conclude that experienced clinicians can assign reliable diagnoses and assess severity based on DAWBA data collected online.

Objective. Previous studies indicate that low IQ is a substantial risk factor for developing mental health problems. Based on these results, we hypothesized that IQ may predict some of the variance in clinician-rated severity of children's mental health problems measured with the Children's Global Assessment Scale (CGAS) and Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). The other aims of this study were to examine if there was any difference in the predictive ability of the different IQ scores of the Wechsler Intelligence Scale for Children, Third edition (WISC-III) and to examine if parent-rated measure of child mental health problems could predict the scores on CGAS and HoNOSCA after controlling for IQ, age, and gender. Methods. In this study, 132 patients at three outpatient clinics in North Norway were assessed with the parent version of the Strength and Difficulties Questionnaire (SDQ), HoNOSCA, CGAS, and with the WISC-III. Results. Hierarchical regression analyses were conducted with HoNOSCA and CGAS as dependent variables. Demographics, WISC-III IQ scores, and SDQ were entered as independent variables. The model with HoNOSCA as the dependent variable predicted 25% of the total variance. The WISC-III full-scale IQ predicted an additional 6% of the variance. The analyses with CGAS as the dependent variable gave no significant results. Conclusion. When a patient has a high HoNOSCA score, an intelligence test in addition to an evaluation of symptoms on mental health should be considered. Future research ought to examine whether HoNOSCA's ability to detect change might be affected by patients IQ.

We examined the agreement between diagnoses assigned based on the Development and Well Being Assessment (DAWBA) information collected online, and ordinary day-to-day diagnostic assignment by Child and Adolescent Mental Health Service (CAMHS) clinicians. Diagnoses were compared for 286 patients. Raw agreement for diagnostic categories was 74-90%, resulting in kappa values of 0.41-0.49. Multinomial regression models for ‘emotional diagnosis’ and ‘hyperkinetic/conduct diagnosis’ were significant ( P < 0.001). Age, gender and number of informants significantly contributed to the explanation of agreement and disagreement. Agreement on mental health diagnoses may be sufficient to replace routine clinical assignment of diagnoses with an online clinical assignment, thereby saving time and resources.

Previous studies indicate that low IQ is a substantial risk factor for developing mental health problems. Based on these results, we hypothesized that IQ may predict some of the variance in clinician-rated severity of children's mental health problems measured with the Children's Global Assessment Scale (CGAS) and Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). The other aims of this study were to examine if there was any difference in the predictive ability of the different IQ scores of the Wechsler Intelligence Scale for Children, Third edition (WISC-III) and to examine if parent-rated measure of child mental health problems could predict the scores on CGAS and HoNOSCA after controlling for IQ, age, and gender.In this study, 132 patients at three outpatient clinics in North Norway were assessed with the parent version of the Strength and Difficulties Questionnaire (SDQ), HoNOSCA, CGAS, and with the WISC-III.Hierarchical regression analyses were conducted with HoNOSCA and CGAS as dependent variables. Demographics, WISC-III IQ scores, and SDQ were entered as independent variables. The model with HoNOSCA as the dependent variable predicted 25% of the total variance. The WISC-III full-scale IQ predicted an additional 6% of the variance. The analyses with CGAS as the dependent variable gave no significant results.When a patient has a high HoNOSCA score, an intelligence test in addition to an evaluation of symptoms on mental health should be considered. Future research ought to examine whether HoNOSCA's ability to detect change might be affected by patients IQ.

Background The use of screening instruments can reduce waiting lists and increase treatment capacity. The aim of this study was to examine the usefulness of the Strengths and Difficulties Questionnaire (SDQ) with the original UK scoring algorithms, when used as a screening instrument to detect mental health disorders among patients in the Norwegian Child and Adolescent Mental Health Services (CAMHS) North Study. Methods A total of 286 outpatients, aged 5 to 18 years, from the CAMHS North Study were assigned diagnoses based on a Development and Well-Being Assessment (DAWBA). The main diagnostic groups (emotional, hyperactivity, conduct and other disorders) were then compared to the SDQ scoring algorithms using two dichotomisation levels: 'possible' and 'probable' levels. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (ORD) were calculated. Results Sensitivity for the diagnostic categories included was 0.47-0.85 ('probable' dichotomisation level) and 0.81-1.00 ('possible' dichotomisation level). Specificity was 0.52-0.87 ('probable' level) and 0.24-0.58 ('possible' level). The discriminative ability, as measured by ORD, was in the interval for potentially useful tests for hyperactivity disorders and conduct disorders when dichotomised on the 'possible' level. Conclusions The usefulness of the SDQ UK-based scoring algorithms in detecting mental health disorders among patients in the CAMHS North Study is only partly supported in the present study. They seem best suited to identify children and adolescents who do not require further psychiatric evaluation, although this as well is problematic from a clinical point of view.

Background Psychotherapy is an effective treatment for mental health disorders, but even with the most efficacious treatment, many patients do not experience improvement. Moderator analysis can identify the conditions under which treatment is effective or whether there are factors that can attenuate the effects of treatment. Methods In this study, linear mixed model analysis was used to examine whether the Full Scale IQ (FSIQ), Performance IQ (PIQ) and Verbal IQ (VIQ) on the Wechsler Intelligence Scale for Children – Third Edition, moderated outcomes in general functioning and symptom load. A total of 132 patients treated at three outpatient child and adolescent mental health services (CAMHS) were assessed at three different time points. The Children’s Global Assessment Scale (CGAS) and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) were used to measure the severity of impairments in general functioning and symptom load. IQ was assessed at the start of treatment. Results Moderator analysis revealed that the FSIQ × time interaction predicted changes in CGAS scores (p p Conclusions FISQ and PIQ moderated change in general functioning and symptom load, respectively. This implies that patients with higher IQ scores had a steeper improvement slope than those with lower scores. The patients with the highest initial symptom loads showed the greatest improvement, this pattern was not found in the improvement of general functioning.

Bakgrunnen for denne undersøkelsen er at barnehager står for svært få av de bekymringsmeldingene som kommer inn til barnevernet (Statistisk sentralbyrå, 2014). Dette gjelder spesielt barn i alderen 0-3 år. Det er stilt spørsmålstegn ved hva som kan være årsakene til dette, når man vet at 9 av 10 barn i alderen 1-5 år går i barnehage. Dette skulle gi barnehagen unike muligheter til å fange opp barn som ikke får dekket sine grunnleggendeomsorgsbehov, og dermed dekket sine rettigheter (Barnekonvensjonen, 1989). I denne oppgaven har problemstillingen vært hvilke forhold ved omsorgssituasjonen til barn i alderen 0-3 år er det som skaper bekymring hos ansatte i barnehager - og hva er det som er styrende i deres vurderinger av hva som skal meldes til barnevernet. Formålet med undersøkelsen har vært å øke kunnskapene om hva som ligger bak den lave frekvensen av barnehagenes bekymringsmeldinger til barnevernet for barn i alderen 0-3 år. Rammeplanen for barnehagens innhold og oppgaver (2006) gir førskolelæreren og styreren et stort ansvar for å følge opp barnehagens samfunnsansvar. Det er derfor viktig å få økt innsikt i hvilke erfaringer og opplevelser førskolelærere og styrere har i forhold til disse temaene Det har vært benyttet kvalitativ metode for å belyse problemstillingen. Et semistrukturert intervju har vært benyttet for innhenting av data. Utvalget har bestått av fem styrere og pedagogiske ledere i en mellomstor kommune. Datamaterialet ble tolket etter en metode kalt systematisk tekstkondensering. Dette er en modifisert fenomenologisk analyse, av Malterud(2008). Resultatene fra intervjuene viste at det i hovedsak var det følgende faktorer som skapte bekymringer for de minste barna blant de som arbeider i barnehagene: • Dårlig hygiene og barn som fremsto som ustelt og slitent • Barn som hadde lite klær og utstyr i barnehagen • Observasjoner av synlige merker på kroppen til barnet • Barn som virker engstelige og/eller vegrer seg for stell • Barn som utfordrer personalets grenser, utagerer eller gråter mye var de faktorene som ble nevnt av informantene Noen av informantene uttalte også at barnas tilknytningsatferd kunne skape bekymringer hos dem. Følgende faktorer var felles i informantenes vurderinger av hva som burde meldes til barnevernet: • Dersom foreldrene har gode forklaringer og/eller deler barnehagens bekymringer, reduseres sjansene for at barnehagen vil melde om bekymring til barnevernet. • Foreldrenes muligheter til å ta barnet ut av barnehagen. Barnehagen risikerer at verdifull til for barnet går, og at de kan miste kontrollen over situasjonen til barnet. • Barnehagen sitt hensyn til foreldrene. Barnehagen tar hensyn til at dersom de melder om bekymring til barnevernet, vil foreldrene havne i en særdeles vanskelig situasjon • Vanskeligheter med å vurdere hva som er bekymringsfull atferd og hva som er aldersadekvat atferd hos barn i alderen 0-3 år hos barna Kun en av informantene beskrev at systematiske observasjoner av barnets atferd, samspillsferdigheter og foreldrenes ferdigheter var en viktige faktorer i deres vurderinger av hva som skulle meldes til barnevernet. Resultatet fra denne undersøkelsen sammenfaller i stor grad med tidligere undersøkelser. En viktig forskjell, som kan bidra til å forklare den spesielt lave meldingsfrekvensen i forhold til sped- og småbarn er nok de forskjellene mellom normalfungering og skjevutvikling hos barna i denne alderen. Dette ser ut til å skape noe større usikkerhet hos barnehagepersonalet i forhold til om de skal melde om bekymringer til barnevernet eller ikke Observasjoner og kartlegginger av sped- og småbarn og deres vansker er spesialisert kunnskap, som ikke mange i barnehage eller barnevern innehar. Det leder til et spørsmål i forhold til om dette bør være en kompetansehevingsområde fremover. Målet med et slikt tiltak vil være å sikre at sped og småbarn i risiko for skjevutvikling får hensiktsmessig hjelp, før vansker får manifestert seg. Stikkord: Barnehage, Barnevernstjenesten, Bekymringsmelding, Sped- og småbarn, Kvalitative metoder.