Validation of Infant-Toddler Mental Health Measures

描述(由申请人提供)：最近的估计表明，10%到12%的1岁和2岁的儿童患有精神健康问题，需要干预。然而，大多数有社交-情绪/行为问题的婴儿和幼儿没有接受任何心理健康服务。尽管最近的立法(IDEA，1997)要求州早期干预计划为社会情绪发展问题提供服务，但这种未得到满足的需求仍然存在，部分原因是可用于评估婴儿和幼儿的社会情绪问题和能力的措施存在局限性。本申请中提出的工作将检验1岁和2岁儿童社交情绪问题和能力的两种家长报告测量的临床有效性：(1)筛选器，简明的婴幼儿社交和情绪评估(BITSEA)；(2)较长的测量，婴幼儿社交和情绪评估(ITSEA)。这些措施评估内化、外化、调节、适应不良和非典型问题，以及社会情绪能力。在较早的一项研究中，BITSEA和ITSEA(B/ITSEA)都证明了可靠的重测和评分者间的可靠性。对其有效性的初步支持来自于它们与其他家长报告措施的关联，以及对儿童问题行为的观察评级。然而，为了改进迫切需要的早期识别和干预努力，关键是要确定它们在识别和表征临床重大问题方面的有效性。在拟议的研究中，B/ITSEA将在临床参考样本(N~200)和社会人口学匹配的对照样本(N~200)中，根据共识的精神诊断状态和亲子互动的观察性评估进行验证。这项拟议工作的主要目标是评估：(1)B/ITSEA在识别有任何共识的社会-情绪诊断的儿童方面的有效性；(2)在识别特定领域中有障碍的儿童方面的主要ITSEA领域(即内在性、外在性和调节障碍)；(3)B/ITSEA在检测亲子关系障碍方面的有效性；以及(4)ITSEA能力领域。一旦得到验证，BITSEA和ITSEA将促进筛查和早期干预努力，以及研究努力，以表征普通人群和临床人群中社会情绪和行为问题的早期过程。

DESCRIPTION (provided by applicant): Recent estimates indicate that 10% to 12% of 1 - and 2-year-olds suffer from mental health problems that warrant intervention. Yet, the majority of infants and toddlers with social-emotional/behavioral problems do not receive any mental health services. This unmet need occurs despite recent legislation (IDEA, 1997) requiring state early intervention programs to provide services for problems in social-emotional development and arises, in part, from limitations in measures that have been available for assessing social-emotional problems and competencies in infants and toddlers. The work proposed in this application will examine the clinical validity of two parent-report measures of social-emotional problems and competencies in 1- and 2-year-old children: (1) a screener, the Brief Infant-Toddler Social and Emotional Assessment (BITSEA); and (2) a longer measure, the Infant-Toddler Social & Emotional Assessment (ITSEA). These measures assess internalizing, externalizing, regulatory, maladaptive and atypical problems, as well as social-emotional competence. In an earlier study, both the BITSEA and ITSEA (B/ITSEA) demonstrated solid test-retest and inter-rater reliability. Preliminary support for their validity comes from their associations with other parent-report measures and from observational ratings of child problem behaviors. However, to improve critically needed early identification and intervention efforts, it is crucial to establish their validity in identifying and characterizing clinically significant problems. In the proposed study, the B/ITSEA will be validated against consensus psychiatric diagnostic status and observational assessments of parent-child interactions in a clinic-referred sample (N~200) and a sociodemographically matched comparison sample (N~200). The primary goals of the proposed work are to evaluate the validity of: (1) the B/ITSEA in identifying children with any consensus social-emotional diagnosis; (2) the major ITSEA domains (i.e., internalizing, externalizing and dysregulation) in identifying children with disorders in specific domains; (3) the B/ITSEA in detecting parent-child relational disturbances and (4) the ITSEA Competence domain. Once validated, the BITSEA and ITSEA will facilitate screening and early intervention efforts, as well as research endeavors to characterize the early course of social-emotional and behavior problems in both general and clinical populations.