Associations between family and clinician ratings of child mental health: a study of UK CAMHS assessments and outcomes

Background: The rated severity of child mental health problems depends on who is doing the rating, whether child, carer or clinician. It is important to know how these ratings relate to each other. Aims: To investigate to what extent clinicians’ views are associated with carers’ and young people’s views in routine care in the United Kingdom. Method: Ratings of clinician and parent/child viewpoints from a large Child and Adolescent Mental Health Services (CAMHS) sample (ns 1773–47,299), as measured by the Children’s Global Assessment Scale (CGAS) and Strengths and Difficulties Questionnaire (SDQ) respectively, were analysed. The parent SDQ added value score (AVS), which adjusts for regression to the mean and other non-treatment change, was also included in the analyses. Results: Small-to-medium correlations were found between family and clinician ratings; however, ratings diverged for the lowest-function CGAS bands. Regression analyses showed that pro-social ratings from both child and parent contributed to clinician ratings. Knowing child-reported emotional problem severity made parent ratings of emotions irrelevant to clinician judgements. There was a positive association between SDQ AVS and CGAS; as hypothesised, CGAS showed more change than the SDQ AVS, suggesting that clinicians over-estimate change. Conclusion: This study shows the importance of multi-informant data gathering and the integration of multiple views by clinicians when monitoring outcomes

A process model of the understanding of uncertain conditionals

To build a process model of the understanding of conditionals we extract a common core of three semantics of if-then sentences: (a) the conditional event interpretation in the coherencebased probability logic, (b) the discourse processingtheory of Hans Kamp, and (c) the game-theoretical approach of Jaakko Hintikka. The empirical part reports three experiments in which each participant assessed the probability of 52 if-then sentencesin a truth table task. Each experiment included a second task: An n-back task relating the interpretation of conditionals to working memory, a Bayesian bookbag and poker chip task relating the interpretation of conditionals to probability updating, and a probabilistic modus ponens task relating the interpretation of conditionals to a classical inference task. Data analysis shows that the way in which the conditionals are interpreted correlates with each of the supplementary tasks. The results are discussed within the process model proposed in the introduction

Children with speech language and communication needs in England: challenges for practice

Teachers and speech and language therapists (SLTs) share concern about children’s speech, language, and communication needs (SLCNs) but they have different foci because of their professional roles. Contemporary research has identified the challenges to schools when meeting the needs of children with SLCN, highlighted terminological controversies, and has increased opportunities for professional development. The views of 170 Educationalists and SLT professionals in England about SLCN, and the children’s associated needs were compared for similarities and differences in an online survey that employed both categorical responses and Likert scales. Comparisons were made between teacher and SLT groups and between SLTs working in schools and clinics. There were few significant differences between the views of SLTs in clinics and education. In contrast, there were often large and significant differences between teachers and SLTs. Education professionals were less familiar with terminology related to speech difficulties, did not discriminate between behaviors that might differentiate speech from language difficulties and varied in the ratings given about other associated difficulties. Additionally, education professionals showed awareness of academic and behavior difficulties associated with language difficulties and highlighted associated problems with reading and writing. SLTs felt confident in their understanding of the relevant terminology but there was less clarity in the features that discriminated speech from language difficulties. Both the Educationalists and SLTs valued additional training needs with over 50% of the Education staff reporting that they had no training in SLCN. The lack of clarity about the language markers of SLCN by teachers and the requests for tools to help in the identification of speech and language problems in school-age children are important areas to address. Both SLTs and Education staff emphasized the co-occurrence of difficulties with reading comprehension and written text production, highlighting the importance of profiling children’s language learning needs rather than a reliance on diagnostic categories

Routine mental health outcome measurement in the UK

This paper offers a short history of routine clinical outcomes measurement (RCOM) in UK mental health services. RCOM developments in primary and secondary care are described, with reference to measures currently in widespread use or likely to be implemented. Assessment procedure and completion rates are discussed. Some of the forces operating in this field are enumerated. Comparison is made with UK attempts at routine outcomes measurement in public education. This field is thus reviewed for lessons for RCOM, and opportunities and challenges considered

Verbal memory and sentence comprehension in aphasia: a case series

This case series explores the relationship between verbal memory capacity and sentence comprehension in four patients with aphasia. Two sentence comprehension tasks showed that two patients, P1 and P2, had impaired syntactic comprehension, whereas P3 and P4’s sentence comprehension was intact. The memory assessment tasks showed that P1 and P2 had severely impaired short-term memory, whereas P3 and P4 performed within the normal range in the short-term memory tasks. This finding suggests an association between short-term memory deficit and sentence comprehension difficulties. P1 and P3 exhibited impaired comparable working memory deficits, suggesting a dissociation between working memory and sentence comprehension