ARTICLES
A DSM-IV—Referenced Teacher Rating Scale for Use in Clinical Management

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ABSTRACT

Objective

Two studies were conducted to examine the psychometric properties of a DSM-IV—referenced teacher-completed rating scale in children receiving special education.

Method

To assess reliability, teachers rated 74 students on two separate occasions (test-retest) using the teacher version of the Child Symptom Inventory-4 (CSI-4T), and teacher aides also rated the children on the first occasion (interrater). In a second study, teacher CSI-4T and Teacher's Report Form (TRF) ratings and consultant diagnoses were obtained for 101 students.

Results

Internal consistency reliabilities (0.72–0.94), 2-week test-retest reliabilities (r = 0.61–0.88), and interrater agreement (r = 0.19–0.56) for the CSI-4T major symptom categories were comparable with dimensional rating scales. CSI-4T ratings showed a consistent pattern of convergent and divergent validity with TRF scores and with consultant diagnoses.

Conclusion

Findings provide preliminary support for the reliability and validity of the CSI-4T as a measure of DSM-IV symptoms in children receiving special education.

Section snippets

STUDY 1

Subjects

The reliability sample consisted of children who were attending a separate public school for special education students with serious behavioral and/or emotional problems located on Long Island, New York. All teachers (N = 15) completed ratings for a subsample (see “Procedure”) of 74 children (56 males and 18 females) between the ages of 5 and 13 years (mean = 8.9 ± 2.0 years). Their ethnic distribution was white (39%), African American (56%), and Hispanic American (5%). Most students qualified

RESULTS

Coefficient α values indicated satisfactory internal consistency reliabilities for CSI-4T symptom categories: ADHD-I (.92), ADHD-HI (.93), ADHD-C (.93), CD (.85), ODD (.94), GAD (.76), MDD (.75), Dysthymic Disorder (.73), Schizophrenia (.72), Autistic Disorder (.86), and Asperger's Disorder (.81).

Two-week test-retest reliabilities were generally strong for the major symptom categories for both Symptom Count and Symptom Severity scores, respectively: ADHD-I (r = 0.84, r = 0.84), ADHD-HI (r =

STUDY 2

Subjects

The validity sample was composed of 101 consecutive students (86 males and 15 females) between 6 and 18 years old (mean = 11.4 ± 2.8 years) who were served by a special education agency in the metropolitan St. Louis area. They were referred by their special education staffs to the agency's child and adolescent psychiatrist (R.E.M.) for consultation regarding behavioral and/or emotional problems. Most students were either in self-contained classrooms (36%) or separate public school centers for

Convergent and Divergent Validity

Examination of the most highly correlated CSI-4T category/TRF syndrome pairs (Table 1) provides evidence of convergent validity: ODD and Aggressive Behavior, CD and Delinquent Behavior/Aggressive Behavior, GAD and Anxious/Depressed, Social Phobia and Withdrawn, MDD and Withdrawn, Dysthymic Disorder and Withdrawn, Schizophrenia and Thought Problems, Autistic Disorder and Thought Problems, and Asperger's Disorder and Withdrawn. Within the ADHD symptom categories, ADHD-I was the most highly

DISCUSSION

Collectively, findings support the reliability and validity of CSI-4T symptom categories in special education students with behavioral and/or emotional problems, further recommending its use for gathering information from teachers about DSM-IV symptoms. Two-week test-retest reliabilities were greater than 0.70 for most symptom categories, and interrater reliability was moderate to strong. Good evidence of convergent-divergent validity was found between CSI-4T symptom categories and TRF scales.

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    Copyright © 2003 The American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.