The utility of pre-assessment standardised diagnosis in child and adolescent mental health services
1. Are the clinical assessments more likely to agree with the standardized diagnosis if the clinician has had access to the standardized diagnosis prior to the first appointment with the family?
2. Are the children more likely to receive an evidence-based treatment if the clinician has access to the standardized diagnosis prior to the first appointment with the family?
3. Are children able to access specialist clinics if clinicians/managers are aware of the diagnostic assessment?
4. Is the level of agreement between the clinical and standardized diagnoses higher in the last six months of the study compared to the first, suggesting that the clinical team is learning from their exposure to the standardized assessments?
5. Do clinicians find the information provided by the standardized diagnosis useful in making their own assessment?
6. Is the rate of attendance at first appointments higher among children whose parents have completed a standardized diagnostic assessment while on the waiting list as compared to control children?
7. Do parents find the completion of a standardized assessment prior to meeting the clinician useful and/or acceptable?
Joint South London and Maudsley and Institute of Psychiatry Research Ethics Committee, 14/09/2005, ref: 05/Q0706/185
Randomised controlled trial
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
See additional files
Childhood psychiatric disorders
Current interventions as of 27/06/2017:
Practitioners assessing and treating children in the intervention were provided with a copy of the standardised diagnostic assessment (the DAWBA www.dawba.info) in the clinic notes – children in the control arm had assessment and treatment as normal – follow up was by questionnaire to the treating CAMHS practitioner and parents at six, 12, 18 and 24 months after baseline – obviously practitioners could only report while the child was still attending the clinic.
The intervention would be the provision of diagnostic information to the intervention group, while the control group would undergo the ordinary clinic assessment. The diagnostic information will be gathered from parents and teachers using the Development And Well-Being Assessment (DAWBA).
Primary outcome measures
The primary outcome measures will be the level of agreement between the DAWBA diagnoses and the clinical assessment, and the type of intervention. After the assessment, clinicians will be asked to report which diagnoses they endorse, including no disorder or none of the above, using a pro forma listing the disorders described by the DAWBA. At six months or case closure, the clinicians will describe the type of intervention using a second structured pro forma, which will be based on the categories available on those used in the proposed national minimum data set for child and adolescent mental health services.
Secondary outcome measures
Secondary outcome measures will be parental and clinician measures of outcome, parents and clinicians opinion of the utility of the standardized assessment, the number of appointments attended and the non-attendance rates of the two groups. The latter is collected routinely by the clinic. Questionnaires using a combination of structured and unstructured questionnaires will address the utility of the standardized assessment from the perspective of parents and clinicians. The outcome measures are the Strengths and Difficulties Questionnaire (SDQ), which will be completed by parents, and the Child Global Assessment Scale (CGAS), which will be completed by parents.
Overall trial start date
Overall trial end date
Participant inclusion criteria
The trial will include all referrals to Croydon child and adolescent mental health service of children aged between 5-11 years of age who are accepted onto the waiting list.
Target number of participants
Target number of participants provided at time of registration: 520; Amended as of 14/02/2007: 500 children, 250 in each arm
Participant exclusion criteria
Children of parents with insufficient English to complete the assessment interview and emergency referrals will be excluded due to the difficulty in completing the standardized assessment. Due to the complexity of parental responsibility and therefore gaining consent, children looked after by the local authority will be excluded.
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Croydon CAMHS (Lead site)
Lennard Lodge Lennard Road
King's College London (UK)
Institute of Psychiatry
De Crespigny Park
+44 20 7848 0675
Medical Research Council (MRC) (UK)
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Planned publication in high-impact peer reviewed journals.
IPD sharing statement:
The datasets generated during and/or analysed during the current study is not expected to be made available due to they do not have appropraite consent for this.
Intention to publish date
Participant level data
Not expected to be available
Results - basic reporting
2013 results in https://www.ncbi.nlm.nih.gov/pubmed/22886389
2013 results in http://onlinelibrary.wiley.com/doi/10.1111/camh.2014.19.issue-2/issuetoc
- ISRCTN31394658_PIS_27Jun17.pdf Uploaded 27/06/2017