The DIPA is an interview of caregivers for children from nine months to six years old. It covers symptoms in thirteen diagnostic categories in self-contained modules that have disorder-specific functional impairment ratings - posttraumatic stress disorder (PTSD), major depression disorder (MDD), bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder, separation anxiety disorder (SAD), specific phobia, social phobia, generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), reactive attachment disorder, and sleep disorders. The symptoms are linked to the DSM-IV criteria (and will be modified when the DSM-5 is released).
Overview
DIPA
Scheeringa MS, Haslett, N (2010). The reliability and criterion validity of the Diagnostic Infant and Preschool Assessment: A new diagnostic instrument for young children. Child Psychiatry & Human Development, 41, 3, 299-312.
It may be downloaded for free from the Tulane Institute of Infant and Early Childhood Mental Health website at http://www.infantinstitute.com/. Click on the Measures and Manuals link on the home page.
Administration
| Domains | Scale | Sample Items |
|---|---|---|
The traumatic events screen provides yes/no endorsements of 12 types of traumatic events; for each type it provides date of first occurence, date of last occurence, and the number of times it occured. Results of the DIPA include endorsements of symptoms in yes/ no replies, dates, frequencies and some scored responses. An optional one-page tally sheet allows interviewers to follow DSM-IV algorithms to determine diagnoses.
Training
Parallel or Alternate Forms
Psychometrics
| Type: | Time Period | Statistics | Min | Max | Avg |
|---|---|---|---|---|---|
| Test-retest | 11 days | Intraclass correlation Coefficients (ICC) | 0.24 OCD | 0.87 PTSD | |
| Test-retest | 11 days | Cohen's Kappa (k) | 0.38 ODD | 0.66 MDD |
Scheeringa, M,. Haslett, N. (2010) The reliability and Criterion Validity of the Diagnostic Infant and Preschool Assessment: A New Diagnostic Instrument for Young Children. Child Psychiatry and Human development. 41, 299-312.
Test-Retest reliability NOTES:
Intraclass Correlation Coefficients (ICC) reliability statistics are out of 7 disorders tested (ADHD, ODD, MDD, PTSD, SAD, GAD, OCD).
In regards to PTSD, reliabilities were calculated for four different PTSD outcomes: DSM-IV without the criterion of impairment, the PTSD alternative algorithm (PTSD-AA) with the criterion of impairment, PTSD-AA without the criterion of impairment, and functional impairment alone (there were insufficient cases to calculate reliabilities for DSM-IV with the criterion of impairment). The PTSD-AA was developed as a more developmentally appropriate, reliable and valid criteria for preschoolers than the DSM-IV (Scheeringa et al, 1995, 2001, 2003). The individual results are below:
The DIPA PTSD module was developed from the Posttraumatic Stress Disorder Semi Structured Interview and Observational Record for Young Children (PTSDSSI) (Scheeringa et al, 1995, 2001, 2003). The symptoms in the PTSD module were derived empirically from assessment of actual trauma-exposed and symptomatic young children in this series of studies.
| Validity Type | Not known | Not found | Nonclincal Samples | Clinical Samples | Diverse Samples |
|---|---|---|---|---|---|
| Convergent/Concurrent | x | ||||
| Discriminant | x | ||||
| Sensitive to Change | x | ||||
| Intervention Effects | x | ||||
| Longitudinal/Maturation Effects | x | ||||
| Sensitive to Theoretically Distinct Groups | x | x | |||
| Factorial Validity | x |
Scheeringa, M., Peebles, C., Cook, C. & Zeahan, C (2001). Toward establishing procedural, criterion, and discriminant validity for PTSD in early childhood. Journal of the American Academy of Child and Adolescent Psychiatry. 40(1), 52-60.
Scheeringa, M., Zeanah, C., Drell, M. & Larrieu, J. (1995). Two approaches to the diagnosis of PTSD in infancy and early childhood. Journal of the American Academy of Child and Adolescent Psychiatry. 34(2), 191-200.
Scheeringa, M., Zeanah, C. Meyers, L. & Putnam, F. (2003). New findings on alternative criteria for PTSD in preschool children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(5), 561-570.
| Not Known | Not Found | Nonclinical Samples | Clinical Samples | Diverse Samples | |
|---|---|---|---|---|---|
| Predictive Validity: | |||||
| Postdictive Validity: |
Scheeringa, M,. Haslett, N. (2010) The Reliability and Criterion Validity of the Diagnostic Infant and Preschool Assessment: A New Diagnostic Instrument for Young Children. Child Psychiatry and Human development. 41, 299-312.
Data for inter-rater reliability, internal consistency, and parallel reliability are not available. Sensitivity and specificity are not known as generally there is no gold standard for a diagnosis in psychiatry.
Translations
Population Information
The DIPA was developed from a precursor, the Posttraumatic Stress Disorder Semi Structured Interview and Observational Record (PTSDSSI). The symptoms for the PTSDSSI were developed empirically by evaluating actual young children who had been exposed to trauma and were symptomatic (Scheeringa, Zeanah, Drell & Larrieu, 1995). Modifications to the PTSDSSI were based on studies using clinical samples (Scheeringa, Peebles, Cook & Zeanah, 2001) and a nonclinical sample (Scheeringa, Zeanah, Myers & Putnam, 2003).
The reliability and validity of the DIPA was assessed using a clinical sample of fifty children recruited through a state run mental health clinic for birth to five-year old children (Scheeringa & Haslett, 2010).
Pros & Cons/References
- The PTSD module includes a traumatic events screen that provides thorough coverage of the number of times each type of event occurred, plus the first and last dates.
- The DIPA covers symptoms necessary to evaluate for DSM-IV and alternative diagnostic criteria for PTSD (such as the PTSD-AA).
- This measures accounts for disorder specific functional impairment, which is absent from many other questionnaires or scales.
- The DIPA uses developmentally appropriate language and symptoms for caregivers of the 0-6 year old population.
- The DIPA is thorough yet concise – the comprehensive interview includes 13 self-contained modules for specific disorders in 47 pages and 517 questions.
- The tally sheet provides a quick way to determine the number of symptoms endorsed in each disorder and whether diagnoses have been met.
- The interview was designed for either clinical or research work.
- Free.
-The main study of the psychometrics of the DIPA was limited by the size and character of the sample: 50 participants, no child younger then 1.6 years old, largely low socioeconomic status and minority population (Scheeringa & Haslett, 2010).
- Data for inter-rater reliability, internal consistency, and parallel reliability are not available for the DIPA.
-More research is needed to gather additional data, and replication of the current findings is needed with larger and more diverse samples.
Scheeringa, M,. Haslett, N. (2010) The reliability and criterion validity of the Diagnostic Infant and Preschool Assessment: A new diagnostic instrument for young children. Child Psychiatry and Human development. 41(3), 299-312.
Scheeringa, M., Peebles, C., Cook, C. & Zeanah, C (2001). Toward establishing procedural, criterion, and discriminant validity for PTSD in early childhood. Journal of the American Academy of Child and Adolescent Psychiatry. 40(1), 52-60.
Scheeringa, M., Zeanah, C., Drell, M. & Larrieu, J. (1995). Two approaches to the diagnosis of PTSD in infancy and early childhood. Journal of the American Academy of Child and Adolescent Psychiatry. 34(2), 191-200.
Scheeringa, M., Zeanah, C. Meyers, L. & Putnam, F. (2003). New findings on alternative criteria for PTSD in preschool children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(5), 561-570.
Scheeringa, M., Zeanah, C., Myers, L. & Putnam, F. (2005). Predictive validity in a prospective follow-up of PTSD in preschool children. Journal of the American Academy of Child and Adolescent Psychiatry. 44 (9), 899-906.
Wolfe V., Gentile C., & Wolfe D. (1989). The impact of sexual abuse on children: a PTSD formulation. Behavioral Therapy 20, 215–228
The DIPA has been used and cited in the following articles:
De Young, A., Kenardy, J. & Cobham, V. (2011). Diagnosis of posttraumatic stress disorder in preschool children. Journal of Clinical Child & Adolescent Psychology. 40 (3), 1-10
DeYoung A, Kenardy J, Cobham V, Kimble R (2012). Prevalence, comorbidity, and course of trauma reactions in young burn-injured children. Journal of Child Psychology and Psychiatry 53,1,56-63. Follow-up of DeYoung et al., 2011.
Gleason, M., Zeanah, C. & Dickstein, S. (2010). Recognizing young children in need of mental health assessment: development and preliminary validity of the Early Childhood Screening Assessment. Infant Mental Health Journal. 31(3), 335-357
The author of the DIPA has read this review and was given the opportunity to make edits.