Developmental Disabilities Modification of the Children’s Global Assessment Scale

National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA.
Biological Psychiatry (Impact Factor: 10.26). 03/2007; 61(4):504-11. DOI: 10.1016/j.biopsych.2007.01.001
Source: PubMed


Interventions for pervasive developmental disorders (PDD) aim to alleviate symptoms and improve functioning. To measure global functioning in treatment studies, the Children's Global Assessment Scale was modified and psychometric properties of the revised version (DD-CGAS) were assessed in children with PDD.
Developmental disabilities-relevant descriptors were developed for the DD-CGAS, and administration procedures were established to enhance rater consistency. Ratings of clinical case vignettes were used to assess inter-rater reliability and temporal stability. Validity was assessed by correlating the DD-CGAS with measures of functioning and symptoms in 83 youngsters with PDD. Sensitivity to change was assessed by comparing change from baseline to post-treatment with change on the Aberrant Behavior Checklist-Irritability and Clinical Global Impressions-Improvement subscale scores in a subset of 14 children.
Inter-rater reliability (intraclass correlation coefficient [ICC] = .79) and temporal stability (average ICC = .86) were excellent. The DD-CGAS scores correlated with measures of functioning and symptoms with moderate to large effect sizes. Changes on the DD-CGAS correlated with changes on the Aberrant Behavior Checklist-I (r = -.71) and Global Impressions Scale-I (r = -.52). The pre-post DD-CGAS change had an effect size of .72.
The DD-CGAS is a reliable instrument with apparent convergent validity for measuring global functioning of children with PDD in treatment studies.

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    • "Global rating scales for young children are clinically meaningful (De Kruif & McWilliam, 1999; Wagner et al., 2007) and have been reported to be sensitive to change following behavioural intervention programmes (Endicott, Spitzer, Fleiss & Cohen, 1976; Lehmann, 1984). Some argue that global ratings provide a more comprehensive view of child behaviour as compared to scores based on specifi c subtask analysis or scores based on the opinion of a single informant (Wagner et al., 2007). Research demonstrates that rating scales can have considerable levels of short-and long-term predictive validity throughout later school years and even into adulthood (Epstein, Schweinhart, DeBruin-Parecki & Robin, 2004). "
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    • "In the trial, a treatment responder was defined as a rating of 1 (''very much improved'') or 2 (''much improved''), and all other endpoint ratings were considered non-responders. Developmental Disability–Child Global Assessment Scale (DD-CGAS; Wagner et al. 2007). The DD-CGAS is a reliable and valid (test–retest, r = .86; "
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    • "Possible explanations of why these associations were not detected in the regression analysis could be that the sample size in our study was too small and that 23% of the sample in this study had an IQ below 70. The CGAS has been criticized for not covering all relevant domains of functioning in children with developmental disabilities (Wagner et al., 2007). It could be that the part of the sample in this study with an IQ under 70 primarily has difficulties related to problems that are common among children with developmental disabilities, and that impairment related to psychiatric symptoms are not the most prominent problem. "
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