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Learning to use the dawba online rating screens (page 2)

Click here if you haven't yet opened a window with the report screens

Exploring further
Having seen the overview in the ALL report, you should now use the navigation bar in order to look at all the more specific reports, and familiarise yourself with the other options available to you. In future, when you are working through the practice cases, you will be more selective about which screens to look at, choosing the ones that seem relevant on the basis of the overview. But for this first look round the dawba online screens, it is worth exploring all the possibilities.

Focusing on one domain at a time
Most of the grey buttons lead to reports that provide more detailed accounts of just one domain:

ASD	Autism Spectrum
SepA	Separation anxiety
SpPh	Specific phobias
SoPh	Social phobia
PanAg	Panic and agoraphobia
PTSD	Post-traumatic stress disorder
OCD	Obsessive compulsive disorder
GenA	Generalised anxiety
Dep	Depression
TRES	Teacher report of emotional symptoms
ADHD	Attention and activity disorders
ODD	Oppositional defiant disorder
CD	Conduct disorder
Eat	Anorexia / Bulimia
Tic	Tics
Other	Other concerns

The domain-specific reports

• We'll use the report about specific phobias as an example. Click on SpPh in the navigation bar.

• If you want to look up the latest diagnostic criteria, you can click on the buttons marked DSM-IV Criteria or ICD-10 Criteria. To get back again, you will need to click on the Back button of your browser (normally on the top left of the screen). Following the buttons for the diagnostic criteria are the computer predictions of diagnostic probability that you have have already seen in the last two columns of the green table of the All report (with 6 levels of diagnostic probability ranging from -- to +++). Clicking on 'Computer Prediction' will let you find out more about these probabilities.

• Most of the rest of the report is taken up with the answers to the structured questions. In general, anything that is '++' or more is worth taking seriously, whereas '-' or '+' are negative or borderline answers.

• The first column gives a brief summary of the theme of the relevant questions - click on these row labels to find out exactly what questions were asked, and how the responses were coded (and use the Back button of your browser to return again).

• To see the text answers to open-ended questions, click on Text buttons (and use the Back button of your browser to return again). The Text buttons with detailed answers are usually on the bottom line - Text buttons elsewhere contain briefer answers. Text buttons don't appear when there are no relevant answers (so while there are lots of Text buttons for Woody, there are far fewer for the real practice cases).

• The horizontal stripes are designed with two purposes in mind. The main one is to make it easier to read across a line, matching the row title with the correct answers. A subidiary purpose is to let you know when two or more rows correspond to a single diagnostic criterion. For example, in the SepA report, the three items related to sleep problems are all included in the same stripe, alerting you to the fact that even if the child has all three problems, this still only meets one of the criteria for separation anxiety.

• In the ADHD report, at the top of the section on attention, you can see teachers' estimates of how long the child can stay on a task that he or she enjoys and is good at. The answer is not closely linked to diagnostic criteria, but it is useful because teachers sometimes report a lot of inattentive symptoms in children who have a good attention span for things they enjoy and can do well. This may occur when a child has specific or generalised learning difficulties without associated ADHD or Hyperkinesis.

• The ODD report on oppositional defiant disorder needs to be reviewed in close conjunction with the CD report on conduct disorder. In ICD-10 (but not DSM-IV), it is possible to combine symptoms from the two areas into a single operationalised diagnosis. Because the two domains and two diagnoses are so closely related, the click-on links to diagnostic criteria from the ODD and CD reports tell you about both oppositional defiant and conduct disorders.

• Teachers are asked about oppositional and conduct symptoms as a single block, and make just one rating of the impact and burden due to these symptoms. This combined rating appears both on the ODD and CD reports. This is why you may see a conduct disorder report with no teacher-reported symptoms, but with marked teacher-reported impact - the explanation is that the teacher has reported some definite oppositional symptoms, and it is these oppositional symptoms that are having an impact.

• Whereas a DSM-IV diagnosis of conduct disorder is based on symptoms in the last 12 months, ICD-10 considers only the last 6 months. Symptoms shown as ++ were reported for the previous 6 months and are equally relevant to DSM-IV and ICD-10 diagnoses. By contrast, symptoms shown as (++) were present between 7 and 12 months prior to the interview, but haven't been present in the previous 6 months - such symptoms are relevant to DSM-IV but not to ICD-10 diagnoses.

• When children do meet criteria for an ICD-10 conduct disorder, the diagnostic options include socialised and unsocialised conduct disorders. To make this decision easier, the bottom of the CD report includes ratings (taken from the Strengths and Difficulties Questionnaire) of the child's friendships and popularity.

• The DSM screen allows you to enter your DSM-IV diagnoses. The click-down menus against each diagnosis generally provide a choice of No, Unsure and Yes. Since this is a demonstration case, you can change the diagnoses but you can't save those changes. The same is true for the practice cases.

• The ICD screen is the equivalent for ICD-10 diagnoses. If you are rating for a research study, you may need to record the diagnoses in both DSM-IV and ICD-10 in order to keep publication options as open as possible. Clinics, however, usually only need diagnoses in one of the two systems.

• Note includes a notepad for clinical raters. You can find out more about the notepad by looking at what it says in Woody's case. Just below the notepad are two pull-down menus that allow raters to adjust the process variables. On the left, raters use the pull-down menu to move cases between in-tray, pending tray and out-tray. To the right of this, the second pull-down menu can be used to flag cases that the rater needs to come back to or discuss with someone else.

• The SDQ report shows scores and bandings on the Strengths and Difficulties Questionnaire, which is usually administered prior to the DAWBA itself. For most of the scores, the bandings are designed so that about 80% of a community sample are close to average, 10% are slightly raised, 5% are high and 5% are very high. Prosocial scores are the exception, with about 80% close to average, 10% slightly low, 5% low and 5% very low.

• The Atta report is about the child's attachment figures.

• The +ve report is about children's positive qualities and behaviours. It is usually interesting to see the good things parents can report about their children, and that children can report about themselves. Much of the interview is focused on children's deficits or problems, so respondents often enjoy the opportunity to report positive things too. You too are likely to enjoy the opportunity to learn more about the 'whole child'. It is also very revealing when respondents can hardly find a single good thing to say about a child.

• The Open report provides access to all the open-ended comments from a single screen. Raters use this to check that they haven't missed anything, or to move backwards and forwards between the open-ended comments on different topics.

• The Crit report provides access to all the DSM-IV and ICD-10 diagnostic criteria from a single screen.

• The pdf option lets you print off a pdf file of the reports that you can then file in the case notes or research records.

That's it!
You've now looked round all the options. If you want to, you can go back to the rating screen one last time in order to shut that window down. Having familiarised yourself with the dawba online rating system, you can now look through the training cases whenever you feel ready. There are 54 cases to look through. If you want to continue with the training cases now, then it's up to you to decide whether you are going to:

	work through the practice cases in order
	focus in turn on different diagnostic categories

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Last modified : 27/03/2012