Use of DAWBA online in a municipalitybased service in rhus DAWBA seminar, Lund 2'4'08

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Use of DAWBA on-line in a municipality-based
servicein ÅrhusDAWBA seminar, Lund 2.4.08

• Jon Arnfred
• Socialoverlæge
• Århus Kommune

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• The Municipality of Århus 300.000 inhabitants
• Since 1998 interdisciplinary initiatives aimed at
  children with possible child psychiatric
  problems.
• Participants (Physiotherapist), psychologists,
  doctors, teachers, kindergarten teachers.
• Consultants from the Psychiatric Hospital for
  Children and Adolescents in Århus.
• Present project called basisteam is funded in
  part by the Ministry of Social Wellfare but is in
  the process of implementation as a rutine service
  in the municipality.

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The basisteam project

• Setting A cooperation between the child public
  health service and the educational services in
  the Municipality of Aarhus (300,000 inhabitants).
• Aim That children in Aarhus with psychiatric
  needs are offered evidence-based interventions.
• (This more often than not involves cooperation
  with specialist services in the individual cases)
• Financing The Ministry of Social Affairs has
  paid most of the costs the first three years. As
  the project is increasingly used by the
  Municipality Education and Social authorities,
  everything points to a permanent implementation
  of the method used.

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The basisteam project

• Referral Children are referred to the project
  after an initial assessment by an educational
  psychologist.
• Staff Educational psychologists, child public
  health doctors and teachers/nursery teachers work
  part-time in the project forming
  multidisciplinary teams.
• Method Systematic multiaxial assessment,
  including evaluation of diagnostic criteria
  according to DSM IV. This is followed by an open
  dialogue with the parents to determine the
  appropriate strategies in the individual case.

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SDQ

• SDQ - the Strengths and Difficulties
  Questionnaire is a brief behavioural screening
  questionnaire about 3-16 year olds. It is an
  integral part of the DAWBA, but is also widely
  used independently.
• We use the stand alone paper version of the SDQ
  to collect preliminary information from parents
  and kindergarten/school/after school centre.
• This information is discussed at the introductory
  network meeting with the parents and other
  informants.

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SDQ

• Clinical benefits from using the SDQ as a first
  line tool in the assessment process
• It becomes clear who sees what problems in which
  contexts.
• The respondents are tuned in to focus on the
  how? instead of the why?.
• There is an opportunity to discuss1. the
  interpretation of key questions2. the proper
  measuring scale for behaviourbefore the
  subsequent use of the DAWBA on-line
• The SDQ on paper or in the version integrated
  in DAWBA on-line in addition provides figures
  enabling monitoring, documentation and
  potentially also evaluation of the service as a
  whole.

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SDQ
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DAWBA on-line

• Is used after the paper-version SDQ and the
  intital network meeting to collect
  comprehensive information from the adults who
  know the child from day-to-day life.
• All professionals and most parents are able to
  fill in the on-line questionnaire.
• The report is used in the planning of the
  clinical part of the assessment, where typically
  the psychologist and the doctor see the child and
  talk to the parents independently.
• The teacher/nursery teacher from the team visits
  the school or kindergarten, talks to the teachers
  and makes observations, depending on the
  clinical questions.

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DAWBA on-line

• As can be seen, the information from DAWBA
  on-line is integrated into the assessment
  process, and thereby further qualified and
  validated in relation to the individual case.
• One of the results is a thorough documentation of
  relevant diagnostic criteriae.
• This documentation is of great importance in a
  transparent, high quality cooperation process
  with the specialist services.

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DAWBA on-line

• DAWBA on-line used in a child public health
  setting has established itself as a
  well-accepted, robust and very efficient tool,
  supporting the efforts to provide evidence based
  interventions to children with psychiatric needs.