The DAWBA in a child public health setting in Denmark DAWBA workshop, ESCAP, Florence 27. aug Jon Arnfred M.D. Municipality of Aarhus

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.

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.

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.

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 discuss 1. the interpretation of key questions 2. the proper ”measuring scale” for behaviour before 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.

SDQ

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.

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.

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.