Related Experiment Video
Updated: Jun 3, 2026
11:29
Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
Are clinicians' assessments of improvements in children's functioning "global"?
Andres De Los Reyes1, Candice A Alfano, Deborah C Beidel
1Department of Psychology, University of Maryland at College Park, Biology/Psychology Building, Room 3123H, College Park, MD 20742, USA. adelosreyes@psyc.umd.edu
Summary
Clinician ratings of treatment success for social anxiety disorder may be unreliable. Discrepancies between parent and blinded rater reports significantly impact these assessments, affecting outcome interpretations.
Area of Science:
- Psychiatry
- Clinical Psychology
- Developmental Psychology
Background:
- Social anxiety disorder (SAD) is a prevalent condition in children and adolescents.
- Accurate assessment of treatment improvement is crucial for evaluating therapeutic efficacy.
- Discrepancies in outcome reporting can arise between different informants, such as parents and clinicians.
Purpose of the Study:
- To examine the relationship between clinician ratings of treatment improvement and discrepancies between parent and blinded rater reports of child social functioning in social anxiety disorder.
- To investigate how the direction of discrepant reports (parent vs. blinded rater) influences clinician assessments of treatment outcomes.
- To assess the implications of these findings for the use of clinical ratings as primary outcome measures in controlled trials.
Main Methods:
- A clinic sample of 101 children (7-16 years) with social anxiety disorder receiving treatment was studied.
- Parent and blinded laboratory rater reports of child social functioning were collected before and after treatment.
- Clinician ratings of treatment improvement were compared with discrepancies between parent and blinded rater reports.
Main Results:
- Clinician ratings indicated a lack of improvement when parents reported persistent social functioning deficits not identified by blinded raters.
- When blinded raters reported deficits not noted by parents, this did not similarly affect clinician ratings.
- These patterns were replicated in a subset of participants (n=81) reporting on social anxiety symptoms.
Conclusions:
- The findings suggest that clinician ratings of treatment improvement in pediatric social anxiety disorder can be influenced by the source of discrepant information.
- Discrepancies where parents report ongoing difficulties, not observed by blinded raters, appear to significantly temper clinician perceptions of improvement.
- These results highlight the importance of considering informant discrepancies when interpreting clinical ratings as primary outcome measures in treatment trials.
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