Diagnostic interviewing with children: the use and reliability of the diagnostic coding form

There have been few attempts to standardize assessment methods in Child Psychiatry. This paper describes a semi-structured approach to diagnostic interviewing of the child. Thirty-four children six to 13 years of age, and their parents, were interviewed two weeks apart by two different psychiatrists. A diagnostic coding form consisting of 29 clinical symptom items, eight summary items, and nine positive health ratings was used. Three diagnostic items were also included: "severity of clinical condition," "probability of disorder," and "adjustment status." Twelve of the Time 2 interviews with the child and parent were videotaped and rated by three different psychiatrists. Results indicated that summary items had higher reliability than individual symptom items and the three diagnostic items had the highest reliability, suggesting reliability is better for broad classes of behaviour. Interrater reliability was higher for the face-to-face rating than videotaped ratings. This suggests first that face-to-face interviews are reasonably stable over a two week period and second, since videotaped ratings had lowest reliability on items that depended on inferences about the child's feedlings, an important source of variance in assessment may be the clinician's ability to empathize with the child and draw inferences about internal feeling-states. It was concluded that this interview schedule can be a part of routine clinical practice. It ensures a reasonably standard, yet flexible and reliable approach to diagnostic interviewing.