YOQ-30
The YOQ-30 is a short form of the YOQ-2.0. It was developed as a brief measure of severity of disturbance in mental health patients under 18 that can be used repeatedly and is sensitive to change. It provides a total score or global index of behavioral and emotional distress in a child/adolescent’s life. Critical items alert clinicians to potential high-risk behaviors (e.g. suicide, substance abuse). The instrument provides easy to use interpretive indices. A cut off score discriminates between the normal and dysfunctional range and a reliable change index is used to determine if the change during treatment is clinically significant. The YOQ-30 is available in English and Spanish. The YOQ has a broad normative sample and has been used extensively in research and clinical applications.
The YOQ-30 is available in a parent rating version (staff members can complete the parent version in 24-hour care), which is appropriate for ages 4 through 17, and a self-report version (YOQ-30 SR), which is appropriate for ages 12 through 17. The question of whether a parent-report or a self-report measure is most appropriate for child and adolescent populations is not settled. Developmental considerations, such as verbal skills and reading ability, factors such as motivation for treatment, social desirability, and perception of the problem behavior or feelings (i.e. whether the child sees a particular symptom as problematic or his parents or teacher sees it as problematic), all influence the decision to use parent or self-report data with children. With children under 11 or 12, parent-report is the norm with the assumption being that parents will be the most reliable source for obtaining data about a young child’s functioning and behavior. In adolescents, research (Achenbach and Edelbroch, 1991) have shown that the major differences between parent and self-report are: 1) the tendency of adolescents to under-report their symptomatology as compared to parents and 2) the finding that parents are better sources of data regarding objective behaviors (e.g. oppositional attitude, school failures, etc) while adolescents themselves are considered more accurate informants regarding their subjective states (moods, feelings, etc).
The YOQ-30 is designed to be used repeatedly and is sensitive to change in children and adolescents receiving mental health treatment. The YOQ-30 provides easy to use interpretive indices that enable a clinician to quickly assess his/her client’s level of disturbance and adequacy of treatment response. A cutoff score discriminates between normal functioning and clinical disturbance. Also, a reliable change index (RCI) has been established so changes in patient scores can be evaluated to determine if they are clinically significant. Additionally, there are flags for clinical follow-up of critical items such as suicidality and drug/alcohol abuse.
The thirty items for the YOQ-30 were chosen from the YOQ 2.0 based on their individual sensitivity to change as estimated from a large-scale study of patients undergoing treatment in a variety of settings. The items that comprise the YOQ 30 address commonly occurring problems and symptoms across a wide variety of disorders.
Outstanding features of the measure include:
• Standardized data: The Y-OQ® 30.1 is a standardized instrument with empirical support.
• User-friendly. The Y-OQ® 30.1 is brief to complete (less than 5 minutes), provides real time feedback, and is designed to be incorporated into an office visit in an unobtrusive manner.
• Can be used by either the parent (guardian) or youth patient capable of self reporting.
Guidelines for Clinical Interpretation
The total score on the YOQ 30 reflects the total behavioral and emotional distress in a child’s or adolescent’s life. It is a global index that assess a child’s functioning relative to normative populations as well as his/her progress in treatment. The higher the score the more disturbed the child.
Cutoff scores have been derived for the (parent reported) YOQ 30 and the (client reported) YOQ 30 SR. The sensitivity and specificity analysis for the YOQ 30 is based on the cut off score of 29. A score of 29 or higher is in the clinical range; a score below 29 is in the non-clinical or normal range. For the YOQ 30 SR, the cut off score is 30. This higher score reflects the tendency of adolescents to under-report their symptomatology as compared to parents and the finding that parents are better sources of data regarding objective behaviors, e.g. oppositional attitude, externalizing behaviors, school failures, etc. (Adolescents are considered to be more accurate informants regarding their subjective states, e.g. moods, feelings, etc.) A score of 30 or higher is in the clinical range; a score below 30 is in the non-clinical or normal range.
A reliable change index was derived to determine clinically significant change (Jacobson and Truax, 1991). In order for an individual’s score to be considered to have changed reliably for either version of the YOQ 30 the RCI value must be 10 points or greater. Using the cutoff score and the RCI value enables a clinician to interpret the clinical significance of patient change in treatment. Thus, in a child’s score has decreased by ten points or more over the course of treatment, then the change may be characterized as clinically significant improvement. If the score has decreased by ten or more points and the child’s total score is in the normal range, then the child has recovered in addition to have improved. If a child’s score increases by ten or more points then the child’s progress may be characterized as deteriorated.
