Judging Mental Health-Sickness in Children: Development of a Rating Scale

The Health-Sickness Rating Scale for Children, with 24 clinical vignettes as “anchors” for various points along the scale, was developed as a measure of overall mental health and sickness in children. Despite a diversity of perspectives, senior clinicians rank-ordered the vignettes with a high degree of concordance (0.90). Interrater reliability, low variability, and discriminant and concurrent validity in the first field trials of the scale support the hypothesis that, despite the complexity of judgments, mental health-sickness in children can be estimated with considerable agreement when clinically-anchored guidelines are provided. Potential problems and proposed uses of the scale are discussed. J. Am. Acad. Child Adolesc. Psychiatry, 1988, 27. 2:193–199.