The development and psychometric evaluation of an innovative self-reported mental health assessment instrument for school-aged children

The overarching objective of this PhD Research Program was to develop a broad, digitally animated assessment instrument capable of detecting self-reported emotional and behavioural distress in primary school children (aged 5-11 years). The instrument utilises cartoon animations as assessment items and is presented via a highly accessible internet-based application. The ultimate purpose of the instrument, named the Interactive Child Distress Screener (ICDS) is to increase detection rates of emotional and behavioural difficulties to facilitate prevention, further assessment, and earlier intervention for child mental health problems. The ICDS was co-designed and tested in this research with 366 children over staged iterative development and validation studies. An exploratory sequential mixed methods approach with an emphasis on iterative, participatory codesign was utilised throughout each stage. In the pilot study, assessment domains were identified with experts (N = 9) in child and youth mental health and psychometrics, and feasibility of the digital, animated concept was supported with children (N = 18). Study 2 aimed to first understand the Child's (N = 20) perspective of emotional and behavioural constructs and then develop a series of emotional and behavioural typologies from which the animated items were subsequently designed. Study 3 qualitatively validated and refined the animated assessment items with children (N = 62) until >80% accuracy and acceptability ratings were attained. Study 4 field tested the ICDS instrument in a community sample of parent and child dyads (N = 266) and conducted preliminary psychometric validation. Classical evaluation of the ICDS revealed a clear two-factor structure with good overall psychometric properties and high acceptability with children aged five through 11 years. Results demonstrated that young children can accurately report on their own internalising and externalising states via digitally animated assessment items. Findings also highlighted the importance of iterative and participatory co-design methodologies when developing instruments for children to ensure outcomes are acceptable and accurate. This research program produced a digitally animated instrument capable of obtaining self-reported emotional and behavioural distress from young children. The highly accessible and unrestricted format of the internet based ICDS presents a feasible approach for broad application