Discriminant Validity of a DSM-IV-Based Teacher Checklist: Comparison of Regular and Special Education Students.

A long-standing problem for special educators is the difficulty in sharing information about emotional or behavior disorders (E/BD) in children with physicians and other mental health professionals (Forness & Kavale, 2001). One aspect of this problem is the marked disparity in their respective conceptualizations of child psychopathology. Clinicians generally use the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) to diagnose childhood disorders, whereas educators use the classification criteria specified in the Individuals with Disabilities Education Act (IDEA). To communicate effectively with clinicians, special education teachers must have a working knowledge of relevant DSM-IV diagnoses and a practical, cost-effective procedure for conveying relevant symptom information. Unfortunately, neither the field of special education nor child psychiatry has sufficiently emphasized the development of comprehensive measures for this purpose. The reasons for this situation are many, and two of them are noted here. First, special education researchers rarely use psychiatric diagnoses as a study variable. For example, our examination of three major special education journals (i.e., Behavioral Disorders, Exceptional Children, Journal of Emotional and Behavioral Disorders) over the past 5 years (1995-2000) found that DSM-IV disorders were reported in a relatively small number of articles (0%-24%) that investigated students and were used primarily as descriptors in small case studies. Moreover, a scientifically validated DSM-IV diagnostic instrument was rarely used (0%-13%) to assess student behavior, and in no case did this involve teachers. Second, child psychiatry depends primarily on interviews with parents and/or students to derive psychiatric diagnoses. Consequently, teacher versions of established psychiatric interviews are only in the early stages of development-for example, the teacher Diagnostic Interview Schedule for Children (DISC; Mitsis, McVay, Schulz, Newcorn, & Halperin, 2000). Because interviews with teachers are time consuming and often difficult to arrange, some effort has been made to develop teacher-completed rating scales for specific DSM-IV disorders such as attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD), and these scales have been well received (e.g., DuPaul, Power, Anastopoulos, & Reid, 1998; Pelham, Evans, Gnagy, & Greenslade, 1992; Sprafkin, Gadow, & Nolan, 2001; Wolraich, Feurer, Hannah, Baumgaertel, & Pinnock, 1998). One rating scale that is a faithful adaptation of DSM-IV criteria and assesses the full spectrum of psychiatric diagnoses in children and adolescents is the teacher version of the Child Symptom Inventory-4 (CSI-4T; Gadow & Sprafkin, 1994; 1997; 1998). Psychometric research (Gadow & Sprafkin, 1994; 1997; 1998) indicates that CSI-4T symptom categories demonstrate satisfactory internal consistency and concurrent validity with corresponding scales of the Teacher's Report Form (Achenbach, 1991) and the IOWA Conners Teacher's Rating Scale (Loney & Milich, 1982). CSI-4T Screening Cutoff scores for the ADHD, ODD, and pervasive developmental disorder (PDD) symptom categories also show moderate convergence with data-based psychiatric diagnoses and structured psychiatric interviews. Diagnostic accuracy is improved, however, when CSI-4T ratings are combined with parent CSI-4 ratings. Confirmatory factor analysis supports, for the most part, the internal construct validity of the ADHD, ODD, CD, generalized anxiety disorder (GAD), and depressive disorder symptom categories (Hartman et al., 2001). Although the findings of these studies are encouraging, relatively little research has focused on the application of the CSI-4T for children receiving special education services. For example, it is important to know how well this measure differentiates different populations of children in general and special education in terms of DSM-IV symptoms (i. …