What is the DAWBA?

The DAWBA is a youth mental health assessments tool which consists of a package of interviews, questionnaires and rating techniques designed to generate ICD-10 and DSM-IV or DSM-5 psychiatric diagnoses on 2-17 year olds.

The DAWBA covers the common emotional, behavioral and hyperactivity disorders, without neglecting less but sometimes more severe disorders. You can consult a list of diagnoses covered.

Information is collected from up to three sources:

  • An interview with the parents of 2-17 year olds. Tell me more
  • An interview with 11-17 year olds themselves. Tell me more
  • A questionnaire completed by teachers of 2-17 year olds. Tell me more

The DAWBA interviews can be administered either by humans or by computers. For the ever-increasing proportion of young people and parents who are at home with computers, the computer-administered interviews have the advantage of cutting out the cost of employing an interviewer. In addition, some respondents find it easier to be honest with a machine than a person. There is also a convenience factor since a growing number of respondents are able to complete the ‘on line’ DAWBA from home or work. But there are also many circumstances where having an interviewer is an advantage. It is quick to train DAWBA interviewers and previous clinical experience is not essential (see Interviewers’ Instructions).

The interviews and questionnaires involve a mixture of closed questions such as “Does he ever worry?” and open-ended questions such as “Please describe in your own words what it is that he worries about?” With the computer-administered interviews, the respondent types the open-ended answers into the text boxes. With the interviewer-administered interviews, it is the interviewer who transcribes the answers. Interviewers can also add comments to the transcript, e.g. about a respondent’s difficulty understanding particular questions, or about a respondent’s reluctance to speak about specific topics.

To increase acceptability and reduce costs, the interviews and questionnaires have deliberately been kept as short as possible. As a rough guide to length, the parent interview takes around 50 minutes to administer to a community sample. The corresponding youth interview takes around 30 minutes to administer to a community sample. The teacher questionnaire takes around 10-15 minutes.

The length of interviews is further reduced by skip rules that allow entire sections to be omitted when screening questions indicate that the child is extremely unlikely to have the diagnoses covered by those sections. More about skip rules.

Information from the different informants is drawn together by a computer program that also predicts the likely diagnosis or diagnoses, generating six probability bands, ranging from a probability of less than 0.1% of having the relevant diagnosis to a probability of over 70% of having the relevant diagnosis. The computer-generated predictions may be enough for some research studies, but for clinical use and some research studies, the computer predictions are not the finishing point – they are simply a convenient starting point for experienced clinical raters who decide whether to accept or overturn the computer diagnoses (or lack of diagnoses) in the light of their review of all the data, including transcripts. A rater’s manual provides guidance on how to deal with common difficulties and “grey cases”. More about clinical rating.

The DAWBA combines the cheapness and simplicity of respondent-based measures with the clinical persuasiveness of investigator-based diagnoses. Getting repondents to complete the interview online can reduce costs by 80% or more. If interviewers are needed, then using non-clinical rather than clinical interviewers reduces costs. Skilled clinical investigators are expensive and scarce – the DAWBA uses them very economically. For example, the 1999 British nationwide survey employed around 300 non-clinical interviewers to assess over 10,000 children – but only required 2 clinical raters back at base.

The initial validation study of the DAWBA suggested it had considerable potential as an epidemiological measure and promise as a clinic assessment (Abstract). A decade of subsequent experience has confirmed this. The DAWBA has been used in all the British nationwide surveys of child and adolescent mental health, (e.g. summary of 1999 survey). These surveys, and similar surveys in many other countries, have generated reasonable prevalence rates, and shown the expected pattern of association between disorders and independent risk factors – thereby providing further evidence for the validity of the DAWBA. The DAWBA has also taken off as a clinical assessment in a wide range of contexts and countries.