Appendix G_Standardized Instruments_Outcome and Impact Data_CLEAN

APPENDIX G

Standardized instruments for outcome and impact analysis

 

 

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) Public reporting burden for this collection of information is estimated to average 1.25 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

OMB Approval number: 0970-0527, Expiration Date: XX/XX/XXX.

Summary of RPG Cross-Site Evaluation Standardized Instruments

Domain	Standardized Instrument	Recommended Age Range for Focal Child	Administration Time-point
Child well-being (Administer only one instrument)1	Child-Behavior Checklist (Two forms -CBCL Preschool Form/1.5-5 years; CBCL School-Age Form 6-18 years)	1.5-18 years	Baseline and Program Exit
	Infant-Toddler Sensory Profile (Two forms - ITSP 0-6 months, ITSP 7-36 months)	0-36 months	Baseline Program Exit2
Family functioning	Adult Adolescent Parenting Inventory (AAPI-2)	0-18 years	Baseline (Form A); Program Exit (Form B)
	Center for Epidemiologic Studies Depression Scale (CES-D)	–	Baseline and Program Exit
Recovery	Addiction Severity Index Self-Report (ASI-SR; alcohol and drug use subscales only)	–	Baseline and Program Exit
	Trauma Symptoms Checklist 40 (TSC-40; Optional)	–	Optional at Baseline and Program Exit
Total	Up to 5 instruments for each family

References for Standardized Instruments for the Outcomes and Impact Analysis

1. Addiction Severity Index, Self-Report Form (McLellon et al. 1992)

   1. McLellan, A.T., H. Kushner, D. Metzger, R. Peters, I. Smith, G. Grissom, H. Pettinati, and M. Argeriou. “The Fifth Addition of the Addiction Severity Index.” Journal of Substance Abuse Treatment, vol. 9, 1992, pp. 199-213

2. Adult-Adolescent Parenting Inventory (Bavolek and Keene 1999)

   1. Bavolek, S.J., and R.G. Keene. Adult-Adolescent Parenting Inventory – AAPI-2: Administration and Developmental Handbook. Park City, UT: Family Development Resources, Inc., 1999.

3. Center for Epidemiologic Studies-Depression Scale, 12-Item Short Form (Radloff 1977)

   1. Radloff, L.S. “The CES-D Scale: A Self-Report Depression Scale for Research in the General Population.” Applied Psychological Measurement, vol. 1, 1977, pp. 385–401.

4. Child Behavior Checklist-Preschool Form (Achenbach and Rescorla 2000)

   1. Achenbach, T.M., and L.A. Rescorla. Manual for the ASEBA Preschool Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families, 2000.

5. Child Behavior Checklist-School-Age Form (Achenbach and Rescorla 2001)

   1. Achenbach, T.M., and L.A. Rescorla. Manual for the ASEBA School-Age Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families, 2001.

6. Infant-Toddler Sensory Profile (Dunn 2002)

   1. Dunn, W. The Infant/Toddler Sensory Profile Manual. San Antonio, TX: The Psychological Corporation, 2002.

7. Trauma Symptoms Checklist-40 (Briere and Runtz 1989)

   1. Briere, J., and M. Runtz. “The Trauma Symptom Checklist (TSC-33): Early Data on a New Scale.” Journal of Interpersonal Violence, vol. 4, 1989, pp. 151-163.

1 Grantees will ask each family to complete only one child well-being instrument, depending on the focal child’s age.

2 If the child is 18 months or older at baseline, the age-appropriate form of the CBCL should be administered at both baseline and program exit. If the child is under 18 months at baseline, the age-appropriate form of the ITSP should be administered at both baseline and program exit.