The Development and Well-Being Assessment (DAWBA) is a novel package of questionnaires, interviews, and rating techniques designed to generate ICD-10 and DSM-IV
psychiatric diagnoses on 5–16-year-olds. Nonclinical interviewers administer a structured
interview to parents about psychiatric symptoms and resultant impact. When definite
symptoms are identified by the structured questions, interviewers use open-ended questions
and supplementary prompts to get parents to describe the problems in their own words.
These descriptions are transcribed verbatim by the interviewers but are not rated by them.
A similar interview is administered to 11–16-year-olds. Teachers complete a brief
questionnaire covering the main conduct, emotional, and hyperactivity symptoms and any
resultant impairment. The different sorts of information are brought together by a computer
program that also predicts likely diagnoses. These computer-generated summary sheets and
diagnoses form a convenient starting point for experienced clinical raters, who decide
whether to accept or overturn the computer diagnosis (or lack of diagnosis) in the light of
their review of all the data, including transcripts. In the present study, the DAWBA was
administered to community (N = 491) and clinic (N = 39) samples. There was excellent
discrimination between community and clinic samples in rates of diagnosed disorder. Within
the community sample, subjects with and without diagnosed disorders differed markedly in
external characteristics and prognosis. In the clinic sample, there was substantial agreement
between DAWBA and case note diagnoses, though the DAWBA diagnosed more comorbid
disorders. The use of screening questions and skip rules greatly reduced interview length by
allowing many sections to be omitted with very little loss of positive information. Overall, the
DAWBA successfully combined the cheapness and simplicity of respondent-based measures
with the clinical persuasiveness of investigator-based diagnoses. The DAWBA has
considerable potential as an epidemiological measure, and may prove to be of clinical value
too.