DIAGNOSTIC INFANT AND PRESCHOOL ASSESSMENT (DIPA) version October 10, 2019 Copyright 2004 MICHAEL S. SCHEERINGA, MD, MPH TULANE UNIVERSITY 1440 CANAL ST., #8448 NEW ORLEANS, LA 70112 (504) 988-2167 [email protected] The original DIPA citation is: Scheeringa MS, Haslett, N (2010). The reliability and criterion validity of the Diagnostic Infant and Preschool Assessment: A new diagnostic instrument for young children. Child Psychiatry & Human Development, 41, 3, 299-312. The DIPA may be reproduced and used for free, but not sold, without further permission from the author. Date ________________ D.O.B. ________________ ID ___________ Name _________________ PTSD m14-15 m16-17 ODD Algorithm: GAD p14 Intrusive recollections m18-23 4 out of 8 choices: g1 Excessive worries p15 Play reenactment 1 out of m24-m29 o1 o2 g2 Uncontrollability p16 Non-play reenactment o3 or o4 g3 Restlessness p17 Nightmares on trauma o5 o6 g4 Fatigue p18 Nightmares non-trauma DISRUPTIVE MOOD o7 o8 g5 Concentrating p19 Flashbacks DYSREGULATION DIS. o9 g6 Irritability p20 Dissociation Algorithm: all below 1 out of o11-o16 g7 Muscle tension p21 Psychological distress m32 disprprtionate temper g8 Sleep at reminders m33 not age level p22 Physiological distress m34 3 or more/week CONDUCT DISORDER GAD Algorithm: at reminders m35 irritable in between c1 Bullies g1 and g2 p23 Avoidance of external m36 12 mos. duration c2 Initiates physical fights 1 out of g3-g8 p24 Avoidance of people m37 2 out of 3 settings c3 Used weapon 1 out of g10 – g15 p25 Negative emotional c4 Cruel to people p26 Loss of interests BIPOLAR I c5 Cruel to animals p27 Detachment b1 and either b8 or b9 c6 Stole with confrontation OCD p28 Restricted affect 3 out of 7 choices: c7 Forced sexual activity oc1 Obsessions p29 Irritabiility/anger (4 needed if b2 and not b1) c8 Fire setting oc2 Unwanted aspect p30 Hypervigilance b3 b4 c9 Destroyed property oc3 Compulsions p31 Exaggerated startle b5 b6 c10 Broken entry oc4 Anxiety reduction p32 Concentration b7 b8 or b9 c11 Cons/lies for goods oc5 Prevention aspect p33 Initiating sleep b10 c12 Stole without p34 Night waking 1 out of b11-b16 confrontation OCD Algorithm: c13 Stays out late oc1 and oc2 PTSD Algorithm: c14 Run away oc3 A. 1 out of p1-12. ADHD c15 Truant oc4 or oc5 B. 1 out of 5 choices: a1 Fails to give close 1 out of oc8-oc13 p14-16, p17-18 attention CD Algorithm: p19-20, p21, or p22 a2 Difficulty sustaining 3 out of c1-c15 RAD C. 1 out of 6 choices: attention 1 out of c19-c23 r1 doesn’t seek comfort p23 p24 a3 Does not listen r2 little response to comfort p25 p26 a4 Does not follow through r3 limited positive affect p27 p28 a5 Difficulty organizing SAD r4 irritable, sadness, or fear D. 2 out of 5 choices: a6 Avoids mental effort se1 Distress after r5 Reduced reciprocity p29 p30 a7 Loses things separation p31 p32 a8 Easily distracted se2 Withdrawal after RAD algorithm: p33-34 a9 Forgetful separation r1 and r2 E. Duration at least 1 month a19 Fidgets se3 Distress from 2 out of 3: r3, r4, or r5 F. 1 from p39-44. a20 Leaves seat anticipated separation Dev. age > 9 mos. (r10) a21 Runs about or climbs se4 Fear about harm to a22 Trouble being quiet parent DISINHIBITED SOCIAL MDD a23 “On the go”/”motor” se5 Fear about sudden ENGAGEMENT DIS. m1 Sad/unhappy a24 Talks excessively separation r6 Absent reticence m2 Irritable a25 Blurts out answers se6 Refusal to leave home r7 Overly familiar m3 Loss of interests a26 Difficulty waiting turn se7 Fearful to be alone r8 Rarely checks back m4 Anhedonia a27 Interrupts se8 Reluctance to sleep r9 Willing to go off with m5 Boredom alone unfamiliar adults m6 Reduced appetite Inattention Subtype se9 Nightmares of m7 Weight loss Algorithm: separation DSED algorithm: m8 Increased appetite 6 out of a1-a9 se10 Physical symptoms on 2 out of 4: r6-r9 m9 Night waking a11 (two settings) separation Dev. age > 9 mos. (r10) m10 Sleepiness 1 out of a12-a16 m11 Psychomotor agitation SAD Algorithm: (Note: the insufficient care m12 Psychomotor Hyperactivity Subtype 3 out of 8 choices: criterion C for RAD and retardation Algorithm: se1, se2, or se3 DSED is not asked). m13 Fatigue 6 out of a19-a27 se4 se5 m14 Worthlessness a29 (two settings) se6 se7 Sleep Onset Dyssomnia m15 Guilt 1 out of a30-a34 se8 se9 Sl1 m16 Concentration se10 Night Waking Dyssomnia m17 Indecisiveness 1 out of se12-se17 Sl2 m18 Talks about death ODD Both: 4 wks duration m19 Death play themes o1 Loses temper SPECIFIC PHOBIA ≥5 nights/week m20 Suicide play themes o2 Argues Specific Phobia Algorithm: not if <12 months of age. m21 Suicidal thoughts o3 Breaks rules 1 out of sp1-sp15 m22 Suicidal plans o4 Disobedient 1 out of s1-s6 for specific m23 Suicide attempts o5 Annoying phobia. o6 Blames others MDD Algorithm: o7 Touchy SOCIAL PHOBIA 5 symptoms total o8 Angry/resentful Social Phobia Algorithm: 1 must be m1-2 or m3-5. o9 Spiteful or vindictive 1 out of so1 or so2 m6-8 m9-10 1 out of s1-s6 for social m11-12 m13 phobia. Allow respondents to hold this during the interview to help with answering. Frequency How many times did that happen in the past month? 0 None of the time 1 Little of the time once or twice (less than 10%) 2 Some of the time once or twice a week (approx. 20-30%) 3 Much of the time several times a week (approx. 50-60%) 4 Most of the time daily or almost every day (more than 80%) Intensity In the past month, how intense was the symptom? 0 Not at all None Mild minimal distress/ Little or no disruption of 1 A little bit got a little upset activities Moderate distress Some disruption of 2 Somewhat clearly present but still activities manageable Severe considerable Marked disruption of 3 A lot distress activities Severe impairment/ Extreme/ incapacitating 4 A whole lot Unable to continue distress activities Functional Impairment: Rate the impact on their relationship 0 No adverse impact on relationships 1 Slight/mild impact on relationships, some impairment 2 Moderate impact on relationships 3 Severe impact, marked impairment, few aspects of relationships still intact 4 Extreme impact on relationships ACCOMMODATION: “Do you make accommodations so that s/he has fewer conflicts with you?” 0 None 1 Accommodates some, but not usually (<50% of the time) 2 Accommodates half the time (~50%) 3 Accommodates more than not (>50% of the time) 4 Almost always accommodates DIPA Introductory script: “This interview can take a half-hour, an hour, or maybe longer, depending on how much there is to talk about. I’m going to ask you a bunch of questions about your child’s emotions and behaviors.” TRAUMATIC LIFE EVENTS Parent Version TO BE ENDORSED, AN EVENT MUST HAVE LED TO SERIOUS INJURY OR THE POTENTIAL FOR SERIOUS INJURY TO THE CHILD, OR TO A LOVED ONE AND THE CHILD WITNESSED IT. 0 = Absent 1 = Present Write how many times Write the age when Write the age when this happened to your this happened to this happened to child. If it happened lots your child for the first your child the last of times, please make time. time. your best guess. P1. Accident or crash with automobile, 0 plane, or boat. 1 0 P2. Attacked by an animal. 1 0 P3. Man-made disasters (fires, war, etc) 1 P4. Natural disasters (hurricane, tornado, flood) (stayed through the 0 storm) 1 P5. Witnessed another person beaten, raped, threatened with serious harm, or 0 killed. 1 0 P6. Physical abuse 1 P7. Sexual abuse, sexual assault, or 0 rape 1 0 P8. Accidental burning 1 0 P9. Near drowning 1 P10. Life-threatening hospital visit or 0 medical procedure 1 P11. Learned that one of the events 0 above happened to a caregiver 1 P12. Other: __________________ 0 (e.g. came back after a storm) 1 P13. IF MORE THAN ONE EVENT, ASK FOR WORST EVENT: “Which of these do you think caused the most emotional or behavior problems for your child?” WRITE THE EVENT NUMBER 1-12 IF NO TRAUMATIC EVENTS, SKIP TO NEXT DISORDER. “Next, I'm going to ask you a bunch of questions about your child's reactions. Some of these questions are not really appropriate for young kids who can't talk yet. We try to ask all the questions in an age-appropriate fashion. Please bear with me if I phrase a question that doesn't really fit your child's age.” PTSD 1 DIPA EDUCATIONAL INTRO: “Now I’m going to ask you a bunch of questions about any symptoms your child might have developed since the trauma(s). For something to be a symptom, it must be abnormal. I’ll be repeating that a behavior needs to be “more than the average child his/her age.” We know that sometimes this is obvious and sometimes it’s hard to figure out. TOTALITY RULE: IF A CHILD HAS EXPERIENCED MORE THAN ONE TRAUMATIC EVENT, ASK THE REMAINDER OF THE PTSD QUESTIONS FOR THE TOTALITY OF ALL EVENTS, THAT IS, SYMPTOMS CAN BE ENDORSED FOR ANY OF THE EVENTS. P14. INTRUSIVE RECOLLECTIONS “Does s/he have intrusive memories of the trauma? Does s/he bring it up on his/her own?” IF YES, YOU MUST GET AN EXAMPLE. If yes, ask: “And this was present in the last 4 weeks?” Date of first occurrence / / Frequency How many times did that happen in the past month? 0 None of the time 1 Little of the time, once or twice 2 Some of the time, once or twice a week 3 Much of the time, several times a week 4 Most of the time, daily or almost every day P14a.