SCA-PI
Services for Children & Adolescents - Parent Interview
INTERVIEW
Use the best respondent, parent or adolescent, for these questions.
You may use a second respondent for clarification or additional information.
By
Peter S. Jensen, M.D.
Kimberly Hoagwood, Ph.D.
Margaret T. Roper, M.S.
L. Eugene Arnold, M.D.
Carol Odbert, B.S.
Adapted for the ADHD-MTA Study
For information, contact:
Carol Odbert
6001 Exec. Blvd. Rm. 7221
Bethesda, MD20892
301-443-2422
I would like to ask about any help [child] may have received since [date of the last SCAPI] for attentional, learning, emotional, or behavioral difficulties. We are interested not only in new services, but also in changes in services due to vacations, summer time, or starting another school year. We will ask about medication, school services and therapy.
a)What grade was [child] in on [date of last SCAPI]?
b)What date did that grade end?
c)What date did school begin again?
a)What grade was [child] in then?
Would you mind if this call is tape recorded for training purposes?
1.Since [date of the last SCAPI], has [child] received [this/any other/any] medication for attentional, learning, emotional, or behavioral difficulties, or any other similar difficulty? 1 = yes, 2 = no
If yes, ask:
a)What is the name of the medication?(expanded lists on last pages of interview)
Trade Name Generic Name
9 = Adderall*(amphetamine)
18 = BuSpar(buspirone)
5 = Catapres(clonidine)
46 = Catapres TTS-1,2,3+(clonidine)
19 = Celexa(citalopram)
51 = Concerta**(methylphenidate)
3 = Cylert(pemoline)
20 = Depakote(divalproex)
2 = Dexedrine*(dextro-amphetamine)
56 = Dextrostat*(dextro-amphetamine)
21 = Effexor*(venlafaxine)
4 = Haldol(haloperidol)
44 = Lithobid**(lithium)
14 = Luvox(fluvoxamine)
54 = Metadate**(methylphenidate)
53 = Methylin*(methylphenidate)
55 = MethyPatch+(methylphenidate)
52 = Oros**(methylphenidate)
31 = Pamelor(nortriptyline)
13 = Paxil(paroxetine)
12 = Prozac*(fluoxetine)
79 = Risperdal(risperidone)
1 = Ritalin*(methylphenidate)
57 = Spansules** (Dexedrine)(dextro-amphetamine)
43 = Tegretol*(carbamazepine)
8 = Tofranil(imipramine)
7 = Wellbutrin*(bupropion)
6 = Zoloft(sertraline)
99 = other [before coding as ’99,’ look on last page of interview for more options]
b)What is the main reason [name of med] was prescribed … ADHD, learning problems, other behavioral or emotional difficulties, or another difficulty?
1 = ADHD
2 = learning
3 = other behavioral/emotional
99 = another [______]
c)On a typical day, since [date of the last SCAPI] how many times does [child] take [name of med] ?
d)What is the dosing schedule (___+____+…+____+___) and are any long acting?
(1=regular short acting mg, 2=ANY long acting SR/ER/XR mg, 3=mL, 4=patch cm)
e)So that means that [child] is taking [___.___](1=regular short acting mg, 2=long acting SR/ER/XR mg, 3=mL, 4=patch cm)all together each day?
f)When did [child] first begin taking [name of med] with this dosing schedule?
[____/____/____] (mm/dd/yy)
g)Is [child] still taking [name of med] or planning on continuing with the same dosingschedule? 1 = yes, 2 = no
If yes, put in today’s date for “last date.”
If no, ask:
h)When did [child] stop taking [name of med] with this dosing schedule?
[____/____/____] (mm/dd/yy)
i)Did [child] stop taking [name of med] for more than four weeks during
the summer?
j)Has [child] received any other medications for attentional, learning, emotional, or behavioral difficulties, or any other similar difficulty? 1 = yes, 2 = no
2)Have you had any visits to have [this medication/any of these medications] monitored since [date of the last SCAPI]? 1 = yes, 2 = no
If yes, ask:
a)Who did [child] see?
30 = pediatrician
31 = family doctor
33 = nurse
34 = physician’s assistant
35 = psychiatrist
49 = neurologist,
99 = other [______]
b)How many visits since [date of the last SCAPI] did [child] have? [__] (total visits)
c)About how long was each visit? [_____] (minutes)
d)Do you plan on taking [child] back for more medication check-ups? 1=yes, 2=no
e)When was [child’s] last medication check-up? [____/____/____] (mm/dd/yy)
f)Has [child] seen anyone else to monitor medications?
- Since[date of the last SCAPI], has your family received [this/any other/any] family therapy? 1=yes, 2=no
If yes, ask:
a)What was the main reason for receiving this service… ADHD, learning problems, other behavioral or emotional difficulties, or another difficulty?
1 = ADHD
2 = learning
3 = other behavioral/emotional
99 = other [______]
b)Who didthe familysee?
36 = psychologist
35 = psychiatrist
48 = psychologist or psychiatrist (when not sure which one)
37 = social worker
32 = counselor
44 = family therapist (use ONLY if cannot use more specific providers above)
99 = other [______]
c)When didthis help first begin? [____/____/____] (mm/dd/yy)
d)How often since [date of the last SCAPI/date help first began] hasthe familyreceived this help? [_____] (total times)
e)About how many minutes each time? [_____] (minutes)
f)Do you plan to have the family continue? 1 = yes, 2 = no
g)When did the family last get this help? [____/____/____] (mm/dd/yy)
h)Has the family received any other family therapy?
- Other than counseling at school, since[date of the last SCAPI], has [child] received [this/any other/any] counseling, therapy, or in-home case management?
1=yes, 2=no
If yes, ask:
a)What did [child] receive?
63 = individual therapy or counseling
62 = group therapy
90 = in-home case management
99 = other [______]
b)What was the main reason for receiving this service… ADHD, learning problems, other behavioral or emotional difficulties, or another difficulty?
1 = ADHD
2 = learning
3 = other behavioral/emotional
99 = other [______]
c)Who did[child]see?
30 = pediatrician
31 = family doctor
33 = nurse
36 = psychologist
35 = psychiatrist
48 = psychologist or psychiatrist (when not sure which one)
37 = social worker
32 = counselor (use ONLY if cannot use more specific providers above)
99 = other [______]
d)When didthis help first begin? [____/____/____] (mm/dd/yy)
e)How often since [date of the last SCAPI/date help first began] has[child]received this help? [_____] (total times)
f)About how many minutes each time? [_____] (minutes)
g)Do you plan to have [child] continue? 1 = yes, 2 = no
h)When did [child] last get this help? [____/____/____] (mm/dd/yy)
i)Has [child]received any other counseling, therapy, or management?
- Since[date of the last SCAPI], has [child] stayed overnight anywhere [else] because of:
- attentional, learning, emotional, or behavioral difficulties, or any other similar difficulty, OR
- been removed from the home overnight for any reason?
The kind of situations that might be included in this question would be:
- placement in a foster home
- juvenile detention facility
- residential treatment facility
- prison
- half-way house
- psychiatric hospital or
- psychiatric wing of general hospital
The placement can be voluntary or ordered by a court, other law enforcement or social services agency. 1 = yes, 2 = no
If yes, ask:
a)Where did [child] stay?
80 = psychiatric hospital or psychiatric wing/ward of general hospital
82 = boarding school (therapeutic)
85 = residential treatment facility
83 = juvenile detention facility
86 = foster home
87 = adult prison (long-term stay)
88 = adult jail (short-term stay)
150 = group home/half-way house
153 = boot-camp (non-military, ordered by court)
154 = secure correctional facility for juveniles
99 = other [______]
b)What was the main difficulty that this stay was for … ADHD, learning problems, other behavioral or emotional difficulties, or another difficulty?
1 = ADHD
2 = learning
3 = other behavioral/emotional
4 = removed from home
c)When was [child] admitted? [____/____/____] (mm/dd/yy)
d)When was [child] released? [____/____/____] (mm/dd/yy)
Did [child] receive any medication for attentional, learning, emotional, or
behavioral difficulties, or any other similar difficulty while here that you have not
told me about?
Did [child] receive any counseling, therapy, or in-home case management while
here?
e)Has [child] stayed overnight anywhere else because of attentional, learning, emotional, or behavioral difficulties, or any other similar difficulty?
6.Since[date of the last SCAPI], has [child] received [this/any other/any] special help at school for any difficulties? This includes:
- Individual Educational Plans known as IEPs
- whether they are in-place without a formal meeting or
- in-place with a formal meeting
- and all separate IEP meetings
- tutoring
- special testing
- counseling
- special help in the classroom or resource room
- referrals for help outside of school, or
- speech, occupational or physical therapy that may have been received in or out of school.
1 = yes, 2 = no, 3 = not applicable because:
1 = graduated from high school before start of SCAPI window
2 = dropped out of school for whole SCAPI window
3 = expelled from school for whole SCAPI window (see Item 14)
4 = home schooled, not getting any educational related services
99 = other [______]
If yes, ask:
a)What help did [child] receive? (prompt if necessary)
65 = Individual Educational Plan (IEP) meeting
[66 = 504 plan (accommodations – do not collect this information)]
97 = gifted program in school
57 = occupational/physical therapy in or out of school
52 = referral for additional help
14 = school counseling
12 = special education classes/resource room
11 = special help in regular, academic classroom to manage behavior.
13 = day long special education programs
101 = special school for ADHD/LD children
51 = special testing for attentional, learning, behavioral or emotional problems
71 = speech and language therapy in or out of school
67 = tutoring/help with schoolwork or homework, in or out of school by non-parent
93 = summer school
99 = other [______]
b)Was this mainly for … ADHD, learning problems, other behavioral or emotional difficulties, or another difficulty?
1 = ADHD
2 = learning
3 = other behavioral/emotional
99 = other [______]
c)Who provided this help?
39 = classroom aide
57 = occupational/physical therapist
29 = principal of school
35 = psychiatrist
36 = psychologist
48 = psychologist or psychiatrist (when not sure which one)
38 = regular, academic classroom teacher
41 = school/guidance counselor (use ONLY if cannot use more specific providers above)
37 = social worker
40 = special education teacher/resource teacher
71 = speech and language therapist
65 = staff at IEP meeting (use when service is 65 – IEP meeting above)
67 = tutor (use when tutoring done by someone other than codes 38-40 above)
99 = other [______]
d)When didthis help first begin? [____/____/____] (mm/dd/yy)
e)How often since [date of the last SCAPI/date help first began] has[child]received this help? [_____] (total times)
f)About how many minutes each time? [_____] (minutes)
g)Do you plan to have [child]continue to receive this help? 1 = yes, 2 = no
h)When did [child]last receive this help? [____/____/____] (mm/dd/yy)
i)Has [child]received any other help in school for any difficulties?
- Since[date of the last SCAPI], has [child] attended [this/any other/a] summer, weekend or after school treatment program for any difficulties? 1 = yes, 2 = no
If yes, ask:
a)Was it a summer or weekend program?
22 = summer treatment program (5 day/week)
23 = weekend treatment program (Saturdays)
24 = after school treatment program (specifically for help w/ADHD or
behavioral/emotional problems)
b)Was the program mainly for … ADHD, learning problems, other behavioral or emotional difficulties, or another difficulty?
1 = ADHD
2 = learning
3 = other behavioral/emotional
99 = other [______]
c)When didthis begin? [____/____/____] (mm/dd/yy)
d)How long is each day? [_____] (hrs) e.g. 7.5 or 8.0
e)Is [child] still in this program? 1 = yes, 2 = no
f)When did [child] last attend? [____/____/____] (mm/dd/yy)
g)Since [date of the last SCAPI], has [child]attendedany other daily treatment program for any difficulties?
8.If interviewing parent: Since[date of the last SCAPI], have you or your partner, attended [this/any other/any] group, class, or counseling to help manage [child]? 1 = yes, 2 = no
If yes, ask:
a)What did you or your partner attend?
18 = ADHD group for parents
19 = other parent support group
60 = parent training classes or groups for help with this child
73 = parent training classes or groups for help with another child
61 = parent counseling, guidance or training individually for help with child
52 = referral for additional help
99 = other [______]
b)Was it mainly to help you help [child] with … ADHD, learning problems, other behavioral or emotional difficulties, or another difficulty?
1 = ADHD
2 = learning
3 = other behavioral/emotional
99 = other [______]
c)Who did you or your partner see?
36 = psychologist
35 = psychiatrist
48 = psychologist or psychiatrist (when not sure which one)
37 = social worker
58 = another parent (usually used with groups like CHADD)
46 = rabbi/pastor/priest/minister
32 = counselor (use ONLY if cannot use more specific providers above)
99 = other [______]
d)When was the first meeting? [____/____/____] (mm/dd/yy)
e)How often since [date of the last SCAPI/date of the first meeting] have you or your partner gone? [_____] (total times)
f)About how many minutes each time? [_____] (minutes)
g)Do you or your partner plan to continue attending? 1 = yes, 2 = no
h)When did you or your partnerlast go? [____/____/____] (mm/dd/yy)
i)Since [date of the last SCAPI], have you or your partner attendedany other groups, classes, or counseling to help manage [child]?
9.If interviewing parent: Since[date of the last SCAPI], have you or your partner received [this/any other/any] counseling or therapy for your own difficulties? 1 = yes, 2 = no
If yes, ask:
a)What help did you or your partner seek?
52 = a referral for emotional or behavioral difficulties
21 = a self-help group for alcohol, drug or any other difficulties
62 = group therapy
63 = individual therapy or counseling for own difficulties
20 = marriage classes/activities (usually run by non-mental health person, not formal therapy)
72 = marital/couples therapy
99 = other [______]
b)Who did you or your partner see?
36 = psychologist
35 = psychiatrist
48 = psychologist or psychiatrist (when not sure which one)
37 = social worker
45 = alcohol/substance use counselor
46 = rabbi/pastor/priest/minister
33 = nurse
43 = marriage counselor (use ONLY if cannot use more specific providers above)
32 = counselor (use ONLY if cannot use more specific providers above)
99 = other [______]
c)When was the first visit? [____/____/____] (mm/dd/yy)
d)How many visits since [date of the last SCAPI/date of the first visit] have there been? [_____] (total visits)
e)About how long was each visit? [_____] (minutes)
f)Are there plans to continue? 1 = yes, 2 = no
g)When was thelast visit? [____/____/____] (mm/dd/yy)
h)Have you or your partner been in any other counseling or therapy for your own difficulties?
- If interviewing parent: Since [date of the last SCAPI], have you or your partner received
[this/any other/any] medication for ADHD or other emotional or behavioral difficulties?
1 = yes, 2 = no
If yes, ask:
a)What is the name of the medication?(expanded lists on last pages of interview)
Trade Name Generic Name
9 = Adderall*(amphetamine)
15 = Anafranil(clomipramine)
16 = Atarax(hydroxyzine)
17 = Ativan(lorazepam)
18 = BuSpar(buspirone)
5 = Catapres(clonidine)
**46 = Catapres-TTS-1,2,3+(clonidine)
19 = Celexa(citalopram)
51 = Concerta**(methylphenidate)
20 = Depakote(divalproex)
2 = Dexedrine*(dextro-amphetamine)
21 = Effexor*(venlafaxine)
22 = Elavil(amitriptyline)
23 = Eskalith**(lithium)
4 = Haldol(haloperidol)
27 = Klonopin(clonazepam)
44 = Lithobid**(lithium)
14 = Luvox(fluvoxamine)
55 = MethyPatch+(methylphenidate)
29 = Neurontin(gabapentin)
13 = Paxil(paroxetine)
12 = Prozac*(fluoxetine)
79 = Risperdal(risperidone)
1 = Ritalin*(methylphenidate)
33 = Serzone(nefazodone)
34 = Sinequan(doxepin)
56 = Spansules** (Dexedrine)(dextro-amphetamine)
43 = Tegretol*(carbamazepine)
8 = Tofranil(imipramine)
36 = Trazadone(desyrel)
38 = Valium(diazepam)
7 = Wellbutrin*(bupropion)
40 = Xanax(alprazolam)
6 = Zoloft(sertraline)
41 = Zyprexa(olanzapine)
99 = other [before coding as ’99,’ look on last page of interview for more options]
(Record who received medication in recipient column)
b)On a regular day, since [date of the last SCAPI] how much [name of med] is taken all together as a total daily dose? [__.__]
(1=regular short acting mg, 2=long acting SR/ER/XR mg, 3=mL, 4=patch cm)
c)When was [name of med] first prescribed? [____/____/____] (mm/dd/yy)
d)Is [name of med] still being taken? 1 = yes, 2 = no
If yes, put in today’s date for “last date”.
If no, ask:
e)When was [name of med] stopped? [____/____/____] (mm/dd/yy)
f)Have you or your partner taken any other medications for ADHD or other emotional or behavioral difficulties?
Now that [child] is getting older, we would like to ask some questions about adolescent behavioral difficulties. We realize these questions may be sensitive. Remember, your answers are confidential and [your child's] name will never be used. As always, feel free to decline questions you feel uncomfortable answering.
If the first administration: Since this is the first time we have asked you these questions, we would like for you to include all events that happened in the last two years, that is from [today’s date – two years] until now.
- Since[2 years ago/date of the last SCAPI], has [child] skipped school or been truant?
1 = yes, 2 = no, 3 = not applicable because:
1 = graduated from high school before start of SCAPI window
2 = dropped out of school for whole SCAPI window
3 = expelled from school for whole SCAPI window (see Item 14)
4 = home schooled, not getting any educational related services
99 = other [______]
If yes, ask:
a)When didthis first happen since [2 years ago/date of the last SCAPI]? [____/____/____] (mm/dd/yy)
b)How many times has this happened since then? [_____] (total times)
This next question asks about fights. By fights we mean serious ones, either verbal, physical or both, whether started by the child or others; this does NOT include simple differences of opinion.
- Since [2 years ago/date of the last SCAPI ], has [child] had fights in school?
1 = yes, 2 = no, 3 = not applicable because:
1 = graduated from high school before start of SCAPI window
2 = dropped out of school for whole SCAPI window
3 = expelled from school for whole SCAPI window (see Item 14)
4 = home schooled, not getting any educational related services
99 = other [______]
If yes, ask:
a)Were the fights with children or teachers?
102 = fights with other children
103 = fights with teachers
b)Which was it, verbal, physical, or both?
1=physical only
2=verbal only
3=both physical and verbal
c)When didthis first happen since [2 years ago/date of the last SCAPI]? [____/____/____] (mm/dd/yy)
d)How many times has this happened since then? [_____] (total times)
e)Were there also fights with [teachers/children]?