The Child and Adolescent Services Assessment: Interrater Reliability and Predictors of Rater Disagreement

  • Karen T. G. Schwartz
  • Amanda A. Bowling
  • John F. Dickerson
  • Frances L. Lynch
  • David A. Brent
  • Giovanna Porta
  • Satish Iyengar
  • V. Robin Weersing
Original Article


The current study evaluated the interrater reliability of the Child and Adolescent Services Assessment (CASA), a widely used structured interview measuring pediatric mental health service use. Interviews (N = 72) were randomly selected from a pediatric effectiveness trial, and audio was coded by an independent rater. Regressions were employed to identify predictors of rater disagreement. Interrater reliability was high for items (> 94%) and summary metrics (ICC > .79) across service sectors. Predictors of disagreement varied by domain; significant predictors indexed higher clinical severity or social disadvantage. Results support the CASA as a reliable and robust assessment of pediatric service use, but administrators should be alert when assessing vulnerable populations.


Reliability Service use Child Adolescent 



This study was funded by the National Institute of Mental Health (5R01MH084935; 5R01MH084916); however, the funding source had no role in any aspect of study creation, implementation, or preparation of this manuscript.

Compliance with Ethical Standards

Conflict of interest

Dr. Brent receives research support from NIMH, royalties from Guilford Press, royalties from the electronic self-rated version of the C-SSRS from ERT, Inc., royalties from performing duties as an UptoDate Psychiatry Section Editor, and consulting fees from Healthwise. He has no other conflicts of interest to report. Ms. Schwartz, Ms. Bowling, Dr. Dickerson, Dr. Lynch, Ms. Porta, Dr. Iyengar and Dr. Weersing declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent and assent were obtained from all adult and youth participants, respectively, included in the study, in accordance with the San Diego State University and University of California, San Diego institutional review boards.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Karen T. G. Schwartz
    • 1
  • Amanda A. Bowling
    • 2
  • John F. Dickerson
    • 3
  • Frances L. Lynch
    • 3
  • David A. Brent
    • 4
    • 5
  • Giovanna Porta
    • 5
  • Satish Iyengar
    • 6
  • V. Robin Weersing
    • 1
    • 2
  1. 1.San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical PsychologySan DiegoUSA
  2. 2.Department of PsychologySan Diego State UniversitySan DiegoUSA
  3. 3.Center for Health ResearchKaiser Permanente NorthwestPortlandUSA
  4. 4.Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghUSA
  5. 5.Western Psychiatric Institute and ClinicUniversity of Pittsburgh Medical CenterPittsburghUSA
  6. 6.Department of StatisticsUniversity of PittsburghPittsburghUSA

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