title: Preliminary development of a rapid assessment of supervision scale for young children.
abstract: OBJECTIVE
  Standardized evaluation tools have been shown to reduce variability in care. The objective of this study was to develop a clinically oriented evaluation tool for the rapid assessment of the adequacy of supervision of a young child.
  
  
  METHODS
  The Rapid Assessment of Supervision Scale (RASS) was developed via a 3-step process: (1) a modified Delphi survey of child abuse experts identified the most important characteristics for use in the assessment of adequacy of supervision; (2) the RASS was designed by using standardized definitions and the results of the Delphi survey; and (3) a total of 4 medical professionals evaluated 139 real case scenarios by using the RASS. Reliability and feasibility were assessed.
  
  
  RESULTS
  Sixty-seven child abuse experts participated in round 2 of the Delphi process and 50 participated in round 3. The RASS included 9 supervision characteristics identified from the Delphi process, standardized definitions, and a scoring system. The interclass correlation coefficients for interrater reliability of the mean RASS scores and overall supervision classification were 0.63 (95% confidence interval: 0.56-0.70; P = .000) and 0.59 (95% confidence interval: 0.51-0.67; P = .000), respectively, indicating moderate to strong agreement. For intrarater reliability, correlation coefficients for mean RASS scores indicated moderate to high correlation (0.50-0.83). Correlation for overall classification of supervision ranged from low to high (0.27-0.80).
  
  
  CONCLUSIONS
  The RASS scale has been shown to be efficient and, in a small sample, to have moderate to substantial interrater agreement. Further development could result in a tool that aids clinicians and researchers in the evaluation of supervision.
authors.affiliation: Section on Child Abuse and Neglect, Children’s Mercy Hospital, University of Missouri Kansas City School of Medicine, Kansas City, Missouri 64108, USA. jdanderst@cmh.edu
authors.forename: Jim
authors.initials: J
authors.lastname: Anderst
authors.forename: M Denise
authors.initials: MD
authors.lastname: Dowd
authors.forename: Patricia
authors.initials: P
authors.lastname: Schnitzer
authors.forename: Tom
authors.initials: T
authors.lastname: Tryon
mesh_terms: D000367:Age Factors; D002648:Child; D002649:Child Abuse / Q000517:prevention & control*; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016730:Program Development / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D013997:Time Factors