- What is Kids Insight?
Kids Insight is a nonprofit dedicated to measuring and improving well-being outcomes in child welfare. Kids Insight partners with Outcome Referrals, Inc. to adapt the TOP tool for use by caseworkers and child welfare agencies — and then works directly with state and local systems to implement TOP as part of their day-to-day practice.
- What is well-being?
According to the US Department of Health and Human Services’ Children’s Bureau, a focus on “social and emotional well-being is to attend to children’s behavioral, emotional and social functioning — those skills, capacities, and characteristics that enable young people to understand and navigate their world in healthy, positive ways.” (ACYF-CB-IM-12-04, dated April 17, 2012)
- Why measure well-being?
Most child welfare data systems are set up to track why kids are there, where kids are, and how long they’ve been there. But existing systems don’t capture information from all the different people involved in a child’s care or services, nor do they use common measures for tracking how children are doing. This makes it hard to share knowledge and make critical decisions about services and care. Kids Insight offers an easy-to-use solution.
- How does Kids Insight work?
Kids Insight has customized a behavioral assessment tool for use by state and county child welfare agencies to better understand whether children are getting better or not over time. This information can enhance practice at both the frontline and agency-wide levels. Well-being data also offers important performance information about an agency’s private provider partners.
- What is the TOP tool?
TOP is a well-being assessment that measures a child’s (age 3 and up) or teen’s social and emotional well-being over time.
- What does TOP measure?
TOP measures 13 well-being domains for children and 11 for adolescents.
Child domains include: ADHD, Assertiveness, Conduct, Depression, Eating, Incontinence, Psychosis, Separation Anxiety, Sexual Acting Out, Sleep, Strengths (Resiliency), Suicide, and Violence. Adolescent domains include: ADHD, Conduct, Depression, Mania, Psychosis, Sleep, Social Conflict, Substance Abuse, Suicide, Violence, and Work/School Functioning.
- How does TOP work?
TOP is 48 – 58 questions filled out online or on paper by a caseworker and key people in a child’s life. It also collects information about a child’s medical history and stressful life events. Together, this input offers a 360º perspective on how a child is doing — immediately available online through easy-to-read multi-rater and individual reports.
- What is WellnessCheck?
WellnessCheck is the web-based application where caseworkers can access and manage TOP. It includes an accessible dashboard that enables a caseworker to fill out the TOP questionnaire online and, with a single click, email other stakeholders, such as a foster parent or therapist, to also fill them out. Caseworkers can also view and print TOP reports on WellnessCheck, which are available as soon as a questionnaire has been completed.
- Is TOP a validated instrument? Is it normed to the general population?
Yes, TOP has exceptional psychometric properties. Unlike other tools used in child welfare or behavioral health, questions and domains were not developed by expert consensus or refined with small samples of college freshman. It was refined empirically (and slowly over 20 years of data collection), starting with a massive databank of nearly three hundred easy-to-rate behavioral symptoms and strengths and refined through increasingly large samples of real-world child, adolescent and adult observations until a highly reliable, intuitive (face valid) and stable set of factors were derived. This ‘construct validity’ of TOP is the foundation that allows it to achieve high predictive validity — the ability to predict future behavior and performance (e.g., risk of hospitalization, risk of poor treatment outcome, poor patient-clinician matching).
Normative data comes from random samples of the general population and saturation sampling from specifically selected school systems across the US. Norms for child welfare are rapidly growing from multiple jurisdictions from urban to rural populations.
- Is TOP culturally sensitive?
Yes, TOP has demonstrated cultural sensitivity. The proper way to handle cultural sensitivity on a scale like TOP is through factor invariance studies and the construct validity of the tool. TOP has demonstrated no factor invariance across variables including gender, race, and level of care.
- Can TOP be used for DSM diagnoses?
We do not believe the goal of using our tools is to generate a DSM diagnosis. Far more important is profiling each child’s behavioral strengths and weaknesses, whether or not they have a behavioral health diagnosis.
- Does TOP measure trauma?
Yes, please click here to learn more about The TOP Trauma Screen
- How do you work with child welfare jurisdictions; what support is available?
We help jurisdictions adopt TOP and engage stakeholders through on-the-ground assistance and online support that builds internal capacity and affects practice change. Each jurisdiction is assigned a Kids Insight Project Director who partners with an agency project manager and team to make policy decisions and coordinate rollout. Click here to learn more about our implementation support.
- How long does implementation take?
Implementation time varies according to the needs and schedule of each state or county. After a contract is signed, we recommend a three-month period to design protocols for TOP usage, develop a training plan, test technology compatibility and begin initial outreach to key stakeholders. We then recommend a 1 – 2 month pilot with a single unit or division to test and adjust the protocol as necessary. Following the pilot, we suggest training all frontline staff within 2 – 3 months. Implementation requires a strong commitment from agency leadership to hold stakeholders accountable for using TOP information to improve outcomes for children and families.
- What does a successful TOP implementation look like?
Successful implementation means multiple things, including:
- A leadership team committed to integrating TOP information into day-to-day practice
- Caseworkers and facilitators using TOP information to drive meeting discussions and decisions
- More involved and included foster parents, teens and bio parents
- Private providers adjusting services based on results
- Understanding who we are serving well and who needs more attention
- Shifting resources to services that work
- Showing taxpayers what their tax dollars are achieving
- Showing society at large the positive outcomes that child welfare can produce
The child went from a residential placement with suicidal thoughts to step down — and we could see that he’s working hard and reinforce the right behaviors. The TOP confirmed our recommendation and what we’re seeing.