TOP Assessment

TOP: Presenting scientifically valid and reliable trends

Developed using 20 years of research and real-world data collection with community mental health providers, TOP leverages the world’s largest database of health, trauma and well-being outcomes, consisting of 1.1 million individuals and 60,000 providers. This allows Kids Insight to present scientifically valid and reliable trends. TOP is currently used in 34 states, including Medicaid providers in 18 states.

How TOP works:

  • A simple, web-based, checklist is completed by the child, birth and foster parents, clinicians, teachers and caseworkers
  • TOP provides credible and scientifically validated information that is comparable across all stakeholders
  • Assessments consist of 48–58 easy-to-understand questions look at 11–13 different dimensions of well-being — and can be completed in about 10 minutes
  • TOP automatically collects and scores the results using multiple analytical methods to present immediate results and easy-to-follow graphs
Multi-rater format captures multiple perspectives


  • Everyone on the child welfare team — caseworkers, therapists, teachers, coaches, families and foster parents, and even the kids themselves — enters data into the same system
  • Collecting multiple perspectives in one place sharpens the ability to measure and track progress, make accurate assessments, and allows everyone involved to have a voice in the child’s care and well-being
  • Observer bias can be avoided, and outlier data can be captured, while keeping the child’s well-being front and center
  • Caseworkers can easily manage online dashboards and invite raters to complete the online assessments


A multi-dimensional view on well-being


  • Most behavioral health assessments are incomplete, focusing on one presenting issue — yet two-thirds of all patients suffer from 3 or more behavioral health problems*
  • TOP reports focuses on 11–13 behavioral health outcomes to assess a child’s multiple challenges and track changes in well-being over time
  • Questions are grouped into strength, symptom and functional categories (not DSM or diagnosis-based)
  • Different survey questions are provided by age group: for children, adolescents and adults/emancipated minors
  • Results are normed to the general population to be culturally sensitive
  • TOP provides a complete view of the child, and actionable information

* Source: Outcome Referrals Database of over a million patients.

20 Years of research peer reviewed and scientifically validated

  • TOP’s child-to-provider matching algorithm scientifically pairs children with doctors, increasing positive outcomes from 14% to 80%*
  • TOP was developed specifically to measure behavioral health outcomes based on 20 years of research and real-world data collection with community mental health providers
  • TOP Leverages a dataset comprised of over 1.1 million patients and more than 40,000 providers
  • TOP has been peer reviewed and scientifically validated by leading academic institutions including Harvard University, The University of Pennsylvania, George Washington University and Case Western
  • TOP is currently being used in 34 states, including Medicaid providers in 18 states

* Source: Outcome Referrals Database of over a million patients.

TOP: Questions & Answers


  1. 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.
  1. 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.

  1. 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.
  1. 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.
  1. 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.

  1. 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.
  1. 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.
  1. Does TOP measure trauma?
    Yes, please click here to learn more about The TOP Trauma Screen
Embedding TOP
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