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Graduate Student Journal of Psychology                                                                            Copyright 2008 by the Department of Counseling & Clinical Psychology

2008, Vol. 10                                                                                                                        Teachers College, Columbia University                         ISSN 1088-4661

An Exploratory Study of the Influences on Response Stability of the

Interactive Dominic/Terry Questionnaire

M. Alice Shillingsburg
Marcus Institute

Emory School of Medicine

Kevin Ragsdale
Lee County Youth

Development Center

   Steven K. Shapiro
 Auburn University

Jason Sikorski
Central Connecticut

State University

The Dominic Interactive is a pictorial structured child interview screener with features to address devel-

opmental issues that are often problematic for young informants. It includes items depicting non-

symptomatic activities as well as activities demonstrating DSM-IV (American Psychiatric Association,

1994) symptoms of several childhood disorders. We examined the reliability of the Interactive

Dominic/Terry, as well as potential factors influencing response stability, with a sample of 59 inpatient

adolescents. Response stability refers to the tendency for the same response to be given over time.

Analyses yielded good to excellent reliability for the majority of the scales. Response stability was

similar regardless of age, gender, or race. Results also suggested an inverse relationship between Verbal

IQ and rate of response change. Overall, these preliminary results suggest that this instrument is suitable

for children and adolescents of different racial backgrounds, although the impact of intelligence requires

further investigation.

Children and adolescents referred to inpatient psychiat-

ric facilities are frequently the focus of extensive medical

and psychological assessment. The primary diagnostic tool

often is the clinical interview even though interviewer-

and/or diagnostic criteria variance are common (Silverman

& Ollendick, 2005). To overcome this limitation a number

of diagnostic interviews, either highly structured or semi-

structured, have been developed (McClelland, 2004).  In

the inpatient setting a “respondent-based” interview (An-

gold & Fisher, 1999) yielding information regarding the

thoughts and feelings of the youth is desirable to comple-

ment observational material from staff reports.

However, difficulties with traditional interview meth-

ods  such  as  the  use  of  abstract  language,   cumbersome

Author note: We thank Todd Smitherman, Natalie Arnette, and

Kanika Bell for their assistance with data collection and J. P.

Valla for his helpful suggestions on previous drafts of this article. 

Appreciation is extended to the participants and staff of Lee

County Youth Development Center.

This paper is based on a Master's thesis conducted by the first

author while at Auburn University. 

Correspondence concerning this article should be directed to

Steve Shapiro, Department of Psychology, 226 Thach, Auburn

University, Alabama 36849-5214; shapisk@auburn.edu

length, and references to time have been noted (Edelbrock

& Bohnert, 2000; Fallon & Schwab-Stone, 1994). Studies

have shown that up to half of adolescents are not interested

in traditional interviews and one-third has difficulty paying

attention (Shaffer et al., 1993). Adolescents have also re-

ported difficulty understanding interview questions (Edel-

brock & Bohnert, 2000). These factors may impede the

utility of the information gathered. In order to increase in-

terest and attention, a diagnostic interview may necessitate

a concrete format to which young informants can relate.

Instruments showing pictures representing psychopa-

thology, thereby combining auditory and visual modalities,

seem appropriate.

As demonstrated by Furman and Bierman (1983), pre-

senting a combination of both auditory and visual informa-

tion when posing questions to children as young as four

years old results in increased comprehension of the ques-

tion (see also Bierman, 1984). This dual-modality approach

is consistent with Paivio’s dual-coding theory, which posits

two distinct subsystems, an auditory and a visual system,

that process cognitive information (Paivio, 1986). Such a

combined approach has been shown to aid comprehension

and learning, enhance children’s memory (Pressley &

Miller, 1987; Schneider & Pressley, 1997), improve atten-

tion, and stimulate interest (Calvert, 1999; Peeck, 1987;

Pezdek & Stevens, 1984). In addition, according to Bender

and Levin (cited in Pressley & Miller, 1987) the dual-

modality approach significantly improved learning in a



SHILLINGSBURG, SHAPIRO, RAGSDALE, & SIKORSI

30

group of educable mentally retarded children. Given previ-

ous research indicating that adolescents, similar to younger

children, have difficulty paying attention during structured

interviews, the combination of visual and auditory stimuli

may also be beneficial when interviewing adolescents, par-

ticularly those with lower intelligence.   

Among pictorial instruments, the Dominic is one of the

oldest and most widely tested (Bidaut-Russell, Valla, Tho-

mas, Bergeron, & Lawson 1998; Ederer, 2004; Valla,

Bergeron, Berube, Gaudet, & St-Georges, 1994).  The

Dominic demonstrates robust psychometric properties in

the general population and outpatient clinic children (Cot-

tler, Reich, Rourke, Cunningham-Williams, & Compton,

2000; Loney & Frick, 2003; Murphy, Cantwell, Jordan,

Lee, Cooley-Quille, & Lahey, 2000).  It has, however, not

been validated with inpatient youths.

The Dominic Interactive (Valla, 2000) is part of a

relatively new set of structured child interview screeners

(Dominic-R, Interactive Dominic/Terry) developed in an

attempt to resolve many of the problems with traditional

face-to-face interviews (Valla et al., 1994; Valla, Bergeron,

Bidaut-Russell, St-Georges, & Gaudet, 1997; Valla,

Bergeron, & Smolla, 2000).  This screening tool is a picto-

rial structured interview that, in addition to blending visual

and verbal information, has a short administration time (10-

20 minutes), presents the child with simple response op-

tions, and does not include questions regarding time and

frequency. As the interviewee views the pictures he or she

simultaneously hears a voice describing the pictured activ-

ity.  This interview portrays, in still-frame, a boy or girl

named Dominic (Caucasian), or Terry (African-American)

engaging in various activities and situations. Some of the

activities and situations demonstrate non-symptomatic ac-

tivities and are included on a Strengths and Competencies

Scale, which has received little empirical investigation.

Other activities and situations presented demonstrate DSM-

IV (American Psychiatric Association, 1994) symptoms of

Attention-Deficit/Hyperactivity Disorder (ADHD), Oppo-

sitional Defiant Disorder (ODD), Conduct Disorder (CD),

Major Depressive Disorder (MDD), Separation Anxiety

Disorder (SAD), Generalized Anxiety Disorder (GAD),

and Specific Phobias (SPh). Upon presentation of the

items, the child either answers “yes” or “no” as to whether

s/he acts similarly to Dominic/Terry (Valla et al., 2000).

Currently, an incomplete set of versions is available across

age, language, and race. Thus, this instrument has consid-

erable potential as a tool for cross-cultural applications.

Valla and colleagues (1994, 1997, & 2000) have re-

viewed the construction and psychometric properties of the

paper-based version of the Dominic and Dominic-R. Of 42

symptom scales (7 diagnostic-approximates, or “tenden-

cies,” for six age groups) included on the Dominic-R, 33

obtained an Intraclass Correlation Coefficient (ICC) above

.70. Seven were between .60 and .69 and 2 were below .60.

The 2 symptom scales below .60, Specific Phobia and

Conduct Disorder, were obtained from the group of 6-year-

olds. Internal consistency for both internalizing and exter-

nalizing Tendency scales were .89. Alphas for the individ-

ual symptom scales ranged from .64 to .83.

Bidaut-Russell and colleagues (1998) introduced

Dominic-R versions depicting African Americans (Terry).

Using 36 referred and non-referred children, these re-

searchers obtained test-retest kappas for Terry tendencies

from .70 to .76 and ICCs between .77 and .88. Cronbach’s

alphas ranged from .78 to .90. These findings are commen-

surate with those obtained using the Dominic-R and indi-

cate that the measure can be used reliably with African

American children.  Still, as noted by Valla et al. (2000), it

is necessary to further document the psychometric charac-

teristics of the Terry. This is consistent with the need to

develop more ecologically sensitive instruments to facili-

tate identification with the material and enhance self-

disclosure (Merrell, 2003).

The computer-based Interactive Dominic was first in-

troduced by Valla, Bergeron, and Smolla (1997). Unpub-

lished research conducted by Bergeron and Smolla (2002),

using 609 non-clinical and clinical French and English-

speaking children, report psychometric properties that were

similar to or better than the paper version. Valla et al.

(2002), demonstrated the measure’s transcultural appropri-

ateness and ability to discriminate between clinically re-

ferred and non-referred children, as well as referred chil-

dren with and without a clinical judgment-based diagnosis.

The psychometric characteristics of the Interactive Terry

have not been reported.

Previous findings suggest that the Dominic-R elicits

responses that demonstrate better test-retest reliability than

those yielded from the K-SADS, the DISC, and the DISC-2

(Valla et al. 1994). However, initial studies with the

Dominic-R using both outpatient clinic and community

samples resulted in limitations in the calculation of some

kappa values due to the low base rate of some symptoms.

Because the Dominic already demonstrated acceptable

psychometric qualities in other settings, and instruments

tend to be more reliable in clinical settings (Boyle et al.,

1993; Schwab-Stone, Fisher, Piacentini, Shaffer, Davies, &

Briggs, 1993; Welner, Reich, Herjanic, Jung, & Amado,

1987), the current study was not designed as a comprehen-

sive validation study. Instead, we first aimed to extend the

reliability evidence of the Interactive Dominic to an inpa-

tient setting and its parallel version (Terry) with a sample

of African Americans. Second, we were interested in ex-

amining whether measured intelligence affected response

stability. A plethora of literature has documented adaptive

behavior deficits (e.g., difficulties with hygiene care, daily

living skills) and the full range of psychopathology in chil-

dren presenting with intellectual deficits (see Dykens, 2000

for a review). It follows, therefore, that children with intel-

lectual delays would be well represented in inpatient psy-

chiatric settings. Comorbid cognitive delays and behav-

ioral/ emotional problems pose particular assessment chal-

lenges (Dykens, 2000; Hodapp & Dykens, 1996; Singh,

Oswald, & Ellis, 1998). Indeed, previous reliability studies

on traditional structured diagnostic interviews frequently



INFLUENCES ON RESPONSE STABILITY

31

have excluded children due to low intelligence (Edelbrock,

Costello, Dulcan, Conover, & Kalas, 1986; Herjanic &

Reich, 1982; Moretti, Fine, Haley & Marriage, 1985; Wel-

ner et al., 1987). Third, the influence of gender, age, race,

test-retest interval, and attenuation was explored as possi-

ble factors affecting response stability.

Method

Participants

Participants were 59 inpatient adolescents consecu-

tively referred between July 2002 and April 2003 to a resi-

dential treatment and diagnostic center, which provides

short-term emergency shelter in East Alabama. Males

(52.5%) and females (47.5%), African Americans (46%)

and Caucasians (54%) were equally represented in the

sample, and ranged in age from 12 to 17 (M = 14.3, SD =

1.63). Inclusion criteria were: age between 12 and 17, in-

formed consent/assent, and presence during the period of

data collection. There were no exclusion criteria. The range

of presenting problems was wide and these teens partici-

pated in a variety of treatment programs, in addition to an

evaluation.

Measures

Interactive Dominic/Terry Interactive (Valla, 2000).

We used the 6-11 version of the instrument with our inpa-

tient sample since the African-American version (Terry) is

not yet available for adolescents. Downward extensions of

adult questionnaires have been widely criticized because

children’s language comprehension may differ markedly

from that of adults due to factors previously outlined. In the

present study, however, the measure has been developed

with young children, and the more recent adolescent ver-

sion (Smolla, Valla, Bergeron, Berthiaume, & St-Georges

(2004), with few exceptions, utilizes the same formulations

as the 6-11 version (J. P. Valla, personal communication,

July 2006). The child version of the Dominic/Terry yields

diagnostic-approximate information (tendencies) based on

a normative sample aged 6-11. Cut-off points obtained with

that sample were irrelevant for our adolescent participants

and no attempt was made to study diagnostic prevalence

estimates.

Wechsler Intelligence Scales. The Wechsler Intelli-

gence Scale for Children, Third Edition (WISC-III;

Wechsler, 1991) and Wechsler Adult Intelligence Scale,

Third Edition (WAIS-III;  Wechsler, 1997) represent the

most widely used measures of intellectual abilities (Kauf-

man & Lichtenberger, 2000), and yield a Full Scale IQ,

Verbal IQ, Performance IQ, and four factor scores. Reli-

ability and validity of these instruments are well docu-

mented (Sattler, 2001).

Procedures

Upon arrival at the facility each resident received a

standard diagnostic battery, which among other measures,

included a semi-structured clinical interview, the WISC-III

or WAIS-III, and the Interactive Dominic/Terry. Nothing

was mentioned regarding Dominic's/Terry's youthful ap-

pearance. Interviewers presented the task using the stan-

dard prompt provided in the test. The test-retest interval for

the Dominic/Terry ranged from 3 to 17 days (Mdn = 7; M =

8.33; SD = 3.3). Informed consent and assent were secured

from the parents/guardians and adolescents, respectively,

prior to the data being obtained in an anonymous fashion

from the participants’ file.

Analyses

The overall sample of 59 participants was used to de-

termine the internal consistency (Cronbach’s alpha) of the

Interactive Dominic/Terry tendency scales. Of these 59

youths, 10 left the facility before completing retest. No

differences on any study variable existed between youths

with retests and those without. Therefore, test-retest analy-

ses were based on a sample of 49 adolescents (24 females

[49%], 23 African Americans [46.9%]). Kappa coefficients

were calculated to assess the test-retest reliability of

symptoms. Intra-class Correlations (ICCs) were computed

to examine the test-retest reliability of the seven tendency

scales, the Strengths and Competencies scale, and the total

instrument.

Of these 49 subjects, 47 (23 females, 21 African-

Americans) were administered the WISC-III or WAIS-III,

depending on age (12-17; M = 14.4; SD = 1.62). We com-

puted Pearson product-moment correlations in order to

examine the relationship between the amount of response

change on the Interactive Dominic/Terry and intelligence.

Response change at retest was calculated for every ten-

dency scale and every participant. Response change refers

to the change from one response to another from the first to

second administration. Less response stability results in

greater response change. The amount of response change

was computed by summing the number of responses that

were changed from test to retest and dividing by the num-

ber of possible responses per tendency scale.

In order to further examine differences in terms of

amount of response change and IQ, participants were

grouped according to IQ. Those with IQs of 79 and below

were classified as “Moderately or Significantly Below Av-

erage,” those with IQs between 80 and 89 were classified

as “Below Average,” and those with IQs of 90 and above

were classified as “Average or Above.” We conducted an

analysis of variance (ANOVA) for each diagnostic scale

with post-hoc comparisons (Tukey HSD). These IQ groups

were also used to examine ICC patterns among the seven

tendency scales, the Strengths and Competencies scale, and

the total instrument. Univariate analyses explored other

possible factors affecting response change, and examined



SHILLINGSBURG, SHAPIRO, RAGSDALE, & SIKORSI

32

attenuation differences according to gender and two age

groups (12-14 and 15-17).

Results

Acceptability of the Pictorial Approach

Participants were observed to be quite interested in the

computer-based interview relative to other components of

the assessment. There was no reaction to the age of

Dominic with the exception of two participants who com-

mented on how young Dominic/Terry appeared.

Internal Consistency

Cronbach’s alphas ranged from .66 (Strengths) to .91

(ADHD). Alphas for the internalizing and externalizing

tendency scales were both very high (.94).

Test-retest Reliability

ICCs were calculated for the overall sample as well as

for groups based on gender, race, and age. For the overall

sample, ICCs of the eight tendency scales ranged from .81

to .96. The ICC for the total instrument was .97. Except for

the Strengths and Competencies scale and the Specific

Phobia tendency scale, all ICCs were above .90. ICCs

ranged from .79 to .97 for the younger group (12 to 14) and

.84 to .96 for the older group (15-17). ICCs for the two

groups for each scale and the total test were similar; how-

ever, the younger group obtained an ICC of .83 on the Spe-

cific Phobia tendency scale while the older group obtained

an ICC of .94.

Because the Interactive Dominic/Terry provides

slightly different characters based on gender and race, test-

retest reliability was examined depending on the version

given (see Table 1). ICCs for both genders were similar

except for the Specific Phobia tendency scale: males ob-

tained a lower ICC (.69) than females (.91) on that scale.

ICCs for the African American and Caucasian groups were

similar with the exception of the Strengths and Competen-

cies scale where the African American group obtained a

lower ICC (.71) than the Caucasian group (.91).

Of the 91 symptoms, kappas were .70 or above for 42

symptoms, between .60 and .69 for 17 symptoms, between

.50 and .59 for 14 symptoms, and below .50 for 18 symp-

toms. Using the classification approach offered by Landis

and Koch (1977), the Interactive Dominic/Terry yielded 27

symptoms with excellent reliability (above .75), 34 with

good reliability (.59 to .74), 19 with fair reliability (.40 to

.58), and 5 with poor reliability. Six items had low base

rates at both test and retest.

Intelligence and Response Stability

Full Scale IQ (FSIQ) scores ranged from 54 to 116 (M

= 84.13, SD = 12.76), Verbal IQ (VIQ) scores ranged from

52 to 126 (M = 84.02, SD = 14.23), Performance IQ (PIQ)

scores ranged from 62 to 112 (M = 87.11, SD = 11.09), and

Verbal Comprehension Index scores ranged from 54 to 102

(M = 84.16, SD = 11.85). FSIQ and PIQ were negatively

correlated with response change for four of the eight ten-

dency scales (SPh: r = -.35 and -.34, p < .05; SAD: r = -.40

and -.40, p < .01; CD: r = -.31 and -.29, p < .05; Strengths:

r = -.44, p < .01 and r = -.30, p <.05) and the overall in-

strument (r = -.50 and -.30, p < .01). Significant negative

associations were also obtained between VIQ and response

change for all but one (ODD) tendency scale (p < .05:  SPh

r = -.31, SAD r = -.35, GAD r = -.29, MDD r = -.29, CD r

= -.29, ADHD r = -.29; p < .01: Strengths r  = -.48) as well

as the overall instrument (r  = -.53, p <.01). The Verbal

Comprehension Index was negatively associated with five

tendency scales (SAD r = -.42, p < .05; MDD r = -.38, p <

.05; CD r  = -.35, p  < .05; ADHD r  = -.46, p  < .01;

Strengths r = -.59, p < .01) and the overall instrument (r = -

.56, p < .01).

Table 1

Intraclass Correlation test-retest reliability of scales of the

Interactive Dominic/Terry based on gender and race

Males

N=25

Females

N=24

African

American

N=23

Caucasian

N=26

Tendencies ICC
a

CI
b

ICC CI ICC CI ICC CI

SPh .69 .29,

.86

.91 .80, .96 .86 .68, .94 .89 .76, .95

SAD .95 .88,

.98

.94 .86, .97 .94 .86, .97 .95 .89, .98

GAD .96 .91,

.98

.91 .80, .96 .95 .89, .98 .93 .85, .97

MDD .95 .88,

.98

.96 .91, .98 .97 .93, .99 .95 .89, .98

ADHD .95 .88,

.98

.97 .93, .99 .96 .91, .98 .96 .91, .98

ODD .88 .72,

.95

.94 .87, .98 .95 .87, .98 .89 .75, .95

CD .96 .90,

.98

.88 .71, .95 .94 .86, .97 .94 .87, .97

Overall

Total

.96 .91,

.98

.97 .94, .99 .98 .94, .99 .96 .92, .98

Strengths .83 .62,

.93

.80 .53, .91 .71 .31, .88 .91 .80, .96

a
Intraclass Correlation Coefficient

b
95% confidence interval

Based on the ANOVA between VIQ groups (“Moder-

ately or Significantly Below Average,” “Below Average,”



INFLUENCES ON RESPONSE STABILITY

33

and “Average or Above”), the lowest VIQ group tended to

show higher response changes, but only significantly so on

the CD and SAD tendency scales as well as on the

Strengths and Competencies scale (see Table 2). Similarly,

all scale ICCs remained above .90 regardless of  VIQ

group, except for the lowest VIQ group’s SPh scale (.79)

and the lower two VIQ groups’ Strengths and Competen-

cies scale (.35 and .84, respectively).

Table 2

VIQ group differences in amount of response change

Mean Amount of

Response Change

Tendencies

MSBA

VIQ
a

N=13

BA

VIQ
b

N=19

AA

VIQ
c

N=15

F p
Tukey

HSD

SPh .128 .076 .052 1.72 .191 NS

SAD .163 .145 .050 4.43 .018 MSBA,

BA>AA

GAD .226 .140 .142 2.33 .109 NS

MDD .181 .158 .093 2.64 .083 NS

ODD .188 .164 .178 .097 .908 NS

CD .165 .071 .109 3.52 .038 MSBA>BA

ADHD .170 .130 .081 2.65 .080 NS

Overall

Total

.177 .127 .089 7.39 .002 MSBA >

AA

Strengths .231 .168 .053 8.40 .001 MSBA,

BA>AA

a
 Moderately or Significantly Below Average VIQ = 79 and

below
b
 Below Average VIQ = 80-89

c
 Average or Above VIQ = 90 and above

Note. SPh=Specific Phobia, SAD=Separation Anxiety Dis-

order, GAD=Generalized Anxiety Disorder, MDD=Major

Depressive Disorder, ADHD=Attention-

Deficit/Hyperactivity Disorder, ODD=Oppositional Defiant

Disorder, CD=Conduct Disorder, Strengths=Strengths and

Competencies

Other Factors Affecting Response Stability

Age, gender, race, and test-retest interval were ex-

plored as possible factors affecting amount of response

change. Univariate analyses resulted in no significant dif-

ferences for gender, age, or test-retest interval indicating

that these factors did not affect response change. Only one

scale (Strengths) resulted in a significant difference when

comparing African Americans (M = .19, SD = .14) and

Caucasians (M = .11, SD = .11), t (47) = 2.18, p < .05.

Attenuation is the tendency to change positive re-

sponses at the first administration to negative responses at

the second administration. Thus, attenuation is an important

phenomenon to consider when examining response change.

Attenuation was seen for all scales. On the SPh scale, mean

rate of attenuation for males (M = 1.5, SD = 0.97) was

lower than females (M = 2.71 SD = 1.23), t (47) = 2.33, p <

.05. All other comparisons showed no differences. No cor-

relation was found between age and attenuation.

Discussion

The goals of the current study were to: 1) test the reli-

ability evidence of the Interactive Dominic in an inpatient

setting and its parallel version with African American

youth; and 2) explore the relationship between response

stability, intelligence, and demographic variables.

Reliability

Internal consistency statistics derived in the present

study are generally commensurate with those obtained on

the paper-based version (Bidaut-Russell et al, 1998; Valla,

Bergeron, Bidaut-Russell et al., 1997), though notably

higher values were found on the GAD/OAD scale (.86 ver-

sus .66) and the CD scale (.85 versus .64). Furthermore, the

test-retest reliability results of the present study are higher

than those obtained previously by the authors of the Inter-

active Dominic/Terry both for symptoms and symptom

scales. ICCs obtained in the present study also compare

favorably with those obtained by Valla and colleagues.

Such improved reliability was expected in an inpatient

sample of older youth, since younger children tend to be

less consistent in their reports than older ones (Edelbrock et

al, 1985). In addition, community samples are unlikely to

endorse a sufficient number of the more severe symptoms

(Shaffer, Fisher, & Lucas, 1999), which influences statisti-

cal power. Thus, the higher rates of symptom endorsement

in our inpatient sample could have accounted for the higher

reliabilities. Consistent with this, test-retest reliabilities

obtained in the present study with inpatient adolescents

were considerably higher than those reported by Fisher et

al. (1997; see also Shaffer et al., 2000), using the DISC-IV

on a sample of psychiatric outpatient children and adoles-

cents (9-17 years old).

In an early study of the Child and Adolescent Psychiat-

ric Assessment self-report (CAPA-C) reliability, Angold

and Costello (1995) also found typically higher ICCs for

inpatients relative to outpatients. Our results compare fa-

vorably with these authors’ ICCs for symptoms of Major

Depression; in contrast, our ICCs were considerably higher

for symptoms of Separation Anxiety Disorder, Opposi-

tional Defiant Disorder, and Conduct Disorder. Few other

studies of inpatients are available, making further compari-

sons difficult. Regardless, no other diagnostic screening

instrument has combined auditory and visual stimuli.

Audio computer-assisted self-interviewing has been shown



SHILLINGSBURG, SHAPIRO, RAGSDALE, & SIKORSI

34

to foster adolescent disclosure of socially undesirable

symptoms (Turner et al., 1998). In addition, the Voice

DISC-IV has shown utility in juvenile justice settings,

where the use of evidence-based instruments is highly vari-

able (Wasserman, McReynolds, Lucas, Fisher, & Santos,

2002). Attention should, therefore, be directed towards

establishing the incremental utility of the Dominic Interac-

tive as part of an evidence-based diagnostic evaluation

process.

The tendency scales on the Interactive Dominic/Terry

demonstrated acceptable reliability for both genders and for

African-Americans and Caucasians, indicating that the in-

strument may be quite useful for children and adolescents

of different racial backgrounds. Similar to previous studies

of the Dominic (Bidaut-Russell et al, 1998; Valla,

Bergeron, Bidaut-Russell et al., 1997), attenuation was seen

for all tendency scales. This phenomenon has been docu-

mented by other interview developers as common (e.g.,

Angold & Costello, 1995; Piacentini et al, 1999).

The Specific Phobia (SPh) and Strengths and Compe-

tencies scales demonstrated lower ICCs and internal con-

sistency than other scales, and of the items with poor reli-

ability, four were on the Strengths scale and three were on

the SPh scale. Various types of specific phobias (e.g., dogs,

bugs, heights) are represented on the SPh scale, as opposed

to the severity of any one specific experience required in

the DSM-IV. Specific phobias tend to diminish as children

age (Barrios & O’Dell, 1998); thus, for our adolescent

sample, endorsement base rate was very low.  Valla,

Bergeron, Bidaut-Russell et al. (1997), reported adequate

internal consistency and good test-retest reliability for the

SPh scale in their sample aged 6-11 years.

Items on the Strengths scale refer to having fun with

friends, feeling good about school, and liking the place

where the youth lives. Affirmative responses may be ex-

pected from well adjusted children living in the commu-

nity. However, due to the upheaval associated with a resi-

dential placement, this scale may not translate into inpa-

tients’ current situation. As noted, African-Americans ob-

tained a lower ICC on this scale compared to Caucasians.

This finding may indicate less cultural applicability of this

scale to African-American youths’ perception of their

strengths and competencies. Previous studies did not report

the psychometric properties of this scale. Therefore, clarifi-

cation of the utility and integrity of this scale is needed.

Response Stability and IQ

Our adolescent participants did not have a parental re-

port available and were the sole providers of information

during the diagnostic evaluation, in addition to historical

records. This limited access to information is also a con-

cern in juvenile justice settings (see Wasserman et al,

2002). For adolescents of lower cognitive functioning who

do not have parental report available to supplement their

self-report, the method of eliciting information is crucial.

The Interactive Dominic/Terry was developed with the

receptive and expressive limitations of children in mind. It

relies less on the respondents’ verbal ability than sentence-

based interviews that ignore limitations, and as a result, is

likely less influenced by measured “verbal intelligence.”

Although age of our participants would suggest that a sen-

tence-based interview is acceptable, the cognitive abilities

of many participants suggest otherwise. Verbal IQ is still

an associated factor in respondents’ ability to provide sta-

ble responses over time on the Interactive Dominic/Terry.

Although there is an impact of IQ on the Dominic’s reli-

ability, this impact seems minimal and should not preclude

the use of this instrument with intellectually delayed indi-

viduals.

Systematic research on the impact of intelligence on

reliability of traditional questionnaires and interviews is

surprisingly sparse. The fact that many studies investigat-

ing the properties of sentence-based interviews exclude

children based on cognitive ability suggest that those inter-

views (and other self report measures) may not have an

adequate base of evidence on which to claim reliability.

The format of the Interactive Dominic/Terry may allow for

useful diagnostic screening that might otherwise not have

been possible.

Limitations and Future Directions

The main limitation of our preliminary study is the

small sample size. A larger sample size allows for better

examination of symptoms rarely endorsed. Further, larger

samples of each race and gender would have been desir-

able.

Another clear limitation of the present study is the use

of the 6-11 year old version of the instrument with an ado-

lescent population. At the time of the current investigation,

the adolescent version of the measure was in the process of

being created and had not yet been made available. How-

ever, the authors of both versions of the measure indicated

that with few exceptions the adolescent version used the

same formulations as the 6-11 version (J. P. Valla, personal

communication, July 2006). One primary difference is the

older appearance of the child in the adolescent version.

Given that only two of the participants made statements

about the age of the child depicted, it is likely that this is an

insignificant factor. In addition, given that diagnostic in-

formation was not relevant to the current study, cut-off

scores based on a younger normative sample were not used.

Lastly, although the age of our participants would suggest

that a sentence-based interview would be sufficient, the

cognitive abilities of many participants and lack of an ado-

lescent version suggests that use of the child version of the

instrument was appropriate.

This study did not examine the Interactive

Dominic/Terry and a DSM-IV-, sentence-based interview

simultaneously, and thus the extent of the improvement

presumably brought about by the combination of verbal

and visual information with adolescents of lower cognitive

functioning could not be determined. It would be important



INFLUENCES ON RESPONSE STABILITY

35

to examine the relationship between Verbal IQ and both

types of interview in order to determine whether the dual

modality presentation improves response stability of low

functioning adolescents. As noted by Klein, Dougherty,

and Olino (2005), most studies have not directly compared

different diagnostic interviews in the same sample, thus

making it difficult to identify advantages with particular

instruments (see also Angold & Fisher, 1999). It might also

be worthwhile to investigate whether order effects are pre-

sent with the Interactive Dominic, consistent with findings

that youths (and parents) report more symptoms for diag-

noses assessed early in the more traditional structured in-

terviews (Jensen, Watanabe, & Richters, 1999). Although

an inverse relationship between IQ and response change

was seen with some scales for lower functioning individu-

als relative to higher functioning individuals, the impact

seems minimal and may be less of a factor when using a

pictoral interview compared to more traditional structured

interviews. The current investigation did not directly com-

pare the effects of IQ on response stability using the two

interview formats. Future studies should directly compare

these two modalities to determine the impact of IQ when

using a dual-modality approach compared to traditional

interviews. Lastly, although the length of the retest interval

was examined as a potential factor affecting response sta-

bility, we did not specifically examine the effect on at-

tenuation. Future investigations should include this analysis

to fully understand the effects of the length of the retest

interval.

Clinical Implications

As implied above, this study provides preliminary evi-

dence on the reliability of the Interactive Dominic/Terry

with both African-American and Caucasian adolescent in-

patient populations, yielding useful information in an effi-

cient manner. This novel assessment approach based on

both visual and auditory stimuli may be indicated with low

functioning adolescents for whom traditional sentence-

based interviews and inventories pose particular challenges.

Attention might also be directed towards establishing the

incremental utility of the Dominic Interactive as part of an

evidence-based diagnostic evaluation process. Investiga-

tions of convergent and divergent validity and factors that

influence the validity of obtained Dominic/Terry responses

are essential. This information would provide support for

the usefulness of this type of interview with an adolescent

population. In addition, similar investigations of test-retest

reliability with the adolescent version of the instrument are

warranted.

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