Assessment as a process in pediatric psychology.

In this editorial, we have highlighted several key aspects of the assessment process. First, we consider it critical that pediatric psychologists view "assessment as a process," and not as a test or measure. Assessment begins with the formulation of a precise, answerable question--and this maxim is equally important for researchers and clinicians. It is especially critical that research questions be conceptually based, as well as of applied interest. The development of an appropriate assessment strategy should always follow directly from the question that is posed. Second, in developing an assessment strategy, we advocate selecting the "best" informants and the "best" measurement methods available, also taking into consideration the developmental level of the participants and the types of constructs being assessed. In most cases, it will be desirable to use multiple informants, rather than relying on a single source. Given the measurement constraints discussed earlier, we also advocate using multiple measures to assess a construct, and avoiding single-item measures. We also feel strongly that pediatric psychologists should consider designing focused studies of developmentally appropriate age groups, rather than evaluating children from a very broad age range (e.g., infants to teens). Third, as pediatric psychological research moves into new areas of inquiry, assessment should represent a "growth area." We need psychometrically sound measures that are appropriate for use with pediatric health populations. We also need to develop assessment strategies that capture the rich and complex process of dealing with health and disease and, therefore, we should consider gathering qualitative data, to supplement standardized questionnaires. Finally, we recognize that pediatric psychologists face many practical constraints and challenges in the assessment process, especially in today's volatile health care climate. We have seen and will continue to see radical changes in the way health care is provided; pediatric psychologists and other care providers are continually making adjustments in their activities to respond to these frequent shifts and changes. In part because of these changes, pediatric psychologists need to develop and use methods to assess the financial costs and benefits of their interventions. With the increasing emphasis on providing quality medical care at the lowest possible price, efforts to document the valuable contributions of pediatric psychologists become paramount. By sharing our ideas and strategies, as many of the contributors to this issue have done, we stand a better chance of making a better future.