StepOne Online (StepOne) is the name of a computer-assisted mental health screening system that is available on the world wide web (Web). The system consists of the adolescent clinical screening questionnaire (ACSQ) and the clinical screening report. The ACSQ was developed in order to involve, educate and support parents first and foremost. StepOne is a significant departure for mainstream mental health where instruments are designed exclusively to support health care professionals who provide services.

The clinical screening report is generated by the StepOne program and is based on responses provided by parents who are qualified and are deemed reliable informants by StepOne. The clinical screening report provides information in an organized format that can help parents seek help, communicate with school and health care professionals and advocate for the services they believe are appropriate and necessary. StepOne can also provide community specific information and referral support.

StepOne provides a “terms of use” agreement and also qualifies the user by testing the user’s knowledge of the terms of use. The user must actually pass a test to access the system. This approach provides a means to measure informed consent. StepOne also qualifies the user by asking questions about their education, knowledge of their child, reading ability and primary language. In addition to screening the user, StepOne is designed to protect family privacy and to involve, educate and empower parents with information and initial guidance. StepOne does not replace the role of parents or the role of health care professionals. StepOne is designed to involve and support parents in screening their children and to respect parental rights and responsibilities.

StepOne is designed specifically to be administered on the Web. StepOne can be taken anywhere that a parent has access to the internet. Parents can start their questionnaire, save their responses and return later to finish. The computer system and software is designed to provide the highest level of encryption and data security available to the public. The services offered have been reviewed by a multidisciplinary team of health and education professionals. The system substantially meets or exceeds ethical and professional standards for development and operation of an internet mental health screening system.

StepOne is designed to be simple and easy to use. No appointment, oversight, third-party approval or government involvement is necessary. Parents set up a secure account and are then asked to complete a series of questionnaires regarding their child’s current as well as past behavior. These questions include their child’s behavior over the past 4 weeks.

StepOne is designed to ask a high number of questions. The purpose is not just to screen children. Parents who use StepOne may discover how well they know their child based on questions they may have never considered. Parents who answer a high number of questions "Don't Know" are advised to talk with their child or have a mental health professional talk to their child about these issues.

When two parents complete the questionnaire they may discover how much they agree or disagree about their child’s behavior and history. This is also an indicator that parents may need to spend more time with or talk more with their child. Parents are exposed to a broad range of questions not only to identify potential problems but to raise the parent’s awareness of potential problems. The mere action of parents getting to know a child better can be a positive first step for many parents. Discussion between parents regarding their child’s mental and emotional well-being is an important part of parenting and, of itself, can help children. By exposing parents to a large number of questions, the questions in the ACSQ can sensitize parents and help parents recognize problem behavior in the future. Parents become aware and more involved in identifying potential problems.

The ACSQ can be used to identify symptoms and signs of behavioral problems, syndromes and mental health disorders. The questionnaire can also be used to obtain historical and behavioral observations and ratings over time and from multiple sources. This can provide information about the presence or absence of symptoms and disorders as well as response to interventions, treatment and programs.

The ACSQ utilizes a multi-informant history, behavior rating and symptom checklist procedure. The use of multiple informants (i.e., two parents) in this way provides an estimate of the consistency and, therefore, the reliability and validity of results. It is a basic psychometric principle that the upper limit of validity is determined by the reliability and thoroughness of the information gathered and analyzed. Using multiple informants can be an effective way to gather information as well as determine and increase the validity of results.

StepOne is designed to support and not replace the role of clinical interviews, diagnosis and the creation of treatment plans. InCrisis reports are based on research principles that demonstrate how reliable and accurate data with content and concurrent validity can produce useful information for health care professionals seeking information for diagnostic purposes.

Dated: December 30, 2007