The Treatment Outcome Package (TOP) – Child

Assessment Rating:
A – Psychometrics Well-Demonstrated
See entire scale

David Kraus, PhD

Description / Purpose:

Type of Tool: The Treatment Outcome Package (TOP) – Child is both a Screening Tool and Assessment Tool.

The Treatment Outcome Package (TOP) - Child is a comprehensive well-being assessment that is used in behavioral health and child welfare settings. It assesses several domains, including Depression, Psychosis, Sleep Problems, Violence, and Suicidality.

The Child TOP Clinical Scale (TOP-CS) is a 48-item scale that assesses 13 domains such as Eating Issues, Incontinence, and Lack of Resiliency. Participants indicate "All" to "None of the Time" for each behavioral item on a 6-point Likert scale. Prior to completing a TOP-CS for a client, demographic information is collected via a Client Registration (CR) form and previous stressful life events that may impact treatment are captured via a Case-Mix (CM) form. These data provide valuable historical information and are used to predict future TOP-CS scores.

Target Population: Child version: 3–18 years of age

Time to Administer: About 10 minutes

Completed By: Self and/or raters who know the client well (e.g., clinician, relative, social worker)

Modalities Available: Computerized, Pen and Paper, Online, Mobile

Scoring Information: Computer program

Languages Available: English, Spanish

Training Requirements for Intended Users: No training is required.

Availability: The tool is available for free with a data collection and reporting software subscription.

Contact Information

Company: Outcome Referrals, Inc.
Phone: (508) 861-2866

Summary of Relevant Psychometric Research

This tool has received the Measurement Tools Rating of "A – Psychometrics Well-Demonstrated" based on the published, peer-reviewed research available. The tool must have 2 or more published, peer-reviewed studies that have established the measure’s psychometrics (e.g., reliability and validity, sensitivity and specificity, etc.). Please see the Measurement Tools Rating Scale for more information.

Kraus, D. R., Boswell, J. F., Wright, A. G. C., Castonguay, L. G., & Pincus, A. L. (2010). Factor structure of the Treatment Outcome Package for children. Journal of Clinical Psychology, 66(6), 627–640.


Participants — 12,165 children, treated in 299 different behavioral health centers across the United States, whose parent completed the child version of the TOP at intake as part of standard treatment

Race/Ethnicity — 70.2% White/Caucasian, 13.5% African American, 6.8% Other, 6.6% Hispanic, 2.6% Native American, and 0.3% Asian


This article describes the development of the Child TOP questionnaire and its internal structure, using both exploratory and confirmatory methods. With large samples of diverse patients, 103 items were reduced to 48, with 13 stable and clinically useful subscales. The final confirmatory factor analysis of 7,267 patients replicated the model with excellent results. Although some of these subscales were similar to factors derived from the adult version of the TOP, others were specific to childhood disorders. In addition, the analyses demonstrated that the TOP is not restricted to manifestations of distress and impairment, but also captures a unique factor of childhood strengths (i.e., resiliency).

Baxter, E. E., Alexander, P. C., Kraus, D. R., Bentley, J. H., Boswell, J. F., & Castonguay, L. G. (2016). Concurrent validation of the Treatment Outcome Package (TOP) for children and adolescents. Journal of Child and Family Studies, 25, 2415–2422.


Participants — 203 children and adolescents, ages 3–18 years, from a community sample

Race/Ethnicity — Not specified


The primary purpose of this study was to examine the concurrent validity of the Treatment Outcome Package for adolescents (TOP) with the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ) with a community sample. Results demonstrated that the TOP for adolescents has strong concurrent validity and measures constructs that are similar to those measured by well-established and widely used psychological assessments. The Adolescent TOP ADHD scale was highly correlated with both the SDQ Hyperactivity scale and the CBCL Attention Problems scale. The Adolescent TOP Depression scale correlated significantly with the SDQ Emotional Problems scale and both of the CBCL depression scales (Anxious/Depressed and Withdrawn/Depressed). Finally, the TOP Violence scale was highly correlated with the SDQ Conduct scale, the CBCL Rule-breaking scale, and the CBCL Aggressive Behavior scale. Each of these correlations exceeded the Bonferroni-adjusted significance level.

Date Reviewed: September 2021