ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Intellectual Disabilities
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1612911
Estimating a minimum clinically important difference for the Developmental Behaviour
Provisionally accepted
Daniel L Sutherland1*
Emma L Taylor1,2
Kylie M Gray2,3
Richard P Hastings1,2Amanda Allard4Joanna Carr4Joanna Griffin1,2Nicola McMeekin5Elizabeth Randell6Daisy Russell4Bronwen Willoughby-Richards4
Jeanne Wolstencroft7
Paul A Thompson2- 1Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, United Kingdom
- 2Intellectual Disabilities Research Institute (IDRIS), School of Social Policy and Society, University of Birmingham, Birmingham, United Kingdom
- 3Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
- 4Council for Disabled Children, London, United Kingdom
- 5School of Health & Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom
- 6Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
- 7The Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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Background: Evaluating the effectiveness of interventions relies on understanding what change in a main outcome is sufficient to be considered meaningful. Our aim was to estimate a Minimum Clinically Important Difference (MCID) for the Developmental Behaviour Checklist, parent-report (DBC-P)-a measure of behavioural and emotional problems in children and adolescents with intellectual disabilities. Methods: We generated distribution-based estimates through meta-analysis of intervention evaluations using the DBC-P as an outcome measure. We also generated anchor-based estimates using case scenarios with 10 parent carers and 21 professionals working with people with intellectual disabilities. Results: 21 studies were included in the meta-analyses and indicated an average DBC total raw score decrease of 3.01 or 4.73 (depending on analytic methods) in randomised controlled trials, and an average decrease of 9.16 points in pre-post designs. Parent carers provided a median MCID estimate of 6 (IQR 4, 7) and professionals provided a median estimate of 8 (IQR 5, 14). Conclusions: These findings contextualise DBC-P score changes in relation to outcomes from other interventions and parent carer and professional views. Which MCID value to choose depends on what factors are prioritised for an intervention.
Keywords: Intellectual Disabilities, autism, minimum clinically important difference (MCID), meta analysis, Developmental behavior checklist (DBC)
Received: 16 Apr 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Sutherland, Taylor, Gray, Hastings, Allard, Carr, Griffin, McMeekin, Randell, Russell, Willoughby-Richards, Wolstencroft and Thompson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Daniel L Sutherland, Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, United Kingdom
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.