“Iceland now has an ambitious mental health policy that emphasises early intervention and the responsibility of systems toward children and their families. At the same time, however, there is a need for more reliable assessment tools to identify children who are experiencing difficulties,” says Örnólfur Thorlacius, assistant professor at the Faculty of Psychology. Örnólfur leads a research project on the development of computerised adaptive testing (CAT) for assessing emotion regulation and social skills in children and adolescents. The tests are based on an assessment scale developed by Örnólfur during his doctoral studies at UI, which has received positive international evaluation.
Early intervention is essential for effective support
Although Iceland has set ambitious goals to improve young people’s mental health and strengthen early intervention, there remains a shortage of evidence-based assessment tools that can evaluate children’s and adolescents’ functioning both accurately and efficiently. This is something Örnólfur aims to address.
The project is grounded in the principle of early intervention, i.e. that services, support, or resources are provided before difficulties escalate and develop into more complex psychological problems. Örnólfur points out that early intervention is a central pillar of the government’s mental health policy through 2030 and is considered essential for ensuring equal opportunities and comprehensive support for children. The emphasis is on identifying difficulties early, before problems persist into adulthood. In this context, Örnólfur stresses that screening instruments play a key role and must be selected carefully.
He notes that many existing assessment tools are primarily designed to identify children with the most severe difficulties. Children who are beginning to develop problems often fall outside diagnostic thresholds and may not receive support until their difficulties become substantial. Örnólfur therefore asks: “Do we want assessment tools that only reach those who clearly require help, or do we also want to identify children who may be moving toward difficulties?” According to Örnólfur, it is important not to focus solely on the most distressed 5–10% of children. “We want to assess all children across developmental dimensions such as emotion regulation and social competence. This allows us to better understand where children are functioning well and where they may be approaching risk, before difficulties reach the lowest percentiles.”
Computerised adaptive testing (CAT) saves time and improves precision
Örnólfur’s research also focuses on the development of CAT tests. This method, commonly used in educational and standardised testing, adapts in real time to respondents’ answers. The test selects subsequent questions based on previous responses and omits items that are not relevant in the case of the individual being assessed. As a result, the assessment becomes both more efficient and more targeted than traditional fixed-length questionnaires. “Our aim with CAT tests is to shorten assessments while maintaining, or even improving, their accuracy,” Örnólfur explains. In Iceland, there is a clear need for teacher-based screening measures to assess students’ social and emotional functioning. According to Örnólfur, such instruments must have strong measurement properties and measure factors related to children‘s behaviour, emotional functioning, and educational development. “For example, if a child shows strong social skills, the teacher does not need to answer numerous questions about clinical difficulties in this area. This makes the task more manageable for teachers while still producing an equally accurate assessment,” he says. Using conventional screening tools, teachers are often required to answer up to 60 questions per student, sometimes twice per year. This can be time-consuming and may reduce accuracy, particularly when many items are not relevant for the individual child. A CAT test presents only questions that are informative for each child.
