The Outcome Rating Scale (ORS) and Child Outcome Rating Scale (CORS) are measures that can be used to monitor children’s, young people and their families or carers feedback on progress.
The ORS is a simple, four-item session-by-session measure designed to assess areas of life functioning known to change as a result of therapeutic intervention. These include: symptom distress, interpersonal well-being, social role, and overall well-being. The ORS translates these four dimensions of functioning into four visual analogue scales which are l0cm lines, with instructions to place a mark on each line with low estimate to the left and high to the right. The ORS is designed to be accessible to a child with a 13-year-old’s reading level, making it feasible for adolescents and adults.
The CORS was developed for children age 6–12. It has the same format as the ORS but with more child friendly language and smiley and frowny faces to facilitate the child’s understanding when completing the scales (Duncan et al., 2003).
For children 5 or under there is also the Young Child Outcome Rating Scale (YCORS), which has no psychometric properties, but can be a useful way of engaging young children regarding their assessment of how they are doing.
|Reliability||Degree to which respondents in a similar sample had similar scores||Research on the ORS demonstrates moderate to high reliability (Bringhurst, Watson, Miller & Duncan, 2006)|
|Test-retest reliability||Degree to which the same respondents have the same score after period of time when trait shouldn’t have changed||Research on the ORS demonstrates moderate test-retest reliability (Bringhurst et al., 2006)|
|Concurrent validity||Correlation of the measure with others measuring the same concept||The ORS shows moderately strong concurrent validity with longer, more established measures of treatment outcome and therapeutic alliance (Bringhurst et al., 2006; Miller, Duncan, Brown, Sparks & Claud, 2003)|
|Discriminant validity||Lack of correlation with opposite concepts||No information available|
The ORS can be completed by children aged 13-18 years old and the CORS can be completed by children aged 6-12 years old. Parents/carers can also complete the ORS/CORS. If the young person is 13 or over and fills out the ORS, the carer fills out the ORS on how they perceive the young person doing. Similarly, if the young person is 12 and under and fills out the CORS, than the carer fills out the CORS on the young person.
Users may also obtain the measures in English and languages other than English at www.scottdmiller.com.
Licenses for the following measures are available from the developer Scott D Miller:
Scoring and Interpretation
Scoring is done in front of the client using a ruler. Each of the four visual analogue scales is 10cm, so the score for each of the four visual analogue scales is the measurement length on the ruler (e.g. 3.3cm = score of 3.3) with 10 being the highest score for each scale. The score is written in the right margin, and the four scores added together for the overall score. The total possible score is 40. Next, each person’s overall score is plotted on a graph or entered into an electronic database to monitor the trajectory of progress.
The ORS (ages 13 and over) cut-off scores are:
Cut off for 13–17 year olds = 28
Cut off for 18 and over = 25
The CORS (ages 12 and under) cut-off scores are:
Child Self Reporting = 32
Carer Reporting on Child = 28
The ORS, CORS and YCORS measures are licensed by Scott D. Miller and ICCE.
If you are planning to use this measure for the delivery and improvement of health and/or social care, a license to incorporate it into electronic systems can be obtained from NHS Digital. Please note that licenses obtained via this route may be restricted to particular territory (e.g. England, UK). If planning to use the measure outside of England, you may wish to contact NHS Digital to clarify the geographical scope of the licence.
Additional guidelines and examples on how to administer, score and interpret the ORS can be found in the ORS manual, available at www.scottdmiller.com.
Information about the related Session Rating Scale is available here [link to measure page].
Bringhurst D. L., Watson C. W., Miller S. D., Duncan B. L., (2006). The reliability and validity of the Outcome Rating Scale: a replication study of a brief clinical measure. Journal of Brief Therapy, 5, 23–30.
Duncan B. L., Miller S. D., Sparks J., Claud D., Reynolds L., Brown J., Johnson L., (2003). The Session Rating Scale: Preliminary psychometric properties of a “working” alliance measure. Journal of Brief Therapy, 3, 3–12.
Miller, S. D., Duncan, B.L., Brown, J., Sparks, J., & Claud, D. (2003). The Outcome Rating Scale: A preliminary study of the reliability, validity, and feasibility of a brief visual analog measure. Journal of Brief Therapy, 2, 91-100.
Please note that the information on this page was last updated in April 2017.