Table 1.

Transdiagnostic criteria for clinical staging of internalising and externalising syndromes emerging in childhood (5–11 years)

Clinical stage	Disability and functioning	Internalising and/or externalising symptoms
Stage 0: at-risk—no current symptoms	No impairments	No current symptoms
Stage 1a: nonspecific symptoms	Mild to moderate impact on social, educational, physical, and daily living	Mild to moderate severity without specific features indicative of more disabling syndromes
Stage 1b: attenuated syndrome	Moderate to severe impact on social, educational, physical, and daily living	Moderate severity with specific symptoms indicative of attenuated syndromes
Stage 2: discrete disorder or major syndrome	Severe and ongoing impact on social, educational, physical, and daily living	Meets criteria for internalising and/or externalising disorder
Stage 3: persistent, treatment resistant illness	Ongoing impact on social, educational, physical, and daily living lasting at least 2 years or over a 12-month period after entry into psychological, pharmacological, or multidisciplinary intervention	Symptoms lasting at least 2 years, with ≤ 3 months of remission or no improvement at 12 months after entry into psychological, pharmacological, or multidisciplinary intervention
Stage 4: severe, persistent, unremitting illness	Evidence of marked deterioration in social, educational, physical, and daily living due to persistence illness	Chronic symptoms lasting at least 5 years or no improvement after 2 years after entry into psychological, pharmacological, or multidisciplinary intervention

Refer to Table 2 for Stage 0 risk factors