Determining whether outcome scores are close to normative means is a commen
dable way to assess clinical significance. However, to be valid, norms requ
ire samples that are carefully chosen to be representative of relevant popu
lations. The Eyberg Child Behavior Inventory norms used by Sheldrick et al.
were not representative of relevant populations, thereby casting doubt on
conclusions concerning the clinical significance of outcomes. In addition t
o being used for categorical judgments of whether outcomes approximate a no
rmative mean, valid norms are needed for deciding who needs treatment; for
evaluating outcomes for problems too severe to approach the normative mean;
for making diagnostic criteria more sensitive to age, gender, and other di
fferences; and for evaluating aspects of functioning beside those targeted
for treatment.