As the service system for children and adolescents with emotional and behavioral disorders has evolved, increasing emphasis has been placed on developing ongoing evaluation procedures to determine the effectiveness of community-based interventions. As a result, the Southern Consortium for Children (SCC), an administrative agency dedicated to improving mental health services for children in a 10-county area of southeastern Ohio, embarked on a search for outcome assessment instruments that could be used to evaluate local mental health systems and services. After an extensive search for practical measures, the SCC decided to work with local university partners to develop a clinical outcome measure that would be practical yet scientifically sound. The Ohio Youth Problems, Functioning, and Satisfaction Scales (Ohio Scales) evolved out of this collaboration and has now been adopted statewide in Ohio for the assessment of outcome for children receiving publicly funded mental health services (Ohio Department of Mental Health, 2000; Vital Signs, 1998). In this chapter, the conceptualization, development, validation, and potential uses of the Ohio Scales are described.