Child Behavior Checklist

Synonyms

ASEBA; CBCL

Description

The Achenbach System of Empirically Based Assessment (ASEBA) comprises a family of forms for rating behavioral/emotional problems and adaptive characteristics. For ages 1½ to 90+ years, developmentally appropriate forms are designed to be completed by collaterals who know the person who is being assessed. These forms include versions of the Child Behavior Checklist (CBCL), completed by parent figures for 1½- to 5-year-olds and for 6- to 18-year-olds; the Caregiver-Teacher Report Form (C-TRF) for ages 1½–5, completed by daycare providers and preschool teachers; the Teacher’s Report Form (TRF) for ages 6–18, completed by teachers and other school personnel; the Adult Behavior Checklist (ABCL) for ages 18–59, completed by spouses, partners, family members, friends, therapists, and other collaterals; and the Older Adult Behavior Checklist (OABCL) for ages 60 and older, completed by caregivers as well as by collaterals.

The ASEBA also includes parallel forms completed by the people being assessed, including the Youth Self-Report (YSR) for ages 11–18, the Adult Self-Report (ASR) for ages 18–59, and the Older Adult Self-Report (OASR) for ages 60 and older. The collateral and self-report forms assess functioning in everyday contexts over periods of 2–6 months.

In addition to the collateral and self-report forms, other ASEBA forms are designed for rating behavior observed in specific situations. These forms include the Direct Observation Form (DOF), which is completed by observers who rate two or more 10-min samples of children’s behavior observed in classrooms and other group settings; the Semistructured Clinical Interview for Children and Adolescents (SCICA), which provides an interview protocol and a rating form completed by the interviewer who administers the SCICA to 6- to 18-year-olds and the Test Observation Form (TOF), which test examiners use to rate the behavior observed during the administration of individual ability and achievement tests to 2- to 18-year-olds. Table 1 summarizes the ASEBA forms, ages covered, who completes the forms, and references to manuals for each form.

Child Behavior Checklist. Table 1 ASEBA assessment instruments

Normed Profiles

Scores obtained from all ASEBA forms are displayed on profiles in relation to norms that are based on distributions of scale scores obtained by large samples of peers. For the collateral and self-report forms for ages 1½ to 90+ years, norms are based on a US national probability sample of people who had not received mental health or substance abuse services in the preceding 12 months. For the CBCL/6–18, TRF, and YSR, norms are provided for many cultures in addition to the USA, as detailed later (Achenbach & Rescorla, 2007a, b). Multicultural norms for the CBCL/1½–5 and C-TRF were released in 2010. For the DOF, SCICA, and TOF, norms are based on ratings of children observed in the contexts for which these instruments are designed.

Each profile displays an individual’s scale scores in terms of standard scores (T scores) and percentiles based on the normative sample of that individual’s peers, as rated by a particular type of informant (e.g., parent, teacher, self). The profiles also display demarcations between the normal range, borderline clinical range, and clinical range on each scale. Figure 1 illustrates a profile of syndrome scales scored from the YSR completed by 15-year-old Wayne Webster (not his real name).

Child Behavior Checklist. Figure 1

Syndrome profile scored from the Youth Self-Report completed by 15-year-old Wayne Webster (From Achenbach & Rescorla, 2001, p. 33)

Scales on Which ASEBA Instruments Are Scored

ASEBA problem items are scored on scales for syndromes derived empirically via exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs). These empirically derived syndromes reflect patterns of problems found to co-occur in ratings by each kind of informant.

In addition to the syndrome scales, each form is scored on DSM-oriented scales constructed by having experts from many cultures select ASEBA problem items that are very consistent with particular diagnostic categories of the American Psychiatric Association’s (1994) Diagnostic and Statistical Manual-Fourth Edition (DSM-IV). Like the syndrome scales, the DSM-oriented scales are displayed on profiles in terms of T scores, percentiles, and normal, borderline clinical, and clinical ranges. Most forms are also scored on scales comprising critical items that are of particular concern to clinicians.

The collateral and self-report forms are additionally scored on scales for favorable characteristics, such as competence, adaptive functioning, and personal strengths. The particular items and scales are geared to the developmental level of people being assessed and to the informants’ knowledge of people being assessed. For example, parents of 6- to 18-year-olds provide data regarding their children’s involvement in sports, nonsports activities, organizations, jobs and chores, friendships, and relationships with parents, siblings, and peers. Teachers provide data on children’s academic performance and adaptive characteristics at school. For adults, data are requested regarding friendships, relations with spouse or partner, children, job, and enrolment in educational programs. Only the items relevant to the adult being assessed are scored. For example, adults who lack a spouse or partner, children, job, or enrolment in educational programs are not scored on those items. Adult forms also have normed scales for substance use.

Cross-Informant Comparisons

Meta-analyses have revealed that correlations between parent, teacher, and self-reports of children’s problems are typically only low to moderate (Achenbach, McConaughy, & Howell, 1987). Consequently, professionals who work with children recognize the need to obtain reports from multiple informants. Meta-analyses of correlations between collateral and self-reports of adult psychopathology have also revealed only modest correlations that argue for using multi-informant data to assess adults (Achenbach, Krukowski, Dumenci, & Ivanova, 2005).

Because each informant may provide valid and useful information that differs from what other informants provide, data from multiple informants should be compared. Software for scoring ASEBA forms facilitates cross-informant comparisons by printing scores obtained from parallel forms on parallel profiles. In addition, it prints side-by-side comparisons of ratings by up to eight informants on all problem items that have counterparts on forms completed by different informants. It also prints Q correlations that measure the degree of agreement between each pair of informants and compares them with Q correlations between pairs of informants in large reference samples.

An especially useful kind of comparison between informants’ reports is illustrated in Fig. 2. This is a comparison between syndromes scored from the YSR completed by Wayne Webster, CBCLs completed by Wayne’s parents, and TRFs completed by three of Wayne’s teachers. For each syndrome, such as the Anxious/Depressed syndrome shown in the upper left-hand corner, the bars reflect the magnitude of standard scores (T scores) obtained from ratings by each kind of informant. Because the T scores are based on ratings by each kind of informant for a normative sample of children, the height of the bar indicates the level of the problems reported by a particular kind of informant compared to problems reported by that kind of informant for a normative sample of children. For example, the leftmost bars indicate that the Anxious/Depressed syndrome scores obtained from CBCL ratings by Wayne’s parents are above the top broken line compared to parents’ CBCL ratings of a normative sample of adolescent boys. As scores above the top broken line are in the clinical range, the CBCL bars indicate that Wayne’s parents reported more problems of this syndrome than were reported by parents of 97% of boys in the normative sample.

Child Behavior Checklist. Figure 2

Cross-informant comparisons of syndrome scores for Wayne Webster (From Achenbach & Rescorla, 2001, p. 39)

Multicultural Norms

Norms obtained in one society may not be generalizable to other societies. To determine the degree of generalizability across societies, the same assessment instruments must be administered to large representative samples of people in different societies. This has been done with ASEBA instruments in many societies. CFAs of CBCL, TRF, and YSR data from many societies support the generalizability of syndromes that were initially derived from US samples. Comparisons of scale scores show that the distributions of CBCL, TRF, and YSR scores in many societies approximate those obtained in the USA. However, some societies have substantially lower or higher mean scores. To take account of societal differences in scale scores, separate sets of norms have been constructed for the societies obtaining relatively low scores, societies obtaining intermediate scores, and societies obtaining relatively high scores. Because parent, teacher, and self-ratings often yield different scores, the multicultural CBCL, TRF, and YSR norms were constructed separately. For some societies, problem scores obtained from one kind of informant are relatively low, while scores obtained from another kind of informant are intermediate or high. For example, CBCL and TRF problem scores obtained from Japanese parents and teachers are in the low range, whereas YSR scores obtained from self-ratings by Japanese youths are in the intermediate range.

To enable practitioners and researchers to compare CBCL, TRF, and YSR scores with culturally appropriate norms, the scoring software provides options for displaying problem scale scores in relation to norms for low-scoring, intermediate-scoring, and high-scoring societies. For example, CBCL and TRF scores for a Japanese youth would typically be displayed in relation to norms for low-scoring societies. However, the youth’s YSR scores would be displayed in relation to norms for intermediate-scoring societies. If the Japanese youth lived in the USA and attended an American school, the TRF scores would be displayed in relation to US norms for teachers’ ratings. If the youth’s parents were well acculturated to the USA, the CBCL scores could be displayed in relation to US norms and also in relation to Japanese norms to see whether the scores were clinically deviant according to either set of norms.

Historical Background

The ASEBA stems from Achenbach’s (1966) factor-analytic derivation of syndromes of child and adolescent psychopathology. Since then, over 4 decades of research and practical experience have produced ASEBA instruments for ages 1½ to 90+ years. Achenbach (2009) documents the historical development of ASEBA research, instruments, theory, and applications, as well as directions in which the ASEBA is now moving. Translations are available in 85 languages. Over 6,500 publications by some 9,000 authors report use of the ASEBA in 80 cultural groups and societies (Bérubé & Achenbach, 2010). ASEBA instruments are available in paper and Internet-based electronic versions in many countries around the world for practical assessment in clinical, educational, forensic, and other services, as well as for research on countless topics, such as genetics, medical conditions, outcome evaluations, epidemiology, development, diagnosis, and multicultural comparisons. Because the ASEBA’s conceptual framework is open ended and generative, it continues to advance in multiple directions (Achenbach, 2009).

Psychometric Data

Table 2 summarizes psychometric data for all ASEBA instruments in terms of mean alphas, test-retest reliability, and the percentage of variance in ASEBA scale scores accounted for by clinical referral status, after partialing out demographic effects. Many additional psychometric findings – including goodness of fit obtained from CFAs in diverse samples – are reported in ASEBA manuals and in refereed publications listed by Bérubé and Achenbach (2010).

Child Behavior Checklist. Table 2 Summary of ASEBA psychometric data

Clinical Uses

ASEBA instruments have numerous clinical uses. Bérubé and Achenbach (2010) list publications reporting use of the ASEBA in relation to over 150 medical conditions. Some 600 publications report use of the ASEBA for evaluating treatments and outcomes for many kinds of psychopathology and other problems.

ASEBA instruments can be used at many stages of clinical processes, including screening to identify needs for help, documentation of problems and adaptive functioning for use in clinical referrals, and intake assessment on which to base treatment decisions. During the course of treatment, ASEBA instruments are useful for determining whether goals are being met. Following the treatment, ASEBA instruments can be readministered to evaluate outcomes and subsequent functioning. At any point, ASEBA instruments can be used to assess behavioral/emotional concomitants of neuropsychological and medical disorders. The availability of similar ASEBA instruments for children and adults facilitates family assessment, as well as close coordination between interventions for parents and their children.