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Child Behavior Checklist (CBCL)
Availability
Please visit this website for more information about the instrument: Child Behavior Check List
Classification
Supplemental: Epilepsy, Mitochondrial Diseases (Mito), Neuromuscular Diseases (NMD), and Traumatic Brain Injury (TBI)
Exploratory: Sport-Related Concussion (SRC)
Short Description of Instrument
Child Behavior Check List (CBCL) for ages 1.5 to 5 years:
Description: The Child Behavior Check List (CBCL) measures a child’s competencies by using their parent’s perception of their performance on three scales, which include activities, social and school. Separate forms for ages 1.5 to 5 years and 6 to 18 years, as well as separate forms to be filled out by the parent/caregiver or teacher, are available. Scores for three competence scales and a total competence score can be computed.
Procedures: The CBCL can be completed independently by the caregiver or administered by a professional familiar with the CBCL manual. The test can be completed by paper/pencil, online, or on a scannable form. The entire test, which includes the school competence scale, lasts approximately 25–30 minutes. Skills commensurate with at least a Master’s degree level in psychology, social work, or special education are recommended for interpretation.
Comments: The CBCL has two sets of forms, for ages 1.5 to 5 and ages 6 to 18.
CBCL for ages 6-18:
Purpose: A 118-item plus two open-ended item checklist asking parents, close relatives and/ or guardians asking about the child’s competencies and behavioral/ emotional problems.
Description: The CBCL (CBCL/ 6–18) was revised in 2001 to include new normative data, including new DSM-oriented scales, and to complement the preschool forms. It is a 118-item scale that collects information from the parents and other adults involved with the children on 20 competence items. These 20 items cover the child’s activities, social relations and school performance. The 118-items describe specific emotional and behavioral problems of the child, with the two open-ended items giving the parents the ability to record additional problems. The items are rated on a scale of 0 to 2, with “0 being not true (as far as you know)”, “1 being somewhat true or sometimes true” and “2 being very true or often true”. The items ask about the preceding 6 months until now. The checklist is designed for children between the ages 6–18 and is available in English and Spanish.
Comment: The scale has several sub scores, including Aggressive Behavior, Anxious/Depressed, Attention Problems, Delinquent Rule-Breaking Behavior, Social Problems, Somatic Complaints, Thought Problems, Withdrawn, Externalizing, Internalizing, Total Problems, plus DSM-oriented scales. A form for children between the ages of 1.5 and 5 years can complete the Child Behavior Checklist/ 1½–5 (CBCL 1½–5). Adults aged 18–59 can complete the Adult Behavior Checklist (ABCL).
Primary Dependent Measures: Three specific competence scales (Activities, Social, and School) and Total Competence.
Time Estimates: 15 minutes.
Vendor: Achenbach System of Empirically Based Assessment.
Rationale/Justification
Rationale: “The CBCL School Competence subscale asks parents to rate their child’s performance in several academic subjects from failing to above average, and children with TBI have been rated as having lower academic performance than typically developing children.” - McCauley et al., 2012.
 
Specific to Mitochondrial Disease: Not validated in people with mitochondrial disorders, however children and adults with mitochondrial disorders are at risk for behavioral disturbances, therefore it may be a useful tool. The CBCL has been used as a screening tool for social and emotional problems with similar type of multi-systemic disorders, congenital disorders of glycosylation that have primary neurological involvement.
Strengths: The scale has several sub scores, including Aggressive Behavior, Anxious/Depressed, Attention Problems, Delinquent Rule-Breaking Behavior, Social Problems, Somatic Complaints, Thought Problems, Withdrawn, Externalizing, Internalizing, Total Problems, plus DSM-oriented scales.
Assessments can be completed in multiple environments in home by caregiver and in school by teachers.
Weaknesses: Long assessment, only available in English and Spanish. The instrument has not been specifically utilized in this population and its psychometric properties for this group are therefore unknown.
 
Sport-Related Concussion Specific: The CBCL is very well studied and has been used in pediatric concussion studies but not specifically in sport concussion studies. In more recent studies of mild TBI, it has been used to identify premorbid behavioral or emotional risk factors rather than post-injury effects. The School Competence Scale is part of the Total Competence Score of the CBCL and examines academic functioning with respect to performance in various subjects and implementation any academic interventions.  CBCL Total Competence Score has been studied as a predictor of outcome in a  pediatric ED concussion population (not specific to sport concussion). Teacher form not used as extensively as the partent measure.
Scoring
Permissible values: Raw scores, t scores (M=50, SD=10), and percentiles are given based on test results. The value of t scores for each range varies depending on the scale; in some scales higher t scores are associated with normal functioning and on others lower t scores are associated with normal functioning.
References
Achenbach, T. (1991). Manual for Child Behavior Checklist/ 4-18 and 1991 Profile. University of Vermont, Dept. of Psychiatry: Burlington, VT.
Reynolds, CR., Fletcher-Janzen, E. (2007) Encyclopedia of Special Education. John Wiley & Sons: Inc. Hoboken, New Jersey.
TBI:
Ewing-Cobbs L, Barnes M, Fletcher J, Levin H Swank P, Song, J. Modeling of longitudinal academic achievement scores after pediatric traumatic brain injury. Dev Neuropsychol. 2004;25(1-2):107–133.
Fletcher J, Ewing-Cobbs L, Miner M, Levin H, Eisenberg H. Behavioral changes after closed head injury in children. J Consult Clin Psychol. 1990;58(1):93–98.
Sport-Related Concussion:
McNally KA, Bangert B, Dietrich A, Nuss K, Rusin J, Wright M, Taylor HG, Yeates KO. Injury versus noninjury factors as predictors of postconcussive symptoms following mild traumatic brain injury in children. Neuropsychology. 2013;27(1):1–12.
van de Loo KF, van Dongen L, Mohamed M, Gardeitchik T, Kouwenberg TW, Wortmann SB, Rodenburg RJ, Lefeber DJ, Morava E, Verhaak CM. Socio-emotional Problems in Children with CDG. JIMD Rep. 2013;11:139–148.
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