Behavioral Profiles of Children With Williams Syndrome From Spain and the United States: Cross-Cultural Similarities and Differences.
Country-specific T-scores erase most cross-border CBCL differences in Williams syndrome—skip raw totals.
01Research in Context
What this study did
The team asked parents in Spain and the United States to fill out the same Child Behavior Checklist.
All of the children had Williams syndrome.
The goal was to see if culture changes how parents rate behavior.
What they found
Spanish parents ticked more problem boxes when raw scores were counted.
Once the researchers used country-specific T-scores, only the Social Problems scale stayed higher for Spain.
Boys and girls looked the same in both countries.
How this fits with other research
Wu et al. (2012) saw the same raw-score inflation in Taiwanese preschoolers.
They also warn BCBAs to use local norms, not U.S. cut-offs.
Howard et al. (2019) extend the Williams focus to siblings; caregivers there under-reported emotional problems, echoing the need for careful interpretation.
De Kegel et al. (2016) add another red flag: CBCL alone is too vague to screen for ASD, so combine it with other tools.
Why it matters
Before you write "elevated problems" in a report, check if the T-scores come from the child’s own country.
If you work with Spanish-speaking families, expect slightly higher Social Problems scores even when overall adjustment is fine.
Pair the CBCL with direct observation or local norms to avoid over-pathologizing.
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02At a glance
03Original abstract
To identify similarities and differences in the behavioral profile of children with Williams syndrome from Spain (n = 53) and the United States (n = 145), we asked parents of 6- to 14-year-olds with Williams syndrome to complete the Child Behavior Checklist 6-18. The distribution of raw scores was significantly higher for the Spanish sample than the American sample for all of the higher-order factors and half of both the empirically based and Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales. In contrast, analyses based on country-specific T-scores indicated that the distribution for the Spanish sample was significantly higher than for the American sample only on the Social Problems scale. No gender differences were found. Genetic and cultural influences on children's behavior and cultural influences on parental ratings of behavior are discussed.
American journal on intellectual and developmental disabilities, 2017 · doi:10.1111/j.1467-7687.2007.00626