CBCL in the assessment of psychopathology in Finnish children with intellectual disability.
CBCL spots emotional distress in mild ID but needs backup evidence in deeper ID or when ruling out autism.
01Research in Context
What this study did
Koskentausta et al. (2004) looked at CBCL scores in Finnish children with intellectual disability. They grouped kids by ID level: mild, moderate, severe, or profound.
The team wanted to see if the checklist could spot emotional and behavior problems in each group. No treatment was tested; they just described the score patterns.
What they found
For children with mild ID, high CBCL scores lined up well with known psychopathology. In kids with deeper ID, the same high scores were harder to read.
The authors warn that moderate-to-profound ID can mask or mimic true behavior disorders, so interpret with caution.
How this fits with other research
De Kegel et al. (2016) seems to disagree. They found CBCL profiles were poor at screening for autism, with lots of false positives. The gap is about purpose: Terhi used CBCL to describe existing problems, while Alexandra tried to use it as a gatekeeper for ASD diagnosis.
Gjevik et al. (2015) bridge the two views. In youth with ASD, CBCL agreed well with clinical interviews for ADHD, depression, and ODD, but it missed anxiety disorders. This supports Terhi’s take: the tool flags broad distress, not specific diagnoses.
Neo et al. (2021) add that narrowband and broadband CBCL scales hold up in preschoolers with neurogenetic syndromes, backing the checklist’s basic structure even in developmental disability.
Why it matters
If you work with kids who have ID, use the CBCL as a first alert, not a verdict. High scores in mild ID are meaningful; in moderate-to-profound ID, pair the checklist with direct observation and caregiver history. Do not rely on it alone to rule autism in or out—follow up with gold-standard tools.
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02At a glance
03Original abstract
Structured checklists have been used to supplement psychiatric assessment of children with normal intelligence, but for children with intellectual disability, only a few checklists exist. We evaluated the Child Behavior Checklist (CBCL) in the assessment of psychopathology in Finnish children with intellectual disability. The CBCL was completed by parents or other carers of 90 children aged 6-13 years. Of the 118 CBCL problem items, the lowest scores were for 'Suicidal talks' and 'Alcohol, drugs', and the highest score for 'Acts too young'. Total Problem, Internalizing, and Externalizing scores were highest among children with moderate intellectual disability and lowest among those with profound intellectual disability. Externalizing scores were significantly higher among children with mild or moderate intellectual disability than among those with severe or profound intellectual disability. Compared with the original normative samples, Total Problem scores were higher in the present study. With a T-score cut-off point of 60, the rated frequency of psychiatric disorders was 43%. We conclude that, despite certain limitations, the CBCL can be used in the assessment of psychopathology among children with mild intellectual disability but is less reliable for those with moderate, severe, or profound intellectual disability.
Research in developmental disabilities, 2004 · doi:10.1016/j.ridd.2003.12.001