Child Behavior Check List 1½-5 as a tool to identify toddlers with autism spectrum disorders: a case-control study.
The CBCL 1½-5 Withdrawn and PDP sub-scales give BCBAs a quick, parent-done screen that spots autism in toddlers with better than 90 % accuracy.
01Research in Context
What this study did
The team gave the Child Behavior Checklist 1½-5 to parents of 18-36-month-old children.
Some kids already had an autism diagnosis. Some had other delays. Some were typically developing.
They looked at which CBCL sub-scales best predicted who later got an ASD diagnosis.
What they found
The Withdrawn and Pervasive Developmental Problems sub-scales scored above 90 % accuracy.
That means nine times out of ten the CBCL correctly spotted the toddlers who had autism.
Only a few children were missed or falsely flagged.
How this fits with other research
Limberg et al. (2017) ran a similar study in Germany with preschoolers. Their accuracy was a bit lower, but the same two CBCL scales still worked.
Gabriels et al. (2001) and Vanvooren et al. (2017) showed the M-CHAT also works for toddlers. CBCL is not better or worse—it is just another tool you can pull from the shelf.
Heyvaert et al. (2010) used day-care staff instead of parents to fill out a different checklist. Their tool worked too, proving that both parents and teachers can help catch autism early.
Why it matters
You already have the CBCL 1½-5 in most clinics. Flip to the Withdrawn and PDP scores. If either T-score is high, move the child up the ASD assessment line. No extra packets, no new cost, just faster answers for families.
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02At a glance
03Original abstract
Tools to identify toddlers with autism in clinical settings have been recently developed. This study evaluated the sensitivity and specificity of the Child Behavior Check List 1½-5 (CBCL 1½-5) in the detection of toddlers subsequently diagnosed with an Autism Spectrum Disorder (ASD), ages 18-36 months. The CBCL of 47 children with ASD were compared to the CBCL of 47 toddlers with Other Psychiatric Disorders (OPD) as well as the CBCL of 47 toddlers with Typical Development (TD) in a case control study. One-way analysis of variance (ANOVA) and logistic regression with odds ratio (OR) analyses were performed. In order to establish the optimal threshold able to discriminate children with ASD from children with OPD and TD, Receiver Operating Characteristic (ROC) analyses were performed. One-way ANOVA revealed significant differences between the three groups. Logistic regression analysis showed that the Withdrawn and the Pervasive Developmental Problems (PDP) subscales can recognize toddlers subsequently identified as ASD from both children with TD (p<0.001) and OPD (p<0.001). ROC analyses showed very high sensitivity and specificity for the PDP (0.98 and 0.91) and Withdrawn (0.92 and 0.97) subscales when ASD was compared to TD. Sensitivity and specificity of Withdrawn (0.90 and 0.83) and PDP (0.85 and 0.83) remained high when comparing ASD versus OPD. In conclusion, the CBCL 1½-5 seemed to be able to identify toddlers subsequently diagnosed with ASD from children with TD and OPD. Its high sensitivity and specificity, coupled with its efficiency in terms of time and cost, suggest this broadband tool should be tested in a pilot screening survey of toddlers in the general population.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2012.12.020