Exploring the agreement between questionnaire information and DSM-IV diagnoses of comorbid psychopathology in children with autism spectrum disorders.
CBCL works for flagging ADHD, depression, and ODD in kids with autism but misses anxiety and can over-count core ASD traits.
01Research in Context
What this study did
The team compared two ways to spot extra problems in kids with autism. They gave parents the Child Behavior Checklist (CBCL). They also ran a full Kiddie-SADS interview. Then they checked how well the short form matched the long form.
They looked for ADHD, depression, anxiety, and oppositional defiant disorder. All kids already had an autism spectrum disorder (ASD) diagnosis.
What they found
CBCL scores lined up well with the interview for ADHD, depression, and ODD. Agreement for anxiety was poor. Overall, the checklist often flagged core ASD traits as new problems, so specificity was low.
How this fits with other research
De Kegel et al. (2016) also found CBCL too broad: it flagged many kids who did not have autism. Their study looked at screening, not comorbidity, so the low accuracy makes sense together.
Geurts et al. (2008) seems to disagree. They showed CBCL Withdrawn and PDD subscales beat the GARS at spotting autism. The gap is explained by focus: M et al. used narrow subscales for autism traits, while Elen et al. used the whole CBCL to find separate disorders.
Camodeca et al. (2020) extend the story. They proved the CBCL-DP factor holds in ASD youth, giving you a quick way to track dysregulation linked to mood and aggression.
Why it matters
Use CBCL to help rule in ADHD, depression, or ODD in your clients with autism. Do not rely on it for anxiety. If a child scores high on many scales, ask: is this a true comorbidity or just autism showing through? Pair CBCL with a brief interview or direct observation before you add new goals or meds.
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02At a glance
03Original abstract
Autism spectrum disorders are often comorbid with other psychiatric symptoms and disorders. However, identifying psychiatric comorbidity in children with autism spectrum disorders is challenging. We explored how a questionnaire, the Child Behavior Check List, agreed with a Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV)-based semi-structured interview, the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children (Kiddie-SADS). The sample comprised 55 children and adolescents (age 6 to 18 years) with autism spectrum disorders, including the main autism spectrum disorder subgroups and the broad range of cognitive and language functioning. High rate of psychopathology was found both through questionnaire and interview assessment. Using predefined Child Behavior Check List cutoffs, we found good agreement between the Child Behavior Check List and the Kiddie-SADS for identifying attention deficit/hyperactivity disorder, depressive disorders, and oppositional defiant disorder. However, overall the specificity of the Child Behavior Check List was low. The Child Behavior Check List was not useful for identifying anxiety disorders. The Child Behavior Check List may capture core symptoms of autism spectrum disorders as well as comorbid psychopathology, and clinicians should be aware that the Child Behavior Check List may be unspecific when used in children and adolescents with autism spectrum disorders.
Autism : the international journal of research and practice, 2015 · doi:10.1177/1362361314526003