Identification of autism spectrum disorders using the Child Behavior Checklist in Singapore.
A nine-item slice of the CBCL gives BCBAs a quick, fair-quality autism screen for school-age intakes.
01Research in Context
What this study did
Ooi et al. (2011) asked if the Child Behavior Checklist can flag autism in Singapore. They looked at kids with ASD, ADHD, other problems, and typical kids. Parents filled out the CBCL. The team pulled out nine key items that best pointed to autism.
What they found
The nine-item CBCL scale caught 68 to 78 percent of ASD cases. It also kept 73 to 92 percent of non-ASD kids from being wrongly flagged. Withdrawn, Social Problems, and Thought Problems sub-scales helped the most.
How this fits with other research
Koegel et al. (2014) seems to disagree. They tested four broadband scales on toddlers and found poor sensitivity. The gap is age: L’s toddlers moved too fast for broad checklists, while Phaik’s mixed-age group gave clearer patterns.
Allison et al. (2008) and Hedley et al. (2015) back the idea that short parent or play-based screens can work. Q-CHAT and ADEC both reached 90 % sensitivity in very young kids, showing quick tools can be accurate when matched to the right age.
Toh et al. (2018) add a warning: even the gold-standard M-CHAT misses many kids under 21 months. Their point lines up with L et al. — toddler screening is simply harder, so poor numbers there do not kill the value of a CBCL scale for older children.
Why it matters
If you already use the CBCL in clinic, flip to the Withdrawn, Social Problems, and Thought Problems sub-scales. A score in the borderline or clinical range on all three is your free autism screener. Add the nine-item cut-off for a fast second step before scheduling full ADOS time. It saves hours and still catches most ASD cases in mixed-age intakes.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Open last week’s CBCL file and check the Withdrawn + Social + Thought scores; if both T ≥ 65, place the child on your ASD watch list.
02At a glance
03Original abstract
We tested the ability of the 2001 CBCL syndromes to discriminate among 86 children with Autism Spectrum Disorder (ASD), 117 children with Attention Deficit Hyperactivity Disorder-Inattentive type, 426 children with Attention Deficit Hyperactivity Disorder-Hyperactive-Impulsive or Combined type, 200 clinically referred children who did not receive a diagnosis, and 436 typically-developing children in a community sample. The Withdrawn/Depressed, Social Problems, and Thought Problems syndromes significantly discriminated the ASD group from the four other groups. An ASD scale, constructed from nine CBCL items, demonstrated moderate to high sensitivity (68 to 78%) and specificity (73 to 92%). Consistent with previous research, findings from this study provide strong support for the CBCL as a screening tool for ASD.
Journal of autism and developmental disorders, 2011 · doi:10.1007/s10803-010-1015-x