Structure, longitudinal invariance, and stability of the Child Behavior Checklist 1½-5's Diagnostic and Statistical Manual of Mental Disorders-Autism Spectrum Disorder scale: Findings from Generation R (Rotterdam).
The CBCL 1½-5 ASD scale works across ages 18 months to 5 years, but treat single-item shifts as noise, not news.
01Research in Context
What this study did
The team tracked the same group of Dutch toddlers for three years. They used the 12-item CBCL 1½-5 ASD scale at 18 months, 3 years, and 5 years. They wanted to know if the scale keeps the same meaning as children grow.
What they found
The total scale stayed stable across ages. It also predicted later autism diagnoses. Yet single items jumped around. A child might score high on “rocking” at 18 months but not at 3 years.
How this fits with other research
Mulder et al. (2020) looked at the same scale in 24 countries. They found the same 12-item structure holds worldwide. This backs the Dutch results.
Pitchford et al. (2019) asked parents and teachers in 19 nations to rate the same items. Parents picked out the same four rare behaviors—rocking, strange actions, withdrawn, and no response to hugs—as the best red flags. The Dutch study shows these same four items can still shift within one child over time.
A Boyd et al. (2024) saw big score changes on the Behavioral Inflexibility Scale after one year. Their message matches this paper: single autism items move as kids develop.
Why it matters
Use the full CBCL ASD scale, not single items, when you screen toddlers. A drop in one item does not rule autism out. Re-screen at each visit and watch the total score trend. This keeps your clinical picture current without over-reacting to daily swings.
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02At a glance
03Original abstract
Although the Child Behavior Checklist 1½-5's 12-item Diagnostic and Statistical Manual of Mental Disorders-Autism Spectrum Problems Scale (formerly called Pervasive Developmental Problems scale) has been used in several studies as an autism spectrum disorder screener, the base rate and stability of its items and its measurement model have not been previously studied. We therefore examined the structure, longitudinal invariance, and stability of the Child Behavior Checklist 1½-5's Diagnostic and Statistical Manual of Mental Disorders-Autism Spectrum Problems Scale in the diverse Generation R (Rotterdam) sample based on mothers' ratings at 18 months (n = 4695), 3 years (n = 4571), and 5 years (n = 5752). Five items that seemed especially characteristic of autism spectrum disorder had low base rates at all three ages. The rank order of base rates for the 12 items was highly correlated over time (Qs ⩾ 0.86), but the longitudinal stability of individual items was modest (phi coefficients = 0.15-0.34). Confirmatory factor analyses indicated that the autism spectrum disorder scale model manifested configural, metric, and scalar longitudinal invariance over the time period from 18 months to 5 years, with large factor loadings. Correlations over time for observed autism spectrum disorder scale scores (0.25-0.50) were generally lower than the correlations across time of the latent factors (0.45-0.68). Results indicated significant associations of the autism spectrum disorder scale with later autism spectrum disorder diagnoses.
Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361317736201