The German version of the Child Behavior Checklist 1.5-5 to identify children with a risk of autism spectrum disorder.
The German CBCL 1.5-5 Withdrawn ≥60.5 or PDD ≥64.5 reliably flags autism risk in preschoolers, though less sharply than earlier toddler data.
01Research in Context
What this study did
Researchers tested the German version of the Child Behavior Checklist 1.5-5. They wanted to see if it could spot autism risk in preschoolers. The team gave the checklist to parents of 3-5 year olds. Some kids already had an autism diagnosis. Others had different issues or were typically developing.
They looked at two subscales: Withdrawn and PDD (Pervasive Developmental Problems). They checked how often these scales correctly flagged kids who actually had autism.
What they found
The Withdrawn scale worked when the T-score hit 60.5 or higher. It caught most kids with autism but also flagged some without it. The PDD scale worked at 64.5 or higher. It was slightly better at avoiding false alarms.
Both scales showed "acceptable" accuracy. This means they are good enough for quick screening but not perfect. Some kids will get referred who don't have autism.
How this fits with other research
Narzisi et al. (2013) found even better results with the same checklist. They tested toddlers months and got over a large share accuracy. The current study shows the tool still works in older German preschoolers, but not quite as sharply.
Parks (1983) warned that early autism scales lacked solid proof they worked. The new German data helps fix that gap for the CBCL.
Vanvooren et al. (2017) validated the French M-CHAT in toddlers the same year. Both studies show translated tools can work, but the CBCL picks up broader behavior issues while M-CHAT focuses only on autism red flags.
Why it matters
If you work with German-speaking families, you can use the CBCL 1.5-5 as a quick first screen. A Withdrawn T-score of 60.5 or PDD score of 64.5 means refer for full autism evaluation. Tell parents this is just a first step - some kids will screen positive but not have autism.
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02At a glance
03Original abstract
A long delay between the first registered symptoms of autism spectrum disorder and a final diagnosis has been reported. The reasons for this are the spare use of specialized autism instruments, missing clinical expertise, and the late referral to specialized centers in primary care. Previous studies recommending the Child Behavior Checklist 1.5-5 for screening have requested additional research. A total of 183 children aged 25-71 months participated in this study. The Child Behavior Checklist scales of 80 children with autism spectrum disorder were compared with 103 children diagnosed with other psychiatric disorders. In the logistic regression analysis, the Withdrawn and Pervasive Developmental Problems Child Behavior Checklist scales with a significant predictive value of risk for an autism spectrum disorder diagnosis were identified. The optimal cutoff points T = 64.5 on the Pervasive Developmental Problems scale (area under the curve = 0.781, sensitivity = 0.83, specificity = 0.60, positive predictive value = 0.62, negative predictive value = 0.82, odds ratio = 7) and T = 60.5 on the Withdrawn scale (area under the curve = 0.809, sensitivity = 0.88, specificity = 0.63, positive predictive value = 0.65, negative predictive value = 0.87, odds ratio = 12) were evaluated in the receiver operating characteristics analysis. The present study confirms the utility of the German version of the Child Behavior Checklist 1.5-5 as a level 1 screening tool to identify children with a risk of autism spectrum disorder; however, a risk of over-identifying should be considered. The Child Behavior Checklist 1.5-5 can complement the pediatric examination as a quick and cost-effective questionnaire.
Autism : the international journal of research and practice, 2017 · doi:10.1177/1362361316645932