Child Behaviour Checklist (CBCL) – Assessing Emotional & Behavioural Problems in Children

Most children often give a tough time to their parents by acting out or being unruly. When you see your child acting out or behaving in a rather unacceptable way once in a while, you may overlook it but if he acts out often and you observe his behaviour getting out of control, you may want to dig deeper and understand the cause behind it.

How? Consider child behaviour checklist (CBCL)- it’s is a popular tool used to assess many behavioural and emotional problems in children including anxiety, depression, aggression, delinquency, etc. It is used in a number of settings including schools, hospitals, mental health facilities, private practices, and research. Read this article to learn about CBCL.

What Is the Child Behavior Checklist (CBCL)?

The CBCL basically consists of a questionnaire that is usually filled by a parent or a caregiver; it can also be given to the school teacher of the student or filled by the student himself. The questionnaire is generally completed with a paper and a pencil. In instances where there are concerns regarding the reading level or comprehension of the parent, the professional may ask questions to the parents. There are close to 100 behavioural problem questions for a parent to answer, which may take up to 30 minutes or more to complete it. For every question, the answer that best describes the child’s behaviour or the frequency of it has to be ticked. Additionally, an explanation of certain behaviour is required by several questions as well. Once complete, a professional then reviews and scores the answers with the results acting as a guide for the assessment of the child or treatment, if warranted.

The CBCL was developed in 1966 by psychologist Thomas M. Achenbach, PhD. He studied the most commonly reported problematic behaviour in children to develop the questionnaire that describes and detects problematic behaviour in children. It is based on behaviour that can be easily observed and identifiable by parents, teachers, caregivers and others.

Role of CBCL

The information gained from the CBCL scoring can be used in a number of ways. A general physician can use the information to determine whether or not the child needs to be referred to a mental health professional. If the child is referred to a mental health professional, he or she may use the tool to narrow down analysis to specific areas of concern. It is particularly useful when the underlying cause for the child’s symptoms or behaviour is unclear. The CBCL can also be used at intervals in the middle of treatment to measure the child’s progress. This would give the therapist a metric to assess the effect of the ongoing therapy or the effectiveness of a medication used in treatment by a psychiatrist.

Who Uses the CBCL Test?

It is essential to understand that CBCL doesn’t give a mental health diagnosis, but it can offer the mental healthcare provider with the necessary information required for a successful diagnosis.  The CBCL test can also go a long way in assisting with managed care. It can be proof for a health insurance company that a certain treatment is necessary to treat an underlying condition by the physician or the mental health professional.

How Is the Assessment Carried Out?

The CBCL is commonly taken up by the child’s parent or the caregiver. There is also a teacher report form that may be given to a child’s teacher if inappropriate behaviour is observed in the classroom. The questions are designed to assess the child’s behaviour, social competence and functioning at the academic level.

The questions are in the form of how true various statements are. They are to be answered by ticking a Likert scale from 0 = Not True, 1 = Sometimes true and 2 = Often true.

Different Versions of CBCL

There are two main versions of the CBCL; the child behaviour checklist for preschoolers and for school-age children.

1. For Preschoolers

This version of CBCL is meant for children between the ages of 18 months and 5 years. The questionnaire to assess the behaviour of the children in this age group contains about 100 questions on behavioural problems that need to be answered by parents and caregivers including daycare providers. It assesses how frequently the problem behaviour has surfaced in the last two months.

2. School-age Children

This version of the CBCL test is used for children between the ages of 6 and 18 years. It contains about 118 questions on the problem behaviours that need to be answered by parents, caregivers, or teachers.

How Is the Test Scored?

The questionnaire or the test for CBCL is scored by a trained professional. The answers are scored and the problem areas that are identified fall under eight categories which are related to different behavioural aspects. The eight problem areas are given below:

• Social withdrawal
• Anxiety/depression
• Somatic complaints
• Social problems
• Thought problems
• Attention problems
• Aggressive behaviour
• Delinquent behaviour

These eight behavioural problems are also classified under two broad scales:

• Internalizing behaviour scale: Anxious/depressive, somatic complaints and scores, and social withdrawal scores.
• Externalizing behaviour scale:  Social problem, social behaviour, and delinquent behaviour scores.

The scores of normal children of the same age can be compared with the child being assessed. A higher than average score indicates problems and they are graded as normal, borderline or clinical.

Pros of CBCL

The CBCL scale is widely used and well researched since the time of its conception. While being inexpensive to administer, its simplicity in gathering data and scoring methods makes it widely popular. Computer-generated reports are also available that can help with the assessment of a child.

Cons of CBCL

One hitch in the CBCL tool is the self-reporting bias system. A highly frustrated parent might over-report symptoms of the child. On the other hand, if a teacher who likes the child, may end up trivialise the symptoms. Since it takes anywhere from 30 minutes to more than an hour to complete, some might find it time-consuming. If they are in an overwhelmed state, a parent or teacher may also be reluctant to complete it or answer in haste.

Is There Any Preparation Required for the Test?

There is no preparation required to take up the CBCL in general, as it requires the parent or teacher to give accurate and honest answers as much as possible. However, it helps if parents make note of the specific behaviour of the child that concerns them the most. It’s imperative to be as honest as possible to get an accurate result from the questionnaire.

If the questionnaire is being completed by the child, the child needs to be told that there are no right or wrong answers and there is no grading involved – this will take the pressure off and the child will answer the questions with utmost honesty. A small reward for completing the test is also a good motivator for children.

If you are being asked to complete a CBCL on your child or decide to do it on your own, it’s important to be as accurate and transparent as possible. The assessment will go a long way in helping the child’s paediatrician or counsellor determine the appropriate course of action.

Also Read:

How to Deal with Stubborn Child
Antisocial Behaviour in Kids
Attention Seeking Behaviour in Kids