Child Behavior Checklist (CBCL)
Explore our child behavior checklist (CBCL) to help understand and manage children's behavior effectively and with care.
What is the Child Behavior Checklist?
The Child Behavior Checklist (CBCL) is a widely used standardized assessment tool designed to evaluate behavioral and emotional problems in children and adolescents aged 6 to 18 years. It is part of the Achenbach System of Empirically Based Assessment (ASEBA), a comprehensive approach to assessing adaptive and maladaptive functioning in individuals across various age groups.
The CBCL is a parent-report questionnaire that consists of approximately 120 items describing specific behavioral and emotional problems. This scale helps capture the frequency and severity of specific behavioral and emotional issues (Achenbach & Rescorla, 2000).
The CBCL provides scores on the following eight syndrome scales:
- Anxious/depressed
- Withdrawn/depressed
- Somatic complaints
- Social problems
- Thought problems
- Attention problems
- Rule-breaking behavior
- Aggressive behavior
These syndrome scales are further categorized into two broad-band scales: Internalizing Problems (comprising Anxious/Depressed, Withdrawn/Depressed, and Somatic Complaints) and Externalizing Problems (comprising Rule-Breaking Behavior and Aggressive Behavior). These broad-band scales offer a more holistic view of a child's emotional and behavioral functioning. Additionally, the CBCL provides a Total Problems score, which reflects the overall level of emotional and behavioral difficulties.
While the CBCL provides valuable information about a child's behavioral and emotional functioning, it is important to note that it is not a diagnostic tool. The results should be interpreted in conjunction with other assessment methods, such as clinical interviews, observations, and additional testing, to inform a comprehensive evaluation and appropriate treatment planning (Rescorla et al., 2011).
What concerns can CBCL assessment address?
The Child Behavior Checklist is a widely used standardized assessment tool to evaluate emotional, behavioral, and social problems in children and adolescents. This comprehensive assessment can address a wide range of concerns, including:
- Internalizing problems: This checklist assesses internalizing concerns such as anxiety problems, depression, withdrawal, and somatic problems, which can often go unnoticed or be less apparent than externalizing behaviors.
- Externalizing problems: The assessment evaluates externalizing issues like aggressive behavior, rule-breaking behavior, and conduct problems, which can significantly impact a child's functioning and relationships.
- Attention problems: The CBCL includes items that assess attention-related difficulties, including inattention, hyperactivity, and impulsivity, which can indicate conditions like Attention Deficit Hyperactivity Disorder (ADHD).
- Social problems: The assessment covers various social issues, such as difficulties with peer relationships, social withdrawal, and oppositional defiant problems, which can impair a child's social development and adjustment.
- Thought problems: The CBCL includes items that evaluate unusual or bizarre thought patterns, which can indicate underlying mental disorders or neurological conditions.
- Developmental and adaptive functioning: The CBCL assesses a child's competencies and adaptive functioning in areas like academic performance, activities, and social relationships, providing a comprehensive understanding of their overall functioning.
Child Behavior Checklist (CBCL) Template
Child Behavior Checklist (CBCL) Example
How to use the Child Behavior Checklist
Achenbach's Child Behavior Checklist is relatively easy to use! The psychologist or health practitioner must issue this to the parent(s) or guardian(s) reporting on their child's potential behavioral and emotional problems. On the part of the parents/guardians, they need to do the following:
Step 1: Provide general information
General information refers to the child's name, gender, age, birthday, school, demographic information, etc. The person filling out the form will also indicate the job (or the usual jobs) the child's parents/guardians have.
Step 2: List and rate things about the child related to school, chores, and relationships
After the general information section of the checklist, the next part is about what the child likes, what and how they do in school, a little bit about home, and their relationships with people, especially within their age group.
The parent/guardian will list things like the child's favorite hobbies, the sports they like doing, the chores they usually do at home or if they have jobs, etc. They will also rate these by considering how the child does compared to others.
Some segments ask the parent/guardian to describe the child by answering guide questions concerning whether their child has any illnesses or mental health concerns and disabilities, the parents' concerns for the child, and the child's best qualities.
Step 3: Rate the items
The last part of this checklist is a list of 113 items for the parents/guardians to rate. Some of these items need to be filled with answers. It has items relating to well-being and social competence like the following:
- Can't get mind off specific thoughts/obsessions
- Bragging/boasting
- Complains of loneliness
The parent/guardian completing this assessment rates each item with one of the following:
- 0 = Not true (as far as you know)
- 1 = Somewhat or sometimes true
- 2 = Very true or often true
This will give you a total score compared to other normative data sets.
Step 4: The psychologist will score according to the scales
The scoring will not be done on the checklist itself. Once the parent/guardian submits a fully accomplished checklist, the psychologist will interpret the answers using ASEBA's scoring materials. The results will come in the form of scale measurements.
The CBCL scores and other data, such as a teacher's report form and other psychological tests, should help you create a treatment plan to be discussed with the child's parents/guardians.
Scoring and interpretation
The Child Behavior Checklist (CBCL) provides a standardized approach to scoring and interpreting behavioral and emotional problems in children and adolescents aged 6 to 18 years.
The CBCL consists of approximately 120 items, each rated on a three-point scale (0 = not true, 1 = somewhat or sometimes true, 2 = very true or often true). The scores are then summed and converted into standardized scores based on age and gender norms.
The CBCL yields scores for the following scales:
- Syndrome scales: These measure specific domains of behavior and emotional problems, including Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Social Problems, Thought Problems, Attention Problems, Rule-Breaking Behavior, and Aggressive Behavior.
- Internalizing and externalizing broad-band scales: The Internalizing Problems scale combines scores from the Anxious/Depressed, Withdrawn/Depressed, and Somatic Complaints scales, while the Externalizing Problems scale combines scores from the Rule-Breaking Behavior and Aggressive Behavior scales.
- Total problems scale: This provides an overall measure of the child's emotional and behavioral difficulties.
Interpreting CBCL results involves analyzing the scores on the syndrome scales, broad-band scales, and total problems scores. Higher scores indicate a greater presence of behavioral and emotional challenges.
Elevated T-scores of 64 or higher on the broadband scales and 70 or higher on the syndrome scales are considered clinically significant. These elevated scores indicate the need for a more comprehensive diagnostic evaluation.
The syndrome scales can help identify specific areas of concern. For example, elevated scores on the Anxious/Depressed scale may indicate the presence of anxiety or depressive symptoms. In contrast, high scores on the Attention Problems scale may suggest issues with attention and concentration.
The broad-band scales (Internalizing and Externalizing Problems) provide an overview of the child's general functioning. Internalizing problems reflect difficulties within the self, and externalizing problems reflect difficulties in the child's interactions with their environment.
The total problems score provides a global assessment of the child's overall emotional and behavioral functioning, with higher scores indicating a greater degree of difficulties.
Whether a person's scores fall within the clinically significant or borderline range, these results point to the importance of conducting a more thorough diagnostic assessment to fully understand the individual's condition and determine the appropriate course of action (Pandolfi et al., 2012).
When would you typically use the Child Behavior Checklist?
The Child Behavior Checklist is usually issued when the parent/guardian of a child sets up an appointment with you because they suspect their child might have emotional and behavioral problems. It is also typically issued during your appointment.
It usually takes 15-20 minutes to complete. Of course, the parent/guardian can take home the checklist if they need to think long and hard about their answers and ratings.
This can also be used alongside other psychological instruments to help those with ADHD, anxiety, or oppositional defiant disorder. The data can also go beyond parent ratings and consider cross-informant comparisons such as teachers, tutors, or other figures in contexts where the child interacts. The CBCL provides a more comprehensive picture of these conditions and can be used for additional support, such as an outcomes assessment.
Who can use the Child Behavior Checklist?
The following healthcare practitioners can use the CBCL for their respective practices:
- Clinical psychologists
- Mental health therapists
- Counselors
- Public health agencies
- Training programs
- Research center
Benefits of using the Child Behavior Checklist
Parents/guardians can make more insightful reflections
Just because they have suspicions of their child having behavioral and emotional problems doesn't necessarily mean that they've taken the time to reflect on the different aspects of their child.
The Child Behavior Checklist asks the parent/guardian to think about their child in terms of how they're doing in school, what they are like around other children, what they love doing, what sports they like, how they fare in doing things compared to others, how they respond to certain things, and what their disposition is.
They can only honestly answer the checklist if they stop and think about their child's behaviors objectively.
Psychologists and practitioners can develop effective plans
Because it's comprehensive, psychologists can take the answers from fully accomplished checklists or another clinical scale and use ASEBA's scoring tools to interpret the findings. They'll be able to look at the syndrome scale scores and how they apply to different aspects such as affective problems, attention problems, problem behavior if present, and more.
With comprehensive findings that can be correlated with the Diagnostic and Statistical Manual (DSM), they can develop a plan for the parents/guardians and their child that covers different aspects of their life to prevent suspected behavioral and emotional problems from worsening and work to make things better and ensure the child is well-adjusted and confident. Best of all, this CBCL is a free PDF that does not require extensive knowledge to use.
References
Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA preschool forms and profiles (Vol. 30). Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.
Pandolfi, V., Magyar, C. I., & Dill, C. A. (2012). An initial psychometric evaluation of the CBCL 6-18 in a sample of youth with autism spectrum disorders. Research in Autism Spectrum Disorders, 6(1), 96–108. https://doi.org/10.1016/j.rasd.2011.03.009
Rescorla, L. A., Achenbach, T. M., Ivanova, M. Y., Harder, V. S., Otten, L., Bilenberg, N., Bjarnadottir, G., Capron, C., De Pauw, S. S., Dias, P., Dobrean, A., Döpfner, M., Duyme, M., Eapen, V., Erol, N., Esmaeili, E. M., Ezpeleta, L., Frigerio, A., Fung, D. S., Gonçalves, M., … Verhulst, F. C. (2011). International comparisons of behavioral and emotional problems in preschool children: parents' reports from 24 societies. Journal of Clinical Child and Adolescent Psychology, 40(3), 456–467. https://doi.org/10.1080/15374416.2011.563472
Commonly asked questions
The CBCL can be used at various stages to assess a child's emotional, behavioral, and social functioning. It is commonly administered when there are concerns about a child's behavior or development or as part of a comprehensive evaluation for conditions like ADHD, anxiety, or depression. Regular re-assessments can also track a child's progress and response to interventions.
Initially, the CBCL was primarily available in a print format for parents or caregivers to complete. However, with advances in technology, electronic versions are now available. These can be filled digitally, offering flexibility and ease for both practitioners and respondents. Always ensure that the version and format officially provided by the ASEBA (Achenbach System of Empirically Based Assessment) are used to guarantee accuracy and validity.
Scoring the CBCL requires specific procedures outlined in the manual. For paper forms, scoring involves transferring raw scores to profile forms and consulting norm tables based on the child's age and gender. Computer-based scoring programs can automate this process, providing standardized scores and interpretive reports. Proper training is recommended to ensure accurate scoring and interpretation of results.