Use of the Pervasive Developmental Problems Subscale on the Child Behavior Checklist 1.5 to 5 to Screen for Autism Spectrum Disorders

Background:

The Childhood Behavior Checklist (CBCL), is a parent-report standardized questionnaire developed to assess various maladaptive behavioral and emotional problems in children aged 18 months to 18 years (Achenbach 2000, 2001). The preschool version of the measure (CBCL 1.5 to 5), groups behaviors into three broadband scales: externalizing, internalizing, and total problems, as well as seven syndrome-oriented and five DSM-oriented subscales, one of which assesses for “Pervasive Developmental” problems (PDP).  Several studies have demonstrated the usefulness of the CBCL PDP subscale in discriminating autism spectrum disorders against the “gold standard” diagnostic measures.  Specifically, PDP subscale elevations have been associated with ASD and group classification on the ADOS-G (Hartley, et al., 2008; Sikora, et al, 2008). However, the performance of the CBCL as a screening measure, particularly against other commonly used screening measures, is unclear.  As the CBCL is commonly regarded as an efficient method of screening for a variety of childhood concerns, it is important that the validity of the PDP subscale as a screener be assessed, particularly the relationship of this subscale to the MCHAT, SRS, and SCQ, the most commonly used screening tools for discriminating ASD from non-ASD disorders in preschool aged-children.

Objectives:

The focus of this present study is to further evaluate the clinical use of the CBCL 1.5 to 5 PDP subscale as a screening measure for discriminating ASD from non-ASD disorders. of the CBCL.  Specifically, the aim of this study is to further evaluate the construct validity of the PDP scale by assessing its relationship to the MCHAT, SCQ, and SRS total score and subscales.

Methods:

Study participants included 67 children (54 male) who were referred to a hospital-based Autism Clinic due to concern of ASD.  Children who met the age criteria for the CBCL 1.5 to 5 were selected (i.e., 18 to 71 months of age; Mean = 42.6 months, S.D. = 11.6 months).  All children in this sample were given the CBCL as part of their assessment battery, in addition to the MCHAT for children aged 18 months to 47 months of age, and the SCQ and SRS for children aged 48 to 71 months of age.  Pearson’s bivariate correlations were used to evaluate the PDP subscale of the CBCL to the MCHAT, SCQ, and SRS.

Results:

The PDP subscale was significantly correlated with the SCQ (r = .82, p = <0.001), as well as the critical items and total items scores on the MCHAT (r = .63, r =.66, p = <0.001, respectively). Comparing the PDP subscale to the subscale scores and total score of the SRS yielded the following significant correlations: Social Communication, r=.45, p=0.034, Social Motivation, r=.71, p=<0.001, Autistic Mannerisms, r=.67, p=<0.001, and Total Score, r=.57, p=<0.001.  All other subscale correlations on the SRS were non-significant.

Conclusions:

Results of the present study provide further support for the use of the CBCL PDP subscale as a screening tool for ASDs.