The Child Behavior Checklist

The child behavior checklist (CBCL) is the most commonly used tool for assessing emotional and behavioral problems in children. The checklist provides a fast and efficient way for a treatment provider to gather information about a child’s mood and behavior.

The CBCL consists of a series of questions that usually a parent or caregiver completes. The answers are then scored by the professional and the results can help guide the assessment or treatment (if it is warranted).

The information gleaned from the CBCL may be used in a variety of ways. A physician may use the tool to determine if a child should be referred to a mental health treatment provider. Or, a mental health treatment provider may use the CBCL to assess specific areas of concern.

The CBCL doesn’t provide a mental health diagnosis but it can provide a treatment provider with information that helps in the diagnostic process. For example, the scores may reveal that a child with behavior issues has an underlying mental health issue, like anxiety. Treating the anxiety may be a key component to improving the behavior.

Sometimes the CBCL assists with managed care. The scores can help a physician or mental health treatment provider show a health insurance company that a particular treatment is warranted.

It may also be administered at intervals to check on a child’s progress. A therapist may use it to see if therapy is helping a child’s depression or anxiety, or a psychiatrist may administer it to see if ADHD medication is reducing a child’s symptoms.

The CBCL is most commonly given to a child’s parent or caregiver to complete. There’s also a teacher report form that may be given to a child’s teachers.

The questions assess a child’s behavior, social competence and academic functioning (when a child attends school).

The person answering the questions documents how true various statements are using a Likert scale: 0 = Not True, 1 = Somewhat or Sometimes True, and 2 = Very True or Often True.

There are two different versions of the CBCL:

• Preschool: This version is appropriate for children ages 18 months to 5 years. Parents or close caregivers (such as daycare providers) report how often a specific behavior has occurred during the previous two months. It contains 100 problem behavior questions.
• School-age: This version is used for children from 6 to 18. It contains 118 problem behavior questions.

The checklist only takes about 15 minutes to complete and it can be scored in about 10 minutes.

A trained professional scores the test. The answers are scored and problem areas are broken down into the following eight categories:

1. Aggressive Behavior
2. Anxious/Depressed
3. Attention Problems
4. Rule-Breaking Behavior
5. Somatic Complaints
6. Social Problems
7. Thought Problems
8. Withdrawn/Depressed

There are two broadband scales that combine several of the scales. The internalizing problems score assesses the anxious/depressed, withdrawn/depressed, and somatic complaints score. Externalizing problems cover the rule-breaking and aggressive behavior domains.

The CBCL scores can be compared to the normal scores for children in the same age range. Higher scores indicate greater problems. Scores are considered either normal, borderline, or clinical.

The CBCL is well-researched and widely used. It’s updated from time to time to reflect changes in the Diagnostic and Statistical Manual.

It’s also inexpensive to administer and easy to score, making it a simple way to gather data. Computer-generated reports are available with feedback and the assessment shares a child’s strengths.

A potential drawback of the CBCL is the issue of self-report bias. A parent who is really frustrated by a child’s behavior may over-report symptoms. Similarly, a teacher who really likes a child may underreport symptoms.

Additionally, some caregivers see the forms as time-consuming to complete. An already overwhelmed parent or teacher may be reluctant to complete the forms in a timely manner.

If someone asks you to complete a CBCL on a child, it's important to complete the checklist as accurately as possible. If you have any questions, don't hesitate to ask.

Whether you're a parent, teacher, or another caregiver, your feedback will likely be an integral part of the assessment of a child. Your responses can help shape any interventions that may be necessary to help a child manage her mood or behaviors better.