The CBCL 1.5-5 and the identification of preschoolers with autism in Italy

Area of Science:

• Child psychology
• Developmental pediatrics
• Behavioral science

Background:

• Early identification of autism spectrum disorder (ASD) is crucial for timely intervention.
• The Child Behaviour Checklist (CBCL) 1.5-5 scales are widely used in pediatric assessments.
• Validating screening tools for preschoolers at risk of ASD is an ongoing research priority.

Purpose of the Study:

• To evaluate the utility of the CBCL 1.5-5 scales for the early identification of preschoolers with autism spectrum disorder (ASD).
• To compare the performance of specific CBCL scales in differentiating ASD from other psychiatric disorders (OPD) and typical development (TD).

Main Methods:

• A comparative study involving three groups of preschoolers: 101 with ASD, 95 with OPD, and 117 with TD.
• Statistical analyses included one-way ANOVA, logistic regression with odds ratio (OR), and receiver operating characteristic (ROC) analyses.
• CBCL scores were analyzed to assess predictive validity and diagnostic accuracy.

Main Results:

• ANOVA indicated significantly higher CBCL scores in ASD and OPD groups compared to the TD group across most scales.
• The ASD group showed significantly higher scores than the OPD group on Withdrawn, Attention Problems, and Pervasive Developmental Problems (PDP) scales.
• ROC analysis demonstrated high sensitivity and specificity for PDP and Withdrawn scales in identifying ASD versus TD, though specificity decreased when comparing ASD to OPD.

Conclusions:

• The CBCL Pervasive Developmental Problems (PDP) and Withdrawn scales exhibit good predictive validity for identifying preschoolers at risk of autism.
• These scales could serve as a valuable first-level screening tool in primary care settings for early autism detection.
• Further investigation is needed to address the lower specificity of these scales when differentiating ASD from other psychiatric disorders.