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Child Behavior Check List 1½-5 as a tool to identify toddlers with autism spectrum disorders: a case-control study

Antonio Narzisi1, Sara Calderoni, Sandra Maestro

  • 1Division of Child Neurology and Psychiatry, Stella Maris Scientific Institute, Pisa, Italy. antonio.narzisi@inpe.unipi.it

Research in Developmental Disabilities
|February 5, 2013
PubMed

Insights

The Child Behavior Check List 1½-5 effectively identifies toddlers with Autism Spectrum Disorder (ASD) compared to typical development and other psychiatric disorders. This tool shows high sensitivity and specificity, suggesting its use in general population screening.

Area of Science:

  • Developmental Psychology
  • Child Psychiatry
  • Clinical Psychology

Background:

  • Early identification of Autism Spectrum Disorder (ASD) in toddlers is crucial for timely intervention.
  • Validated tools are needed to accurately screen young children in clinical settings.
  • The Child Behavior Check List 1½-5 (CBCL 1½-5) is a widely used developmental screening tool.

Purpose of the Study:

  • To evaluate the sensitivity and specificity of the CBCL 1½-5 in identifying toddlers diagnosed with ASD.
  • To compare the diagnostic accuracy of the CBCL 1½-5 against toddlers with Other Psychiatric Disorders (OPD) and Typical Development (TD).

Main Methods:

  • A case-control study comparing CBCL 1½-5 data from 47 toddlers with ASD, 47 with OPD, and 47 with TD.
  • Statistical analyses included one-way ANOVA, logistic regression with odds ratio (OR), and Receiver Operating Characteristic (ROC) analyses.
  • Optimal thresholds were determined using ROC analysis to discriminate between groups.

Main Results:

  • One-way ANOVA indicated significant differences across the three groups (ASD, OPD, TD).
  • Logistic regression revealed that the Withdrawn and Pervasive Developmental Problems (PDP) subscales accurately identified toddlers with ASD (p<0.001) compared to both TD and OPD groups.
  • ROC analyses demonstrated high sensitivity and specificity for the PDP (0.98, 0.91) and Withdrawn (0.92, 0.97) subscales when comparing ASD to TD.
  • High sensitivity and specificity were also observed when comparing ASD versus OPD for the Withdrawn (0.90, 0.83) and PDP (0.85, 0.83) subscales.

Conclusions:

  • The CBCL 1½-5 is a viable tool for identifying toddlers with ASD in clinical settings.
  • The Withdrawn and PDP subscales demonstrate strong diagnostic accuracy, supporting their use in early ASD detection.
  • The tool's efficiency, sensitivity, and specificity suggest potential for pilot screening in the general toddler population.

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