Screening for ASD with the Korean CBCL/1½-5

Area of Science:

• Child Psychology
• Developmental Pediatrics
• Psychometric Evaluation

Background:

• The Child Behavior Checklist for ages 1½–5 (CBCL/1½-5) is a widely used behavioral screening tool.
• Its utility in screening for autism spectrum disorders (ASD) requires validation in diverse populations.

Purpose of the Study:

• To evaluate the effectiveness of the CBCL/1½-5 as a screening tool for autism spectrum disorders (ASD) in Korean preschoolers.
• To assess the performance of specific CBCL/1½-5 scales and items in differentiating ASD from other developmental and psychiatric conditions.

Main Methods:

• A cross-sectional study involving 456 Korean preschoolers, including groups with ASD, developmental delay (DD), other psychiatric disorders (OPD), and non-referred (NR) children.
• Analysis of CBCL/1½-5 scores, focusing on the Withdrawn and DSM-Pervasive Developmental Problems (DSM-PDP) scales and specific ASD-related items.

Main Results:

• Children with ASD exhibited significantly higher scores on the Withdrawn and DSM-PDP scales compared to other groups.
• A T ≥ 65 cutpoint on the DSM-PDP scale achieved 80% sensitivity for identifying ASD.
• Specificity varied across comparison groups: 87% for NR, 55% for OPD, and 60% for DD.

Conclusions:

• The CBCL/1½-5 demonstrates good performance in Level 1 screening for ASD, particularly in differentiating ASD from the general population.
• Findings support the CBCL/1½-5's utility as an initial screening instrument for ASD in non-Western populations.
• Further research may refine cutpoints to improve specificity in clinical populations.