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Methodologic note for child epidemiological surveys: the effects of instructions on estimates of behavior prevalence

C A Woodward1, H B Thomas, M H Boyle

  • 1Department of Psychiatry, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.

Journal of Child Psychology and Psychiatry, and Allied Disciplines
|November 1, 1989
PubMed

Insights

Altering Child Behavior Checklist (CBCL) instructions, by adding "never," reduced parent use of the "0" category for child behaviors. This change shifted reporting to the "1" category, impacting prevalence data.

Area of Science:

  • Child psychology
  • Behavioral assessment
  • Psychometric research

Background:

  • The Child Behavior Checklist (CBCL) is a widely used parent-report measure for assessing child behavior problems.
  • Subtle changes in survey instructions can influence participant responses and affect reported prevalence rates.
  • Understanding the impact of wording variations is crucial for accurate behavioral data collection.

Purpose of the Study:

  • To investigate how modifying the instructions for the '0' category (never or not true) on the Child Behavior Checklist affects reported behavior prevalence in children.
  • To assess the impact of adding the word 'never' to the standard 'not true' instruction.

Main Methods:

  • Parents were recruited through convenience sampling and randomly assigned to complete CBCL items.
  • One group received standard instructions ('not true' for the '0' category).
  • The other group received modified instructions ('never or not true' for the '0' category).

Main Results:

  • Adding 'never' to the instructions significantly decreased parents' use of the '0' category.
  • Conversely, the use of the adjacent '1' category (rarely true) increased when 'never' was included.
  • These changes suggest a shift in response patterns due to instruction wording.

Conclusions:

  • Wording in assessment instructions, even minor changes, can influence parent reporting of child behaviors.
  • The findings highlight the sensitivity of the Child Behavior Checklist to instruction modifications.
  • Careful consideration of wording is necessary to ensure the validity and reliability of behavioral prevalence data.

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