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Agreement Between Two Behavioral Rating Scales in Preschoolers Born Very Preterm
Marie Camerota1,2, Jessica Bagley2, Elisabeth C McGowan2,3
1Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI.
Insights
Agreement between the Behavior Assessment System for Children, Third Edition (BASC-3) and Child Behavior Checklist (CBCL) is weak to moderate for preschool children. Hyperactivity and attention scales show better agreement, but discrepancies exist when interpreting behavioral problems.
Area of Science:
- Child Psychology
- Developmental Pediatrics
- Behavioral Science
Background:
- Broadband parent rating scales are essential tools for assessing behavioral problems in children.
- Understanding the agreement between different rating scales, such as the Behavior Assessment System for Children, Third Edition (BASC-3) and the Child Behavior Checklist (CBCL), is crucial for accurate interpretation.
- Limited research exists on the concordance of these widely used scales in specific pediatric populations.
Purpose of the Study:
- To evaluate the agreement between the BASC-3 and CBCL in a sample of children born very preterm.
- To compare correlations, within-person differences, and clinical categorization agreement between corresponding BASC-3 and CBCL subscales and composite scores.
Main Methods:
- Seventy-three children born before 30 weeks' gestational age were assessed at age 4.
- Caregivers completed both the BASC-3 and CBCL for each child.
- Statistical analyses included correlations, examination of within-person differences in T-scores, and agreement in clinical classifications.
Main Results:
- Significant correlations were found between comparable BASC-3 and CBCL subscales, with varying magnitudes.
- Subscales and composite scores for hyperactivity, attention problems, externalizing problems, and total problems demonstrated the strongest agreement.
- Agreement in clinical classifications ranged from weak to moderate, with higher agreement for hyperactivity, attention, externalizing, and total problems.
Conclusions:
- Agreement between the BASC-3 and CBCL is generally weak to moderate in very preterm preschoolers.
- Specific domains like hyperactivity and attention show better concordance, but overall interpretation requires caution due to potential discrepancies.
- Clinicians and researchers should be mindful of these differences when using these scales to assess behavioral problems in this population, as conclusions may vary depending on the instrument used.
Objective:
Broadband parent rating scales are commonly used to assess behavioral problems in children. Multiple rating scales are available, yet agreement between them is not well-understood. The objective of this study was to evaluate agreement between the Behavior Assessment System for Children, Third Edition (BASC-3), and Child Behavior Checklist 1.5 to 5 years (CBCL) in a sample of children born very preterm.
Method:
We assessed 73 children born < 30 weeks' gestational age whose caregivers completed the BASC-3 and CBCL at age 4. We examined correlations, within-person differences, and agreement in clinical categorization for all corresponding subscales and composites.
Results:
Comparable subscales on the BASC-3 and CBCL were significantly correlated, albeit to differing magnitudes. Subscales indexing hyperactivity and attention problems were the most comparable across the 2 measures, evidenced by strong correlations and few to no differences in mean T-scores. Composite scores indexing internalizing, externalizing, and total problems were also strongly correlated, and there were no differences in the mean T-scores for externalizing or total problems across measures. Agreement in clinical classifications were weak to moderate, though again, the highest agreement was found for hyperactivity, attention, externalizing, and total problems.
Conclusion:
Agreement between BASC-3 and CBCL subscales was weak to moderate, with the exception of subscales related to attention and hyperactivity, as well as composite scores indicating overall behavior problems. Researchers and clinicians should consider these discrepancies when interpreting the results of behavior rating scales with preschool children because conclusions could differ based on the assessment that is used.
