Topic 13: Assessments for Child Behaviors and Depression {by 7/16}

Post your responses to the Assessment Review Reflection Questions (Likes/Strengths, Dislikes/Weaknesses, Clinical Utility) for the following assessments: (1) Child Behavior Checklist (CBCL): Youth, Caregiver, Teacher and (2) Children Depression Inventory-2 (CDI-2).

 

Your original post should be posted by 7/16.  Post your two replies no later than 7/18.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

35 Comments (+add yours?)

  1. Althea Hermitt- Mcpherson
    Jul 11, 2020 @ 03:14:18

    Strength/ Weakness: Child Behavior Checklist (CBCL): Caregiver.
    This checklist is an observer report assessment and is used to detect children’s social competence, emotional, and behavioral problems. This checklist is used with children 6-18yrs old. This is the Caregiver or parent component of a 3 parts checklist and needs to be filled out by a parent or caregiver. It assesses emotional and behavioral problems within the last 6 months. The revised version is made up of 8 syndrome scales which include anxious/depressed, somatic complaints, social problems, thoughts problems, withdrawn/depressed, attention problems, rule-breaking behavior, and aggressive behaviors. This checklist is available for translation in 60 languages. The CBCL checklist focuses on behaviors that are specific to the child’s home environment for example sleep and disobedience. The assessment uses separate normed scores for boys and girls and it also takes into consideration norms of different age groups. The CBCL includes 93 similar items as the TFR assessment. The first half of the instrument focuses on social competence and then the last half of the test focuses on any behavioral or emotional problem observed by the caregiver.

    Dislikes/Weakness: It’s very long and will take a significant amount of time to complete with 113 questions. The checklist doesn’t offer a diagnosis and therefore clinical interview is necessary to figure out methods of treatment. The scale requires training to interpret.

    Clinical Utility: This assessment has high reliability and validity across many languages and cultural contexts. The result is represented on graphs and touches on all domains so easy comparisons can be made to ascertain areas of need or problem areas.

    Child Behavior Checklist: Youth Self Report (YSR)
    Strength/ Weakness: The checklist is a self-report instrument, for school-age children 11-18. It assesses students’ emotional and behavioral problems. This YSR checklist consists of 14 items that evaluate socially desirable characteristics. The assessment questions are open-ended. This assessment is sensitive to changes throughout therapy. It provides DSM -5 diagnostic information. There are 3 more scales so it provides a cross-section of information from parents and teachers as well. The assessment uses separate normed scores for boys and girls and it also takes into consideration norms of different age groups.

    Dislikes/ Weakness: It consists of 112 questions which is very long. The first 2 pages of questions ask the youth to make comparisons with others in their age range; this information might not be accurate. The scale requires training to interpret. There is potential for bias when filling out the scale.

    Clinical Utility: The assessment has strong criterion-related validity and also tests retest reliability and internal consistency. The result is represented on graphs and touches on all domains so easy comparisons can be made to ascertain areas of need or problem areas.

    Likes Strengths Teacher Checklist (TFR): The TFR is well researched and widely used. This checklist is an observer report assessment and is used to detect children’s social competence, emotional, and behavioral problems. The TRF checklist tries to focus on behaviors that are specific to the child school environment. Another strength is that it also provides information on a child’s strengths. This assessment consists of over 90 similar items to the parent checklist which aids in comparison. Teachers are asked to give information about how long they know the child, how much time they spend in their class, and how well they know the child. Teachers are also asked about the child’s adaptive functioning which includes their dedication to school, behavioral appropriateness in school, ability to learn, and happiness. This assessment is used for children 6-18yrs old. It assesses emotional and behavioral problems within the last two months due to the need for periodic reassessments. The results are broken down into internalizing and externalizing behaviors and are detailed and computer-generated. It uses a 3 point likert scale which gives variation in responses. The assessment uses separate normed scores for boys and girls and it also takes into consideration norms of different age groups.

    Weaknesses/ Dislikes: A major weakness is that the interpretation could be confusing especially for people who don’t know what a t-score or percentile ranking is. Therefore scores might need to be interpreted. This assessment has a total of 113 questions plus two pages of information at the beginning of the assessment which is very lengthy.

    Clinical Utility: The assessment has strong criterion-related validity and also tests retest reliability and internal consistency. The scoring sheet makes it easy for a clinician to interpret the scores as the clinical norm and the t scores are represented in the graphs. Scores are detailed and well organized. In order to administer and interpret the TFR training is required.

    Children Depression Inventory-2 (CDI-2).
    Strengths/ Likes: The CDI-2 assessment is well established as it was first developed in 1979 based on the adult Beck depression Inventory and has been revised in 2010. The CDI-2 scale assesses the severity of cognitive, affective, and behavioral signs of depression. The assessment is well rounded and focuses on 4 subscales of depression which include negative mood/physical symptoms, negative self-esteem, interpersonal problem, and ineffectiveness. It’s a self-report assessment that assesses the key symptoms of depression over the past two weeks. It can also be used to monitor treatment effectiveness. The assessment consists of only 28 questions and is used for children between 7 and 17yrs old. This assessment will take 10-15 minutes to complete. One of the major strengths is that the assessment has multiple rater forms which include a teacher and parent observer report assessment. This scale is also available in Spanish and translated into 23 languages.

    Dislikes/ Weakness: One weakness is that children may give desired answers instead of their real emotional state. Some children may also have difficulty expressing or verbalizing their emotions. Individuals can, therefore, fake the score. This assessment may fail to detect mild depressive symptoms.

    Clinical Utility: The scale is short but hard to interpret. He requires training to interpret the scores. It has high reliability and validity. The scale is easy to score but might be confusing.

    Reply

    • Madi
      Jul 14, 2020 @ 16:10:51

      Hi Althea,
      I thought you showed a good understanding of both of these assessments. While the CBC assessment is on the lengthy side I think its length come from the multiple domains that it looks at. For the CDI-2 I agree with your strengths and I thought your weaknesses for the assessment showed a great deal of insight. I thought it was a very good point you made that some children might try to give the answers that the child thinks are expected of him or her.

      Reply

    • Francesca DePergola
      Jul 14, 2020 @ 21:38:30

      Hi Althea,

      In both of your answers about the two assessments, you offer a very thorough review of each, especially with the CBCL. This is great because I have learned a few things I had not known before reading your post. I missed mentioning the aspect of the first assessment that included distinguishers for boys and girls and their respective age groups. I agreed with you about the length aspect of this assessment. Although it is assessing a lot, it might be overwhelming for kids to take. So, that is an important thing to mention when considering using this instrument.

      Regarding the CDI-2, I did not realize that this was based on the BAI which was very interesting to find out but made sense I presume. I agree with you that the observer reports are great for this assessment as it might be harder for children to realize they are symptomatic. Additionally, the aspect of children being unable to express or verbalize their emotions as a weakness was not a thought of mine at first, but seems to be probable!

      Reply

    • Casey Cosky
      Jul 18, 2020 @ 13:57:49

      Hi Althea,
      I agree with you on all of the weaknesses for the Child Behavior Checklist. While having as much information as possible is definitely useful, it’s harder to interpret than the other assessments we have learned about, which makes it more complicated to use. It also has a lot of questions, which could cause the person taking the assessment to lose focus or speed through it without making sure the responses are entirely accurate. I noticed you included many more strengths than weaknesses, though. Aside from the few setbacks that cause it to be more complicated and difficult, it definitely is a strong assessment with many positive aspects to it.

      Reply

  2. Francesca DePergola
    Jul 13, 2020 @ 13:20:29

    (Likes/Strengths, Dislikes/Weaknesses, Clinical Utility)
    (1) Child Behavior Checklist (CBCL): Youth, Caregiver, Teacher
    The Child Behavior Checklist is great in that it provides almost the same assessment for the youth being assessed, their parent or caregiver assessing them, and then their teacher assessing them. This assessment covers all aspects by focusing on a wide range of issues that could be occurring in the child. It looks specifically at competence, syndrome, whether the child is internalizing, externalizing total and other problems, etc. This assessment can give a holistic view of what the child may be experiencing which is important when something is concerning at such young ages.

    Although this assessment seems daunting and can be for those who are younger, I do not know if it’s a limitation because all aspects of the questions are crucial to be answered. I think the format could look a little more pleasing and it might be difficult for those with attention deficit problems to complete this assessment. Other than that, I think this assessment can be very valuable.

    There is a lot of clinical utility with this assessment. The reliability and validity are high which is a great starting off point. I think it is important to note that this assessment comes in 60 languages, so the fact that this can be used cross-culturally is very important as well. The profiles seem to go to great lengths to show an idea of the problematic areas but will need further interpretation of course.

    (2) Children Depression Inventory-2 (CDI-2).
    The Children Depression Inventory-2 is another great assessment that is widely used to help clinicians decide whether further assessment and observation need to be met to diagnosis a child with depression. This assessment is another assessment that gives a general idea of depression as It focuses on four subscales: negative mood/physical symptoms, negative self-esteem, interpersonal problems, and ineffectiveness. Another strength of this assessment is that it is not just a self-report. Parents and teachers can take this as observers of the child’s cognitive, affective, and behavioral related issues possibly due to depression. This assessment is very similar to that of the CBCL because it has a self-report and observer report, reliability and validity are high, it comes in many languages, and both are widely used and accepted.

    I think this assessment’s weakness is its length. There are depression scales out there that are much shorter, but for adults. I think a depression scale for children should be just as short, or somewhat shorter than this assessment at 28 items.

    This assessment has clinical utility as this seems easy to administer and score. Scoring looks a little difficult, but once practicing how this is scored, I am sure it will come easier. This assessment is great in that it has high reliability and validity too.

    Reply

    • Madi
      Jul 14, 2020 @ 16:05:14

      Hi Francesca,
      Regarding the CBCL I agree with all of your points. I liked how you focused on the holistic approach of this assessment. I find that to be a very key aspect for an assessment. You want an assessment to look at the whole client not just a part of the client. Regarding the CDI-2, I liked how you commented about how the assessment is not just a self-report. I’m not sure if I agree with you about length. I thought it was a decent length. I think the wording of the questions makes the length reasonable.

      Reply

    • Althea Hermitt- Mcpherson
      Jul 14, 2020 @ 20:39:46

      Hi Francesca, I agree with you that the CBI-2 is a great assessment that is used to help clinicians decide whether further assessment and observation are needed for a diagnosis for depression. It can also be used to monitor treatment effectiveness. It is also from a well-established instrument. I also liked that the scale is accompanied by an observer component especially when it requires a diagnosis and potentially medication for children. This ensures that the information is somewhat corroborated. Your point about the scale being too long for children is on point,t I totally agree. I really like these two assessments as they give outsider insight which is often important so clinicians can get a better understanding of the problem.

      Reply

    • Haley Scola
      Jul 16, 2020 @ 19:46:29

      Hi Francesca,

      For the CBCL I agree with your point that it provides several aspects of a wide range of issues the child could have. I love how you described it as “holistic”. I completely agree and stated that in my post as well but in different words. Seeing the child, parent, and teacher’s perspectives are so important in understanding in depth because since the client is a child, they may not be able to communicate their thoughts and feelings as well as an adult client could. I also made reference to the attention-deficit disorders and completely agree with you. I didn’t notice how high the reliability and validity were until I read your post so that is definitely a huge pro. For the CDI-2 I also pointed out the length as a weakness. I think that it may be difficult to get a child to take a test more than 10 questions about their emotions and cognition’s. I think you did a really good job at summarizing this assessment and thought it was insightful of you to point out the specific scales they measured.

      Reply

    • Casey Cosky
      Jul 18, 2020 @ 14:05:47

      Hi Francesca,
      I appreciate you highlighting the importance of the Child Behavior Checklist being available in 60 languages. It’s a very strong assessment that covers a lot of information so it’s good that it’s so accessible to so many people. In regards to the Children Depression Inventory-2, I agree with you that it’s a strong assessment due to the fact that it’s not just a self-report. I really loved that teachers and parents were able to fill it out too because they both see the child often enough but in different settings. Knowing how a child acts at home vs in an academic setting vs how they reflect on their own thoughts and behaviors can really cover a lot of information.

      Reply

  3. Yen Pham
    Jul 14, 2020 @ 12:32:54

    1. Child Behavior Checklist (CBCL): Youth, Caregiver, Teacher

    Likes (or Strengths)
    There is some strength of The Child Behavior Checklist (CBCL). The CBCL is a common tool for assessing depression in children, as well as other emotional and behavioral problems. It is used in a variety of settings such as pediatricians’ offices, schools, mental health facilities, private practices, hospitals, and research. In addition, the CBCL has high utility due to its rapid coverage of a wide range of problems in various settings, the inclusion of scales to assess adaptive functioning, recently published cross cultural normative data, and its extensive use in the research literature. The CBCL’s instruction is clear and has multiple options for each item.Finally, there are easily two ways to administer the CBCL: self-administration and interview. The parent or guardian may answer the questions by him/her or may have the assistance of an interviewer in going through the questions of the test. This test usually lasts between 15 minutes and under an hour.

    In particular, the CBCL/6-18 with 113 items is completed by parents or surrogates; the TRF/6-18 with 113 items is completed by teachers and other school staff; and the YSR/11-18 with 112 items is completed by youths. The CBCL/6-18 helps parents to rate items that describe specific behavioral and emotional problems of their children. The TRF/6-18 helps the teachers to rate the child’s academic performance and adaptive functioning, the appropriateness of the child’s behavior, how much the child is learning, how hard the child is working, and how happy the child appears. I am interested that this assessment includes 93 items in common with the CBCL/6-18; the remaining items concern school behaviors. Finally, the YSR/11-18 is the self-report, it can be completed by youths with 5th-grade reading skills, or it can be administered orally. Youths rate themselves on both problem behaviors and socially desirable qualities.

    Dislikes (or Weaknesses)
    It will be long for some people and the scoring and interpretation of results are not simple. A trained counselor is essential. Beside, several problem behavior items in the CBCL system include blanks for respondents to provide specific examples. When interpreting scores, it is important to ensure that the respondent has accurately understood the items. Finally, labels for the CBCL sub-scales may be misleading. For example, the Aggressive Behavior subscale describes oppositional and defiant behaviors, with few items describing aggression. Scores on the Thought Problems subscale can be affected by various cognitive problems, and scores are not equivalent to a thought disorder. Such problems underscore the need to review a scale’s items to ascertain what they really measure.

    Clinical Utility
    The target population of this assessment is wide. It includes children and adolescents ages 6-18, and/or or parents or teachers of the child/adolescent being assessed. It also has high reliability and validity. Besides, three forms of CBCL allow you to obtain information about problematic behavior in school-age children from parents, teachers, and, in the case of older children, the youths themselves. Each of the three forms provides raw scores, T scores, and percentiles. All norms are based on a U.S. national sample, and all forms have parallel internalizing, externalizing, and total problems scales. All of that information is good for a clinical utility because it provides a clinician to understand a background of clients. In turns, it will help to diagnose and provide a treatment.

    2. Children Depression Inventory-2 (CDI-2)

    Likes (or Strengths)
    CDI- 2 is self-report with 28-item assessment which takes between 5 and 15 minutes for the child to complete. The CDI-2 is designed to detect symptoms of depression and to distinguish between depression and other psychiatric disorders. It can also be used as an instrument to monitor changes in depression symptoms over time. The CDI is popular in part because it is easy to administer and score. A child with age-appropriate reading abilities can complete the scale relatively quickly.

    Dislikes (or Weaknesses)
    Only a professional trained on the properties of the CDI-2 can accurately interpret the results. A raw score on the test is essentially meaningless without a professional’s interpretation. Besides, like other self-report assessments used in children, the CDI-2 is vulnerable to certain limitations. For example, because children don’t have the same sophistication as adults related to understanding and reporting their emotions, their responses may not reflect their true emotional state. Finally, children may be more likely than adults to attempt to give what they believe to be the desired answers rather than answers that represent their true feelings.

    Clinical Utility
    The target population is from ages 7 to 17. The CDI-2 has excellent psychometric properties, which means that it measures depression in children accurately and reliably when used properly. In addition, the CDI-2 is good at detecting the presence of depressive symptoms, but it is not the best at determining their severity. Milder symptoms may respond well to support and self-care, while more moderate to severe symptoms may require other treatments such as medications or psychotherapy.

    Reply

  4. Madi
    Jul 14, 2020 @ 16:00:39

    1. Child Behavior Checklist(CBCL): Youth, Caregiver, Teacher
    a. I found this assessment very aesthetically pleasing. The assessment was something that we have not seen before. It was a combination of fill in the blank and Likert. There have been a lot of Likert scale assessments, but I find this combination very important. The questions are a mix of obvious and ambiguous, which is a large strength. I think the limitation comes from the fact that children are more likely to be annoyed by having to take a test and fake the answers so they can be done with it. I find that there is a lot of clinical utility with this assessment, which comes from the cross-cultural aspect and the fact that it examines many possible problems.
    2. Children Depression Inventory-2 (CDI-2)
    a. The number of questions was a good amount. I also though the wording for the questions was excellent. It is made for children, so the questions were definitely geared toward children. I also thought it was good that it wasn’t a typical Likert scale and that the sentences were written out for each option. This set up would make it easier for a child to take the assessment. I thought the scoring page was well laid out and easy to follow. I thought the last two pages were confusing and not necessarily clear. Maybe someone who is better trained would not be confused by this. There is also of clinical utility because the assessment looks at multiple domains assessing multiple aspects of a child’s well-being.

    Reply

    • Althea Hermitt- Mcpherson
      Jul 14, 2020 @ 19:56:51

      Hi Madi, I like your observation about the CBCL checklist using both the likert scale and filing in the blank, as I overlooked that information in my review. I agree that the combination is special and very necessary. I, however, didn’t like that the filling the blank information took up two whole pages this just made the checklist longer. I think it was very smart of them to not add the number of these fill in the blank question to the total number of items in the assessment as this would seem super lengthy to anyone. I also agree with you that the clinical utility is a strength of this checklist. Children are sometimes impatient and perhaps over 20% of children completing this assessment may just want to get it over with and therefore doesn’t spend enough time answering correctly. I have personally done the caregiver checklist for a student in my care and I was really annoyed about the length and had to complete it in portions to avoid just checking off an answer to be done with the assessment.

      Reply

    • Francesca DePergola
      Jul 14, 2020 @ 20:44:34

      Hey Madi,

      Your answer to the CBCL was interesting because I thought this assessment was oddly organized and might be hard for children to follow, but I see where you are going. Additionally, since this assessment is widely used, I doubt it is hard for children to follow since if it were they probably would have changed it by now. I thought that this assessment had a good combination of Likert and fill in the blank answers that I found as a strength as well. I think your point about the fact that children might become annoyed by having to take the test is valid. I find that because of the length it might be a little hard for them to pay close attention to each question.

      I like all the points you mentioned about the CDI-2. I especially agree with you that the last two pages were confusing, but with the experience, I am sure there is less confusion. I think it was good that it was not a typical Likert scale either, because I think this could help a child when they take this. Great points Madi!

      Reply

    • Haley Scola
      Jul 16, 2020 @ 19:52:31

      Hi Madi,
      I agree that the use of both fill in the blank and the likert scale were very beneficial to this assessment. The use of both allowed for a wide variety of information which is extremely helpful for the therapeutic process. I didn’t think about the point that children can easily fake the answers just to finish it so it was very insightful you pointed that out. For the CDI-2 I disagreed with you and said that the number of questions may be too much for a child. I also disagreed in the last two pages being difficult because found the scoring to be easier that a lot but i did think there was a lack of what the interpretations meant. Great job summarizing!

      Reply

    • Christopher LePage
      Jul 16, 2020 @ 21:44:30

      Hi Madi, I liked how you mentioned how you liked the formatting of the CBCL, as it was one of my favorite parts about the assessment. While this assessment is rather lengthy, I think by changing up the formatting on the individual it keeps the assessment feeling fresh and new in a way. I know if I was a child going through this assessment, and if it were just using Likert scales I would get fidgety and try to fly through it. However, since it does mix up the questions and the style of answering them I think it is extremely beneficial to both parties, since it could help the child keep focus and answer the questions as honestly as they can. For the CDI-2, I also enjoyed the way the questions were phrased and the fact they did not just use a Likert scale. By posing these questions this way, I do believe that it is more “kid friendly” and much easier for a child to go through and comprehend.

      Reply

  5. Haley Scola
    Jul 16, 2020 @ 19:37:40

    (1) Child Behavior Checklist (CBCL): Youth, Caregiver, Teacher

    Something I loved about this assessment was that the child, parent, and teacher all complete a form. This provides the clinician with crucial information from all three important perspectives. For example, the child may be acting up at home but the teacher reports the child is acting perfectly fine. This gives insight to the clinician that the problem source is home life and further therapy can help explore that possibility. I also thought the assessment items covered a wide variety of information or possible issues the child could be having or experiencing. This is very beneficial to the therapeutic process because it gives the clinician a full picture of the child.
    A weakness I noticed was the length. This is due to the fact that if a child is filling this assessment out, the chances there is an ongoing problem is high. ADHD or ADD could be the possible reasons for the ongoing issue at hand so because of the length, a child with one of these disorders may be incapable of completing this or may need several sessions in order to complete it. I do think that that may also be beneficial to the clinician’s insight because they can physically see the child struggling and be able to conduct further analysis. Another weakness was the difficulty in scoring and interpretation. I found myself confused trying to figure out how to score it completely which is a huge downfall.
    I think this assessment has immense clinical utility due to the fact it gives the clinician three vital perspectives of the child’s life and the item’s cover a variety of thoughts and feelings the child may be experiencing. This assessment can provide the clinician with the full picture which helps in determining the correct diagnosis and treatment plan. This assessment is also provided in numerous languages which allows for it to be culturally utilized.

    (2) Children Depression Inventory-2 (CDI-2).

    A huge strength of this assessment is its clarity and easiness to administer and score. I thought that this assessment was extremely insightful in the item’s as well because it covered the important aspects of the diagnostic criteria of depression. The second strength was the wording of the items. The statements were easy to read for a child and easy to understand. They were straight to the point which is extremely helpful in administering this to a child.
    Something I thought was a weakness was length.
    This assessment is for children to self-report so I think 28 questions could have been narrowed down. Although, I do think all the information was vital so it may be a win-lose. I also think that although it’s easy to score, the interpretations aren’t detailed enough. I think there needs to be more information provided for this to be an excellent assessment.
    I think this assessment has nice clinical utility. It’s not my all-time favorite depression inventory we’ve seen but I think it gets the job done. It was clear which is a huge pro but it didn’t give a lot of information in regards to what the scores mean exactly. I would probably use this in the future if I couldn’t find another assessment I liked more.

    Reply

    • Christopher LePage
      Jul 16, 2020 @ 21:38:55

      Hi Haley, it is a really interesting point that you brought up about assessing the child while they are taking this test. This could be very beneficial because it does allow clinicians to be able to visually see how a child handles a lengthy task. This could also be difficult for a child with anxiety, because they may feel that they are taking too long for the assessment and may rush through it; however, I do agree with you on the fact that a child with ADD would not handle an assessment at this length very well.

      Reply

    • Selene Anaya
      Jul 17, 2020 @ 20:28:55

      Hey Haley!

      I agree with you about loving that the CBCL has forms for children, parents, and teachers. I think it is super important that the checklist allows clinicians to obtain information from all of these perspectives. I mentioned it in my post too, but having this information from each perspective can give clinicians insight into where certain behaviors are occurring and where they are not, which can further impact our treatment plan and where we are assessing and addressing the issue at hand. I think any assessment that allows for the opportunity to gain a holistic view of the patient is beneficial because every situation and environment is so complex, something can be missed if we just look at one. I did have concerns about the length, but I think the fact that the assessment is constructed in a manner that allows the child to fill out the answers instead of choosing can be helpful. I do like that you considered the length or the fill-in-the-blank questions being an issue for some children, and these are the situations where an assessment can become a collaborative tool that can be completed together. As for your opinions about the CDI-2, I completely agree with you. I think the assessment is worded appropriately for children to understand and asks a lot of important questions that can be helpful for the clinician. I also thought there could have been more detail to the interpretations. Overall, I think as a depression inventory for children, it is a pretty strong assessment.

      Reply

    • Michelle McClure
      Jul 20, 2020 @ 20:08:41

      Hi Haley! I really liked how you talked about how the Child Behavior Checklist includes information from 3 sources; the parent, the teacher and the child. The three perspectives as you mentioned means that the clinician is getting information on the child from unbias as well as bias sources and as well as from the child themselves. You have a point that a possible weakness of the assessment is the length of the child form. A child may have a hard time focusing and answering all the items, especially if that child has a possible attention disorder. The Child Depression Inventory-2 is also a little long for a child attention span that already has an attention disorder.

      Reply

  6. Trey Powers
    Jul 16, 2020 @ 20:59:34

    Child Behavior Checklist (CBCL): Youth, Caregiver, Teacher
    Likes/Strengths
    This assessment examines a number of elements within a child’s life. An extensive list of symptoms and behaviors is presented for the youth, caregiver, and teacher for each to rate the truth of each statement. This list is nearly identical for all three individuals being assessed. In addition to this list, there are also a number of questions that provide supplemental information for the clinician. It would seem as though this one assessment is capable of creating a telling picture of what the child is experiencing, and specific areas in which they are either struggling or acting out in that can then be addressed in appropriate ways.
    Dislikes/Weaknesses
    This assessment is quite long, and requires three separate individuals in order to fully complete. Although the assessment is tapping three different resources for data, there is still the possibility for self-report bias. Additionally, the results are presented in a way that would likely be confusing for a layperson to interpret, and would likely require an extensive explanation on the part of the clinician in order to gain an accurate understanding of what each graph represents, as well as how severe the symptoms are.
    Clinical Utility
    Overall, this assessment is a comprehensive overview of a variety of elements of a child’s life. It takes into consideration inner thoughts/experiences, social roles, and academic and pleasure activities, as well as other symptoms, both physical and psychological. This assessment clearly has the potential to reveal a great deal about a child’s mental state, and can reveal a great deal to parents and teachers, provided the results are explained properly by the clinician.

    Children Depression Inventory-2 (CDI-2)
    Likes/Strengths
    This assessment begins with very clear instructions that are clearly geared for children. They include bold faced font for distinguishing important elements to pay attention to, an example of how to mark each box, and a sample item that encourages kids to practice with before the test. The statements within the test range from a positive to neutral to negative statement, which allows some freedom of response. The statements are also short and easily understandable. The instructions for scoring are detailed, and include boxes with large equation symbols that make it obvious as to where scores should go, and how to add them together. Results are also broken down into males vs females. Within each gender category, the scores are separated into four subcategories indicating the elevation of symptoms, and six subcategories indicating domain. As a result, it is easy to understand what each score means.
    Dislikes/Weaknesses
    To a certain extent, the scales used for each item appear too simple. Having only three possible levels to choose from seems somewhat limiting. In addition, some items do not contain a truly neutral statement, but rather one that is phrased slightly negatively rather than completely negatively. Some items also do not have an option for choosing N/A, such as the item asking about worrying about aches and pains.
    Clinical Utility
    It is important for assessments specifically designed for children to be simple enough that they are understood by the child, while also being effective at assessing their mood and symptoms. Overall, this assessment meets both criteria. I can easily see this assessment being used in either schools or other clinical settings when assessing children suspected of experiencing depression.

    Reply

    • Selene Anaya
      Jul 17, 2020 @ 20:55:03

      Hey Trey!
      I also thought one of the biggest strengths of this assessment was the amount of information that can be gathered from it. I mentioned it in my other posts, but obtaining other perspectives can be super helpful for clinicians when assessing the issue as well as making the treatment plan itself because there are so many different aspects that are looked at. I like how you put it into words that the assessment is capable of creating a telling picture of what the child is experiencing because this is so true. The child could exhibit one behavior in one situation and not the other, and this assessment can provide us with that information. I did not catch that all three forms must be completed in order to be done, but that would make sense! This could cause difficulties especially for some children who don’t have just one teacher or if this assessment is being used when school is not in session. I also thought it was interesting that you mentioned the self-report bias because I could totally see a child answering the questions with their egocentric thinking. I also think interpretation for this assessment could be a little confusing. For the CDI-2, I also thought the instructions were extremely clear and are perfect for the population the test would be given to. I am curious what you thought about the subcategories, I thought it was very helpful that it was included. I thought your comment about there not being a neutral statement was interesting. I didn’t think about this at first and thought there was a pretty good balance, but now I can see what you mean about that. I also didn’t catch an N/A option for physiological symptoms that may not be experienced by every child. Overall, I also think it is a good tool to use when the child is suspected of experiencing depression.

      Reply

  7. Christopher LePage
    Jul 16, 2020 @ 21:35:11

    1.) The biggest strength of the CBCL, is that it covers almost all aspects of a child’s life. By having this wide net, you are getting a better understanding of the child. This can also be helpful as clinicians, because as we discussed in class this could give us opportunities to “mirror” the child. For instance, lets say the child listed football as a sport they like to take part in. For me, this would be where I would start the session because, especially with younger kids, going into a session can be daunting. By striking up a relatable conversation, this could help them feel more comfortable.

    The biggest dislike I have for this assessment is how time-consuming it is. Especially for a younger client they may not have the patience to sit there and fill out certain sections that they may deem tedious. Another dislike that I have for the assessment, is that there are questions that I would assume majority of kids would not answer honestly. For example, the questions about drinking alcohol without your parents knowing or cutting class. Without any prior meeting to the clinician, the child may be nervous as to how you are going to react to these things and may not tell the truth. Also, since the questions are the same for the other demographics, it is most likely that the parent does not know fully what is going on. More specifically with the internalizing thoughts. Often times, kids hide stuff about them from their parents all the time so by asking these questions it is most likely not going to be helpful to you. However, since this assessment does cover such a wide range of the child’s life it does carry with it significant clinical utility. By covering all these different topics you are allowing yourself to get the most background information out of your client.

    2.) With the CDI-2, what I liked most about the assessment was that the questions are clearly designed for kids. This makes it much easier for them to understand the questions, and allows for more accurate response. I also liked that this assessment has clear face and content validity. The child taking this assessment is going to know what you are looking for, and with the content validity we know that it is going to measure what it is supposed to.

    As far as dislikes there is not much that I dislike about this assessment. One thing that I would suggest is to lower the number of questions as this may be overwhelming for kids (maybe make it one page). The interpretation of the results also seemed confusing at first glance, as well as time consuming. With clinical utility this assessment is very kid-friendly and the administration of this test is simple, which means it can be used in a variety of locations.

    Reply

    • Dawn Seiple
      Jul 17, 2020 @ 12:06:32

      Hi Chris,

      I really like the point you made about using the CBCL to identify a child’s interests for the purpose of making a therapeutic connection with them. Almost like a personality inventory, this assessment can be used for mirroring purposes. It can be difficult to make a child feel comfortable and open to talking. By starting with a personal interest of theirs, you can immediately connect with a child on a very safe and comfortable topic. In this post and in your others, I find you do a good job of envisioning the actual therapy dynamic. You think about the potential future challenges and how you can overcome them. This is a great skill.

      I also agree that the CBCL is long. The topics are intense and a child could easily tire of thinking about them and responding. As with any self-report, there is a definite risk that an individual will not be completely truthful. This does seem more likely for a child who may be trying to keep different activities a secret from their parents. However, this checklist is widely used and is considered reliable and valid, so it must be that children provide enough honest information to make it useful. Having parents and teachers also provide information on the same topics can give clinicians insight into how honest a child is being. Having 3 different sources of data for this and the CDI-2 is so helpful.

      Reply

    • Trey Powers
      Jul 18, 2020 @ 17:53:14

      Hey Chris!

      I totally agree with you about the way kids might respond to certain questions. They may not understand the concept of confidentiality, and think that other people will be allowed to see what they answered. They might also think that what they say could get them in trouble, so they may chose to answer dishonestly, especially with the more serious items. At the end of the day, this is the problem with self-report data. There is always the chance that people will either recall incorrectly, or intentionally answer dishonestly. Unfortunately, the other ways of obtaining information are far more time consuming and costly, so we just have to settle for self-assessment in many cases.

      Reply

    • Michelle McClure
      Jul 20, 2020 @ 19:47:15

      Hi Chris! I really liked the children Depression Inventory as well. I thought the child friendly way that the assessment explains itself was really well done. The questions are easy for a child to understand and to answer which is important for an assessment that is meant for a child. The child behavior checklist really does do a good job at covering all areas of a child’s life. I really liked how you mentioned that you can use the results of the assessment to build rapport with the child based on the child’s self reported interests.

      Reply

  8. Dawn Seiple
    Jul 16, 2020 @ 21:45:02

    Child Behavior Checklist (CBCL): Youth, Caregiver, Teacher

    Likes (or Strengths)-These questionnaires cover all aspects of a child’s life. By utilizing multiple raters, clinicians get a more comprehensive view of what is happening for a child. Especially when assessing young children, it seems very important to get input from parents and teachers. I like that a clinician can compare the input from each source. Whether the information provided is similar or different, a clinician can learn a lot. If all the sources are in agreement, that clearly tells one story. If any of the sources significantly differ from the others, this can be very revealing in a different way. For instance, if a parent is not aware of the behaviors and feelings of their child, this could be important to learn. If a child has no difficulty in school, only at home, this would be helpful to know. I like that the checklists ask about the child’s general information related to interests, friends, family and school performance, but then present more than 100 statements related to specific problematic behaviors or feelings and ask if those are not true, somewhat true or very often true. It’s important that certain statements are highlighted as critical items. These statements contain some pretty disturbing behaviors and need to be addressed as soon as possible. There is the possibility that a child could display a critically disturbing behavior, but that it gets lost in the summarized data because it is a more isolated issue.

    Dislikes (or Weaknesses) – The scoring for the Competence section feels too subjective and less reliable. For instance, the parent form asks the parent to compare their child’s performance in their hobbies or their chores against the performance of their peers. Then, the clinician needs to use that information to score the child’s competence. There are just too many factors involved to use that information to rate a child psychologically. The Syndrome scales ask for ratings on difficult, negative, statements. Parents may be familiar enough with their child’s behaviors and feelings but may have a harder time answering honestly.

    Clinical Utility (e.g., scoring, interpretation, population, assessment and treatment) While these checklists may not be too difficult to score, training would be required to interpret the findings. Though the results are displayed visually, they are pretty complex- utilizing T scores, percentiles, and classifications of clinical and borderline clinical ranges. It would be difficult to share data with parents in this format. These checklists provide a great deal of data about a child and seemingly should reveal any significant areas of concern. With 3 different raters, at least one is likely to share instances of problematic behavior or feelings. The information is consolidated into more specific categories such as “aggressive behavior” or “anxious/depressed” and this allows the clinician to better understand all the child’s issues and target their treatment accordingly.

    Children Depression Inventory-2 (CDI-2)

    Likes (or Strengths)-In general, I think this is a very useful assessment. The statements are direct and easy to read for most children in the targeted age group. They are appropriately adapted to reflect depression in children, rather than adults. The entire inventory includes a self-report, a teacher report and a parent report. By combining the data from each, these tools provide a lot of information on the presence and nature of any depressive symptoms in a given child. Even though there are multiple scales, the self-report we reviewed is easy to administer, score, and interpret. The instructions for the child and for the scorer are very clear. It has good validity and reliability. I like that it has been time-tested over many years.

    Dislikes (or Weaknesses) – I did not find much to dislike about this assessment. I do believe it may be a little too juvenile for more mature teens, 16-17, and could be a little long for children who are 7-8. They may be better candidates for the shorter form.

    Clinical Utility (e.g., scoring, interpretation, population, assessment and treatment)
    Because the authors did such a good job constructing this assessment, it has excellent clinical utility. It is clear, organized, and reliable. It identifies depressive symptoms in children and provides additional data about the nature of those symptoms. The more specific breakdown into sub-scales helps clinicians be more targeted in their assessments and treatment plans.

    Reply

    • Brigitte Manseau
      Jul 18, 2020 @ 23:56:18

      Hi Dawn,
      I, too, found that a strength of the CBCL was that it provides a lot of information from various sources (e.g. the child, their caregiver, and their teacher). It allows the clinician to gain a thorough understanding of the child’s depressive symptoms. I liked that you suggested that there should be a shorter form for children ages seven and eight. I agree that the youth assessment seems far too long for children nine years old and under. Before the child starts the assessment that is over 110 questions long, they must also fill out over seven sections related to his or her demographics, hobbies, extracurricular activities, interpersonal relationships, and school performance. The assessment overall seems long and possibly overwhelming for younger children.

      Reply

  9. Selene Anaya
    Jul 16, 2020 @ 21:45:19

    1. Child Behavior Checklist (CBCL): Youth, Caregiver, Teacher

    The Child Behavior Checklist is very interesting! For starters, I really like how there are three forms, as all three perspectives and opinions are very important to obtain a holistic view on child behavior, especially in different settings. With this information, we can find similarities that exist across all environments and perspectives, and we can also see if there are certain behaviors that are present in one environment, and that area can be further assessed for more information about what may be causing the behavior. The Caregiver form contains a lot of great information, and I think another strength of the assessment could be to see how well the caregiver knows his/her child. This could also be seen as a weakness, especially if caregivers cannot provide children or the community in which they live don’t offer sports or opportunities for growth in other activities. Another possible weakness for the caregiver report could be bias and denying that his/her child doesn’t play well with other children and behaves. There is a possibility for subjectivity in that it is up to the caregiver’s opinion about what is bad because I know some parents who could just see that behavior as “what children do” and not something that could be a cause for concern. To balance these biased opinions, that is one area where it is great that there is another perspective by the teacher. Aside from hoping that all forms are filled out truthfully, the teacher’s perspective can offer a less biased opinion. I think this form could be more helpful for children in 5th grade and younger, just because I know in Jr. High, (at least from my experience) children are moving from teacher to teacher and may only have a teacher once a day. However, there are usually homeroom teachers, and those are the teachers that would probably be best to give the checklist to. I really like the youth form of the CBCL and I think it can provide clinicians with some really important information. It is always good to have the client’s perspective and the fact that there is a form that is for children that they can fill out is a strength itself. There are a few items on the last page of the youth form that I am a bit wary of, but I’m sure there is good reasoning behind that given that it is a widely used assessment. Going back to clinical utility, I think the interpretation of all three assessments can be strong and provide clinicians with really helpful information.

    2. Children Depression Inventory – 2 (CDI-2)

    It is clear this assessment is widely used and can be helpful for clinicians to examine the next steps that should be taken with the client in terms of depression. The directions at the beginning of this assessment are very straightforward and I think it is perfect given that it is for children. The scores assess emotional problems and functional problems, and simply having those two categories can show visually which area needs more focus when developing the treatment plan. I also really like the profile and how it gives both T-scores and percentiles that the client falls into after obtaining the total score in each category as well as for each subscale as well. This can help interpretation and put where the client falls in certain areas into perspective. I am a bit confused about the organization of the scoring sheet, but once I broke it down it was easy to understand and score both the total score as well as the total number for emotional problems and functional problems. For clinical utility, I think it is a great assessment to give children to assess the scale of depression because it is easy to understand and assesses a variety of different symptoms and experiences. It is a well-rounded assessment and will also provide clinicians with a lot of useful information that can be used to direct treatment plans and areas of focus. I would like to see other assessments that are used to measure depression in children!

    Reply

    • Yen Pham
      Jul 17, 2020 @ 11:00:43

      Hi Selene,
      I appreciate your insight into the CBCL assessment, like you, I like the wide range of this scale as it provides us with lots of information about children from three areas: parents, teachers she and the children themselves. It is a good idea for an counselor to have as much as information which is possible about the client. In turn, it helps the counselor in the diagnosis and treatment. Besides, I also like this scale because of its high validity and high reliability. It is available in 60 different languages, including my Vietnamese language too. I am so excited so I found an study of Dang, Nguyen, and Weiss, 2017. This study was to assess the validity of Vietnamese versions of the Child Behavior Checklist (CBCL), and the Strengths and Difficulties Questionnaire (SDQ) in Vietnam. The authors found that Internal consistency was in the fair to excellent range for all CBCL scales (.76-.96) and for the SDQ Total Problems scale (.81); SDQ subscale internal consistency was in the poor to fair range (.31-.73). There is good support for the reliability and validity of the Vietnamese version of the CBCL, and for the SDQ Total Problems scale (Dang, et al., 2017). Finally, I think the CBCL can be used in a variety of settings such as pediatricians’ offices, schools, mental health facilities, private practices, hospitals, and research.
      I also like you explanation on the weakness of the CBCL, you note that the caregivers report could be bias and denying that his/her child. They just see that behavior as “what children do” and not something that could be a cause for concern. I agree with you that some caregivers or parents they have no comprehensive way to look at the problems of their children are facing, for example when they see a child not attending school and failing on the exams. They only scold and blame their children for not studying hard instead of finding out why their children did not get good grades. With a superficial perspective, they will report bias on the child’s behavior. In addition, I think the CBCL is weak when it is not an overly positive measure. It doesn’t measure strengths in the child, just deficiencies. The items designed to detect social desirability sets or lying were not added. Although this desire to maintain face validity is quite important, it is my opinion that there is a greater need to avoid the situation where the scale is perceived as vulnerable to raters’ potential impulses and deceptions, a condition that is very important, for example, in research involving juvenile offenders who might be motivated to minimize their problems.

      Reply

    • Dawn Seiple
      Jul 17, 2020 @ 13:10:03

      Hi Selene,

      I think you make some insightful comments on the CBCL. You mention that the caregivers’ answers can be helpful in more than one way. First, what they know and share about their child can inform a clinician, but also, what they don’t seem to know can also be helpful. If they don’t know enough about what is happening with their child, this could indicate that they are not very involved. They might not be involved because of other commitments like long job hours or other children, or simply because they are unavailable because of their own psychological issues. This would be helpful for a clinician to know. You also mention that a clinician could learn whether or not there are opportunities for a child to be involved. For me, this is one area that could be culturally or socio-economically biased. Some parents have to work a lot of hours and may not have the financial resources for their child to be involved in sports or activities. It would be important to understand why a child might not be active and competent in extracurriculars. I also made note of the fact that some parts of the caregiver report might not yield the best information as it is their subjective opinion. You make a good point that the teacher may have a more balanced and informed view of the child, especially in relation to other children their age. This does get more difficult as children begin to move from teacher to teacher in the older grades, but in small schools, the teacher may still know the child well. You note that by utilizing input from the child, the teacher and the parent, you get a more holistic view of the child and this is very valuable.

      Reply

    • Brigitte Manseau
      Jul 18, 2020 @ 23:59:35

      Hi Selene,
      I, too, found that the clear directions provided for the CDI-2 was a strength. I liked that the instructions included how the child should mark his or her answer and that there was an example that the child could practice marking. It is clear that the assessment was created by professionals who know what works well for children. I was not a fan of the scoring sheet as well at first glance. The unaesthetic nature of the scoring sheet instantly reminded me of the Anger Disorders Scale—Short form. I also like that the assessment may be used by a variety of health professionals (e.g. school psychologists, pediatric doctors, child psychiatrists, child therapists).

      Reply

  10. Casey Cosky
    Jul 16, 2020 @ 23:43:58

    Child Behavior Checklist (CBCL): Youth, Caregiver, Teacher

    This assessment is very detailed and can cover a significant amount of information at once. It is also visually appealing, organized, and easy to understand. There are scales as well as open-ended questions. The opportunity to list favorite sports, hobbies, etc makes the assessment a little bit more personal than other ones we have learned about. The assessment also includes questions that involve comparing the child to others their age. It’s a smart balance between a personalized understanding of the individual and a comparison to see where they “should” be.

    A child may not have the attention span to fill this entire assessment out accurately. There are multiple pages of questions, which can be come tedious. When a child is stuck doing something tedious that they no longer want to do, there is a chance they will lie or answer the questions without thinking about them enough first. Another weakness was the difficulty in scoring. I personally struggled trying to interpret the scores, and it’s possible that many others may have a difficult time with it as well.

    This assessment is very useful because it examines the child from three different angles. The child is able to express their own thoughts and behaviors and then they are also evaluated by two other people who see them in different settings/circumstances regularly. There is also a very wide range of symptoms that are covered in this assessment, which can be a great tool in examining possible needs for treatment.

    Children Depression Inventory-2 (CDI-2)

    Normally a self-report for children is risky because they may not understand the directions clearly. I really like how they provided a clear example at the top of the first page to briefly explain what the form does, show the child how to do it and also ease their minds a little bit. Many different symptoms of depression were also covered, which can provide the clinician with more accurate information to create the best treatment plan.

    Depending on the child, there is still a chance that this 28 item assessment may be too long for them to want to put time into thoroughly completing. The questions are relatively brief to answer, though, so it shouldn’t be too much of a problem. Providing the child with only three options to answer with may help them not get so overwhelmed but it also might not be enough to get accurate responses. While administrating the assessment seems relatively simple, I was confused by the scoring and interpretation. Overall, this is an assessment that is important because it allows the child to contribute and answer from their own point of view. It’s also important in general to be able to notice signs of depression in a child so they can be treated sooner.

    Reply

    • Yen Pham
      Jul 17, 2020 @ 11:28:27

      Hi Casey,
      I agree you that the CBCL assessment is very detailed and can cover a significant amount of information at once. The content of some item is so insightful and engaging that it is a good opportunity for children to show their personalities in a number of issues such as sports and hobbies. I also agree with that the scoring is not simple. We know that even though the directions for hand scoring the CBCL are included in the manual, but hand scoring is highly tedious and most examiners make at least one or two minor errors on every protocol. It is easy to misreport items because they do not transfer in sequence to the profile form and sometimes load on more than one scale. Moreover, the Internalizing and Externalizing composites are not a simple total of their respective syndromes. Hoover I think that the CBCL has another strength such as the sitting is so wide. It can be used in a variety of settings such as pediatricians’ offices, schools, mental health facilities, private practices, hospitals, and research with 60 different languages. Many researchers found that the CBCL is high validity and reliability. Finally the useful information we receive about a child from three different sources: the family, the teacher and the child themselves will help the clinical utility when it is the beginning to assess the competencies and problems of children and adolescents.

      Reply

    • Trey Powers
      Jul 18, 2020 @ 17:58:00

      Hey Casey!

      I agree with much of what you had to say about the CDI-2. It seems like it was designed by individuals who really understand kids, as it seems to be perfectly suited for them in terms of the instructions and the simplicity of the assessment overall. I also had the thought that only three possible responses might be limiting. While it is necessary to not overwhelm kids by having an excessive number of options, at the same time, you need to get an accurate clinical picture in order to properly diagnose and treat them. It seems like there is a fine line here between the two, and hopefully it has not led to many false negatives.

      Reply

  11. Michelle McClure
    Jul 20, 2020 @ 18:28:40

    1. Child Behavior Checklist

    Strengths- The child behavior checklist is very detailed and the parent form I think especially gives a good indication of how well parents know their child. I thought the items were really good indicators of a child’s activities. I also like how the child form asks about the child’s relationships with friends, parents, and siblings. I also like how it asks the child about how they are doing academically and if they have any concerns or problems about school. I like how the teachers form provides more unbiased information about the child’s activities and school performance. I think all three forms contained really informative items and especially if you put them together would give any clinician some great insight into the child. I also found the assessment to be visually pleasing and well organized as well as following a logical progress through the items. The profile is in depth and contains really good information on the child and where the scores for the child fall in a range.
    Weaknesses- I was really impressed with this assessment I do not really see any weaknesses in the assessment itself but more if the child does not answer honestly or if the parent does not provide as much accurate information, but even in those cases that still gives the clinician important information about the child, so that’s not really a weakness. The scoring is also a little confusing
    Clinical Utility- This assessment has diverse clinical utility and can be used in a variety of clinical settings. This assessment has use in schools, school counselors offices as well as in inpatient and outpatient clinical settings. This assessment would also be useful in family counseling.
    2. Children Depression Inventory-2
    Strengths- I really like how this assessment starts out explaining itself in a child friendly way. I like how this assessment tells the child in a very non intimidating way how to answer and that there are no right or wrong answers. I feel like this assessment tries to put the child at ease from the start which may help the child feel more comfortable answering the items honestly, which is important. I think the items are worded in a child friendly way and are easy for a child to understand. I like how the assessment measures multiple areas of negative thinking including negative mood, negative self-esteem, emotional problems and functional problems, interpersonal problems, and ineffectiveness.
    Weaknesses- I really like this assessment but the scoring is a little confusing at first.
    Clinical utility- This is a really good assessment to use in schools, in doctor offices, and in inpatient and outpatient clinical settings. I can see this assessment being used by an in home therapist in family therapy.

    Reply

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

Adam M. Volungis, PhD, LMHC

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Join 59 other followers

%d bloggers like this: