The Child Behavior Checklist for Ages 6-18 (CBCL/6-18; Achenbach & Rescorla, 2001) is one component of the multi-rater ASEBA (Achenbach System of Empirically Based Assessment), which measures a broad range of behavioral and emotional problems and is widely used for clinical and research purposes. Within the ASEBA system, multiple forms (i.e., parent-, teacher-, self- ratings; direct observations; interviews) are available for assessment of individuals across age ranges, including preschool (ages 1 ½-5 years); school-age (6-18 years); adults (18-59 years); and older adults (60-90+ years). The CBCL/6-18 is the parent/caregiver-rating form of the ASEBA system for school-age children. In addition to the CBCL/6-18, Teacher Report Forms (TRF) and Youth Self-Report (YSR) are also available for school-agers. The CBCL/6-18, TRF and YSR yield empirically-based syndrome scales: Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Social Problems, Thought Problems, Attention Problems, Rule-Breaking Behavior, and Aggressive Behavior. In addition, several DSM-5 oriented scales can be derived from all three forms. The CBCL/6-18 also yields Competence scores. Scoring is completed using their scoring software, which now includes multicultural norms for all ages. Selection of various norm-groups (i.e., gender) is possible for scoring. ASEBA forms have been translated into more than 100 languages, though not all forms are available in all languages. More information about translated forms can be accessed on the ASEBA website.
Age: 6 to 18 years
Time to Administer: 15-25 minutes
Method of Administration: Individually-administered, norm-referenced parent rating scale of child emotion and behavior; teacher form (TRF) and self-report (YSR) are also available
Yields T-scores (M = 50, SD = 10), percentile ran
Subscales: Composite Scores: Total Competence, Total Problems; Internalizing Problems, Externalizing Problems
Competence Subscale Scores: Activities, Social, School
Syndrome Scale Scores: Anxious/Depressed, Withdrawn/ Depressed, Somatic Complaints, Social Problems, Thought Problems, Attention Problems, Rule-Breaking Behavior, Aggressive Behavior
DSM-oriented Scales: Depressive Problems, Anxiety Problems, Somatic Problems, Attention Deficit, Oppositional Defiant Problems, Conduct Problems
Autism Related Research
The following findings are from autism-related research with the downward extension of this instrument, the CBCL/1 ½-5 (i.e., for preschoolers). In a study of the psychometric properties of the CBCL/1 ½ - 5, this version was found to be a sound and useful way to assess for emotional and behavioral problems in preschoolers with ASD (Pandolfi, Magyar, & Dill, 2009). Rescorla and colleagues’ (2019) recently completed study with the CBCL/1 ½- 5 confirmed other previous research with this version of the CBCL that the Pervasive Developmental Problems scale and the Withdrawn scale differentiated well between children diagnosed with ASD and those not diagnosed. These subscales from CBCL/1 ½-5 have better sensitivity and specificity in identifying young children with autism than the Gilliam Autism Rating Scale (GARS) (Sikora, Hall, Hartley, Gerrard-Morris, & Cagle, 2008).
Magyar & Pandolfi (2017)
Age Range: 6-18 years
Sample Size: 93
Evaluation of reliability and validity of CBCL/6-18’s DSM-oriented scales for assessing depression and anxiety in youth with ASD
Outcome:Magyar & Pandolfi (2017)
The Affective Problems and Anxiety Problems scales each measured a single construct reliably (depressive and anxiety disorders), neither scale measured symptoms of ASD, and youth with a depressive disorder had other emotional/behavioral comorbidities.
Conclusions: Findings demonstrate the DSM-Oriented Affective and Anxiety Problem Scales can be used to screen for depression and anxiety in youth with ASD.
Havdahl, von Tetzchner, Huerta, Lord, & Bishop (2016)
Age Range: 2-13 years
Sample Size: 389
Utility of CBCL profiles in differentiating ASD from other clinical disorders
Outcome:Havdahl, von Tetzchner, Huerta, Lord, & Bishop (2016)
Discriminative validity of CBCL profiles proposed for ASD screening was examined with areas under the curve (AUC) scores, sensitivity, and specificity. The CBCL profiles showed low discriminative accuracy for ASD (AUC 0.59–0.70). Meeting cutoffs proposed for ASD was associated with general emotional/behavioral problems (EBP; mood problems/aggressive behavior), both in children with and without ASD. Cutoff adjustment depending on EBP-level was associated with improved discriminative accuracy for school-age children. However, the rate of false positives remained high in children with clinical levels of EB problems.
Conclusion: use of the CBCL profiles for ASD-specific screening would likely result in a large number of misclassifications. Although taking EBP-level into account was associated with improved discriminative accuracy for ASD, acceptable specificity could only be achieved for school-age children with below clinical levels of EBP.
Hoffman, Weber, Konig, Becker, & Kamp-Becker (2016)
Age Range: 4-18 years
Sample Size: 1800
Examination of symptom profiles and usefulness of CBCL for screening in ASD
Outcome:Hoffman, Weber, Konig, Becker, & Kamp-Becker (2016)
Children and adolescents with ASD showed a high prevalence of behavior problems, which was even higher in cases of comorbid ASD + ADHD. However, the sensitivity and specificity of the CBCL syndrome scales were low.
Conclusions: Although the CBCL is not a suitable screening instrument for the identification of ASD, high scores on the syndrome scales Social problems, Withdrawn, Thought problems, and Attention problems might be an indication for further and differential diagnostic procedures. The CBCL is useful to evaluate co-occurring behavior problems in ASD but should be only one component of an assessment.
Pandolfi, Magyar, & Dill (2012)
Age Range: 6-18 years
Sample Size: 122
Psychometric properties of CBCL/6-18 in ASD sample
Outcome:Pandolfi, Magyar, & Dill (2012)
Confirmatory factor analysis supported the unidimensionality of the CBCL’s syndrome scales and its internalizing-externalizing factor structure. Significance tests indicated that many scales discriminated between two subgroups: ASD + emotional/behavioral disorders versus ASD alone. Diagnostic accuracy analyses indicated that the CBCL had good sensitivity but low specificity for detecting co-occurring disorders.
Conclusions: results supported the use of the CBCL in conjunction with other clinical data when assessing for EBD in youth with ASD.
Mazefsky, Anderson, Conner, & Minshew (2010)
Age Range: 8-18 years
Sample Size: 175
Identify patterns of elevations in school-age children with high-functioning autism
Outcome:Mazefsky, Anderson, Conner, & Minshew (2010)
Scores on the DBCL Thought and Social Problems scales significantly differentiated children with ASD from controls. In two independent ASD samples within the study, the same pattern of elevation emerged, with mean scores > 2SDs for Social, Thought, and Attention Problems. The Withdrawn/Depressed scale was elevated to at least the borderline clinical range for half of the ASD symptoms.
Conclusion: this pattern of elevations is consistent with prior studies of the CBCL in ASD samples; when such profiles are seen, follow-up assessment to rule-out ASD may be warranted.