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PubMed2003

Child Stress Disorders Checklist: a measure of ASD and PTSD in children.

OBJECTIVE: To assess the psychometric properties of the Child Stress Disorders Checklist (CSDC), a 36-item observer-report instrument that measures acute stress and posttraumatic symptoms in children. METHOD: The CSDC was administered to parents of 43 children with acute burns and 41 children who had experienced a traffic crash. This instrument was also administered to the burned children's primary nurse to estimate interrater reliability. The CSDC was completed again by parents of burned children, 2 days and 3 months later. Convergent validity was determined by correlating scores on the CSDC with scores on instruments of known validity for assessing posttraumatic stress disorder (PTSD) in children. Concurrent validity was determined through an examination of the relationship between CSDC scores and an index of trauma severity (percentage of body surface area burned). Discriminant validity was assessed by administering the Child Behavior Checklist (CBCL): it was hypothesized that PTSD symptoms would be more closely related to the PTSD scale of the CBCL than the Thought Problems scale of the CBCL. RESULTS: The CSDC has reliable and valid psychometric properties. CONCLUSIONS: The CSDC, an observer-report instrument of ASD and PTSD in children, has important utility in clinical and research settings.

Accidents, Traffic↗
PubMed1985

A checklist system for critical review of medical literature.

In order to teach critical review of medical literature, an approach was devised in a family practice residency setting for teaching students and doctors to review medical literature quickly while remaining critical of what is read. This is done through the use of a simple checklist which guides the user in reading an article. Such a checklist is readily modified to suit individual needs, is self-explanatory, and lends itself to use in journal club settings as well as in private reading.

Education, Medical, Continuing↗
PubMed1991

A 15-item checklist for screening mentally retarded males for the fragile X syndrome.

A 15-item checklist, including physical and behavioral features frequently observed in fragile X syndrome, was used in a prospective study of 188 mentally retarded males in order to identify males at risk for this syndrome. Of the 188 males, 19 were found to have the fragile X syndrome, while the remaining 169 males had no recognizable cause of their mental retardation, including normal chromosomes. Significant differences (p less than 0.01) were found between mentally retarded males with and without the fragile X syndrome with increased hyperactivity; shorter attention span; more tactile defensiveness, hand-flapping, perseverative speech, and hyperextensibility; large ears and testes; higher frequency of simian creases or Sydney lines and plantar creases; and more positive family histories of mental retardation in the fragile X syndrome males. Multiple regression and discriminant analyses of the 188 males indicated several physical features were useful predictors for inclusion in the fragile X syndrome group. An overall correct classification rate of 93% was achieved based on 6 variables (plantar crease, simian crease, hyperflexibility, large testes, large ears, and a positive family history of mental retardation) that were entered into the discriminant equation. Therefore, our experience with a 15-item checklist suggests the potential of screening for the fragile X syndrome in mentally retarded males and that 6 of the 15 variables were particularly good predictors of this syndrome.

Adolescent↗
PubMed1996

Use of an occupational therapy motor performance checklist by a school health service: a pilot study.

OBJECTIVE: The aim of this pilot study was to assess whether the School Health Service could play a role in identifying the children in most need of community occupational therapy services. METHODOLOGY: A two-tiered referral system, which incorporated a Motor Performance Checklist (MPC) devised by the authors, was used. This checklist consisted of 12 gross and fine motor items and was administered to 123 children in their first year of school. Comparison was made between parent/teacher referrals alone and the two-tiered referral system as measured against a 'gold standard' test (the Bruininks-Oseretsky Test of Motor Proficiency) in a smaller subgroup. RESULTS: Results indicated that the two-tiered referral system incorporating the MPC had a sensitivity of 75% and specificity of 95% while the teacher/parent referrals had a sensitivity of 88% but a low specificity of only 41%. There was no significant difference in sensitivity (z = 0, P > 0.05) but a highly significant difference in specificity (z = 3.56, P < 0.005) between these two systems. CONCLUSIONS: This two-tiered referral system has the potential to impact significantly on paediatric occupational therapy utilization, service delivery and waiting times in the community health setting.

Child, Preschool↗
PubMed1996

Child Behaviour Checklist classification of behaviour disorder.

OBJECTIVE: The aim of this study was to determine the applicability of the published clinical cut-off scores of the Child Behaviour Checklist (CBCL) for the classification of behaviour disorders. METHODOLOGY: Child Behaviour Checklists were obtained for 1342 subjects newly referred to the six major mental health centres in Melbourne. The normative community sample of 1002 7-, 12- and 15-year-olds was drawn from a school-based asthma prevalence study. RESULTS: The mean total problem T-score for the children referred to mental health centres was 67 and was above the clinical range for all age groups. Using referral to psychiatric services as the gold standard, the sensitivity and specificity of the CBCL using a cut-off of > or = 60, was 77.4 and 83.2%, respectively. This compares favourably with the sensitivity of 68% and specificity of 82% for the American sample. Using a cut-off score of > or = 63, the sensitivity was 70.5% and the specificity was 88.6%. The referred and community samples differed with respect to socio-economic status, family structure and mothers' level of education. Fifty-two per cent of the clinically referred children lived with both parents, compared with 89% of the community sample. CONCLUSIONS: While there are some limitations to this study in terms of both the clinic and community sample, support is provided for the usefulness and applicability of the recommended CBCL cut-off scores in an Australian population.

Adolescent↗
PubMed1994

Development of a type 2 diabetes symptom checklist: a measure of symptom severity.

The aim of the present study was to develop a Type 2 diabetes symptom checklist for use in clinical and epidemiological research, which can measure differences in symptom severity between patients and detect changes over time within patients. Face and content validity of items and dimension structure were based on literature and experiences of diabetologists. Two Likert scales were used to measure symptom frequency and perceived burden. Reliability, responsiveness and validity were studied in 185 Type 2 diabetic patients. Factor-analysis confirmed the predesigned dimension structure with 34 items, distributed over 6 dimensions. The internal consistency with Cronbach alpha coefficients between 0.76 and 0.95 and test-retest reliability with Pearson product-moment correlation coefficients between 0.79 and 0.94 were satisfactory. The ability to detect change over time (responsiveness) was estimated in stable subjects, using sample size calculations. A minimal detectable mean change of 0.07-0.58 points in total score on the 10-point scale within a group of 100 subjects suggests an impressive responsiveness. Significant differences in symptom severity score were found between patients with different co-morbidity status and treatment modes, indicating satisfactory construct validity of the dimension structure. The Type 2 Diabetes Symptom Checklist was found to be a useful diabetes-specific symptom severity assessment method for clinical and epidemiological studies.

Aged↗
PubMed1990

An exploratory use of the Symptoms Checklist-90 in a mixed geriatric study group.

There are currently no self-rating scales of general psychopathology in the older population. Such scales can be used to screen patients who may then be referred on for psychiatric assessment. The validity of the Symptoms Checklist-90 (SCL-90), a self-rating scale of general psychopathology widely used in the nongeriatric adult population, was explored in 44 older subjects. It was compared with the Sandoz Clinical Assessment Geriatric (SCAG) scale and a measure of functional disability, the London Psychogeriatric Rating Scale (LPRS). Caregivers to all subjects also rated the degree of difficulty experienced with their care on a four-point scale. Thirty of the subjects attended a geriatric day hospital, and the remaining 14 were waiting to go into long-term care facilities. Symptoms Checklist-90 was not significantly different between the two groups of subjects (day hospital and preinstitutional) after Bonferroni corrections, though SCAG scale and LPRS were (P less than .01 for both). Although SCL-90 was correlated significantly with the SCAG scale (r = .46), it was not significantly correlated with the LPRS. It showed good internal consistency but poor face validity and an inability to differentiate between levels of difficulty for the caregiver. It is concluded that the use of SCL-90 in older people may be limited because of the lack of sensitivity to functional disability and care difficulty. This nevertheless needs to be further explored, perhaps with some modification of the scale for older people.

Activities of Daily Living↗
PubMed1988

Use of the Child Behavior Checklist in an Israeli adolescent psychiatric unit.

This article deals with the Hebrew version of an instrument for the diagnosis of psychopathology in young adolescents: the Child Behavior Checklist and the associated Child Behavior Profile developed by Achenbach (1978). We report on a study of the reliability and validity of the checklist and its suitability for use with severely disturbed adolescents in Israel. Parents of 130 adolescents, 89 healthy and 41 sick, participated in the research. The scales were found to be valid in that two-thirds of the items were correctly assigned by clinicians in Israel to their respective scales; it is internally consistent as measured by the Cronbach coefficient; and it is reliable in distinguishing between patient and control groups. Scores for control adolescents in Israel were found to be very similar to norms in the United States, the Netherlands and Chile. This finding may have important implications for cross-cultural research.

Adolescent↗
PubMed1999

The Child Behavior Checklist (CBCL) and related material: standardization and validation in Danish population based and clinically based samples.

The Child Behavior Checklist (CBCL) and related material, developed by Achenbach and Edelbrock in Vermont, was validated in a mailed survey. A population based sample of 779 children between the age of four and 17 years was compared to a sample of 146 children referred for child psychiatric service. Danish children scored very much like our Scandinavian and German neighbours, but low compared to most others. The CBCL mean 'total behavior problem score' in the population was 17.7. The checklists, especially the parent and teacher versions, provided good construct validity. Youths generally reported more emotional problem behavior than their parents and teachers did about them. In general, parents and youths agree more, reporting emotional problems, and parents and teachers agree more, when scattering externalizing behavior. Short screening constructs are introduced, and by the use of latent trait analysis, four clinically relevant sub-scales were generated. Predictive value, sensitivity, specificity and clinical validity must be undertaken in a future two-phase study.

Adolescent↗
PubMed1985

A psychometric assessment of Hare's checklist for psychopathy on an English prison population.

The research scale for psychopathy developed by Hare (1980) represents an important recent advance in the assessment of this disorder in that it emphasizes objectivity and reliability. This study compares the factor structure of the scale derived from an English prison sample with the original Canadian sample in order to assess the cross-cultural generalizability of the checklist and reassess the factorial basis of the scale. Results from the first analysis indicate substantial correspondence between psychopathy factors derived from English and Canadian analyses. Results of a second analysis suggest that four main clusters of traits (emotional detachment, superficial relationships, egocentricity, and impulsivity) are centrally important in the identification of psychopathy. Results of further psychometric analyses suggest increasing the scale's validity by deleting several items having little in common with the main features of psychopathy. It is concluded that Hare's checklist is both applicable to an English population and internally valid, and that future research may usefully investigate correlates of each of the four psychopathy factors.

Adult↗
PubMed1993

Using the child behaviour checklist in ordinary primary schools.

The study considers the application of the Child Behaviour Checklist (Achenbach & Edelbrock, 1986) to the identification of children with emotional and behavioural difficulties in ordinary primary schools. Teachers provided checklist data on a sample of 320 boys and 118 girls previously referred to the schools psychological services and a further 183 boys and 39 girls who had not been referred. There was a high level of agreement between referred and non-referred student status and subsequent classification using the CBCL criteria for psychiatric disturbance. An analysis of variance was carried out to determine how far teacher expectations may contribute to CBCL scores. The results indicated that teacher differences within schools are more important than the differences which exist between teachers working in different schools. The results support the validity of the CBCL. The future application of the CBCL in ordinary schools is discussed.

Aggression↗
PubMed1995

A checklist to help students analyze published articles in basic medical sciences.

Because critical analysis of published information is an essential component of scientific life, it is important that students be trained in its practice. Undergraduate students who are more accustomed to reading textbooks and taking lecture notes find it difficult to appreciate primary publications. To help such students, we have developed a checklist that helps them analyze different components of a research article in basic biomedical sciences. Students used the checklist to analyze critically a published article. The students were assigned an article and asked to write a paper (maximum 2 pages of single-spaced type) assessing it. This assignment has been found useful to both undergraduate and graduate students in pharmacology and physiology. Student responses to a questionnaire were highly favorable; students thought the exercise provided them with some of the essential skills for life-long learning.

Education, Medical, Undergraduate↗
PubMed1999

Problems reported by parents of children in multiple cultures: the Child Behavior Checklist syndrome constructs.

OBJECTIVE: The purpose of this study was to compare syndromes of parent-reported problems for children in 12 cultures. METHOD: Child Behavior Checklists were analyzed for 13,697 children and adolescents, ages 6 through 17 years, from general population samples in Australia, Belgium, China, Germany, Greece, Israel, Jamaica, the Netherlands, Puerto Rico, Sweden, Thailand, and the United States. RESULTS: Comparisons of nine cultures for subjects ages 6 through 17 gave medium effect sizes for cross-cultural variations in withdrawn and social problems and small effect sizes for somatic complaints, anxious/depressed, thought problems, attention problems, delinquent behavior, and aggressive behavior. Scores of Puerto Rican subjects were the highest, whereas Swedish subjects had the lowest scores on almost all syndromes. With great cross-cultural consistency, girls obtained higher scores than boys on somatic complaints and anxious/depressed but lower scores on attention problems, delinquent behavior, and aggressive behavior. Although remarkably consistent across cultures, the developmental trends differed according to syndrome. Comparison of the 12 cultures across ages 6 through 11 supported these results. CONCLUSIONS: Empirically based assessment in terms of Child Behavior Checklist syndromes permits comparisons of problems reported for children from diverse cultures.

Adolescent↗
PubMed2003

Item-by-item factor analysis of the Yale-Brown Obsessive Compulsive Scale Symptom Checklist.

Clinical subtypes of obsessive-compulsive disorder may have differing pathophysiological mechanisms and treatment outcomes. The subtypes identified by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Symptom Checklist, clustered by clinical consensus, have never been subject to statistical validation. A factor analysis using a sample of 160 patients with OCD was conducted to determine whether factor analytically derived categories are identical to extant clinically determined categories. Our analysis revealed that the contamination subtype of the Y-BOCS Symptom Checklist contains two distinct subgroups: one relating to discomfort and the other to fear of harm. If replicated on a larger scale, the finding of new subtype groupings would have important implications for future research in obsessive-compulsive disorder.

Adolescent↗
PubMed1985

Use of a child behavior checklist in the psychosocial assessment of children with epilepsy.

Children with epilepsy are faced with many of the same psychosocial stressors as other chronically ill children, and a proper assessment is vital. The purpose of this study was to determine whether the Child Behavior Checklist of Achenbach and Edelbrock could be used as a practical and objective tool for evaluating the psychosocial needs of children with epilepsy. Thirty-eight children were randomly selected from the Neurology outpatient clinic at the Children's Hospital of Eastern Ontario. Questionnaires were completed by the mothers during their waiting period. Results demonstrated the highest risk of maladjustment was within social functioning. As children reach adolescence, adjustment problems are mostly related to school. Although as a group, our sample did not differ from norms for behavior problems, there was evidence to suggest behavioral maladjustment for individual children. The checklist appears to be a good screening tool for maladjustment that could be included as part of the pediatrician's comprehensive assessment of children with epilepsy.

Adolescent↗
PubMed2003

Measuring community mental health in developing societies: evaluation of a checklist format in Nepal.

BACKGROUND: There is growing recognition of the importance of mental health problems in developing countries. In large part, however, we have very limited epidemiological data at national and/or community levels about the prevalence of mental illnesses. AIMS: The purpose of this paper is to describe the reliability and validity characteristics of an assessment tool that may be useful for conducting community-level surveys (particularly in rural communities of developing countries) to obtain prevalence rates of mental illnesses. METHODS: We used a sample of adults residing in a rural village in Nepal to assess disorders with a modified version of the DSM-III-R Checklist. We evaluated construct validity, scale reliability, convergent validity and discriminant validity. RESULTS: There is strong evidence for the construct validity of generalized anxiety and depression in our sample. By contrast, the symptoms associated with mania and schizophrenia were not empirically distinct. Convergent validity is acceptable. As a test of validity characteristics, the pattern of sociodemographic correlations suggests that the specific social origins of disorder in Nepal will require further investigation. CONCLUSION: The first step in obtaining high quality information on the distribution of mental illness in developing countries is to establish some reliable and valid indicators of disorder. The checklist format for assessing disorder appears to meet this objective and offers the possibility that community-level prevalence studies can be reasonably conducted.

Adolescent↗
PubMedDate not supplied

Diabetes quality assurance checklist: assessment of inter-rater and intra-rater reliability.

The Diabetes Quality Assurance (DQA) Checklist was developed to measure adherence to standards of diabetes care. Two raters simultaneously scored a convenience sample of 23 charts of patients with diabetes. These raters scored each chart again 5-7 weeks later. Data obtained were used to assess inter-rater and intra-rater reliability. Inter-rater reliability was estimated for basic assessment at Time 1 (r = 0.94, 95% CI 0.86-0.97) and at Time 2 (r = 0.91, 95% CI 0.81-0.96); and for high-risk assessment at Time 1 (r = 0.88, 95% CI 0.73-0.95). Intra-rater reliability for the basic assessment was estimated for Reviewer 1 (r = 0.84, 95% CI 0.65-0.93) and for Reviewer 2 (r = 0.75, 95% CI 0.49-0.89); the high-risk estimate for Review 1 was 0.60 (95% CI 0.25-0.81) and for Reviewer 2 0.97 (95% CI 0.94-0.99). The DQA Checklist is useful for monitoring and assessing diabetes care.

Diabetes Mellitus↗
PubMed1999

A method for measuring interrater agreement on checklists.

A method for measuring interrater agreement on checklists is presented. This technique does not assign individual scores to raters, but computes a single agreement score from the concordance of their check mark configurations. An overall coefficient of agreement, called phi, is derived. The agreement coefficient that is expected by chance and the statistical significance of phi are determined by statistical simulation. Despite the dichotomous nature of the checklist agreement (raters either agree or disagree on items), we show that the binomial distribution does not provide a means for testing the statistical significance of phi. A medical education study is used to illustrate the phi methodology.

Education, Medical, Undergraduate↗