Terrible ones? Assessment of externalizing behaviors in infancy with the Child Behavior Checklist

Background: This study investigated the occurrence, cross-informant agreement, 1-year stability, and context characteristics of externalizing behaviors in 12-month-old children, as compared to 24- and 36-month-olds. Method: In a general population sample of 786 12-month-olds, 720 24-month-olds, and 744 36-month-olds, the CBCL/11/2-5 was obtained from mothers and fathers and again one year later for a subsample of 307 children. Mothers of 1,831 children also provided complete data on child, mother, and family characteristics. Results: Over three-fourths of the externalizing behaviors occurred in more than 10% of 12-month-olds, over one-third of the items in more than 25%. For almost all externalizing behaviors, the occurrence was significantly lower in 12-month-olds compared to 24- and 36-month-old children. Mother-father agreement and 1-year stability of externalizing behaviors in 12-month-old children were significant, but generally somewhat lower than in 24- and 36-month-olds. Context characteristics were related to externalizing behaviors in 12-month-olds as well as in older children. Some associations were less pronounced in 12-month-old children, but the overall pattern of correlates was similar across age groups. Conclusions: The results of this study show that externalizing behaviors in 12-month-old children merit further research and can be assessed with the CBCL in a valid way. © 2006 The Authors Journal compilation © 2006 Association for Child and Adolescent Mental Health

Measurement issues: measures of infant mental health

Background: Emotional and behavioural problems emerging in very young children can represent a challenge to the child and family and warrant early identification and appropriate support or intervention. Diagnostic systems are being developed that allow for specific difficulties to be identified and this review summarises them. The review describes the psychometric properties and potential for use in clinical practice of a range of instruments and methods that are available to identify infant mental health difficulties, and which may be suitable for use in primary care settings, including observations, questionnaires and checklists. Conclusions: While debate continues about whether infant mental health problems can or should be identified, the use of standardised tools may help clinicians to compare observations of infants so that those emerging as atypical can receive additional attention, reflecting a more targeted approach to primary care services (DH 2009; DH 2010)

Reliability and Validity of the Dutch Version of the Brief Infant-Toddler Social and Emotional Assessment (BITSEA)

Background: The Brief Infant-Toddler Social and Emotional Assessment (BITSEA) is a relatively new and short (42-item) questionnaire that measures psychosocial problems in toddlers and consists of a Problem and a Competence scale. In this study the reliability and validity of the Dutch version of the BITSEA were examined for the whole group and for gender and ethnicity subgroups. Methods: Parents of 7140 two-year-old children were invited in the study, of which 3170 (44.4%) parents completed the BITSEA. For evaluation of the score distribution, the presence of floor/ceiling effects was determined. The internal consistency (Cronbach's alpha) was evaluated and in subsamples the test-retest, parent-childcare provider interrater reliability and concurrent validity with regard to the Child Behavioral Checklist (CBCL). Discriminative validity was evaluated by comparing scores of parents that worry and parents that do not worry about their child's development. Results: The BITSEA showed no floor or ceiling effects. Psychometric properties of the BITSEA Problem and Competence scale were respectively: Cronbach's alphas were 0.76 and 0.63. Test-retest correlations were 0.75 and 0.61. Interrater reliability correlations were 0.30 and 0.17. Concurrent validity was as hypothesised. The BITSEA was able to discriminate between parents that worry about their child and parents that do not worry. The psychometric properties of the BITSEA were comparable across gender and ethnic background. Conclusion: The results in this large-scale study of a diverse sample support the reliability and validity of the BITSEA Problem scale. The BITSEA Competence scale needs further study. The performance of the BITSEA appears to be similar in subgroups by gender and ethnic background