Measurement invariance of the child behavior checklist in children with autism spectrum disorder with and without intellectual disability: Follow-up study

Abstract

BackgroundChildren with autism spectrum disorder (ASD) have high rates of co-occurring emotional and behavioral problems. The Child Behavior Checklist (CBCL) has been used to assess emotional and behavioral functioning in many large-scale studies of children with ASD. However, the previously established factor model may account for symptom patterns differently in children with concurrent intellectual disability (ID). MethodIn a sample of children with ASD, a multi-group nested confirmatory factor analysis was used to compare participant groups with and without concurrent ID on each of the subscales of the CBCL. ResultsIn almost all of the subscales, children with ASD and concurrent ID exhibit different baseline levels, measurement error, and overall predictive ability on the behavioral and emotional problems of the CBCL than children with ASD alone. In younger children with ASD, configural invariance was present in Emotional Reactivity, Anxious/Depressed, and Somatic Complaints, metric invariance was present in Sleep Problems, residual invariance was present in Withdrawn Behavior, and structural invariance was present in Attention Problems and Aggressive Behavior. In older children with ASD, configural invariance was present in Anxious/Depressed, Somatic Complaints, Social Problems, Thought Problems, Attention Problems, and Rule-Breaking; whereas, metric invariance was present in Withdrawn/Depressed and Aggressive Behavior. ConclusionsIn conclusion, when dealing with intellectually heterogeneous ASD samples, the item-level data of the CBCL should be used, rather than broad subscale-level data. These findings underscore a continued need for development and validation of measures that are appropriate for use in individuals with ASD across ages and intellectual functioning.