Achenbach Child Research Articles

Behaviour of Finnish 3-year-old children. I: Effects of sociodemographic factors, mother's health, and pregnancy outcome.

The aim of this prospective follow-up study was to assess the effects of pre- and perinatal factors on children's behaviour at the age of 3 years. Nulliparous women who attended a maternity health care clinic were invited to participate: 1443 women were included. Data were obtained from the mother, father, and clinic nurse. A Finnish translation of Achenbach's Child Behavior Checklist for Ages 2-3 was completed by 1086 families at the child's 3-year visit to the well-baby clinic. The results were analysed using Pearson's chi2, multivariate regression analysis, and coefficient of determination (100 x r2). A good basic education (i.e. >9 years) of the mother and age over 25 years were associated with low syndrome-scale scores, indicating fewer behavioural problems. Poor health of the mother, a high number of pregnancy-related symptoms, and low Apgar scores for the newborn infant were associated with high syndrome-scale scores. In this population sample, the mother's health during pregnancy together with level of education, and marital status are more important in explaining the variation in a child's behaviour than biological risks during pregnancy.

Behaviour of Finnish 3‐year‐old children. I: Effects of sociodemographic factors, mother's health, and pregnancy outcome

The aim of this prospective follow‐up study was to assess the effects of pre‐ and perinatal factors on children's behaviour at the age of 3 years. Nulliparous women who attended a maternity health care clinic were invited to participate: 1443 women were included. Data were obtained from the mother, father, and clinic nurse. A Finnish translation of Achenbach's Child Behavior Checklist for Ages 2–3 was completed by 1086 families at the child's 3‐year visit to the well‐baby clinic. The results were analysed using Pearson's c 2, multivariate regression analysis, and coefficient of determination (100’r2). A good basic education (i.e. >9 years) of the mother and age over 25 years were associated with low syndrome‐scale scores, indicating fewer behavioural problems. Poor health of the mother, a high number of pregnancy‐related symptoms, and low Apgar scores for the newborn infant were associated with high syndrome‐scale scores. In this population sample, the mother's health during pregnancy together with level of education, and marital status are more important in explaining the variation in a child's behaviour than biological risks during pregnancy.

Behavioral characteristics of 187 young adults with autism.

A survey was conducted on the present behavioral characteristics of 187 cases of adult autism in patients over 18 years of age employing Achenbach's Child Behavior Checklist (CBCL). When their behavioral characteristics were evaluated in relation to Present Language Developmental Level (PLDL) and Present Adaptive Level (PAL), it was seen that greater variation in behavior characteristics was seen among those exhibiting increasingly lower PLDL and PAL scores. Behavior characteristics reminiscent of depression were noted even among those exhibiting high PLDL. Behavior pointing to obsession was found in common among almost all cases of autism irrespective of PLDL or PAL. Psychotic symptoms such as hallucinations and delusions were absent in most cases. The results of the present study were indicative not only of the significance of obsessive behavior in autism, but also its significance in terms of delving further into the psychopathology of the disorder.

Hierarchical confirmatory factor analysis of the Child Behavior Checklist/4–18.

Hierarchical confirmatory factor analysis was used to evaluate the 2-factor 2nd-order structure of T. M. Achenbach's (1991) Child Behavior Checklist in a sample of 577 children who had been identified as having serious emotional disturbance. An alternative 1-factor 2nd-order model also was tested. Results supported T. M. Achenbach's model in which the broadband Internalizing factor was represented by the narrowband Withdrawn, Somatic, and Anxious/Depressed syndromes, and the broadband Externalizing factor was represented by the narrowband Delinquent and Aggressive syndromes. Consistent with T.M. Achenbach's model, the remaining narrowband syndromes (i.e., Social, Thought, Attention) loaded equally on both broadband factors and should not be included in scoring either Internalizing or Externalizing. Fit of the 1-factor model also was good and only slightly poorer than the 2-factor model. Therefore, an overall score would be appropriate as a measure of global problem behavior.

Identification of risk factors for psychological disturbance in adopted children

A postal survey explored the prevalence of emotional and behavioural problems in 97 adopted children using Achenbach's Child Behaviour Checklist. Possible predictors of high problem scores were sought in the pre-placement history and in aspects of the adoptive placement. The adopted children studied had significantly higher problem scores than a non-clinic population. Problem scores were significantly higher in children with a history of pre-placement abuse. Abused children also had significantly more placements prior to adoption and were older at adoption. Racial congruence of adopted family, sex of child and ethnicity did not affect problem scores. Sibling contact was positively associated with high problem scores. The findings have important implications for adoption policy and the management of intractable child abuse and require further more detailed investigation. © 1998 John Wiley & Sons, Ltd.

Identification of risk factors for psychological disturbance in adopted children

A postal survey explored the prevalence of emotional and behavioural problems in 97 adopted children using Achenbach's Child Behaviour Checklist. Possible predictors of high problem scores were sought in the pre-placement history and in aspects of the adoptive placement. The adopted children studied had significantly higher problem scores than a non-clinic population. Problem scores were significantly higher in children with a history of pre-placement abuse. Abused children also had significantly more placements prior to adoption and were older at adoption. Racial congruence of adopted family, sex of child and ethnicity did not affect problem scores. Sibling contact was positively associated with high problem scores. The findings have important implications for adoption policy and the management of intractable child abuse and require further more detailed investigation. © 1998 John Wiley & Sons, Ltd.

Raters' Views of the Problems and Competence of Adolescent Girls

This study had 3 goals: (a) to identify the raters who could find adolescent girls in need of mental health services, (b) to identify the raters who could find adolescent girls eligible for special education services, and (c) to determine the relation between behavior problems and competence for hospitalized and comparison samples of girls. We obtained the ratings of parents, teachers, and youth for 16 girls who had been treated in a psychiatric hospital and 16 girls who had not been treated, for total behavior problems and competence, according to Achenbach's Child Behavior Checklist (1991a), Child Behavior Checklist Teacher Form (1991b), and Youth Self-Report Form (1991c). We found that parents identified their hospitalized daughters as clinically disturbed and in need of mental health services, and that parents of hospitalized girls were the only raters who had any significant agreement with teachers and could contribute to finding girls eligible for special education. We also found, within and across raters of comparison girls, a significant and negative correlation between the constructs of behavior problems and competence, a finding that has implications for treating girls' behavior problems by boosting their academic competence.

Parents and Teachers as Raters of Children's Problem Behaviors

ABSTRACT The present study explores the relationships between parents and teachers as raters of children's behavior using Achenbach and Edelbrock's Child Behavior Checklist (CBCL, 1983) and Teacher Report Form (TRF, 1984). Internalizing and externalizing behavior scores from these two instruments revealed a significant relationship between mothers' and teachers' reports for externalizing behaviors only, consistent with other studies in the literature (Achenbach, McConaughy, & Howell, 1987). When the sample was divided into abusive, distressed, and non-clinical groups, the correlation between mother and teacher on externalizing behavior remained significant for the non-clinical group only. It also may be the case that children with internalizing behaviors are misrated by either parents or teachers, even in the non-clinical group, again pointing to the need for multiple raters. From these results, it appears that familial dysfunction can contribute to rater bias and that both parents and teachers, as well as trained professionals, should be used to rate problematic behavior in children.

Factor structure of child behaviour symptoms in a Swedish sample

The stability of a factor structure of child behaviour problems over different instruments, informants, sources of items, methods of analyses, samples, and countries is of substantial importance. The behavioural and emotional problems of 948 Swedish children were investigated by means of interviews with parents and/or teachers. A factor structure was derived with stability over different samples and methods of analyses and substantial relationships to DSM-III diagnoses. When the structure was compared both for content and empirically with that of Achenbach's Child Behavior Checklist, considerable similarities were found both for broad-band and narrow-band syndromes, strongly supporting the generality of this structure.

Families of children with Prader-Willi syndrome: stress-support and relations to child characteristics.

This study examined stress-support in 42 families of 3 to 18-year-old children with Prader-Willi syndrome. Parents were asked about themselves and their families, their child with Prader-Willi syndrome, family supports, and family stress. Compared to reported stress levels in families of children with mixed etiologies of retardation, parents of children with Prader-Willi syndrome showed higher levels of parent and family problems, and comparable levels of pessimism. Parents of children with Prader-Willi syndrome listed other family members and friends as their main supporters; often such supporters lived outside of the respondent's town or city. Although the child's age, IQ, and degree of obesity were not related to familial stress, families experienced greater stress when the child showed more behavior problems overall, more externalizing and internalizing problems, and more problems on five of the nine narrow-band domains of Achenbach's Child Behavior Checklist.

Children of psychosocial risk-mothers: life events, social interaction, and behaviour problems at the age of 8 years.

The number of stressful life events experienced as measured on the modified Swedish version of Coddington's questionnaire, and the presence of behaviour problems assessed by Achenbach's Child Behavior Check List (CBCL) were studied in 45 eight-year-old children of identified psychosocial risk-mothers. The mothers' social network was estimated using the Swedish version of Undén and Orth-Gomér's Interview Schedule for Social Interaction (ISSI). These mothers had been identified during early pregnancy. A control group of 57 children of the same age and their mothers without the presence of psychosocial risk-criteria was used as reference. The results indicated that the index children had experienced significantly more life events, and displayed significantly more behaviour problems than the reference children. The mothers in the index group had a significantly poorer social network than the mothers in the reference group. The study suggests that children of mothers, identified early on psychosocial risk criteria develop suboptimally. Therefore, early interventions are of great importance.

Intelligence and behaviour in children born after in-vitro fertilization treatment.

This study is the first to examine a large group of children born after in-vitro fertilization (IVF) who were old enough at the time of the investigation to make it possible to draw conclusions about the outcome. The aim of the study was to assess the cognitive, behavioural and social development of the children. The study comprised 99 IVF children, 33-85 months of age, from the University Hospitals of Lund and Malmö, Sweden. The children's development was assessed with the Griffiths' scales of mental development. The children's behaviour was delineated through semi-structured interviews with their mothers, covering 50 different behaviours. The mothers also filled in Achenbach's Child Behaviour Checklist (CBCL). All children were examined by a paediatric neurologist. The results were compared to Swedish population groups. Of the children born, 66% were singletons, 22% were twins, 12% were triplets and 28% were born prematurely in gestational weeks 32-36. The cognitive development of the IVF children was excellent, and their behaviour was normal when compared with two Swedish population groups. Our conclusion was that the development, behaviour and social adaptation of the children was very satisfactory.

MATERNAL WITNESSING VIOLENCE AND BEHAVIOR PROBLEMS IN 24 MONTH CHILDREN.† 78

The relationship between being a victim of domestic violence and maternal report of child behavior problems is well documented. The effects of maternal“witnessing violence” and child behavior, however, has not yet been evaluated. In a sample of 97 inner-city women (75.2% African-American) who are part of a study of the developmental outcome of their children, with and without in utero cocaine exposure, the Exposure to Violence Interview(EVI-measures maternal direct witnessing punching, stabbing, shooting etc.), the Center for Epidemiological Studies Depression Scale (CES-D) and the Achenbach Children's Behavior Checklist (CBCL) for 2-3 year olds, were administered to mothers when their children were 24 months. 10.0% of the mothers had witnessed violence (+WV) in the last 12 months by report on the EVI. Women who were victims of violence were excluded (n=5). The group who witnessed violence did not differ significantly in terms of ethnicity, parity, gender of child, marijuana and cocaine use during pregnancy (self-report and biological markers), number of days they drank alcohol during the pregnancy(self-report), birthweight of child (Z-score), educational level of mother, average daily cigarette use during pregnancy (self-report), or Hobel pre-partum risk score, compared to those who did not witness violence (-WV). They did differ significantly on self-reported alcohol use in the past 30 days prior to delivery of the child (67% +WV were non-drinkers compared to 74%-WV; p=0.003) and maternal age at delivery (23.5 yr. for +WV, 26.2 yr. for -WV, p=0.002). Since these two latter variables were not associated with the outcome variable (CBCL Total score), they were excluded from the analyses. A multivariate analysis, controlling for cocaine use during pregnancy and CES-D, showed a significant relationship between maternal +WV and increased behavior problems (total CBCL increase of 5.8 points with p=0.04) While these findings need to be replicated, violence that mothers are exposed to may affect their parenting practices and/or perceptions of their children's behavior. Intervention programs for high risk families must address witnesses of violence as well as the victims.

The Early Screening Project for Young Children with Behavior Problems

Behavioral problems among preschool-age children have become a priority for early childhood educators. Factors such as the exponential rise in childcare utilization and increasing poverty and incidences of child abuse have made the establishment of procedures for the early identification and remediation of problem behaviors among preschool children imperative. Screening is an initial step in identifying those who exhibit a certain disorder, problem, or disability. The goal of the current research was to study the effectiveness of a functional screening and identification system for behavior problems among preschool children ages 3 to 5 years. This research focused on the development of the Early Screening Project (ESP), a multiple-gated screening system adapted from the Systematic Screening for Behavior Disorders. Data were collected over 32 months, from September 1991 through June 1994. Participants were 2,853 children, ages 3 to 6 years, enrolled in typical and special education preschool and kindergarten classrooms in Oregon, California, Texas, Utah, Kentucky, New Hampshire, Nebraska, and Louisiana. Concurrent validity was assessed by administering the Behar Preschool Behavior Questionnaire, the Conners' Teacher Rating Scale, and Achenbach's Child Behavior Checklist measures. Results demonstrated significant reliability and validity coefficients. The ESP procedure provides reliable, cost-effective, and accurate screening of preschool-age children to facilitate early remediation of behavior problems.

Childhood behavioral precursors of adult symptom dimensions in schizophrenia

The present investigation tested the hypothesis that childhood behavioral problems are differentially associated with clinical symptoms in adult-onset schizophrenia. Parents of 29 schizophrenic patients completed questionnaires concerning (1) the childhood behaviors of all their offspring from birth through 15 years of age, and (2) the symptomatology of their schizophrenic offspring. The childhood behavior scale was a modified version of Achenbach's Child Behavior Checklist (1991). Scores were derived for six childhood behavior problem factors: Withdrawal, Anxiety/Depression, Social Problems, Thought Problems, Attention Problems, and Aggression/Delinquency. Ratings of symptoms were based on parental versions of Andreasen's Scale for the Assessment of Positive Symptoms (SAPS; 1983) and Scale for the Assessment of Negative Symptoms (SANS; 1981). Symptomatology scores were computed from the SANS and SAPS following Malla et al.'s (1993) and Liddle's (1987b) tri-dimensional concept of schizophrenia: Reality Distortion, Psychomotor Poverty and Cognitive Disorganization. Regression analyses were conducted to examine the relation between childhood behavior and adult symptomatology in the schizophrenic patients. The results indicated that the Psychomotor Poverty and Cognitive Disorganization dimensions in adult patients are positively associated with Withdrawn behavior and inversely associated with Anxious/Depressed characteristics in childhood. The results are discussed in light of the distinction between primary and secondary negative symptoms, and the three dimension concept of schizophrenia.

Prevalence of Psychiatric Symptoms and Their Relation to Adjustment among Chinese-American Youth

The primary purpose of this investigation is to assess psychiatric symptoms of Chinese-American children using Achenbach's Child Behavior Checklist (CBCL) and to determine the impact of acculturation on these symptoms. One hundred eighty-one forms of a Chinese CBCL and a 10-item questionnaire on adjustment and ethnic patterns of socialization were completed by a parent or guardian of Chinese-American children attending a Chinese school in New York City. The sample's total problem, internalizing, externalizing, total competence, activities, and social scores were significantly lower than Achenbach's American norms by age and sex. Favorable adjustment was correlated significantly with lower total problem and internalizing scores. Recent immigrants did not have higher symptom scores. Lower scores of the Chinese-American children may be due to temperamental differences, underreporting by the respondent, or cultural intolerance of misbehavior.

Children classified as controlling at age six: Evidence of disorganized representational strategies and aggression at home and at school

AbstractThe purpose of this study was to determine whether children classified as controlling in attachment differ from children classified into the traditional Ainsworth attachment categories in their symbolic representations of attachment and level of behavior problems. Sixty-nine middle-class kindergarten children and their mothers participated in a laboratory separation and reunion. Children enacted doll-play stories about attachment-related themes. A four-group representation classification scheme was developed from the doll-play transcripts of 27 children. Mothers (n = 44) completed Achenbach's Child Behavior Checklist and teachers (n = 40) completed a 30-item inventory of classroom behavior. Results showed significant agreement between the representational system and Main and Cassidy's classification system (1988) for children's reunion behavior. The doll-play of controlling children was characterized by themes of catastrophe and helplessness or by complete inhibition of play and suggested disorganization of representational processes. Controlling children also were described by mothers and teachers as significantly more aggressive than other children. The results validate the distinction between the controlling and traditional classification groups and suggest that controlling children are at risk for behavioral maladaptation at home and at school.

The psychological status of children with cancer.

The psychological and social functioning of a sample of 16 children with cancer was assessed 3-5 years after diagnosis using Achenbach's Child Behavior Checklist. Analysis indicated that 81% of the children were involved in age-appropriate social interactions and the same percentage showed normal behavioral patterns. No significant differences were found due to gender, type of tumor, or behavior over time. The children in this sample appeared to be functioning normally, both psychologically and socially, three to five years after a diagnosis of cancer.

Adolescent Schoolboys in SED Classes: Implications for Child Psychiatry

The primary purpose of this study was to determine basic psychosocial characteristics for adolescent socially and emotionally disturbed (SED) boys. Boys aged 12 to 16 years who were recommended for SED placement were compared with same-aged boys recommended for other educational intervention. The main measures were the Kiddie SADS-E interview and Achenbach's parent Child Behavior Checklist and Teacher Report Form scales. The adolescent SED boys were found to have normal intelligence, high rates of family stressors, predominantly DSM-III externalizing disorders, serious dysfunction according to checklist ratings by both teachers and parents, and little current community mental health intervention. They were significantly different from the comparison group on several variables: lower socioeconomic status, more abuse experience, greater diagnostic comorbidity, higher Axis V clinician ratings, and higher teacher ratings on externalizing scales. Findings are similar to those for other age-gender groups of SED students. One implication is the need for more private child psychiatrists to become involved in the collaborative treatment of this complex and seriously ill group of special education students. Consequently, a second implication is to increase the experience of child psychiatry trainees in dealing with the many consultative needs of SED students and staff.

Epidemiology of behavioural and emotional problems of primary schoolchildren in Greece.

The behavioural and emotional problems and the competencies of non-referred children in Athens were studied by administering Achenbach's Child Behavior Checklist to the parents of 466 children aged 6-11 years. In comparison to other countries, relatively high scores were obtained on both the internalizing (mean 15.1 for boys and 13.3 for girls) and externalizing scales (16.4 and 18.6), and relatively low scores on the competence scales. Cut-offs for the indication of high risk of behavioural problems suggested by USA data were exceeded by 36% of boys and 39% of girls on the total behaviour scale; appropriate cut-offs (90th percentiles) for use in Greece were re-computed for all scales. Parents' responses to individual behaviour items were analysed in relation to the child's age and sex and the family's socio-economic status. Results are discussed in relation to cultural factors.