Caregiver Form Printable For Ages 1.5-5 Scoring In King
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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
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FAQ
Response format 3-point Likert scale (0 = “Absent”, 1 = “Occurs sometimes”, 2 = “Occurs often”). Strengths: The CBCL is a valid and reliable measure which is sensitive to change in short interventions.
The CBCL form is self-explanatory and includes biographical and general functioning questions as well as 113 statements that are rated as not true ( score 0), somewhat/sometimes true (score 1), or very true/often true (score 2).
'Clinically significant' elevations are indicated by T-scores ≥ 64 on the broadband scales, and ≥ 70 on the syndrome scales. 'Borderline' elevations range from 60–63 and 65–69 on the broadband and syndrome scales, respectively.
There are two "broadband" scales that combine several of the syndrome scales: Internalizing problems sums the Anxious/depressed, Withdrawn-depressed, and Somatic complaints scores; Externalizing problems combines Rule-breaking and Aggressive behavior.
CBCL/1.5-5 - Child Behavior Checklist for Ages 1.5-5. The CBCL/1.5-5 obtains caregivers' ratings of 99 problem items. Items are scored on the following syndrome scales: Emotionally Reactive, Anxious/Depressed, Somatic Complaints, Withdrawn, Attention Problems, Aggressive Behavior, and Sleep Problems.
The findings showed that the Child Behavior Checklist 1.5-5 performed well in identifying autism spectrum disorder, with high reliability and consistency in the results.
Although the CBCL does not require administration by a clinician, someone with at least a graduate-level degree—that included coursework in standardized assessments—should administer it. The tool requires approximately 15 minutes for administration.
