Assessing emotional and behavioral problems in children with intellectual disability: revisiting the factor structure of the developmental behavior checklist

The objective of the reported study was to reassess the factor structure of the Developmental Behaviour Checklist (DBC) in a large cross-cultural sample representing all levels of intellectual disability. Parent and teacher DBC ratings on a combined sample of 1536 Dutch and Australian children and adolescents (ages 3–22) with mild to profound intellectual disability were used. Principal components analyses produced five subscales: Disruptive/Antisocial, Self-Absorbed, Communication Disturbance, Anxiety, and Social Relating, explaining 43.7% of the total variance. Internal consistencies of these subscales ranged from .66 to .91. The revised factor structure of the DBC appears to be an improved and useful tool for assessing emotional and behavioral problems in children with intellectual disabilities.     

Psychometric evaluation of a Dutch version of the Mini PAS‐ADD for assessing psychiatric disorders in adults with different levels of intellectual disability

Background People with intellectual disabilities (ID) have an increased vulnerability to develop psychiatric problems. Moreover, the early recognition and the accurate diagnosis of psychiatric disorders in the population of persons with ID are challenging. Method A Dutch version of the Mini PAS‐ADD, which is a screening instrument for identification of mental health problems in people with ID, was evaluated in terms of internal consistency, interinformant reliability, item grouping and criterion validity based on a large‐scale random sample (n = 377) and a clinical sample (n = 99) of adults with ID. Results The Dutch version of the Mini PAS‐ADD showed moderate internal consistency, and moderate concordance among informants. Both aspects of the reliability were comparable for different levels of ID. A factor analysis largely confirmed the scale structure. Concurrent validity with the Reiss Screen for Maladaptive Behavior was high for the Depression, Psychosis and Autism scale. The outcome of the criterion‐validity analysis indicated high specificity. The sensitivity for specific psychiatric disorders by the corresponding scales was moderate, but the general sensitivity for the presence of psychopathology on the basis of any of the scales was satisfying. Conclusions The present research reconfirmed the use of the Mini PAS‐ADD as a primary screening device for the identification of mental health problems among people with ID.     

Reliability and Validity of Two Brief Screening Measures of Preschoolers’ Social–Emotional Competencies

The emotional competence screening and the social competence screening for parents and teachers were developed in Romania as brief, multiinformant, strength-focused assessment tools to identify children at risk of underdeveloped social–emotional competencies. The objective of the current study was to gather further reliability and validity evidence concerning the teacher and parent versions of the screeners. Findings provided evidence of high internal consistency, test–retest reliability (3-month interval), and moderate levels of cross-informant reliability. Principal axis factoring was employed for testing latent dimensions associated with the theoretical models underlying the scales’ development. Construct validity was also established using measures of children’s social–emotional competencies and internalizing/externalizing problems and yielded moderate-to-strong correlations across all forms of the screeners. Diagnostic accuracy was assessed relative to the clinical range scores from the internalizing/externalizing problem scales from Achenbach System of Empirically Based Assessment and yielded acceptable specificity and sensitivity indices. Receiver operating characteristic analyses and area under the curve values indicate that these measures have moderate-to-strong utility (AUCs ≥ .78) in detecting children at risk of internalizing and externalizing problems based on ratings of their social–emotional skills. These data support the notion that these instruments might prove potential candidates for school-wide screening practices.     

Psychometric comparisons of three measures for assessing motor functions in preschoolers with intellectual disabilities

Background Deficit in motor performance is common in children with intellectual disabilities (ID). A motor function measure with sound psychometric properties is indispensable for clinical and research use. The purpose of this study was to compare the psychometric properties of three commonly used clinical measures for assessing motor function in preschoolers with ID: the Bruininks‐Oseretsky Test of Motor Proficiency‐Second Edition, the Movement Assessment Battery for Children‐Second Edition and the Peabody Developmental Motor Scale‐Second Edition (PDMS‐2). Method One hundred and ninety‐one children aged 3–6 years with ID were evaluated with the three measures at three time points: two baseline measurements with a 1‐week interval before the intervention, and a follow‐up measurement after 6 months of paediatric rehabilitation programme. One hundred and forty‐one participants completed all of the assessments. The distribution (ceiling and floor effects) and reliability (internal consistency and test–retest reliability) of each measure were examined. Concurrent validity, predictive validity, and responsiveness were examined as well. Results All measures, except for the PDMS‐2, had significant floor effects or ceiling effects at one or more time points. The three measures had good internal consistency (Cronbach α ≥ 0.86) and test–retest reliability (intraclass correlation coefficient ≥ 0.96). The Spearman ρ correlation coefficient for each pair of the three measures was ≥0.80, indicating high concurrent validity. The predictive validity of the three measures was satisfactory (Spearman ρ ≥ 0.52). The responsiveness of the three measures was moderate (0.47 ≤ effect size ≤ 0.74). The minimal detectable changes of the three measures were satisfactory. Conclusions All three measures showed sufficient reliability, validity and responsiveness in preschoolers with ID, but the PDMS‐2 is recommended for its superior psychometric properties.     

A dimensional approach to measuring anxiety for DSM‐5

In preparation for DSM‐5's planned inclusion of dimensional assessments of psychopathology as a complement to traditional categorical diagnoses, we developed brief self‐rated scales for anxiety disorders that are consistent in content and structure. In the present paper, we discuss the creation of the scales and examine their psychometric properties and clinical sensitivity. Phase One assessed psychometric properties of the initial versions of the scales in a large non‐clinical sample (n = 702). Phase Two assessed the psychometric properties of revised versions of the scales, including test–retest reliability, in a non‐clinical sample (n = 57). Phase Three examined the scales' psychometric properties and relationship with clinician ratings of disorder severity in a clinical sample (n = 48). The scales demonstrated internal consistency (α = 0.85–0.92), convergent validity (r_s = 0.39–0.69), and test–retest reliability in the non‐clinical samples (ICC = 0.51–0.81). In the clinical sample, the scales demonstrated significantly higher total scores than in the non‐clinical sample (Cohen's d = 0.72–1.50) and moderate to high correlations with clinician ratings of disorder severity (r = 0.43–0.82) Although further evaluation and refinement of the scales (particularly the specific phobia and agoraphobia scales) is needed, the results provide preliminary support for the use of these scales in DSM‐5 and thus take an important step toward the integration of standardized dimensional measurement into the diagnosis of anxiety disorders. Copyright © 2012 American Psychiatric Association. All rights reserved.     

Validation of a questionnaire on behaviour academic competence among Chinese preschool children

The aim of this study was to validate a questionnaire on academic competence behaviour for use with Chinese preschool children in Hong Kong. A parent version and a teacher version were developed and evaluated. The participants included 457 children (230 boys and 227 girls) aged four and five years old, their preschool teachers and their parents. Besides, 44 children (39 boys and 5 girls) with developmental disabilities were recruited. The children were assessed on the cognitive domain of the Preschool Development Assessment Scale (PDAS). Their parents completed a questionnaire on academic competence behaviour, as well as the Strength and Difficulty Scale (SDQ). Their teachers completed the questionnaire on academic competence behaviour. Rasch analysis results provided support for the unidimensionality of the parent and teacher versions of the scale, with one item deleted. The parent and teacher versions of the revised scale correlated positively with the cognitive domain of the PDAS and the prosocial scale of the SDQ and negatively with SDQ total problem behaviour score. Children with developmental delay were assigned lower scores by their parents and teachers, compared with preschool children, on the revised versions of the academic competence behaviour scale. Reliability estimates (Cronbach's alpha) of the parent and teacher versions of this revised scale were above .80. The results suggested that the two versions of academic competence behaviour scales were promising instruments for the assessment of academic competence behaviour among Chinese preschool children.     

Behavioural and emotional problems in children with intellectual disability attending special schools in Cape Town, South Africa

A sample of 355 children with intellectual disability (ID) attending special schools in Cape Town, South Africa, were assessed on the Developmental Behavioural Checklist – Teacher Version (DBC‐T). A prevalence rate of 31% for psychopathology was found. Boys manifested more behaviour problems than girls, especially in relation to disruptive, self‐absorbed and antisocial behaviours. Children with severe and profound levels of ID showed more behavioural difficulties than those in the mild and moderate categories. Specific behaviour problems were self‐absorbed and autistic behaviours in children with profound ID, communication problems and anxiety in those with severe ID and antisocial behaviour in children with mild ID. Epilepsy, but not cerebral palsy was associated with higher total behaviour scores. Ambulant children were more disruptive and antisocial, while non‐ambulant children were more anxious. Non‐verbal children had higher scores on all of the subscales except for disruptive behaviour.     

The transition to school: adaptation in young children with and without intellectual disability

Background Previous research has highlighted the importance of the transition to school for young children and their families. A child's successful adaptation to school is likely influenced by a number of factors, including academic, social, emotional, behavioural and cognitive competencies. Children with intellectual disability (ID) may be at heightened risk for early school difficulties, in part due to their deficits in cognitive and adaptive behaviours. Methods Factors associated with the adaptive transition to school in young children with (n = 24) and without (n = 43) ID were examined. Adaptive transitions were defined as having few teacher‐reported problem behaviours and positive student–teacher relationships. Child self‐regulatory skills and both parent‐ and teacher‐reported social skills were evaluated to determine if they predicted positive adaptation in school for 5‐ to 6‐year‐old children. Data were gathered from child assessments, parent reports on standardized measures, direct observations of delay of gratification tasks and teacher reports on standardized measures. Results Children with ID had significantly more teacher‐reported problem behaviour, poorer overall student–teacher relationships, fewer parent‐ and teacher‐reported social skills and fewer self‐regulation skills than typically developing children. Self‐regulation at child age 36 months (latency to touch a desired toy) was significantly related to adaptation to school, as were parent and teacher reports of social skills. Social skills significantly predicted adaptation to school, even after accounting for the effects of child IQ and adaptive behaviour. Conclusions Children with ID had less positive early school experiences, as indicated by multiple indices of adaptation to school. Fostering early social skills may be an important target for increasing the positive adaptation to school for young children, especially those with ID.     

Assessment of change with the Developmental Behaviour Checklist

Background The Developmental Behaviour Checklist (DBC) is a 96‐item instrument designed for assessing behavioural and emotional problems among young people with intellectual disability. Methods The present study investigated the validity of the DBC as a measure of change. Changes in individual's DBC scores were correlated with changes in expert clinicians’ ratings of the same subjects. Results A high correlation was found between expert clinician ratings of change in behaviour and change in the total behaviour problem score of the DBC. Conclusions The DBC is able to measure changes in behaviour and emotions which are recognized by an experienced clinician who is following the progress of a child with ID.