Child Behaviour Assessment Instrument (CBAI)

Background

The Child Behaviour Assessment Instrument (CBAI) is a screening tool to identify young children at risk of behavioural problems. The CBAI was developed in Sri Lanka for use with children aged 4 – 6 years in a non-clinical environment. Carers often only present children to practitioners once behaviour reaches crisis point. The CBAI can be administered by community members to identify if professional support may be necessary. A freely available tool that eliminates the need for professional administration means assessment costs are minimised, earlier identification is more likely and subsequent interventions are more timely.

Development

Following a literature review, experts from community medicine, child psychiatry, paediatrics, child psychology and policy making used the Delphi method, to reduce 54-items to 15-items covering six domains: inattention, hyperactivity and impulsivity, aggression, impaired social interactions, abnormalities of communication and restricted, stereotyped pattern of behaviour. A convenience sample of 50 mothers of children aged 4-6 years pre-tested the instrument and amendments to enhance clarity and relevance of checklist items were made. Observable behaviours include “follows instructions of adults” and “speech is relevant to the occasion”. Raters tick if the behaviour has occurred “very often”, “sometimes” or “never” in the past 6 months and can also add other relevant information in a final open question.

Psychometric properties

A validation study used a sample of 332 children aged 4-6 years. Criterion and construct validity was found to be satisfactory. Convergent validity was tested by comparing CBAI assessment results against DSM driven clinical interviews and observations. One-way ANOVA indicated children with behavioural problems had significantly higher mean scores (21.377, p=0.001) than their counterparts (7.040). A test-retest process using a 15% subset of the sample showed satisfactory agreement between assessment times (0.851, CI95 = 0.731-0.971) indicating reliability. No cross-cultural validations were located. Back-translation (English – Sinhala) of the tool suggests research with English speaking samples is viable.

Use

The tool can be accessed via International Journal of Mental Health Systems https://ijmhs.biomedcentral.com/articles/10.1186/1752-4458-4-13 . The assessment instrument is included as a downloadable .pdf file. Permission is not required to use the instrument. Access is unrestricted access providing the original work is cited. Validation with an Australia sample in regional and remote areas is encouraged here. Limited access to support services in regional and remote Australia is an ongoing issue. A community tool such as the CBAI would support early identification in these geographical areas and minimise the risk of early problem behaviours developing into longer term issues. At the time of the study, two members of the research team (Samarakkody and McClure) were based at Monash University in Victoria, Australia (known for outstanding contributions to research) and are encouraged to consider this suggestion.

Reference

Samarakkody, D., Fernando, D., Perera, H., McCLure, R. & De Silva, H. (2010). The Child Behaviour Assessment Instrument: development and validation of a measure to screen for externalising child behavioural problems in community setting. International Journal of Mental Health Systems, 4:13. DOI: 10.1186/1752-4458-4-13