Collaborative ECHO Cohort research led by Shuting Zheng, PhD, of the University of California, San Francisco, Maxwell Mansolf, PhD, of Northwestern University, and Somer Bishop, PhD, of the University of California, San Francisco suggests that scores from a commonly used measure of behavior problems in young children may be skewed depending on the primary language, education, and sex of the caregiver who fills out the survey. This research, titled “Measurement Bias in Caregiver-Report of Early Childhood Behavior Problems across Demographic Factors in an ECHO-wide Diverse Sample,” is published in the Journal of Child Psychology & Psychiatry Advances.
Behavior problems observed in a young child can provide information on that child’s risk for certain developmental conditions and later mental health issues. A valid and unbiased measure of childhood behavior can help researchers and clinicians answer questions about the development of behavior problems in children from different backgrounds.
The Child Behavior Checklist 1.5-5 (CBCL) is a commonly used, caregiver-reported measure of internalizing (e.g., anxious) and externalizing (e.g., aggressive) behavior problems in children ages 1.5 to 5 years. Researchers wanted to find out if scores from this test could be affected by demographic factors such as the child’s age or the caregiver’s sex, education level, and primary language, even after accounting for mental health disparities between these groups. The research team’s goal for this study was to identify factors contributing to measurement bias and identify a subset of questions on the CBCL that were less impacted by bias but still reliably captured childhood behavior problems.
The study included caregivers of over 9,000 children between the ages of 18 to 71 months from 26 ECHO study sites across the United States. The data collected was used to evaluate how the characteristics of the child and the caregiver influence the caregiver responses to the CBCL questions. Researchers found that caregiver or child demographic factors affected caregiver responses to many questions on the CBCL. The language (English vs. Spanish) the caregiver used to complete the survey contributed most to measurement bias, followed by their education level and sex. The child’s age and race also influenced caregiver responses to many CBCL questions.
Researchers then selected the CBCL questions that showed the least amount of bias and compared how well they worked to evaluate childhood behavior problems when compared to the full CBCL survey. The researchers also mapped the scores from the less biased question sets to the scores provided by the full item sets, allowing users to derive comparable scores to the original CBCL scale.