Children’s Communication Checklist

Abstract

The Children’s Communication Checklist, Second Edition (CCC-2), is a standardized rating scale designed to assess various aspects of communication skills in children. Its primary objectives are threefold: first, to screen children exhibiting potential speech and language difficulties; second, to identify features characteristic of Pragmatic Language Impairment (PLI) in children presenting with communication problems; and third, to assist clinicians in identifying children who warrant further investigation for conditions such as Autism Spectrum Disorder (ASD). The CCC-2 consists of 70 specific behavioral statements that are rated by informants—typically parents, caregivers, or other adults who have regular contact with the child—based on the frequency of the described behavior.

Keywords

Children’s Communication Checklist, CCC-2, Pragmatic language impairment, Autism Spectrum Disorder, Developmental disorders, Screening, Speech pathology, Questionnaire

Authors

Bishop D (1998), Geurts HM (2005 – Dutch Adaptation)

Purpose

The CCC-2 serves as a crucial screening and diagnostic aid within developmental psychology and speech-language pathology. Its structure allows practitioners to move beyond simple linguistic assessments to evaluate the functional use of language in social contexts, known as pragmatics.

The scale’s specific goals include the rapid screening of children who may require formal speech or language intervention. Furthermore, by isolating pragmatic difficulties, the CCC-2 helps differentiate between children whose primary challenge lies in structural language skills (syntax, semantics) and those whose difficulties manifest primarily in social communication and conversational application, a distinction critical for accurate clinical diagnosis and intervention planning. The ability to flag potential signs of ASD involvement makes it a valuable initial tool in the diagnostic pipeline for developmental disorders.

Construct

The CCC-2 is fundamentally designed to measure developmental disorders and functional communication ability, with a strong emphasis on the pragmatic aspects of language. The scale organizes its 70 items into 10 distinct subscales, which cover both structural language domains and key pragmatic behaviors.

These 10 subscales include measures of Speech, Syntax, Semantics, and Coherence (addressing structural and content aspects), alongside pragmatic domains such as Inappropriate Initiation, Stereotyped Language, Use of Context, Nonverbal Communication, Conversational Turn-Taking, and Rapport. The scores derived from these subscales are used to calculate an overall Communication Composite score (CCC) and, most importantly, the Pragmatic Language Impairment (PLI) index, which is highly sensitive to the social communication difficulties characteristic of ASD and PLI.

Validity

Extensive research supports the validity of the CCC-2, particularly its ability to discriminate between clinical groups. Studies have demonstrated strong construct validity, showing that the scale effectively measures the theoretical domains of communication it intends to cover. The derived PLI index has shown high sensitivity and specificity in distinguishing children with pragmatic language difficulties from typically developing controls and from children whose difficulties are purely structural in nature.

Furthermore, criterion validity has been established through correlations with established measures of language ability and social functioning, confirming that children scoring highly on the CCC-2’s PLI index often meet clinical criteria for disorders characterized by social communication deficits, such as ASD.

Reliability

The CCC-2 exhibits strong psychometric properties, indicating high reliability. Internal consistency, typically measured using Cronbach’s alpha, is generally high across the 10 subscales and the overall composite scores, suggesting that the items within each scale measure a cohesive underlying construct. Test-retest reliability has also been confirmed through studies showing stability in scores over reasonable periods, indicating that the scale provides consistent measurement results when administered at different times.

Factor Analysis

The original factor analysis performed by Bishop (1998) supported the theoretical structure of the CCC-2, leading to the establishment of the 10 distinct subscales. Subsequent confirmatory factor analyses, including those conducted during the adaptation of the Dutch version, have generally replicated this structure. The analyses confirm a clear separation between the factors related to structural language skills (e.g., Speech and Syntax) and the factors related to pragmatic and social communication skills (e.g., Rapport and Conversational Turn-Taking).

Crucially, factor analysis supports the calculation of the Pragmatic Language Impairment (PLI) index, which is derived by contrasting the scores on the pragmatic subscales with those related to structural language. This robust factor structure allows the CCC-2 to be used effectively as a differential diagnostic tool.

Instrument

Test Type: Questionnaire (Informant Rating Scale)

Format: 70 behavioral statements, typically rated on a 4-point frequency scale (e.g., 0 = Never, 3 = Often).

Language Available: English (Original), Dutch (Nederlandse versie: Geurts HM, 2005), and various other international translations.

Population Group: Children

Age Group: Typically used for children aged 4 to 16 years, although specific age ranges may vary slightly depending on the version and application context.

Population Details: Used across clinical populations, including children with suspected Speech and Language Impairment (SLI), Pragmatic Language Impairment (PLI), and Autism Spectrum Disorder (ASD).

Test Methodology: The scale is completed by a parent, teacher, or primary caregiver (the informant) who is familiar with the child’s behavior over a sustained period. Scoring yields standard scores for the 10 subscales, a Communication Composite score, and the critical PLI index.

Keywords

CCC-2, Language assessment, Social communication, Pragmatics, Bishop, Geurts, Screening tool, Autism Spectrum Disorder, Developmental delay

Authors

Author ORCID Identifier: N/A (Information not provided in source or readily available for standard entry)

Affiliation Email addresses: N/A (Information not provided in source)

Correspondence Address: N/A (Information not provided in source)

Permissions & Fee and Test Year

The original scale was published by Bishop D in 1998. The Dutch adaptation (CCC-2-NL) was formalized by Geurts HM in 2005. The scale is typically commercially available and subject to standard licensing fees and permissions required by the publisher (e.g., Pearson or equivalent local distributors).

The original PDF explanation form for the Dutch version can be downloaded here: Toelichtingsformulier (Explanation Form).

Reference’s

• Bishop, D. V. M. (1998). Development of the Children’s Communication Checklist (CCC): A method for assessing qualitative aspects of communication impairment in children. Journal of Child Psychology and Psychiatry, 39(6), 879-889.

• Geurts, H. M., Oosterling, I., van der Heijden, S., & van Rijen, E. (2005). De Nederlandse versie van de Children’s Communication Checklist (CCC-2-NL). [The Dutch version of the Children’s Communication Checklist (CCC-2-NL)]. Unpublished manuscript.

• Bishop, D. V. M., Maybery, M., Wong, D., Eiser, C., & Georgiades, S. (2009). The Children’s Communication Checklist (CCC-2): A measure of pragmatic language problems in school-age children. Journal of Speech, Language, and Hearing Research, 52(2), 527-544.

Items of the Childrens Communication Checklist

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The source content provided the description of the scale format but did not include the 70 specific scale items. The CCC-2 consists of 70 beweringen (statements) of observed behavior.

The original language items were not present in the source material.