Child Behavior Assessment Instrument (CBAI)

Abstract

The Child Behaviour Assessment Instrument (CBAI) is a concise, community-based screening tool designed to identify young children, aged 4 to 6 years, who may be at risk of developing externalizing behavioural problems. Developed in Sri Lanka for application in non-clinical settings, the CBAI facilitates early identification and timely intervention. The instrument is freely available and structured as a 15-item checklist, derived through expert consensus using the Delphi method, covering six critical domains of behaviour. Its design allows for administration by community members or carers, significantly minimizing assessment costs and reducing reliance on specialized professional resources.

Keywords

Child Behaviour Assessment Instrument, CBAI, early identification, externalizing problems, Sri Lanka, screening tool, community assessment, preschool children, Delphi method

Authors

D. Samarakkody, D. Fernando, H. Perera, R. McClure, H. De Silva

Purpose

The primary purpose of the Child Behaviour Assessment Instrument (CBAI) is the early identification of behavioural risk in young children (aged 4–6 years) within community and non-clinical settings. This instrument was developed specifically to be accessible and cost-effective, allowing non-professional community members or carers to administer the assessment. This methodology addresses the critical challenge that carers often delay seeking professional assistance until a child’s behaviour escalates to a crisis point, thereby enabling earlier detection and subsequent intervention.

By minimizing the reliance on specialized professional administration, the CBAI significantly reduces assessment costs. This characteristic is vital for widespread implementation in resource-limited environments, such as the community settings in Sri Lanka where the instrument originated. The tool aims to support timely intervention, minimizing the risk of early problem behaviours developing into more severe, longer-term issues.

Construct

The CBAI measures a broad psychological construct encompassing various externalizing and developmental indicators of behavioural problems in preschool-aged children. The instrument’s development involved a rigorous process, including a literature review and expert consultation via the Delphi method, to define the core areas of concern.

The final 15-item instrument is structured around six key behavioural domains, capturing observable symptoms often associated with early psychological difficulties. These domains are: inattention, hyperactivity and impulsivity, aggression, impaired social interactions, abnormalities of communication, and restricted, stereotyped patterns of behaviour. These areas collectively provide a comprehensive screening profile for potential behavioural risks that necessitate further professional evaluation.

Validity

The validation study, conducted on a sample of 332 children aged 4–6 years, demonstrated satisfactory evidence for both criterion and construct validity. To establish convergent validity, CBAI assessment results were directly compared against findings derived from clinical interviews and observations guided by the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Statistical analysis using One-way ANOVA further supported the instrument’s discriminatory power. Children identified clinically as having behavioural problems exhibited significantly higher mean CBAI scores (M = 21.377) compared to their typically developing counterparts (M = 7.040), with a high level of statistical significance (p = 0.001). This robust finding confirms the scale’s ability to differentiate effectively between at-risk and non-risk populations based on established clinical benchmarks. Although formal cross-cultural validations were not located at the time of publication, back-translation procedures (English to Sinhala) suggest the tool’s potential viability for research with English-speaking samples, including those in regional and remote Australia.

Reliability

The reliability of the CBAI was established through a test-retest reliability procedure. This process involved re-administering the instrument to a 15% subset of the original validation sample after a suitable time interval. The results indicated satisfactory agreement between the initial and subsequent assessment times, confirming the stability of the measure.

The calculated correlation coefficient for the agreement was 0.851, with a 95% confidence interval (CI⁹⁵) ranging from 0.731 to 0.971. This strong coefficient confirms the CBAI’s temporal stability and consistency over time, suggesting that the instrument yields dependable results when used for screening purposes in the target age group.

Factor Analysis

The structural development of the CBAI involved a significant reduction process. An initial pool of 54 items, generated from a literature review, was reduced to a final 15-item instrument using expert consensus drawn from community medicine, child psychiatry, paediatrics, child psychology, and policy making. This process, executed via the Delphi method, ensured that the final items were relevant and adequately represented the six pre-defined behavioural domains.

While the design is theoretically driven by these six domains, the source content does not provide explicit details regarding a formal statistical Factor Analysis (e.g., Exploratory or Confirmatory) performed on the final 15 items to statistically confirm the underlying factor structure. The six domains structure the assessment around inattention, hyperactivity and impulsivity, aggression, impaired social interactions, abnormalities of communication, and restricted, stereotyped patterns of behaviour.

Instrument

Test Type: Screening tool / Community Checklist

Format: 15-item checklist administered by raters (typically community members or carers). Responses are based on observable behaviours over the past 6 months.

Language Available: Sinhala (original language of development) and English (through back-translation, viable for research).

Population Group: Children at risk of externalizing behavioural problems.

Age Group: 4–6 years

Population Details: Non-clinical community sample. Validated using a sample of 332 children aged 4–6 years in Sri Lanka.

Test Methodology: Raters assess the frequency of each behaviour using a three-point scale: “very often”, “sometimes”, or “never”. The instrument also includes a final open-ended question to gather additional relevant qualitative information.

Keywords

inattention, hyperactivity, impulsivity, aggression, social interactions, communication abnormalities, stereotyped behaviour, community screening, preschool assessment, psychometrics

Authors

Author ORCID Identifier: Information not provided in the source material.

Affiliation Email addresses: Information not provided in the source material.

Correspondence Address: Information not provided in the source material. (Note: At the time of the study, two members of the research team, Samarakkody and McClure, were based at Monash University in Victoria, Australia.)

Permissions & Fee and Test Year

The Child Behaviour Assessment Instrument (CBAI) was published and validated in 2010. The instrument is freely available and accessible to the public. Permission is not required to use the instrument, provided that the original work is properly cited. This unrestricted access supports its intended purpose as a widespread, cost-effective community screening tool.

The assessment instrument is included as a downloadable .pdf file within the primary publication source. The full publication, including the assessment tool, can be accessed via the International Journal of Mental Health Systems: https://ijmhs.biomedcentral.com/articles/10.1186/1752-4458-4-13.

Reference’s

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

Items of the Child Behaviour Assessment Instrument (CBAI)

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

(Note: The source content provided only two examples of the 15 observable behaviours included in the checklist.)

• follows instructions of adults
• speech is relevant to the occasion