The role of the CBCL in the assessment of autism spectrum disorders: An evaluation of symptom profiles and screening characteristics

• High prevalence of behavior problems in children and adolescents with ASD.
• Even higher prevalence of behavior problems in cases of ASD + ADHD.
• The CBCL is not a suitable screening instrument for the identification of ASD.
• Nevertheless, the CBCL can be used for the assessment of co-occurring behavior problems.

BackgroundThe Child Behavior Checklist (CBCL) offers the possibility to obtain information about a large number of psychiatric and somatic symptoms in a short period of time. This study aimed to examine symptom profiles and the usefulness of the CBCL for screening purposes in ASD.MethodOur sample comprised 1800 children and adolescents aged 4–18 years (M = 10.91, SD 3.34), who had been diagnosed with high-functioning ASD (n = 130, IQ > 70), ADHD (n = 337), Internalizing Disorders (n = 364) or other psychiatric disorders (n = 969).ResultsIn line with previous research, children and adolescents with ASD showed a high prevalence of behavior problems, which was even higher in cases of comorbid ASD + ADHD. However, the sensitivity and specificity of the CBCL syndrome scales were low.ConclusionAlthough the CBCL is not a suitable screening instrument for the identification of ASD, high scores on the syndrome scales Social problems, Withdrawn, Thought problems and also Attention problems might be an indication for further and differential diagnostic procedures. Concerning the evaluation of co-occurring behavior problems in ASD the CBCL is of good utility − as part of a thorough assessment routine.