Child behavior checklists are available for use in the diagnosis of conditions from autism to epilepsy. While they are not sufficient on their own, they play a potentially vital role in detecting hidden conditions that might otherwise go unnoticed. A checklist allows parents or teachers to quickly report behaviors, while health care providers are able to tell at a glance whether particularly worrisome traits are present. Yet checklists are prone to the influence of bias and do not take into account the individual differences between children.
Pro: Ease of Use
Rather than trying to remember the many behaviors that children exhibit each day and determine which ones are important to report, a checklist allows parents and teachers to simply answer a list of supplied questions. Behavior checklists use rating scales, so filling out the form is as simple as circling the appropriate number beside each question. Scoring the form is equally easy. According to “The Child Behavior Checklist and Related Forms,” hand-scoring takes around 5 minutes, while computer scoring requires less than 2 minutes.
Pro: Early Detection
Many disabilities are hidden, which means that they are often missed. A busy parent, teacher or health care provider might overlook subtle symptoms or dismiss them as signs of immaturity. The black and white, clear-cut nature of a checklist brings potential symptoms to the forefront. If a particular cluster emerges, the health care provider knows to follow up with further diagnostic instruments.
Con: Individual Differences
Although they are heavily tested for validity and reliability, checklists are inherently limited to averages and norms. They cannot cover the individual differences between children. In addition, a key criteria for diagnosing an emotional or behavioral disorder is that it must cause significant difficulties in two or more areas of daily life. Checklists could lead to over-diagnosis of issues that are not necessarily a problem at all.
Con: Reporter Bias
Behavioral checklists require parents and teachers to rate behaviors according to a designated scale. Inherent biases could cause over-reporting or under-reporting of specific behaviors. For example, “The Child Behavior Checklist and Related Forms” shows a sample rating sheet on which the parent must decide whether the description is not true, true some of the time, or always true. One of the listed behaviors is “Cries a Lot.” A parent with a low tolerance for crying might select “always true,” while one with a higher tolerance might choose “sometimes true.”
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