Diagnostic utility of Behavior Assessment System for Children-3 for children and adolescents with autism.

This study examined the accuracy of the Behavior Assessment System for Children-3 for Autism Spectrum Disorder (ASD) diagnosis using parent (PRS) and teaching rating (TRS) scales. The accuracy of three PRS and TRS derived scores with strong theoretical relationships to ASD (Developmental Social Disorders [DSD], Atypicality [ATP], and Withdrawal [WIT]) and the Autism Probability Index (AUI) was examined. The T scores of 149 children with ASD were compared with typically developing children within similar demographics to assess diagnostic accuracy (i.e., differential validity). The results revealed statistically significant differences for all scales between the group with ASD and the matched group of typically developing children. Sensitivity and specificity were maximized for both the PRS and TRS when DSD, ATP, and WIT scales were greater than 60 and a cut score of on the AUI was set at 55. Overall, sensitivity and specificity indexes associated with these cut scores demonstrated strong diagnostic utility for differentiating the two groups.

Investigation of factor structure and measurement invariance by gender for the Behavioral and Emotional Screening System among high school students.

The Behavioral and Emotional Screening System (BESS; Kamphaus & Reynolds, 2007) is used by U.S. schools to screen students for behavioral and emotional risks. The BESS comprises a student form, a teacher form, and a parent form. We explored the factor structure of the BESS Student Form among high school students and evaluated measurement invariance by gender using multiple-group confirmatory factor analysis. The results suggested that the BESS Student Form has a 5-factor structure and holds to partial invariance by gender. The partial invariance model revealed 5 items that functioned differentially. These item-level findings suggest that female and male adolescents have different perspectives about their relationships with their parents, self-esteem, self-reliance, and atypicality. The implications of our study are twofold: The BESS Student Form might be used with female and male adolescents in its current form, but the analysis of the data suggested that possible changes be made in the item content during the next revision. (PsycINFO Database Record

Evidence-based assessment of ADHD diagnosis in children and adolescents.

This study illustrates the accuracy and efficiency of using an evidence-based assessment (EBA) strategy for diagnosis of attention-deficit/hyperactivity disorder (ADHD) by integrating the scale scores obtained on BASC-3 teacher and parent rating scales. The examined process used empirical diagnostic likelihood ratios (DLRs) derived from a sample of children with ADHD (N = 339) matched on demographic characteristics from the normative sample. The results show that behavioral scales of executive functioning and functional communication provided incremental utility in ADHD diagnosis. With a revised probability of .80 or higher as the diagnostic criterion, teachers, and parents positively diagnosed 70% and 94% of the ADHD cases respectively. The EBA approach was efficient, with four scales on average used to reach the proposed posterior probability for final diagnosis. Finally, teachers and parents demonstrated a high agreement with respect to the diagnosis results and scales used for the diagnosis.

Using the BASC-2 Parent Rating Scales to Screen for Autism Spectrum Disorder in Toddlers and Preschool-Aged Children.

Early identification of toddlers and preschool-aged children with autism spectrum disorder (ASD) is important for ensuring that these youth receive targeted early intervention services. Identifying young children with ASD is complicated by overlap among symptoms of ASD and other developmental delays. Additionally, youth with ASD have a higher risk of experiencing co-occurring challenging behaviors that are beyond the diagnostic criteria for ASD (e.g., attention difficulties, anxiety). Given this, broadband behavioral assessments that measure symptoms of ASD as well as other behavioral and emotional challenges offer a cost-effective method for screening young children. The present study evaluated the utility of one such assessment, the Behavior Assessment System for Children, Second Edition, Parent Rating Scale-Preschool (BASC-2 PRS-P), for identifying young children with ASD from those with other diagnoses (including other developmental delays) and those without diagnoses. The sample included 224 toddlers and preschoolers (age range: 24-63 months, males n = 153 [68 % total sample]) who screened positive on an ASD-specific screening tool. Results demonstrated that the Developmental Social Disorders (DSD) scale on the BASC-2 PRS-P had adequate sensitivity and specificity values when distinguishing youth with ASD from those without any diagnoses, but not when differentiating between youth with ASD and those with other diagnoses. Similar to other multidimensional behavior rating scales, the BASC-2 PRS-P may be most useful for identifying young children who require comprehensive diagnostic evaluations.

Psychometric analysis of the BASC-2 Behavioral and Emotional Screening System (BESS) student form: Results from high school student samples.

The Behavioral and Emotional Screening System (BESS) is a relatively new method for identifying behavior and emotional risk (BER) in children and adolescents. Psychometric evidence regarding this instrument is important for researchers and practitioners considering the use of the BESS for identifying BER in students. Previous psychometric research specifically regarding the BESS Student Form involved the use of samples of elementary and middle school-age children. This study adds to the psychometric evidence for scores on the BESS Student Form by using samples of high school aged students to assess both the factor structure reported by Dowdy, Twyford et al. (2011) and the measurement invariance of the BESS items with regard to ethnicity, English language proficiency, and socioeconomic status. The results indicate that while the proposed 4-factor structure of the BESS Student Form is appropriate, lower than preferred reliabilities for some of the factors indicates that reporting the overall risk T score is more appropriate than reporting factor scores for risk classification purposes. Additionally, the BESS Student Form items did not exhibit measurement bias when comparing across ethnicities, language proficiency classification, or socioeconomic status (via free/reduced lunch classification).

Surveillance of middle and high school mental health risk by student self-report screener.

INTRODUCTION: A 2009 National Academies of Sciences report on child mental health prevention and treatment concluded that screening for mental health risk is an essential component of service delivery. To date, however, there are few practical assessments available or practices in place that measure individual child risk, or risk aggregated at the school or community level. This study examined the utility of a 30-item paper and pencil student self-report screener of behavioral and emotional risk (BER) for surveying community risk among 7 schools. METHODS: In 2010, 2,222 students in 3 middle and 4 high schools in a medium-sized school district in Georgia were administered the Behavioral and Emotional Screening System Self-Report Child/Adolescent form (BESS Student). The BESS is designed to measure 4 sub-syndromal BER factors for developing mental health disorders: inattention/hyperactivity, internalizing, school problems, and personal adjustment. Analysis of Variance and Chi Square analyses were used to assess the association between adolescent self-reported BER as an indicator of school BER, grade level, child ethnic identification and gender, socioeconomic status, and special education placement status. RESULTS: BESS scores differentiated well between schools for overall BER and special education status, as well as between grade levels, ethnicity, and gender groups. One high school, known by the school administration to have numerous incidents of student behavior problems, had the most deviant 4 BER domain scores of all 7 schools. Girls rated themselves as having a higher prevalence of BER (14%) than boys (12%); middle school students reported fewer difficulties than high school students. CONCLUSION: Middle and high school students were capable of identifying significant differences in their own BER across schools, suggesting that universal mental health risk screening via student self-report is potentially useful for identifying aggregated community risk in a given school that may warrant differential deployment of mental health prevention and intervention strategies. BESS results reliably identified individual mental health risk associated with special education placement, which is documented to lead to poor school outcomes such as school dropout and lack of enrollment in post-secondary education.

Longitudinal applications of a behavioral screener of executive functioning: assessing factorial invariance and exploring latent growth.

This study included a replicated derivation of a behavioral screener for executive functions among children, longitudinal invariance analyses to evaluate measurement reliability across time, and latent growth modeling of 4 executive functions: problem solving, attentional control, behavioral control, and emotional control. The sample included 1,237 (52% female) participants age 6 to 11 years. Participants were tracked longitudinally for 3 years with 5 assessment waves, and new participants were recruited at each wave to compensate for attrition. As predicted, the 4-factor model was successfully replicated, with longitudinal invariance newly confirmed. These findings support this screener as a reliable childhood measure for executive functions, and latent growth modeling identified predictive qualities of gender and age on levels and changes in these constructs.

Progress and promise.

This editorial introduces the current issue of the journal School Psychology Quarterly (SPQ).There has been an impressive and promising progress of school psychology science has been reflected in every issue of SPQ, including the current one.

Factor structure of the BASC-2 Behavioral and Emotional Screening System Student Form.

The BASC-2 Behavioral and Emotional Screening System (BESS) Student Form (Kamphaus & Reynolds, 2007) is a recently developed youth self-report rating scale designed to identify students at risk for behavioral and emotional problems. The BESS Student Form was derived from the Behavior Assessment System for Children-Second Edition Self-Report of Personality (BASC-2 SRP; Reynolds & Kamphaus, 2004) using principal component analytic procedures and theoretical considerations. Using 3 samples, the authors conducted exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) to understand the underlying factor structure of the BESS Student Form. The results of the EFA suggested that the SRP contained a 4-factor (i.e., Personal Adjustment, Inattention/Hyperactivity, Internalizing, School Problems) emergent structure, which was supported by CFA in 2 additional samples. Practical and research implications are discussed.

Theoretical and statistical derivation of a screener for the behavioral assessment of executive functions in children.

The problem of valid measurement of psychological constructs remains an impediment to scientific progress, and the measurement of executive functions is not an exception. This study examined the statistical and theoretical derivation of a behavioral screener for the estimation of executive functions in children from the well-established Behavior Assessment System for Children (BASC). The original national standardization sample of the BASC-Teacher Rating Scales for children ages 6 through 11 was used (N = 2,165). Moderate-to-high internal consistency was obtained within each factor (.80-.89). A panel of experts was used for content validity examination. A confirmatory factor analysis model with 25 items loading on 4 latent factors (behavioral control, emotional control, attentional control, and problem solving) was developed, and its statistical properties were examined. The multidimensional model demonstrated adequate fit, and it was deemed invariant after configural, metric, and scalar measurement invariance tests across sex and age. Given its strong psychometric properties, with further tests of item validity, this instrument promises future clinical and research utility for the screening of executive functions in school-age children.

The role of neuropsychologic tests in the diagnosis of attention deficit hyperactivity disorder.

Attention, memory, executive function, language, and visual-motor skills were evaluated in a sample of 621 children, 6 to 11 years old, to assess the discriminant validity of neuropsychologic testing. Attention deficit hyperactivity disorder cases (249) and controls (372) were identified and tested. Analysis of covariance, nonparametric comparison tests, effect sizes, discriminant function, factor analyses, and receiver-operator characteristics curve analyses were used to establish the best diagnostic cutoff points for each variable. Statistically significant differences were found on cognitive effort, auditory skills, continuous performance test, working memory, visual-motor skills, verbal comprehension, and executive function measures (P < 0.05); however, the effect of group sizes was low to modest (0.24 to 0.54). Receiver-operator characteristics curve analysis showed modest sensitivity and low specificity, demonstrating that an important proportion of the variance in test scores was overlapping. Factor analysis of neuropsychologic testing results revealed a structure of six factors each for attention deficit hyperactivity disorder, control, and combined samples. The latent variables produced one discriminant function with a total correct classification accuracy of 61.9%. Neuropsychologic tests should be used as Attention Deficit Hyperactivity Disorder diagnostic tools with caution, but they hold promise for identifying core cognitive deficits and processes that can aid prevention and intervention.

Screening for conduct disorder in an adolescent male sample from Colombia.

This study assessed the validity, reliability, and utility of a screening measure for detecting the signs or symptoms of Conduct Disorder in male adolescents from schools in Medellín, Colombia. A first study examined the differences between 70 male offender adolescents (aged 12-16 years) attending alternative education institutions, and 68 (sex, age, and socioeconomic status (SES)-matched) adolescent controls attending regular schools. A CD checklist (CD-CL) was constructed to be used by mothers (CD-CL-M) and for self-report by adolescents (CD-CL-SR). The validity of the screener for CD diagnosis was supported by significant differences between groups (ANOVA, p<.001). The CD-CL-SR had better sensitivity/specificity with a diagnostic cut-off point of 5 (sensitivity=95.3% and specificity=90.5%) than the CD-CL-M. A second study used the CD-CLSR with a random sample of 190 male adolescents (aged 12 to 16 years) from schools of low, middle and high SES. Reliability as assessed by Cronbach's alpha was 0.86. An epidemiological cut point of 5 classified 35.5% of the adolescents assessed as probable CD cases. A psychometric cut point at T score>59 (85th percentile) estimated 16.8% of the sample as probable CD cases. A psychometric cut point at T score>64 (90th percentile) revealed that 10.5% of the sample would be severe CD cases. Some significant differences (p<0.001) in proportions of CD adolescents were found between age and SES groups. It was concluded that such a high frequency of conduct problems in adolescence argues for the need for preventive programs in Colombian schools.

Validation of two rating scales for attention-deficit hyperactivity disorder diagnosis in Colombian children.

This study assesses the validity of the Behavioral Assessment System for Children-parent and teacher questionnaires for attention-deficit hyperactivity disorder diagnosis in a randomized sample of 344 Colombian children (145 cases, 199 controls), males and females, ages 6 to 11, with an estimated Wechsler Full Scale Intelligence Quotient over 70. The assessment protocol for both groups included psychiatric, neurologic, and psychological interviews, parent and teacher rating forms, and an Attention-Deficit Hyperactivity Disorder Checklist. All Behavioral Assessment System for Children-parent and teacher dimensions, except withdrawal and somatization, significantly differentiated cases and controls. Parents and teachers rated attention-deficit hyperactivity disorder combined type children as significantly more aggressive. Both questionnaires had good discriminant accuracy for detecting cases and control children, but accuracy for discriminating between attention-deficit hyperactivity disorder subtypes was poor. The Behavioral Assessment System for Children-parent and teacher questionnaires for 6- to 11-year-olds may be useful tools for diagnosing the presence of attention-deficit hyperactivity disorder. Additional assessment methods will be needed to discriminate between the subtypes.

A self-report typology of behavioral adjustment for young children.

A large, national U.S. sample of children rated their own behavior and emotions using the Self-Report of Personality-Child version (SRP-C) of the Behavior Assessment System for Children (C. R. Reynolds & R. W. Kamphaus, 1992). Cluster analysis was used to group 4,981 self-reports (SRP-C) of children between the ages of 8 and 11 years. Theoretical and empirical considerations were used to identify a 10-cluster solution. Internal validation procedures revealed that the 10-cluster solution was well replicated by independently classifying 2 large subsamples of participants. External validation evidence revealed that only 2 of the 10 clusters could be differentiated by parent and teacher ratings of behavior problems. Peer ratings of social status and behavior, however, proved far better than adult ratings at differentiating the clusters. These findings suggest that the realm of intraindividual adjustment is not well understood by parents and teachers of these same children.

Academic underachievement and the disruptive behavior disorders.

Academic underachievement (AU) was studied among 177 clinic-referred boys reliably diagnosed as having attention-deficit hyperactivity disorder (ADHD) or conduct disorder (CD). Unlike previous studies, the present study assessed AU using a formula that determined the discrepancy between a child's predicted level of achievement and actual level of achievement while controlling for regression and age effects. AU was associated with both ADHD and CD when the disorders were examined individually. However, when examined in multivariate logit model analyses, the apparent relation between CD and AU was found to be due to its comorbidity with ADHD. When boys with ADHD were divided into those with attention deficits only and those with co-occurring hyperactivity, findings did not support the hypothesis that the association with AU is stronger for attention deficits without co-occurring hyperactivity.