[One of 50 articles written and published for Demand Media in 2013]

As children develop, parents like to see them hitting normal developmental milestones. When it appears something is not quite right, a screening behavioral review is an early step. The widely accepted Achenbach System of Empirically Based Assessment offers two screens, one for children ages 18 months to 5 years, another for children 6 to 18. The preschool list has 100 questions, while the school-age list has 113. Some areas examined include anxiety, depression, aggression, attention, language and sleep.

Checklist Structure

Items on the child behavior checklists are graded by a short scale:

0 = Not True (as far as you know)
1 = Somewhat or Sometimes True
2 = Very True or Often True

The scale allows for a measure of intensity. Teenagers can be moody; some more or less so than others. Scale provides a sense of frequency and extent of the behavior. Some screens come with an additional component, such as the Language Development survey, which measures vocabulary. There are also multicultural supplements that adjust behavior scores as appropriate for cultural context.

Aggression
Aggression is sometimes related to lack of empathy. This shows up in two items from the preschooler screening: “cruel to animals” and “hurts animals or other people without meaning to.” Actually aggressive behavior is signaled by several other items: “destroys his/her own things,” “destroys things belonging to his/her family or other children” and “physically attacks people.” Items asked of the K-12 set include these and some additions: “cruelty, bullying or meanness to others” and self-aggression — “deliberately harms self or attempts suicide.”

Anxiety
Items indicative of anxiety among preschoolers include “afraid to try new things,” “clings to adults or too dependent,” “doesn’t want to sleep alone,” “gets upset when separated from parents.” Among young children and adolescents, some additional markers are “feels he/she has to be perfect,” “feels or complains that no one loves him or her,” “feels worthless or inferior.”
Everyone experiences anxiety at some time; intensity is a key diagnostic element in assessment. Excessive anxiety can be alleviated with treatment.

Attention
Some items can apply to multiple syndromes. For example, “avoids looking others in the eye” could be a sign of inattention, anxiety, depression or anger, depending on context. Having multiple items related to single syndromes helps triangulate the source of the behavior to discern which syndromes are applicable. Attention-related items for preschoolers are “can’t concentrate, can’t pay attention for long,” “can’t sit still, restless or hyperactive,” “can’t stand waiting, wants everything now,” and “demands must be met now.” From 6 to 18, additional items are “fails to finish things he/she starts,” “daydreams or gets lost in his/her thoughts,” “impulsive or acts without thinking,” and “inattentive or easily distracted.”