Level II

For children who are screened positively for problems at Level 1, there is a follow up  instrument (40 items) that screens for problems of attention(and hyperactivity), behavior(aggression and opposition), language and emotional regulation(anxiety and sadness).

The ABLE level II screen uses a parent self-report instrument devised to assess six dimensions of mental health which event identified as principal sources of concern and the most common causes for referral of preschool children for mental health services. The dimensions assessed by Level  concentrate on social functioning and the self-regulation of attention behavior and emotions which are emerging during the preschool period. The specific domains are  attention, aggression, behavior (opposition),  language and  emotion regulation (anxiety –depression). These scales for the mental health screening consist of the Zill(1985) Problem Behavior Index (attention, social maturity, opposition, anxious-depressed).  Assessment of the psychometric properties of the BPI provide convincing evidence of its validity and reliability (Cronbach’s Alpha = .94 total score and .77-.90  for subscales)  (Peterson & Zill, 1986; Gortmaker, Walker, Weitzman & Sobel, 1990)[1] [2]   An effort was made to be sure that the DSMIV criteria for disorders related to the problems were included in the ABLE.    Consequently in the ABLE, the Problem Behavior Index is supplemented with items based on the DSM IV symptoms for the diagnoses of Oppositional defiant, Conduct and Hyperactivity Disorder. However ABLE includes only  those DSM symptoms which are age appropriate(e.g. items related to sexual transgressions, drug use and delinquency are omitted.)[3] To overcome the limitations associated with the three points frequency rating typically used in these problem behavior checklists, a five point scale of problems severity is adopted for this measure. The construct validity of scale scores was  assessed using principal components factor analysis.  Convergent validity was assessed by comparing these problem ratings to other problem ratings. Criterion related validity was established by comparing the scores of children who been referred for mental health problems for children who do not received referral.  Examination of discriminant validity was assessed by correlating the problem scales with the competence scales.

 



[1] Gortmaker, S.L., Walker, D.K., Weitzman, M. & Sobol, A.M. (1990). Chronic Conditions, Socioeconomic Risks, and Behavioral Problems in Children and Adolescents.  Pediatrics, 85,267-276

[2] Peterson, J.L. and Zill, N. (1986). Marital disruption, parent-child relationships and behavior problems in children, Journal of Marriage and the Family. 48, 295-307.

 

[3] Egger, H.L.  (2002).  The Pre-school Age Psychiatric Assessment (PAPA): A structured parent interview for diagnosing psychiatric disorders in preschool children.  IN R. Delcarmen-Wiggens and A. Carter (Eds.). A Handbook of Infant and Toddler Mental Health Assessment. NY: Oxford University Press