The Child Behavior Checklist for Ages 4–18 (CBCL) was used to identify behavioral changes in children with autism. The CBCL was developed by Achenbach and Edelbork to assess the areas of competence and problem behaviors of children and adolescents aged 4–18 based on information obtained from parents (Rinehart et al. 2001). The CBCL 4-18 was first translated into Turkish by Akçakın and Savaşır in 1983, and a reliability study was conducted (Akçakın 1985).
The 1991 version of the CBCL 4-18 was translated into Turkish by Erol et al. (1998) and compared with the 1983 Turkish translation to examine their differences and similarities. In the scale’s internal consistency study, 4,488 children and adolescents were included; the results demonstrated that the scale could be reliably used across the gender and age groups examined, as well as in cities, districts, and villages. The scale’s internal consistency was calculated using Cronbach’s alpha coefficient based on the scores of the 4,488 children and adolescents comprising the study sample; the coefficients were found to be: Introversion = 0.82, Extraversion = 0.81, and Total Problems = 0.88. The scale’s test-retest reliability in Turkish was calculated by administering the test twice to fifty mothers one week apart; the correlations were determined to be 0.78 for Total Competence and 0.84 for Total Problems, indicating high reliability.
The scale consists of twenty competence items and one hundred eighteen problem items. The competence items on the scale cover sports and non-sports activities in which the child or adolescent is interested and actively participates, as well as tasks performed at home or outside the home. Additionally, the child’s social functioning is assessed. Academic achievement, problems at school, and the quality and quantity of participation in school activities are determined. The scores obtained from the activity, social, and school subscales are summed to derive the total competence score (Erol et al. 1998).
The second section of the scale contains 113 items that describe behavioral and emotional problems observed in children and adolescents. Problem behaviors are rated as 0, 1, or 2 based on the frequency of occurrence over the past six months. If the item described in the scale does not apply to the child, it is marked as 0; if it is sometimes or somewhat true for the child, it is marked as 1; and if it is very true or frequently true, it is marked as 2. Two separate behavioral symptom scores—introspection and extraversion—are derived from the scale; there are five subscales belonging to these two main sections and three subscales that do not fall into these groups. The introversion (INT) group consists of the total scores of the social introversion, somatic complaints, anxiety, and depression subscales, while the extroversion (EXT) group consists of the total scores of the delinquent behaviors and aggressive behaviors subscales. Additionally, the scale includes subscales for social problems, as well as thought and attention problems, which do not fall into either of the two main groups. A “total problem score” is derived from the sum of these subscale scores. In this study, the scale’s introversion and extroversion dimensions, as well as the total problem scores, were evaluated. The total problem scores were expressed as the overall behavioral problem score (Erol et al. 1998).