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Project on Human Development inChicago Neighborhoods (PHDCN):
ICPSR 13582
Child Behavior Checklist, Wave 1,
1994-1997
Felton J. Earls
Harvard Medical School
Jeanne Brooks-Gunn
Scientific Director. Columbia University. Teacher's
College. Center for the Study of Children and
Families
Stephen W. Raudenbush
Scientific Director. University of Michigan. School
of Education and Survey Research Center
Robert J. Sampson
Scientific Director. Harvard University. Department
of Sociology
Instrumentsfor ICPSR 13582
P.O. Box 1248National Institute of Justice
Ann Arbor, Michigan 48106Data Resources Program
www.icpsr.umich.edu
U.S. Department of Justice
Office of Justice Programs
National Institute of Justice
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Child Behavior Checklist
Instrument for Cohort 3
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Child Behavior Checklist: Ages 2-3
mL
COPY
2
,
I
am going
to
read
a
list
of items that
describes
children and
youth.
~~
Hand PC
ResDonse
Card 1
please say 2 if the
or
each
item
that describes ***** ppw
o
item
is
-
r
-
f *****.
Say 1
i the
item is
-
r
-
rue;
of *****.
If the item is of ***** say ''0 . Please answer all items as well
as
you can, ven if some do not
seem to
apply
to
*****.
. .
0
=
Not he
as far as you
know)
1
= Somewhat or Sometimes
T m e
2=Very h71eorOfien Ihre
CL3
J
0
1
2
1. Aches or pains (without
medical
cause)
Pe
0
1 2
2. Actstooyoung
forage
e433
0 1 2 3.
A h i d t o t r y n e w t h i n g s
e43 0 1
2
4. Avoids looking others intheeye
e6 0 1 2
cC3
6 1 2
6 .
Ca n't sit still or restless
5 .
Can't concentrate,
can't
pay attention
for
long
ed. init. ed. date
C
? 1
2
7.
Can't
stand having
things out
of place
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C 8 1
2
8. Can'tstandwaiting; wantseverythingnow
9 0 1 2
9.
Chews on hings that aren't edible
10. Clings to adults
or
too dependent
n
~ ' 0
1 2
C/3
f /
0
1
2
11. Constantly
seeks
help
@A A 0 1
2
a 3 0
1
2
13. Cries a lot
14 1 2
C43
f3
0
1
2 15.
Defiant
1- /37/61
2
16. Demandsmustbemetimmedkitely
Cay? 1 2 17,Destroyshis/herownthings
A?
0
1 2 18. Destroys
things
belonging
to
hisher
family
or other children
&3r?9 1
2 19.
Diarrhea or loose bowels when not sick
C&A8
1
2 20.
Disobedient
3J i 1
2
21. Disturbed by
any
change in routine
Cn J b 1 2
22.
Doesn't want tosleepalone
CA 3 0 1 2
23.
Doesn't answer when people
t lk to
himmer
@,W 0
1 2
24.
Doesn't
cat
well
12.
Constipated, doesn't move bowels
14. Cruel
toanimals
. 5
0 1
2 25 Doesn't get along with other children
el3
0
1 2
26.
Doesn't know how
to
have
fun,acts
like a little adult
C.AC;t
1 2
27.
Doesn't
seem to feel guilty
after misbehaving
C&&: 1
2
28. Doesn't want to go out of home
CE5pZ.Q 0 1
2
29.EasilyfrUsmted
~ E J0 0 1 2
C/3 1' 0
1 2
C& ,,& 0
1
2
Ck3
3
0
1 2
33. Feelingsareeasily hurt
t 3 9 0
1 2
C& 3 5 1
2
35.
Gets
inmany fights
@-A 6 0
1
2
36.
ets
into everything
30.
Easilyjealous
31. Eats
or drinks
things
that are not food
-
don't include sweets
32.
Fears certain animals, situations,
or places
34.
ets hurt a lot, accident-prone
2
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C3? 1 2
C&&f
1 2
37. Gets too upset when separated from parents
38. Has trouble getting to sleep
a 9
1 2
0340 1 2
39.
Headaches (without medical cause)
40. Hits others
G3Y
1
2
0 3 9 . 1 2
~ 3 1 2 43.
LOO^
unhappy without good reason
41. Holds his her breath
42.
Hurts
animals or people w ithout meaning to
d
2
~ . ~ n g r y m o o d s
0 3
/5-
0 1 2
e53446 0 1
2
46. Nervous movements
or
twitchmg
C&Y? 1 2
CA&& 1 2
C&.1/ 1 2
0 3 3 7
0
1 2 50.Overtire-d
C.4
5-y
0
1 2 51.
Overweight
C~35.3 1
2 52.
Painful bowel movements
Ck3
3
0
1
2 53.
Physically
attacks
people
C23
59 0 1 2
54.
Picks nose,
skin
or other parts
of
body
w3
55
0
1
2
55.
Plays with
own
sex
parts
too
much
CR56
1
2
56. Poorly coordinated or clumsy
-7
1 2 57. Problems with eyes without medical cause
cd5 1
2
58. Punishment doesnt change hish er behavior
C/352 1 2 59. Quickly shifts from one activity to another
CdSO 1
2
60.Rashes or other skin problems (without medical cause)
c/36/ 1
2
61.Refusestoeat
c436h 1
2 62. Refuses to play active games
0363 1 2 63. Repeatedly rocks head or body
0369
1 2 64.
Resists going
to
bed
at
night
Chgj5-
1
2
65. Resists toilet trahkg
45.
Nausea, feels sick (without medical cause)
47. Nervous,
ighstrung, or tense
48.
Nightmares
49. Overeating
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cA66
0 2 66.Screams a lot
c&6g 1
2
CA68
1 2
&3
9
0 1
2
c&
7D
0 1 2
?/
0
1
2
G A
0 1
2
C&?3
0
1
2
73. Shyortimid
C b 7-y
0 1 2
C 3
?5
0 1
2
C 3?6
0 1
2 76. Speech problem
m27
0
1 2
CB?&
0 1
2
c/3?9
1 2
(3380
1
2
0 3 8 4 1 2
WdA 1 2
C4383 1 2
CnB4
1
2
W B 5 1 2
C45.46 1 2
CAB9 0
1 2 87.Toofearfuoranxious
C&& 1 2
C/E, P 1 2
C& 0 1 2 90.
Unhappy
sad,
or depressed
@
0
1 2
CA
Q 1 2
a 3 o 1 2
a@
1
2
67.
Seems
unresponsive to affection
68. Self-conscious or easily embarrassed
69.
SelfEh or wont share
70.
Shows little affection toward people
71. Shows little interest in thrngs around himmer
72.
Shows
too
little fear of getting hurt
74. Sleeps
less th n
most chddren during day and/or night
75. Smears or plays with bowel movements
77. Stares nto space or seems preoccupied
78.
Stomach
aches or cramps (without medical
cause)
79.
Stores up
things
heishe doesnt
need
80.
Strange behavior
81. Stubborn, sullen, or irritable
82. Sudden
changes
in mood or feelings
83. Sulksalot
84.
Talksorcriesout insleep
85. Temper tantrums or hot temper
86. Too on erned with
neatness
or cleanliness
88. Uncooperative
89. Underactive, slow moving, or
lacks
energy
91.
Unusually loud
92.Upset by new people or situations
93.
Vomiting,
hrowing up (without medical cause)
.Wakesupoftenatnight
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5
CZ5
- 0 1
2
c 3
6 0 1
2
95.
Wanders away
from
home
96.
Wants a
lot
of attention
0 3 9 F
0
1
2 97. whining
98.
Withdrawn, doesn t get
involved
with others
u39P 1 2 99.
worrying
0 3
8
1
2
Please
tell
me
any
problems
your
child
has that
were not
asked
about before.
3
C ' B f i A 0 1 2 100A.
G ~ Joo 3 0 1 2
100B.
e~ o
1 2 1 0 0 ~
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Child Behavior Checklist
Instrument for Cohorts 6-15
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Child Behavio r Checklist: Ages 4-18
ate:
mm dd yy
n
Subject
ID:
s /s/W
Interviewer ID:
ime Started:
I am going to read a l is t of i tems th at describe children an d youth.
I
Ha n d PC Response Ca rd
1
1
For each item th at describes now or within the past 6 mon
t
hs please say 2 if th e
item is very tr ue o r often tr ue of
.
Say
1
if th e item is Somewhat or sometimes tru e
of . If the item is not tr u e of
,
say 0 . Please answ er all items
as
well
as
you
can, even if some
do
not seem to app ly to .
= Not Tru e
1=
Somewhat Tru e
2 = Ve ry T r u e
CC
o
1
2
C C A 1 2 2 Allergy
C C
1 2
3 . Arguesalot
c c 4
0
1 2
4. Asthma
cc
5 1
2
cc
1
2 6.Bowel movements outside toilet
1.
~ c t soo young for h i h e r age
5 Behaves like opposite sex
ed. intl ed. date
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CC?O 1 2
CCP
0
1 2
cc9
0
1 2
C C s r 0 1 2
n ccr/ 0 1 2
CCf4 0 1 2
cc1'3 0 1 2
CCf 0 1 2
ccr5 0 1 2
C1 6 0
1 2
ccr? 0 1 2
ec 1
2
CCf O 1 2
cc;wo 1 2
Ji 0 1 2
cczz 0 1
2
7.
Bragging, boasting
8.
Can t concentrate, can t pay attention for long
9. Can t get hidher mind
off
certain thoughts; obsessions
10 Can t sit still, restless, or hyperactive
11. Clings to adults or too dependent
12. Complains of loneliness
13. Confused or seems to be in a fog
14. Cries a lot
15. Cruel to animals
16. Cruelty, bullying, or meanness to others
17 Day-dreams or gets lost in his/her thoughts
18. Deliberately harms self or attempts suicide
19. Demands a lot of attention
20. Destroys his/her own things
2 1. Destroys things belonging to his/her family or others
22. Disobedient at home
23. Disobedient at school
24. Doesn t
eat
well
25. Doesn t get
dong
with other kids
26. Doesn t seem to feel guilty after misbehaving
27. Easily
jealous
28.
Eats
or
drinks
things that are not food- don t include sweets
29.
Fears
certain
animals,
situations, or places, other
th n
school
30. Fears going to school
3
1.
Fears he/she might
think
or do something bad
32.
Feels he/she
has
to be perfect
33.
Feels
or complains that no one loves himmer
34. Feels others are out to get him/her
2
i 9
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3
a 3 5 1
2
0
1
2
0 1 2
0
1
2
38,
Gets teased a lot
0 1
2 39. Hangs around with others who get
in
trouble
0
1 2 40. Hears sounds or voices
that
aren t there
0 1
2
4
1.
Impulsive or acts without thinking
0 1
2
42.
Would rather be alone than with others
0
1 2
43. Lying or cheating
0
1
2
44. Bites fingernails
0
1
2
45. N ervous, highstrung, or tense
0
1
2 46. Nervous movements
or
twitching
0
1 2 47.
Nightmares
0 1 2 48. Not liked by other kids
0
1 2
49. Constipated, doesn t m ove bowels
0
1 2 50. Too earful or anxious
0
1 2
51. Feels
dizzy
0
1 2 52.
Feels too guilty
0 1
2
53.
Overeating
0
1 2
54. Overtired
35. Feels w orthless or m ferior
36. Gets hurt a
lot,
accident-prone
37.
Gets in many
fights
IJ
CC
55
2
55. Overweight
56. Physical problems without known medical cause:
cc 56a 0 1
2
CC 3-66
0
1 2
ccLT6c
1 2
CC
564
0
1
2
CC
5-6e 1
2
CC
69
o 1
2
C C 5 5 0
2 g.Vomiting, throwing up
a. Aches
or
pains (not headaches)
b. Headaches
c. Nausea, feels sick
d. Problems with eyes
e. Rashes or other
skin
problems
f. Stomach aches or cramps
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4
CCS64
o 1 2
cc5z 0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
9
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
1 2
0 1 2
0 1 2
0 1 2
0 1 2
0 1 2
I
cc83
0 1 2
h. Other physical problems without known medical cause
57. Physically
attacks
people
58.
Picks
nose, s h r other
parts
of
body
59.
Plays with own sex parts
in
public
60. Plays with own sex
parts
too much
61. Poor school work
62. Poorly coordinated or clumsy
63. Prefers being with older kids
64 Prefers being with younger kids
65. Refuses to
t lk
66. Repeats certain acts over and over; compulsions
67. Runs away from home
68. Screams a lot
69.
Secretive, keeps things to self
70. Sees things that aren t there
71. Self-conscious or easily embarrassed
32. Sets fires.
73. Sexual problems
74. Showingoff or clowning
75.
Shy or timid
76.Sleeps
less
th nmost
kids
77. Sleeps more than
most kids during day
and/or night
78.
Smearsor plays with bowel movements
79.
Speech problem
80. Stares blankly
81.
Steals
at home
82. Steals outside the home
83 Stores up things he/she doesn t need
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cc
0 1
2
1 2
84. Strange behavior
85. Strange ideas
0 1
2 86. Stubborn, sullen, or irritable
I -
O
1
2 87. Sudden changes
in
mood
or
feelings
I -
1
O 2
88. Sulks a lot
0 1 2
89. Suspicious
0 1 2 90 Swearing or obscene language
I
g .
1 2
91. Talks about killing self
1
2
1 2
92. Talks or walks in sleep
93. Talks too much
0 2
94. Teases a lot
0 1 2
95.
Temper tantrums or hot temper
1 2
96
Thinks
about sex too much
0 2 97. Threatens people
2
98. Thumb-sucking
1 2
99. Too concerned with neatness or cleanliness
0 1 2 100
Trouble sleeping
1 2
101 Truancy, skips school
1 2 102
Underactive, slow moving, or
lacks
energy
0
2
103 Unhappy, sad or depressed
0 2 104 Unusually loud
1
2
105. Uses alcohol or
drugs for
nonmedical purposes
1
2 106 Vandalism
2
107
Wets self during theday
0
1
2
108
Wets the bed
1
2
109
whining
2
110 Wishes to be
of
opposite sex
1 2 111. Withdrawn, doesnt get involved
with
others
cc7z4 0 1
2
112 Worries
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Please tell me any problems your child has that were not asked about before.
END
OF
INTERVIEW
RECORD
TIME:
c c H 0 1 2 113A.
0
2
113B.
0 2
113C.
6