The clinical validity and reliability of the Brief Infant–Toddler Social and Emotional Assessment (BITSEA)

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Abstract

This study investigates the construct validity and reliability of the Brief Infant–Toddler Social and Emotional Assessment (BITSEA) in a psychiatric clinical sample of toddlers. The sample consisted of a psychiatric clinical sample (N = 112) (male, n = 79; female, n = 33) of toddlers (12- to 42-months old). Both mothers and fathers completed the BITSEA and mothers completed the Child Behavior Checklist 2/3 (CBCL). Children and their parents were administered a comprehensive psychiatric evaluation. Parents were also given the Autistic Behavior Checklist (AuBC) and the Aberrant Behavior Checklist-Community (ABC). The internal consistency of BITSEA scores was good to excellent for both parents. The BITSEA/Problem (P) scores were significantly correlated with Internalizing, Externalizing and Total Problem scores of the CBCL, all subscores of ABC and total score of AuBC. The BITSEA/Competence (C) scores were significantly inversely correlated with ABC total and AuBC lethargy scores. With respect to a community sample, BITSEA/P scores were significantly higher in the disruptive behavior disorder (DBD) and anxiety/depression (Anx/Dep) groups and BITSEA/C scores were significantly lower in the autism group. These results support the reliability and validity of the BITSEA as a screening tool that may be employed in primary health care services and in psychiatric clinical settings for assessing social–emotional/behavioral problems and delays in competence in infants and toddlers.

Research highlights

▶ Brief Infant-Toddler Social and Emotional Assessment (BITSEA) is a reliable tool in psychiatry clinical settings. ▶ BITSEA-problem subscale may be a screening instrument for disruptive behaviors and anxiety/depression. ▶ BITSEA-competence subscale may be promising and simply applied tool for screeening autism.

Section snippets

Setting and participants

Over a period of 14 months, in a child psychiatry outpatient clinic in Turkey, 112 consecutive patients (male, n = 79; female, n = 33,) who were younger than 42 months of age (range = 14–42; mean = 29.86, SD = 7.31), and had no serious medical illness or severe motor and/or mental retardation, were enrolled in the current study. Mothers’ average age was 29.92 years (SD = 5.35, range = 16–43) and fathers’ average age was 34.54 years (SD = 5.66, range = 23–53). 25% of the mothers were working. While 22.3% of the

Results

Six (5.3%) mothers and 15 (13.3%) fathers did not complete the BITSEA. CBCL forms were completed by 105 (93.7%) of the mothers. Ninety parents (80.3%) completed the ABC and 88 parents (78.5%) completed the AuBC. Twenty-four of the 112 participants (21%) were younger than 24 months. In this younger group we diagnosed 8 children with autism, 5 with a sleep disorder, 3 with a disruptive behavior disorder (DBD), and 2 with pervasive developmental disorder – not otherwise specified (PDD-NOS).

Discussion

Internal consistency of the BITSEA/P (Cronbach's α = .80) was good to excellent and the internal consistency of the BITSEA/C (Cronbach's α = .69) was good. Interrater reliability for both scales (BITSEA/P, Spearman's ρ = .66, p < .001; BITSEA/C, Spearmans's ρ = .63, p < .001) were good to excellent. Both maternal and paternal BITSEA/P scores were significantly correlated with the Internalizing, Externalizing and Total Problems scores of the CBCL, all subscores of ABC, and total score of AuBC. The BITSEA/C

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