ARTICLES
A DSM-IV–Referenced Screening Instrument for Preschool Children: The Early Childhood Inventory-4

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ABSTRACT

Objective

To examine the validity of the Early Childhood Inventory-4 (ECI-4), a parent and teacher rating scale designed to screen for DSM-IV emotional and behavioral disorders.

Method

The convergent, divergent, and discriminant validity and clinical utility of the ECI-4 was studied in a sample of 224 consecutive referrals (3–6-year-old children) to a child psychiatric outpatient clinic.

Results

The ECI-4 demonstrated adequate criterion validity for the most common disorders (attention-deficit/hyperactivity disorder, oppositional defiant disorder, pervasive developmental disorder) when compared with data-based psychiatric diagnoses and correlated well with relevant scales of the Child Behavior Checklist, Teacher's Report Form, and Inattention/Overactivity With Aggression (IOWA) Conners.

Conclusion

The ECI-4 appears to be a useful screening measure for certain disorders in clinically referred children, but continued research is needed to determine its value in other settings (e.g., school and community), and its validity with other measurement methodologies.

Section snippets

Participants

The study sample consisted of 224 consecutive referrals (172 boys, 52 girls) to a child psychiatry outpatient clinic in a research-oriented university hospital. The children were between 3 and 6 years old (mean = 4.55, SD = 0.77), and their ethnic status was white (87%), African American (6%), Hispanic American (6%), or Asian American (1%). School-reported IQs (n = 97) ranged from 50 to 142 (mean = 89.7, SD = 17.4). The children's school placements were special education (39% in preschool, 23%

Internal Consistency

Coefficient α was calculated for each symptom category of the ECI-4. For parent ratings, the α value was relatively high for ADHD-I (.91), ADHD-HI (.90), ODD (.93), CD (.87), Autistic Disorder (.90), and Separation Anxiety Disorder (.83), but lower for depressive disorders (.59–.68). Teacher ratings were similar: >.84 for the disruptive behavior disorders and Autistic Disorder, and .42 to .54 for depressive disorders.

Agreement with Chart Diagnoses

ECI-4 Screening Cutoff scores were compared with chart diagnoses using the

DISCUSSION

The ECI-4 is the first DSM-IV–referenced behavior rating scale for assessing the symptoms of a wide array of emotional and behavioral disorders in preschool-age children. The results of this and other studies support the validity of the ECI-4 as a screen for at least some emotional and behavior disorders in this age group (i.e., ADHD, ODD, and PDD) and suggest that continued study and application of this instrument is warranted (Gadow and Nolan, 2002;Gadow et al., 2001, Gadow et al.;Nolan et

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    Information about obtaining the ECI-4 is available at http://www.checkmateplus.com.

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