Reliability and Validity of the Behavioral Check List for Preschool Children to Measure Attention Deficit Hyperactivity Behaviors

Kanami Tsuno, Kouichi Yoshimasu, Takashi Hayashi, Nozomi Tatsuta, Yuki Ito, Michihiro Kamijima, Kunihiko Nakai

Research output: Contribution to journalArticlepeer-review


OBJECTIVES: Nowadays, attention deficit hyperactivity (ADH) problems are observed commonly among school-age children. However, questionnaires specific to ADH behaviors among preschool children are very few. The aim of this study was to investigate the reliability and validity of the 25-item Behavioral Check List (BCL), which was developed from interviews of parents with children who were diagnosed as having Attention-deficit/hyperactivity disorder (ADHD) and measures ADH behaviors in preschool age.

METHODS: We recruited 22 teachers from 10 nurseries/kindergartens in Miyagi Prefecture, Japan. A total of 138 preschool children were assessed using the BCL. To investigate inter-rater reliability, two teachers from each facility assess seven to twenty children in their class, and intraclass correlation coefficients (ICCs) were calculated. The teachers additionally answered questions in the 1/5-5 Caregiver-Teacher Report Form (C-TRF) to investigate the criterion validity of the BCL. To investigate structural validity, exploratory factor analysis with promax rotation and confirmatory factor analysis were performed.

RESULTS: The internal consistency reliability of the BCL was good (α = 0.92) and correlation analyses also confirmed its excellent criterion validity. Although exploratory factor analysis for the BCL yielded a five-factor model that consisted of a factor structure different from that of the original one, the results were similar to the original six factors. The ICCs of the BCL were 0.38-0.99 and it was not high enough for inter-rater reliability in some facilities. However, there is a possibility to improve it by giving raters adequate explanations when using BCL.

CONCLUSIONS: The present study showed acceptable levels of reliability and validity of the BCL among Japanese preschool children.

Original languageEnglish
Pages (from-to)225-234
Number of pages10
JournalNihon eiseigaku zasshi. Japanese journal of hygiene
Issue number2
Publication statusPublished - 2018


  • ADHD
  • child
  • inter-rater reliability
  • preschool
  • scale

ASJC Scopus subject areas

  • Medicine(all)


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