Brief Assessment Checklist for Children (BAC-C)

Assessment Rating:
A
A – Psychometrics Well-Demonstrated
See entire scale
Developer(s):

Michael Tarren-Sweeney, PhD

Description / Purpose:

Type of Tool: Brief Assessment Checklist for Children (BAC-C) is both a Screening Tool and Assessment Tool.

Trauma- and attachment-related mental health difficulties manifested by children in out-of-home care that are not adequately covered by standard carer-report mental health checklists.

The Brief Assessment Checklist for Children (BAC-C) is a 20-item caregiver-report rating scale designed to screen for clinically meaningful trauma- and attachment-related mental health difficulties experienced by children in out-of-home care (foster, kinship, and residential care), as well as children adopted from care. The checklist can also be used as a brief casework and treatment monitoring tool by children’s agencies and mental health services respectively. It can be safely administered and interpreted by health and social care professionals without clinical training. The BAC-C was derived from the Assessment Checklist for Children (ACC, 120 items).

Target Population: Age ranges: 4–11 years of age

Time to Administer: 5 minutes

Completed By: A child’s caregiver (if in family-based care), adoptive parent, or their primary residential worker (if in residential care)

Modalities Available: Pen and paper, with the developer’s permission, some services have created an in-house online version for their client families

Scoring Information: The checklist is primarily hand scored. However, some agencies have created an online version for their client families that is computer-scored.

Languages Available: Dutch, English, German, Spanish

Training Requirements for Intended Users: None. The checklist was designed so that it can be scored and interpreted by caseworkers and support workers who do not have mental health training.

Availability: The checklist can be freely downloaded from the Assessment Checklist measures website at: www.childpsych.org.uk User information about the measure is provided here: http://www.childpsych.org.uk/BACinfo.html The measure is downloaded from here: http://www.childpsych.org.uk/downloadBAC.html

Contact Information

Website: www.childpsych.org.uk
Name: Michael Tarren-Sweeney
Title: Professor
Email:
Phone: (643) 347-4906

Summary of Relevant Psychometric Research

This tool has received the Measurement Tools Rating of "A – Psychometrics Well-Demonstrated" based on the published, peer-reviewed research available. The tool must have 2 or more published, peer-reviewed studies that have established the measure’s psychometrics (e.g., reliability and validity, sensitivity and specificity, etc.). Please see the Measurement Tools Rating Scale for more information.

Show relevant research...

Tarren-Sweeney, M. (2013). The Brief Assessment Checklists (BAC-C, BAC-A): Mental health screening measures for school-aged children and adolescents in foster, kinship, residential and adoptive care. Children and Youth Services Review, 35(5), 771–779. https://doi.org/10.1016/j.childyouth.2013.01.025

Sample:

Participants — 347 children (aged 4 to 11 years, 176 boys and 171 girls) residing in long-term foster (N=297) and kinship (N=50) care in Australia

Race/Ethnicity — Not reported

Summary:

The Brief Assessment Checklist for Children (BAC-C) is a 20-item caregiver-report psychiatric rating scale designed to: 1. screen for and monitor clinically-meaningful mental health difficulties experienced by children in various types of care; and 2. be safely administered and interpreted by health and social care professionals other than child and adolescent mental health clinicians. The BAC-C was also designed to be used as brief casework monitoring tools by foster care and adoption agencies, and for treatment monitoring in CAMHS. The BAC-C was derived from the Assessment Checklist for Children (ACC, 120 items). Internal consistency of BAC-C was 0.89. The BAC-C was highly accurate in screening for clinical range ACC scores (area under the curve (AUC) ranging from 0.96 to 0.99), as well as for CBCL clinical range scores (AUCs: BAC-C=0.89 to 0.92). It was moderately accurate in screening for children that caregivers reported had been referred to mental health services (AUCs: BAC-C=0.74). Initial BAC-C psychometric properties compare favorably with that of existing screening instruments, including the Strengths and Difficulties Questionnaire and the Brief Problem Monitor (CBCL short form).

Harding, L., Murray, K., Shakespeare-Finch, J., & Frey, R. (2018). High stress experienced in the foster and kin carer role: Understanding the complexities of the carer and child in context. Children and Youth Services Review, 95, 316–326. https://doi.org/10.1016/j.childyouth.2018.11.004

Sample:

Participants — 158 foster and kin caregivers in Queensland, Australia

Race/Ethnicity — Not reported

Summary:

The current study examined placement, carer, and child characteristics related to perceived foster parent stress in a sample of foster and kin caregivers. Carers completed a self-report online survey that assessed parenting stress, and carer perceptions of the child in their care and the child protection system. Overall, foster carers reported high stress, with 20% in the clinical range on the Parenting Stress Index (PSI-4-SF). This stress was significantly higher for those providing care for children with carer-reported high emotional and behavioral problems, as measured by the BAC-C (which had a Cronbach's alpha coefficient of 0.86 in this study). The carer's report of the child's emotional and behavioral problems (BAC-C) total score was found to be a significant predictor and accounted for 32% of the variance in parenting stress. Both foster carer stress and the child's emotional and behavioral challenges were significantly related to placement factors such as, the length of time the child had been in their current placement and the child protection court order under which the child had been placed.

Goemans, A., Tarren-Sweeney, M., van Geel, M., & Vedder, P. (2018). Psychosocial screening and monitoring for children in foster care: Psychometric properties of the Brief Assessment Checklists in a Dutch population study. Clinical Child Psychology & Psychiatry, 23(1), 9–24. https://doi.org/10.1177/1359104517706527

Sample:

Participants — 118 Dutch foster children, 4–11 years of age

Race/Ethnicity — Not reported

Summary:

This article reports psychometric properties of the BAC-C, estimated in a population study of Dutch foster children. The results suggest the BAC-C performs both screening and monitoring functions well. Its screening accuracy, internal reliability, and concurrent validity are comparable to those estimated for the SDQ within the same child sample. Future research is needed to assess the value of the Brief Assessment Checklists (BAC) compared to other measures and to validate cut-points for the BAC. This study further establishes the BAC-C as a valid and useful mental health screening and monitoring measure for use with children in foster care.

Tarren-Sweeney, M., Goemans, A., Hahne, A., & Gieve, M. (2019). Mental health screening for children in care using the Strengths and Difficulties Questionnaire and the Brief Assessment Checklists: Guidance from three national studies. Developmental Child Welfare, 1(2), 177–196. https://doi.org/10.1177/2516103219829756

Sample:

Participants — 347 4- to 11-year-olds (same sample as Tarren-Sweeney (2013) above). Dutch study: 118 children (4- to 11-year-olds) (same sample as Goemans et al. (2018) above). English sample: 499 clinic-referred children

Race/Ethnicity — Not reported

Summary:

This article compares mental health screening properties of the Strengths and Difficulties Questionnaire (SDQ), Brief Assessment Checklist (BAC), and a “SDQ proxy” score (generated from a set of Child Behavior Checklist (CBCL) items approximating the SDQ total difficulties scale) in relation to various clinical case reference criteria, across three national studies of children and adolescents residing in alternative care (Australia, the Netherlands, and England). The SDQ and BAC demonstrated moderate to high screening accuracy (sensitivity and specificity) across a range of clinical case criteria—the SDQ being slightly better at predicting general mental health problems and the BAC slightly better at predicting attachment- and trauma-related problems. Accurate first-stage screening is achieved using either the SDQ or the BAC alone, with recommended cut points of 10 (i.e., positive screen is 10 or higher) for the SDQ and 7 for the BAC. Greater accuracy is gained from using the SDQ and BAC in parallel, with positive screens defined by an SDQ score of 11 or higher or a BAC score of 8 or higher. Agencies and post-adoption support services should refer positive screens for comprehensive mental health assessment by clinical services.

Date Reviewed: September 2021 (Originally reviewed in September 2021)