Children's Review Program
A program of
Funded in Whole from Federal and Cabinet for Health and Family Services Funds

How to Complete a Hardcopy Achenbach Child Behavior Checklist (CBCL) for Ages 1 ½ - 5

For all CBCL forms provide all of the child identification information requested in the top half of Page 1.

Complete the problem items (1 – 100) on pages 1 and 2. Do not complete Pages 3 and 4 (Language Development Survey for Ages 18-35 Months).

Fill in the circles completely. Use a pencil. If you make a mistake, erase completely; do not cross it out. These forms are scored by a computer which cannot determine when a circle is crossed out. Use a dark pen or pencil to fill in the circle.

Persons who complete CBCLs should be adults who know the children well, such as parents, foster parents, or State Social Workers.

Report behavior happening now or that happened within the past 2 months. Do not report behavior if it happened before 2 months ago.

If you are not sure whether a child has a problem, it is best to mark it 0, which means not true. If you skip an item you don't know, the computer scoring program may classify the CBCL as invalid, and the CBCL will be returned to you to complete the blank items. Please be as accurate as possible in your responses.

Once the form has been completed, please mail (DO NOT FAX) it to:

Children’s Review Program
1351 Newtown Pike, Building 3
Lexington, KY 40511-1278

For questions or to request additional Child Behavior Checklist for Ages 1 ½-5 forms, contact the CRP office at (859) 455-7452.