OverviewThe BPM/6-18 provides normed multi-informant monitoring of children’s

functioning & responses to interventions (RTIs)Parallel Multi-Informant BPM Forms● Separateformsarecompletedin1to2minutesbyparentfigures(BPM-P),teachers(BPM-T),&youths(BPM-Y)

● Internalizing,AttentionProblems,Externalizing,&TotalProblemsscales● Parallelitems&scalesontheBPM/6-18&theCBCL/6-18,TRF,&YSRenableuserstolinkcomprehensiveinitial&outcomeassessmentstoBPM/6-18scores

● Userscanadditemsforassessingstrengths&problems● Completedatuser-selectedintervalsofdays,weeks,months

Normed Scale Scores● Normsforeachgenderatages6-11&12-18(BPM-P&BPM-T)or11-18(BPM-Y)● Separatenormsforparent,teacher,&self-ratings● User-selectedmulticulturalnormsfordozensofsocieties

Computer Output●Computeroutputcomparesitemratings&normedscalescoresfromupto4infomants● Trajectoriesofnormedscalescoresaredisplayedacrossmultipleoccasions

Copyright 2011 & 2017 T.M. Achenbach www.aseba.org mail@aseba.org

Manual for the ASEBABrief Problem Monitor™ for Ages 6-18

(BPM/6-18)T.M. Achenbach, S.H. McConaughy, M.Y. Ivanova, & L.A. Rescorla

Research Center for Children, Youth, and FamiliesUniversity of Vermont

ContentsUseoftheBPM-P,BPM-T,andBPM-Yina

ResidentialFacility...............................................8UseoftheBPM-PandBPM-Tbya

ResearchTeam....................................................9References.....................................................................10AppendixA.DirectionsforUsingtheBPM/6-18........11AppendixB.DevelopmentoftheBPM/6-18...............11AppendixC.Test-RetestReliabilityand

InternalConsistency...............................................12AppendixD.Criterion-RelatedValidity.......................13AppendixE.Cross-InformantCorrelations..................14

WhatistheBPM/6-18?...................................................2WhoCompletestheBPM/6-18?.....................................2HowtoUsetheBPM/6-18..............................................2ComprehensiveInitialandOutcomeAssessments.........6Age,Gender,Informant,andMulticulturalNorms........6IllustrationsoftheBPM/6-18Applications....................6

UseoftheBPM-TbyaSchoolPsychologist............6UseoftheBPM-PandBPM-Ybya

MentalHealthProvider......................................7

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INT,ATT,andEXTratingsaresummedtoyieldtheTotalProblems(TOT)score.

Afteran informantcompletes theBPM,theratings are entered into the BPM software pro-gram. The output includes bar graphs that pro-videside-by-sidedisplaysofscalescoresobtainedfromratingsby1to4informantsoneachocca-sion.AsdetailedintheDirections(AppendixA),eachratingoccasionisdesignatedbyaRating Pe-riod #.AsillustratedinFigure2,thebarsindicatestandardscores(T scores)basedonnormsforthechild’sageandgender,thetypeofinformant,anduser-selectedmulticultural norms (explained lat-er).ThebrokenlineacrossthebargraphsmarksT scoresof65(93rdpercentilefornormativesamplesofchildren).Tscores<65areconsideredtobeinthenormalrange.T scores>65aresufficientlyel-evated tobeofconcern.Bylookingat thebars,userscanquicklyidentifyscalesonwhichinfor-mants’ratingsagreeonproblemlevelsinthenor-malvs.elevatedrangeandscalesonwhichinfor-mants’ratingsdisagree.

The lowestT scoreonall scales is50 (50thpercentile for normative samples).TheT scoresaretruncatedat50topreventoverinterpretationofdifferencesamongscoresthatareinthelownor-malrange,indicatingverylowlevelsofproblems.ThehighestTscoreis75(99.4thpercentile)ontheINT,ATT,andEXTscales.OntheTOTscale,thehighestTscoreis80(99.9thpercentile),whichal-lowsextradifferentiationamonghighscoresthatarebasedonalltheBPMitems.

Abbreviatedversionsoftheitemscomprisingeachscalearelistedbeneaththebargraphs,alongwitheachinformant’s0-1-2ratings.The0-1-2rat-ingsenableuserstoidentifyitemsonwhichinfor-mantsagreeordisagree.

Thesoftwarecanalsoprint linegraphs thatdisplay trajectories of scale scores across ratingperiods.Figure3illustratestrajectoriesofBPM-Tscores.Thesetrajectoriesenableuserstoiden-tifyscalesonwhichachild’sproblemsimprove,worsen,orstaythesame,accordingtoratingsbyeachinformant.Inaddition,thesoftwarecandis-play scale scores from each informant’s ratingsforeachRatingPeriod,plusratingsofuptothreeuser-specifiedproblemsand/orstrengths.

What is the BPM/6-18?Completedin1to2minutes,theBPM/6-18

isaratingformformonitoringchildren’sfunction-ingandresponsestointerventions(RTIs).(Fromhereon,wewilluse“BPM”torefertotheBPM/6-18.)TheBPMcanalsobeusedtocomparechil-dren’sresponsestodifferentinterventionandcon-trolconditions.

TheBPMincludesitemsforratingInternal-izing (INT),Attention (ATT), and Externalizing(EXT)problemsoveruser-selectedratingintervals(e.g.,5,7,14,30,45days).TheitemsaredrawnfromtheChildBehaviorChecklistforAges6-18(CBCL/6-18),Teacher’sReportForm(TRF),andYouthSelf-Report(YSR)(Achenbach&Rescorla,2001).Eachitemisrated0 = not true, 1 = some-what true,or2 = very true.Userscanaddproblemsand/orstrengthsnotalreadyontheBPM,suchasthosethatareespeciallytargetedforchange.

AppendixAhasdirectionsforusingtheBPM.AppendixBdetailsthedevelopmentoftheBPM,whileAppendicesC-Eprovidepsychometricdata.

Who Completes the BPM?

Separate formsaredesignedforcompletionbyparents(BPM-P),teachers(BPM-T),and11-to18-year-oldyouths(BPM-Y).Otherinformants—suchas familymembers, staff in residential, in-patient,anddetentionfacilities,schoolpersonnel,observers, and practitioners—can also completetheBPM-PandBPM-T.Manychildrenyoungerthan11maybeabletocompletetheBPM-Y.Theformscanbeself-administeredoradministeredbyinterviewersinpersonorbytelephone.Wordedap-propriatelyfortheintendedinformant,eachformoftheBPMassessesthesame18items.However,theBPM-PandBPM-Yhaveanadditionalitemfordisobedienceathome,whichwouldnotbeap-propriatefortheBPM-T.

How to Use the BPMFigure 1 displays the BPM-P. Spaces are

provided forwriting in additional problems andstrengths,aswellascommentsforeachitem.Thesuperscripts INT,ATT,andEXTinFigure1 in-dicate itemswhose0-1-2ratingsaresummedtoyieldscoresforeachBPMscale.(ThesuperscriptsarenotprintedontheactualBPMforms.)Allthe

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Figure 1. The BPM-P. Superscripts indicate the items scored on the INT, ATT, and EXT scales, which are summed to yield the TOT score. (Superscripts are not printed on the actual form.)

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Comprehensive Initial and Outcome Assessments

TheCBCL/6-18,TRF,and/orYSRprovidemorecomprehensiveassessmentsthanarepos-siblewithbrief formssuchas theBPM. Inter-viewswithchildrenandparents,tests,develop-mentalhistories,andmedicalexaminationsmayalsoberelevantinmanycases.Itisstronglyrec-ommended thatcomprehensiveassessmentsbeused todesign interventions.TheBPMis thenusedtoassessresponsestotheinterventions.

Assessments of outcomes should also besufficiently comprehensive to permit detailedcomparisons of children’s post-interventionfunctioning with their initial functioning. Forexample, if theCBCL/6-18,TRF, and/orYSRareamongtheinitialassessments,userscanre-administer themtoevaluateoutcomesin termsofchangesinmanyitemsandscales.

Age, Gender, Informant, and Multicultural Norms

ThebargraphsinFigure2andthetrajectorygraphsinFigure3displayBPMscalesintermsofscalescoresthatarebasedonnormsforachild’sage and gender, as rated by parents (BPM-P),teachers(BPM-T),or11-to18-year-olds(BPM-Y).Iftheuserdoesnotselectparticularmulticul-turalnorms,thedefaultnormsarebasedonaU.S.nationalsample(Achenbach&Rescorla,2001).

Multiculturalnormsareavailableformanynon-U.S. societies (Achenbach & Rescorla,2015). Societies having BPM-P, BPM-T, andBPM-Ynormsarelistedatwww.aseba.org.Forexample,ifaparentfromSocietyAfillsouttheBPM-P,theusercanhavethesoftwaredisplaytheBPM-Pscalescoresintermsofscalescoresthatareappropriateforthechild’sageandgen-der, as ratedbyparents fromSocietyA. If thechild attends aU.S. school, the user can havethesoftwaredisplaytheBPM-Tscalescoresintermsofscalescoresthatareappropriateforthechild’sageandgender,asratedbyU.S. teach-

ers.AndifthechildisoldenoughtocompletetheBPM-YandissomewhatacculturatedtotheU.S.,theusercanhavethesoftwaredisplaytheBPM-Yscoresintermsofscalescoresthatareappropriateforthechild’sageandgender,asrat-edby11-to18-year-oldsinSocietyAandthenby11-to18-year-oldsintheU.S.

Whatifaninformantisfromasocietythatis not listed at www.aseba.org? Extensive re-searchhasshownthatnormativescoresfromallsocietiesanalyzedtodatefallintothreegroups:Compared to all the societies analyzed,Group 1 has relatively low problem scores;Group 2 has intermediatescores;andGroup 3hasrela-tivelyhighscores.Ifaninformantcomesfromasocietythatisnotlisted,theusercanelecttohavetheBPM/6-18scalesdisplayedintermsofthedefault scores (U.S.norms,whichserveastheGroup2norms).Asanalternative,theusercanhavetheBPMscalesdisplayedintermsofscoresappropriateforasocietythatissimilartotheinformant’ssociety.

Illustrations of BPM Applications

TheBPMcanbeusedinmanywaysandun-dermanyconditions.The following illustrationsexemplifyapplicationsbyaschoolpsychologist,amentalhealthprovider,staffinaresidentialfacil-ity,andaresearchteam.Allnamesandotherper-sonalidentifyinginformationarefictitious.Inthecasestudies,“CBCL”referstotheCBCL/6-18.

Use of the BPM-T by a School Psychologist.Third-gradeteacherDorothyRandallcontactedherschoolpsychologistforhelpwithastudentnamed Robby, who was disrupting her class.AfterRobby’sparents consented to an evalua-tion,theschoolpsychologistaskedeachparenttocompletetheCBCLandaskedMs.RandalltocompletetheTRF.TheschoolpsychologistalsoreviewedRobby’stestscoresandgrades,whichwere mostly in the low average range. Com-mentsfromRobby’spreviousteachersindicatedmoderatebehaviorproblems.

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TheprofilescoredfromtheTRFcompletedbyMs. Randall yielded scores well up in theclinical rangeon theAggressiveBehavior,Ex-ternalizing, and DSM-oriented OppositionalDefiantProblemsscales.Robby’sscoresontheTRF Social Problems andAttention Problemssyndromeswereintheborderlineclinicalrange,while his scores on the other problem scaleswereinthenormalrange.HisAcademicPerfor-manceandAdaptiveFunctioningscoreswereintheborderlineclinicalrange,withanespeciallylowratingforBehavingAppropriately.

On the profiles scored from the CBCLscompletedbyRobby’sparents,theSchoolscaleof the competence profile and theAggressiveBehavior scale were in the borderline clinicalrange, but all other scaleswere in the normalrange. The parents’ responses to the CBCL’sopen-endedquestionsindicatedthattheydidnotfeel any need for help with Robby’s behavioroutsideschool.However,theyconsentedtohavetheschoolpsychologistworkwithMs.RandallonacontingencymanagementinterventionthatwouldincludesendinghomedailyreportcardsdocumentingRobby’sprogress towardspecificbehavioral and academic goals. Robby couldearnrewardsinschoolforachievingthegoals.

Toprovidesystematic,norm-referencedassess-mentofRobby’sschoolbehavior,theschoolpsy-chologistaskedMs.RandalltocompleteaBPM-Tformeachweekfor10weeks.Ms.RandalldecidedtocompletetheBPM-TafterschoolonFridaystoreflectRobby’sbehavioronMondaythroughFri-day.TheschoolpsychologistenteredMs.Randall’sweeklyratingsintotheBPMsoftware.

ForWeeks 1, 2, and3, theBPM-Ts com-pleted by Ms. Randall yielded T scores wellabove65ontheEXTscaleforboysofRobby’sageintheU.S.normgroup.HisTscoresontheATTandTOTscaleswerealsoabove65.How-ever,afterWeek3,Robby’sTscoresonallthreescales gradually dropped, until they were allbelow65byWeek8.Thedecliningscores for

ATT,EXT,andTOTsuggestedthatRobbywasrespondingwelltothecontingencymanagementintervention.

Toevaluatetheoutcomeoftheintervention,the school psychologist askedMs. Randall tocompletetheTRFandbothparentstocompleteCBCLs.When comparedwith the initial TRFscores for Aggressive Behavior, OppositionalDefiant Problems, and Externalizing, the out-comeTRFshoweddeclinesfromthehighendoftheclinicalrangetothelowendoftheborderlineclinicalrange.TRFscoresfor theSocialProb-lems, Attention Problems, and other problemscalesandforadaptivefunctioningwerenowinthenormalrange.ThesechangesinTRFscoresindicated that the improvements found in theBPM-TratingsweresubstantiatedbythemorecomprehensiveTRFscales.

The profiles scored from both parents’outcome CBCLs showed improvement on theSchoolscaleofthecompetenceprofilefromtheborderline clinical to the normal range, plus asmallerimprovementontheAggressiveBehav-iorsyndromescale.TheschoolpsychologistandMs.RandallmetwithRobby’sparentstodiscussthe improvements in Robby’s school behaviorandpossibilities for implementingcontingencymanagementathome.

Use of the BPM-P and BPM-Y by a Men-tal Health Provider.Concernedabout13-year-oldAngie’s lack of friends, socialwithdrawal,and chronic underachievement in school, An-gie’smother soughthelp fromamentalhealthprovider.Angie’smotherfeltthattheproblemsdatedbackatleasttothedeathofAngie’sfather,4yearsearlier.

As part of the initial evaluation, the pro-videraskedAngietocompletetheYSRandhermothertocompletetheCBCL.ComparedwithnormsforgirlsofAngie’sagefromtheappropri-atemulticulturalnormgroup, theYSRandtheCBCLbothyieldedscoresintheclinicalrangeontheWithdrawn/Depressed,Internalizing,and

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DSM-orientedDepressiveProblemsscales.ThescoreswereintheborderlineclinicalrangeontheAnxious/Depressed syndrome. The CBCL alsoyieldedascoreintheclinicalrangeontheSocialProblemssyndromeandintheborderlineclinicalrangeon theThoughtProblems syndrome.An-gie’sYSRscoreforSocialProblemswasintheborderline clinical range.On the social compe-tenceprofiles,theYSRandCBCLActivities,So-cial,andTotalCompetencescoreswereinthelownormalorborderlineclinicalranges.TheCBCLSchoolscalescorewasintheclinicalrange.

Based on Angie’s history, the CBCL andYSRscores,andinterviewswithAngieandhermother, the provider concluded thatAngiemetDSM criteria for a diagnosis of Persistent De-pressive Disorder. The provider recommendedweeklycognitivebehavioraltherapysessionsforAngie,plusoccasionalfamilysessionsforAngieandhermothertogether.TomonitorAngie’sre-sponsetotreatment,theprovideraskedAngietocompletetheBPM-YandhermothertocompletetheBPM-Ponthedaybeforethefirsttreatmentsessionandonthesamedayeachweekthereafter.

On both the BPM-Y and the BPM-P, theinitialTscoreswereabove65forINTandTOTbutwerewellbelow65forATTandEXT.After6weeksofindividualsessionsand3familyses-sions, the BPM-YT score for INT declined tojustabove65,while theTOTscoredeclined tothehighnormalrange.TheBPM-PTscoresre-mainedsomewhatabove65ontheINTandTOTscales.

BasedontheBPMfindingsandtheprogressoftherapy,theproviderrecommendedthatAngieattendaweeklysocialskillsgroup,whichAngiereluctantlydid.Theprovider continued tomeetwithAngieforindividualtherapysessionseveryotherweekandforoccasionalfamilysessions.

After3monthsinthesocialskillsgroup,An-gieagaincompletedtheBPM-Yandhermothercompleted theBPM-P.Onboth forms, the INTandTOTscoreswerenowinthenormalrange.

Foranoutcomeevaluation6monthsaftertheinitialevaluation,theprovideraskedAngietocomplete theYSRandhermother tocom-plete theCBCL.Both formsyielded substan-tiallylowerscoresthanattheinitialassessmentontheWithdrawn/Depressed,Internalizing,So-cialProblems,andDepressiveProblemsscales.Scores on the Activities, Social, and Schoolscalesof thecompetenceprofilehadalso im-proved.TosupportfurtherdevelopmentofAn-gie’ssocialskillsandtohelpherprepareforde-velopmentalchallenges,theproviderarrangedtocontinueseeingAngieat3-monthintervals.

Use of the BPM-P, BPM-T, and BPM-Y in a Residential Facility.Afterasuicideattempt,12-year-oldLucasenteredresidentialtreatmentatHatfieldHouse.Lucashadreceivedspecialeducationsincefirstgrade,duetolearningdif-ficulties and emotional disturbance, and hadattendedaself-containedschool-basedmentalhealthprogramforthepast2years.Priortoen-teringHatfieldHouse,Lucashadlivedwithhismotherandsiblingsinmanyplaces,includingahomelessshelter.WhenadmittedtoHatfieldHouse,Lucashad livedwithhisgrandparentsfor2years, followinghismother’s incarcera-tionfordrugoffenses.

Aspart of the admissionsprocedure,Lu-cas’s grandparents completed CBCLs, LucascompletedtheYSR,andhisteacherscomplet-edTRFs. Onmost forms, scoreswere in theclinicalrangeontheAnxious/Depressed,With-drawn/Depressed, Social Problems, ThoughtProblems,Attention Problems,Rule-BreakingBehavior, and Aggressive Behavior scales.Lucas was described as funny and friendlyat times,butalsoasprone toviolent rages inwhichhewouldattackothers,destroyproperty,andsometimeshurthimself.AlthoughhisIQwasinthenormalrange,Lucashadsevereat-tentionproblemsandhiscompetence/adaptivefunctioningscoreswerelow.Hewasoftenbel-ligerentandconfrontationalwith teachersandpeers.

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Because Lucas’s reading and math skillswereonlyatafourthgradelevel,Lucas’sschoolprogram at Hatfield addressed his basic skilldeficits.Thestaffpsychiatristprescribedmedi-cations for Lucas’s attention problems, mooddysregulation, and aggressive behavior. Lucasalsoreceiveddailygrouptherapy,weeklyindi-vidualtherapy,andweeklyfamilysessionswithhis grandparents. He could earn privileges forachievingbehavioralgoals.

TheBPMwasusedtomonitorLucas’sre-sponsetotreatment,withhisteacher,hishouse-parent,andLucascompleting formsat2-weekintervals. Over the first 3 months, his EXTscoresgraduallydropped,decliningfrom>70to65-66accordingtoallthreeraters.Hehadfewerangry and aggressive outbursts, enabling himto earn video game and TV privileges. Lucasshowed improved focus andpersistence in theclassroom,withhisBPM-TATTscoresdeclin-ingfrom72to67overthefirst5ratingperiods.However, theBPM-Pcompletedbyhishouse-parent suggested that Lucas still had attentionproblemswithhomework,soamorestructuredhomeworkprogramwasimplemented.

OntheBPM-Y,Lucas’sINTscorewas73at Rating Period 1 and was still above 70 byRatingPeriod5.Lucas’stherapistreportedthatLucashadonlyrecentlybegunsharinginforma-tion about his life, including memories of hismother’sabsences from thehome,herabusiveboyfriends, frequent moves, and struggles inschool.InadditiontotalkingwithLucasaboutthesepainfulexperiences, thetherapistencour-agedLucastothinkaboutinterestshecouldpur-sueatHatfieldHouse.Inresponse,Lucasbeganworkingoutinthefitnessroomandrunningonthe trackand soon joinedagroupwho joggedwith a staffmember.Lucas also startedwork-ing in theshop,wherehe learned touse tools.Asheadvanced,hestartedhelpingtheHatfieldHousecustodianwithrepairs.Theseexperiencesseemedtobehelpful,becausebyRatingPeriod8Lucas’sBPM-YINTscorehaddeclinedto66.

DuringhislastmonthsatHatfieldHouse,Lucas spent weekends with his grandparents.BPMs (now completed monthly) indicatedfurther improvements. At discharge, CBCLscompletedbyhisgrandparentsandhisHatfieldhouseparent, aswell as theYSRand theTRF,yieldedscores in theborderlinerangeonAnx-ious/Depressed, Attention Problems, and Ag-gressiveBehavior.Thesescores indicatedcon-tinuing needs for support but also significantimprovementssincehisintakeevaluation. Use of the BPM-P and BPM-T by a Re-search Team.Rigoroustestsofinterventionef-fects require statistical comparisons of scoreson comprehensive assessment instruments ad-ministeredpriortointerventionsandagainfol-lowing interventions.However, toevaluate thecourseoffunctioningduringinterventions,itisoftennecessarytousebriefermeasuresthatcanbe quickly completed multiple times betweentheinitialandoutcomeassessments.TheBPMisespeciallyusefulformonitoringthecourseoffunctioningduringevidence-basedinterventionsforthefollowingreasons:TheBPMtakesonly1to2minutestocomplete,canbecompletedbydifferentkindsofinformants,canbere-admin-istered at user-selected intervals, and displaystrajectoriesofnormedscalescores,plusquanti-tativeratingsofspecificitems. Asanexample, a research teamdesigneda comparison of (a) stimulant medication, (b) training in executive functioning, and (c) bothtreatments for 6- to 11-year-olds diagnosed ashaving Attention Deficit-Hyperactivity Disor-der-CombinedType(ADHD-C).Aspartoftherecruitmentforthestudy,parentscompletedtheCBCL and teachers completed theTRF. Chil-drenwhoobtained scores in the clinical rangeontheCBCLandTRFDSM-orientedAttentionProblemsscalewerethenevaluatedclinicallytoconfirmwhethertheymetcriteriaforADHD-C.Children who met criteria forADHD-C wererandomlyassignedto14-weektrialsofinterven-tionconditiona, b,orc.Toevaluatethecourse

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of the children’s functioning, the BPM-P andBPM-Twerecompletedatweeklyintervalsdur-ingthefirst10weeksoftheinterventions.Medi-calevaluationsweredonetodetectpossiblesideeffects. Trajectories of functioning during thethreeinterventionconditionswerecomparedviastatisticalanalysesofrawscalescoresfromthe10 administrations of theBPM-P andBPM-T.Thescoresforthreegroupsofparticipantsat10ratingperiodsmake avarietyof analysespos-sible, such as comparisons of slopes, growthcurvemodeling,andrepeatedmeasuresanalysisofvariance.

RawBPMscalescoresareoftenpreferabletoT scores forstatisticalanalyses,because theBPMTscoresaretruncatedat50.Thetruncationat 50 prevents overinterpretation of unimport-antdifferencesbetweenlowscoreswhenview-ing profiles for individual children. For groupanalyses,however,rawscalescorescanincrease

statisticalpowerbypreservinggreaterdifferen-tiationamongscalescoresthanthetruncatedT scoresdo.

Outcomesforinterventionconditionsa, b, andcwerecomparedviastatisticalanalysesofrawscalescoresonCBCLsandTRFscompletedat14weeks,basedonratingsof thepreceding4weeks.Pre-interventionCBCLandTRFscalescoreswerestatisticallycovariedoutofthecom-parisons between outcome scores for childrenreceivingconditionsa versusb versusc.Clinicalevaluations were also performed to categorizechildrenasstillmeetingdiagnosticcriteriaornolongermeetingdiagnosticcriteriaforADHD-Candtoidentifypossiblechangesinotherdiagno-ses.TheresultscouldthusbecomparedintermsofchangesmeasuredbytheBPM-PandBPM-Tduringthecourseofinterventionconditionsa, b,and c,aswellasCBCLs,TRFs,anddiagnosesfollowingtheinterventions.

References

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). NewYork:AcademicPress.

Dumenci, L., McConaughy, S.H., &Achen-bach,(2004).Ahierarchicalthree-factormod-el of inattention-hyperactivity-impulsivity de-rived from theAttentionProblems syndromeof the Teacher’s Report Form. School Psy-chology Review, 33,287-301.

McConaughy, S.H., Harder, V.S., Antshel,K.M., Gordon, M., Eiraldi, R., & Dumenci,L.(2010).Incrementalvalidityoftestsessionandclassroomobservationsinamultimethodassessment of attention deficit/hyperactivitydisorder.Journal of Clinical Child & Adoles-cent Psychology, 39,650-666.

Rescorla,L.,Ginzburg,S.,Achenbach,T.M.,Ivanova, M.Y., Almqvist, F., Bilenberg, N.,et al. (2013).Cross-informant agreement be-tween parent-reported and adolescent self-reportedproblemsin25societies.Journal of Clinical Child & Adolescent Psychology, 42,262-273.

Achenbach,T.M.,&Rescorla,L.A.(2001).Man-ual for the ASEBA school-age forms & profiles.Burlington,VT:UniversityofVermont,ResearchCenterforChildren,Youth,andFamilies.

Achenbach,T.M.,&Rescorla,L.A.(2007).Multi-cultural supplement to the Manual for the ASEBA School-Age Forms & Profiles. Burlington, VT:UniversityofVermontResearchCenterforChil-dren,Youth,andFamilies.

Achenbach,T.M.,&Rescorla,L.A.(2015).Multi-cultural guide for the ASEBA forms & profiles for ages 1½-59.Burlington,VT:University ofVer-mont Research Center for Children,Youth, andFamilies.

AmericanPsychiatricAssociation. (2000,2013).Diagnostic and statistical manual of mental dis-orders(4thed.,5thed.).Washington,DC:Author.Chorpita,B.F.,Reise,S.,Weisz,J.R.,Grubbs,K.,Becker,K.D.,Krull,J.L.,etal.(2010).EvaluationoftheBriefProblemChecklist:Childandcaregiv-erinterviewstomeasureclinicalprogress.Journal of Consulting and Clinical Psychology, 78,526-536.

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Appendix A. Directions for Using the BPM/6-18Informants Who Complete the BPM.BPM-P:Parents,otheradulthouseholdmembers,staff

of inpatient units, camps, detention and residential facilities. BPM-T: School teachers, staff,observers.BPM-Y:11-18-year-oldyouths;youngerchildreniftheyareable.

User.TheUseristhepersonwhoorganizesBPMassessmentofachild.

ID #.Inthe“Forofficeuseonly”box(toprighthandcorneroftheBPM),theUsershouldwriteanID #forthechild.AllBPMscompletedforachildshouldhavethesameID#thatisusedonlyforthatchild’sBPMstoenabletheBPMsoftwaretolinkthechild’sBPMs.

Rating Period #.Inthe“COMPLETETHISFORMBY”box,theUsershouldwritethedatebywhichinformantsshouldmaketheirfirstratingsofachild.RatingsmadebythisUser-specifieddateshouldallbedesignatedasRating Period #1. Rating Period #2 shouldbeusedtodesignateallratingsmadeafterthedeadlineforRatingPeriod#1andbytheUser-specifieddeadlineforRatingPeriod#2,andsoonforRatingPeriods#3,4,etc. The Rating Period # should be written in the "For office use only" box.

Omission of Item Ratings. If an informantomits ratings for>2of the itemsprintedon theBPM,theBPMsoftwarewilldisplaythefollowingmessage:Scale scores may be invalid because x (thenumberofunrated items) items were left unrated.Omitted itemscountaszeroes inscalescores.

Adding Items.Userscanwriteinadditionalproblemsand/orstrengthsinthespacesprovidedat thebottomof theBPM.The0-1-2 ratingsofup to3additional itemscanbekeyentered fordisplayandexportbytheBPMsoftware.However,becausetheadditionalitemsarenonstandard,theyareexcludedfromthescalescoresandfromthetallyofomitteditems.

BPM Software Output.ScoresforInternalizing(INT),AttentionProblems(ATT), Externalizing(EXT),andTotalProblems(TOT)scalesaredisplayedin2kindsofgraphs:

1. Bar graphs.BargraphsdisplayTscoresfromupto4informantsforeachscaleforeachRat-ingPeriod.TheTscoresshowhowthechild’sscorescomparewithnormsforthechild’sage,gender,thetypeofinformant(P,T,orY),anduser-selectedmulticulturalnormgroup.TheTscoresrangefrom50(50thpercentilefornormativesamplesofchildren)upto75(99.4thper-centile)ontheINT,ATT,andEXTscales,andupto80(99.9thpercentile)ontheTOTscale.Tscores>65arehighenoughtobeofconcern.SeparatebargraphscanalsobeproducedforeachBPM.

2. Trajectory graphs.TrajectoriesofBPMTscorescanbedisplayedacross2to10RatingPeriods.

Appendix B. Development of the BPM/6-18

TheBPMconsistsofCBCL/6-18,TRF,andYSRitemsselectedasfollows:

1. TheBPMINTandEXTitemswereselectedfromtheCBCL/6-18andYSRusingitemre-sponsetheoryandfactoranalysisinastudybyChorpitaetal.(2010).AlthoughChorpitaetal.combinedDisobedient at homeandDisobedient at schoolintoasingleitem,theBPM-PandBPM-YpreservethegreaterdifferentiationaffordedbyretainingtheseparateCBCL/6-18andYSRitemsfordisobedienceathomeanddisobedienceatschool.Becauseschoolperson-

Days in Interval:TheUsershoulddecidethenumberofdaysonwhichratingsaretobebased.TheUsershouldthenwritethisnumber(e.g.,7)ontheBPMinthe“Forofficeuseonly”boxandalsointhespacebefore“days”intheinstructionstoraters.

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BPM-Pa BPM-Ta BPM-Ya

Scale r Alpha r Alpha r Alpha

N=73 3,210 44 3,086 89 1,938INT .81b .80 .86b .80 .80b .78ATT .83b,c .85 .93 .87 .77 .74EXT .83b .88 .88 .88 .85b,c .75TOT .85b .92 .93b,c .90 .88b .86

Note.SamplesaredescribedbyAchenbachandRescorla(2001,pp.101-102).AllPearsonrsweresignificantatp<.001.aMeantest-retestintervalforBPM-PandBPM-Y=8days;forBPM-T=16days.bTime1meanscalescore>Time2byttest(p<.05).cWhencorrectedforthenumberofcomparisons,Time1versusTime2differencewasnotsignificant.

nel are not apt to know about a child’s disobedience at home, the BPM-T has onlyDisobedient at school, but all other BPM-T items are TRF counterparts of BPM-P andBPM-Yitems.Consequent-ly,theEXTandTOTscaleshaveonelessitemontheBPM-TthanontheBPM-PandBPM-Y.

Because Chorpita et al. focused only on Internalizing and Externalizing, we conducted analyses to select items for assessing problems of attention and overactivity, on whichinterventionsoftenfocus.Oursamplesincluded6-to11-year-oldchildrenmeetingresearchcriteria for DSM-IV-TR, which remained similar for DSM-5 diagnoses of ADHD(American Psychiatric Association, 2000, 2013), plus children seen in the same clinicalsettings but notmeeting criteria for any type ofADHD diag-nosis (McConaughy et al.,2010).Wetestedtheabilityofthe10itemscommontotheCBCL/6- 18andTRFAttentionProblemssyndrometodiscriminatebetweenthetwodiagnosticgroups.Sepa-ratelyforthechildren’sCBCL/6-18(N =204)andTRF(N=199),weenteredthe10itemsascandi-datepredictorsinstepwisediscriminantanalyses,withdiagnosesofADHDversusnon-ADHDastheclassificationvariable.

The following items survived as significant discriminators in theCBCL/6-18, TRF, or bothdiscriminantanalyses:Fails to finish things he/she starts; Can’t concentrate, can’t pay attention for long; Can’t sit still, restless, or hyperactive; Impulsive or acts without thinking;andInattentive or easily distracted.WeaddedActs too young for agetothefiveitemsidentifiedinthediscriminantanalyses, because extensive factor analytic research has shown that this item obtained higherloadingsonageneralADHDfactorderivedfromTRFratingsofgeneralpopulation(N=2,635)andclinical (N = 2,702) samples than other items common to the CBCL/6-18 and TRF (Dumenci,McConaughy,&Achenbach,2004).ConfirmatoryfactoranalysesbyDumencietal.supportedthegeneralADHDfactorina3-factormodelwhereallitemsofspecificInattentionandHyperactivity-Impulsivityfac-torsloadedonthegeneralADHDfactor.

Appendix C. Test-Retest Reliability and Internal Consistency

Thetablebelowdisplaystest-retestreliabilitycorrelations(Pearsonr)andinternalconsistencies(Cronbach’salpha)ofBPMscalescorescomputedfortheU.S.samplesdescribedintheManual for the ASEBA School-Age Forms & Profiles(Achenbach&Rescorla,2001,pp.101-102).

2.

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Appendix D. Criterion-Related ValidityCriterion-relatedvaliditywastestedviamultipleregressionanalysesofBPMscalescoresfor

U.S.samplesofchildrenreferredformentalhealthservicesvs.demographicallysimilarnonreferredchildren(Achenbach&Rescorla,2001,pp.109-114,describethesamplesandanalyticprocedures).Numbersinthetableareeffectsizes,i.e.,thepercentageofvarianceinBPMscalescoresthatwasuniquelyaccountedforbydifferencesbetweenscoresobtainedbyreferredvs.nonreferredchildren,afterpartialingouteffectsofage,socioeconomicstatus(SES),andethnicity(white,AfricanAmeri-can,andHispanicontheBPM-PandBPM-Y;whiteandAfricanAmericanontheBPM-T).

AccordingtoCohen’scriteriaformultipleregression,effectsizes2-13%aresmall,13-26%aremedium,and≥26%arelarge.AllBPMscalescoresweresignificantly(p<.001)higherforreferredthannonreferredchildren.

Note. Eachsamplewasequallydividedbetweendemographicallysimilarreferredandnonreferredchildren.AnalysesweremultipleregressionsofrawBPMscalescoresonreferralstatus,age,SES,whitevs.otherethnicity,AfricanAmericanvs.otherethnicity,andLatinovs.otherethnicity(exceptBPM-T).aEffectsizesarethemeanpercentagesofvarianceuniquelyaccountedforbyreferralstatus,averagedacrosseachgender/agegroupanalyzedseparately(eachgenderatages6-11and12-18forBPM-PandBPM-T;eachgenderatages11-18forBPM-Y),afterpartialingouteffectsofage,SES,andethnicity.bTheonlydemographicvariablewhosesignificant(p<.001)effectsexceededchanceexpectationswasSESforBPM-TATT,EXT,andTOTscalescoresobtainedbygirlsages6-11andboysages12-18.Averagedacrossthe4gender/agegroups,theeffectsizesforSESwere1%forBPM-TATTand2%forBPM-TEXTandTOT.Theseverysmalleffectsizesreflectteachers’tendenciestoratechildrenfromlowerSESfamiliesslightlyhigherthanchildrenfromhigherSESfamilies.

Effect Sizes for Referral Statusa, b

Scale BPM-P BPM-T BPM-Y

N= 3,210 3,086 1,938

INT 25 16 11

ATT 29 22 11

EXT 31 19 12

TOT 39 29 17

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Appendix E. Cross-Informant Correlations

Thetablebelowlistscorrelations(Pearsonr)betweenrawscoresonthecorrespondingscalesoftheBPM-P,BPM-T,andBPM-Ycompletedbyparents,teachers,andyouthsinmanysocieties. Cross-Informant Correlations for BPM-Scales

Parents x Parents x Teachers xScale Teachersa Youthsb Youthsa

N= 6,406 27,861 3,929

INT .21 .38 .18

ATT .38 .37 .23

EXT .32 .42 .25

TOT .33 .42 .22

aDatafromsamplesincludedinAchenbach&Rescorla(2007).bDatafromsamplesincludedinRescorlaetal.(2013).