The Brief Infant-Toddler Social and Emotional Assessment: screening for social-emotional problems and delays in competence

J Pediatr Psychol. 2004 Mar;29(2):143-55. doi: 10.1093/jpepsy/jsh017.


Objective: To examine the reliability and validity of the 42-item Brief Infant-Toddler Social and Emotional Assessment (BITSEA), a screener for social-emotional/behavioral problems and delays in competence.

Method: Parents in a representative healthy birth cohort of 1,237 infants aged 12 to 36 months completed the Infant-Toddler Social and Emotional Assessment (ITSEA)/BITSEA, the Child Behavior Checklist (CBCL)/1.5-5, the MacArthur Communication Developmental Inventory vocabulary checklist, and worry questions. In a subsample, independent evaluators rated infant-toddler behavior.

Results: Test-retest reliability was excellent and interrater agreement (mother/father and parent/child-care provider) was good. Supporting validity, BITSEA problems correlated with concurrent evaluator problem ratings and CBCL/1.5-5 scores and also predicted CBCL/1.5-5 and ITSEA problem scores one year later. BITSEA measures of competence correlated with concurrent observed competence and predicted later ITSEA competence measures. Supporting discriminant validity, only 23% of high BITSEA problem scorers had delayed vocabulary. Moreover, the combined BITSEA problem/competence cutpoints identified 85% of subclinical/clinical CBCL/1.5-5 scores, while maintaining acceptable specificity (75%).

Conclusions: Findings support the BITSEA as a screener for social-emotional/behavioral problems and delays in social-emotional competence.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child Behavior Disorders / diagnosis*
  • Child Development Disorders, Pervasive / diagnosis*
  • Child, Preschool
  • Connecticut
  • Female
  • Humans
  • Infant
  • Male
  • Mental Disorders / diagnosis*
  • Psychological Tests*
  • Reproducibility of Results
  • Sensitivity and Specificity