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Brief Assessment Checklist for Adolescents (BAC-A)

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 Adolescents (BAC-A) is both a Screening Tool and Assessment Tool

The Brief Assessment Checklist for Adolescents (BAC-A) is a 20-item caregiver-report rating scale designed to screen for clinically meaningful trauma- and attachment-related mental health difficulties experienced by adolescents in out-of-home care (foster, kinship, and residential care), as well as children and adolescents 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-A was derived from the Assessment Checklist for Adolescents (ACA, 105 items).

Target Population: Age range: 12-17 years of age

Time to Administer: 5 minutes

Completed By: A young person'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), 771–79. https://doi.org/10.1016/j.childyouth.2013.01.025

Sample:

Participants — 230 young people (aged 11 to 18 years, Mean Age=15.3 years) in long-term alternate care, participating in two related studies

Race/Ethnicity — Not reported

Summary:

The Brief Assessment Checklist for Adolescents (BAC-A) is a 20-item caregiver-report psychiatric rating scale designed to: 1. screen for and monitor clinically-meaningful mental health difficulties experienced by adolescents 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-A was also designed to be used as brief casework monitoring tool by foster care and adoption agencies, and for treatment monitoring in CAMHS. Internal consistency of BAC-A scores was 0.87. The BAC-A was highly accurate in screening for clinical range ACA scores (area under the curve (AUC) ranging from 0.96 to 0.99), as well as for CBCL clinical range scores (AUCs: BAC-A=0.93 to 0.94). It was moderately accurate in screening for children that caregivers reported had been referred to mental health services (AUCs: BAC-A=0.79). Initial BAC-A psychometric properties compare favorably with that of existing screening instruments, including the Strengths and Difficulties Questionnaire and the Brief Problem Monitor (CBCL short form).

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 — 101 Dutch foster children, 12–17 years of age

Race/Ethnicity — Not reported

Summary:

This article reports the psychometric properties of the BAC-A, estimated in a population study of Dutch foster children. The results suggest the BAC-A 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 adolescent 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-A as valid and useful mental health screening and monitoring measures for use with children and adolescents 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 — Australian study: 230 12- to 17-year-olds (same sample as Tarren-Sweeney (2013) above). Dutch study: 101 adolescents (12- to 17-year-olds) (same sample as Goemans (2018) above). English sample: 271 clinic-referred adolescents between 12 and 17 years

Race/Ethnicity — Not reported

Summary:

This article compares mental health screening properties of the SDQ, BAC, and a "SDQ proxy" score (generated from a set of 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)