CHILD & ADOLESCENT SYMPTOM INVENTORY-5
(Ages 5 to 18 Years)
By Kenneth D. Gadow, Ph.D. and Joyce Sprafkin, Ph.D.
The Child & Adolescent Symptom Inventory-5 (CASI-5) is a behavior rating scale for DSM-5-defined emotional and behavioral disorders in youths between 5 and 18 years old. There is a parent (173 items, 8 pages) and teacher (125 items, 7 pages) version of the CASI-5. The CASI-5 includes all of the items from both the previously published Child Symptom Inventory-4 (CSI-4) and the Adolescent Symptom Inventory-4 (ASI-4) in a single measure. Furthermore, each symptom category includes an Impairment question (i.e., the degree to which symptoms interfere with the youth’s social or academic functioning).
The CASI-5 replaces the CASI-4R.
The fifth revision to the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) published by the American Psychiatric Association in 2013 resulted in the addition of a few new disorders and in some cases changes in symptoms, names of disorders, or minor alterations in “scoring rules.” Many of these changes are reflected in the CASI-5. Because so many clinicians and researchers are currently using the CASI-4R and some of the DSM-5 revisions are controversial or lack extensive research support, the CASI-5 includes all the original CASI-4R items (with their respective item numbers) to ensure a seamless transition from the CASI-4R to the CASI-5. The CASI-5 can be easily adopted by professionals who are already familiar with the CSI-4, ASI-4, or CASI-4R.
There are no new norms for the CASI-5 because only one new multi-item disorder (3 or more items) was added to the DSM-5 revision, and the symptoms of the remaining disorders were essentially unchanged.
The CASI-5 assesses symptoms of the following disorders: ADHD, oppositional defiant disorder, conduct disorder, generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, disruptive mood dysregulation disorder, major depressive episode, manic episode, dysthymic disorder, schizophrenia, autistic/Asperger’s disorder, anorexia, and bulimia. One or two key symptoms of each of the following disorders are also included: posttraumatic stress disorder, obsessive-compulsive disorder, specific phobia, panic disorder, selective mutism, trichotillomania, motor tics, vocal tics, and substance use.
The CASI-5 is an amalgam of the CSI-4 and the ASI-4, and therefore scoring procedures are highly similar to those for the CSI-4 (children 5 to 12 years in elementary school) and the ASI-4 (youths 12 to 18 year olds in middle, junior or high schools). The CASI-5 can be scored to derive four different scores:
ü Symptom Count Cutoff scores based on the number of symptoms necessary for a DSM-5 diagnosis,
ü Symptom Severity scores based on a dimensional model that uses normative data to generate T scores,
ü Impairment Cutoff scores that indicate whether the youth is impaired by the symptoms of a particular disorder such as ADHD regardless of the youth’s Symptom Count Cutoff score or Symptom Severity score, and
ü Clinical Cutoff score which is a combination of the DSM-5-referenced Symptom Count Cutoff score and the Impairment Cutoff score.
The CASI-5 uses the same normative data as the CSI-4 and ASI-4 as the bases for T scores. For this reason, there are a few symptom categories for which there are no T scores for a particular age group. For children 5 to 12 years old, there are currently no normative data for the following symptom categories: manic episode, schizophrenia, anorexia, bulimia, or substance use. For youths 12 to 18 years old, there are no normative data or T scores for autistic disorder or Asperger’s disorder.
IMPORTANT: There is currently no Scoring Software for the CASI-5, and there is currently no computer-presented version of the CASI-5.
CASI-5 subscale scores generally show a high degree of correspondence with psychiatric diagnoses (predictive validity) and correlate well with other commonly used dimensional scales (concurrent validity). An extensive Annotated Bibliography of research studies that used at least one Checkmate Plus measure can be accessed on the checkmateplus.com website by clicking the “Bibliography of Research” button on the Home page.
New Disorders and Items
New Item Numbers
As noted above, the CASI-5 includes all the original CASI-4R items (with their respective item numbers). All new DSM-5-referenced symptom items are denoted with the letter “z.”
There is one new symptom category, disruptive mood dysregulation disorder (Category Rz) and a new specifier for conduct disorder (Category Cz: with limited prosocial emotions).
New Names for Disorders
Changes to the names of disorders in DSM-5 are as follows: persistent depressive disorder (previously dysthymic disorder), social anxiety disorder (previously social phobia), panic disorder (previously panic attack), and autism spectrum disorder (previously autism and Asperger’s disorder).
Old (DSM-IV) Score Sheets
Because the CASI-4R items and numbering were maintained in CASI-5, all of the CASI-4R score sheets are still valid for DSM-IV-defined disorders. This includes the DSM-IV-referenced Symptom Count Cutoff Score Sheets and the Symptom Severity Profile Score Sheets.
New (DSM-5) Scoring Rules
Autism Scoring Rules
The DSM-IV-based scoring rules for autistic disorder and Asperger’s disorder were maintained because DSM-5 states that “individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.” Furthermore, the validity of the autistic disorder and Asperger’s disorder Symptom Count Cutoff and other scoring algorithms have been validated by extensive research.
NormsThere are no new norms for the CASI-5 because only one new multi-item disorder (3 or more items) was added to the DSM-5 revision, i.e., social (pragmatic) communication disorder, which is technically a communication disorder. All of the other changes to the DSM-5-referenced CASI involve disorders with 2 or fewer items (disruptive mood dysregulation disorder, excoriation disorder), a specifier for a disorder whose diagnostic criteria did not change (limited prosocial emotions in conduct disorder), or subsets of existing DSM-IV symptoms (avoidant/restrictive food intake disorder, binge eating disorder).
ü The Quick Guide to scoring the Child & Adolescent Symptom Inventory-5 (CASI-5) is included in every order. The Quick Guide describes how to score the CASI-5; however, we recommend that you read either the CSI-4 Screening and Norms Manual or the ASI-4 Screening and Norms Manual for a more detailed description of the development, research, and applications of the Symptom Inventories.
ü The 2002 Child Symptom Inventory 4 Screening and Norms Manual is a 179-page book that reviews DSM-IV diagnostic criteria and describes the development, research, scoring guidelines, normative data, and clinical applications for Symptom Count and Symptom Severity scores. Parallel information for the ASI-4 is provided in the 2008 Adolescent Symptom Inventory 4 Screening and Norms Manual.
ü The CASI-5 Parent Checklist and the CASI-5 Teacher Checklist are sold separately in packages of 50 checklists. CASI-5 Symptom Count Cutoff Score Sheets (25 for children and 25 for adolescents) are included.
ü CASI-5 Symptom Severity Profile score sheets can be purchased for the CASI-5 Parent Checklist and the CASI-5 Teacher Checklist. T scores and raw scores are presented separately on the CASI-5 Symptom Severity Profile score sheets by age group (child/adolescent), gender, and informant (parent/teacher). The norms and T scores for the CASI-5 are based on previously-published data for the CSI-4 and ASI-4. Information about the normative samples for the CSI-4 and ASI- 4 can be found on the Products page of the checkmateplus.com website.
The CASI-5 Deluxe Kit contains the following: 25 CASI-5 Parent Checklists, 25 CASI-5 Teacher Checklists, 25 CASI-5 Symptom Count Cutoff Score Sheets for Children, 25 CASI-5 Symptom Count Cutoff Score Sheets for Adolescents, 50 CASI-5 Symptom Severity Profile score sheets (T scores) for the CASI-5 Parent Checklist (25 for children and 25 for adolescents), 50 CASI-5 Symptom Severity Profile score sheets (T scores) for the CASI-5 Teacher Checklist (25 for children and 25 for adolescents), and both the Child Symptom Inventory-4 Screening and Norms Manual and the Adolescent Symptom Inventory-4 Screening and Norms Manual.
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Revised: January 23, 2016