Eyberg Inventory of Behavior in Children.

Normalization of the Spanish version and its

usefulness
for the out-of-hospital pediatrician*
S. García-Tornel Florensa1 , E.J. Road2 , YE Eyberg 2 , J.C. Mas Alguacil 1 , C. Vilamala Serra3 , C. Baraza
Mendoza 3 ,
H. Villena Collado , M. Gonzalez Garcia4 , Mª Calvo Hernández 4 , A. Trinxant Doménech5
3

Summary. Objective: Due to the high prevalence of
behavioral problems in the out-of-hospital pediatrician's office, it
is necessary to have a useful and easy-to-administer instrument.
The psychometric characteristics of the Spanish version of the
Eyberg Behavioral Child Inventory (EBCI) are established, which
consists of 36 items, called the Eyberg Inventory for Child
Behavior (IECN).
Methods: The EBCI questionnaire/inventory was translated
into Spanish, which is based on the assessment of the child's
behavior provided by the parents when responding to the
questionnaire. Healthy children between 2 and 12 years old were
included from pediatric clinics located in Health Centers in towns
on the outskirts of Barcelona and from the outpatient clinic of our
Hospital.
Results: The final sample was made up of 518 subjects. The
average scores for the intensity scale were 96.8 and those for the
problems scale were 3.9. The internal consistency (Cronbach's
alpha) was 0.73 and the test-retest was r=0.89 (p<0.001) for the
intensity scale and r=0.93 (p<0.001) for the problems scale.
0.001). Interobserver reliability was r=0.58 (p<0.001) on the
intensity scale and r=0.32 (p<0.05) on the problems scale. The
analysis of validity between both scales was r=0.343 (p<0.001).
Conclusions: The IECN is a useful and very easy instrument
to use in the general pediatrician's office, as a method of early
detection of behavioral disorders in children.
An Esp Pediatr 19989;48:475-482.
Keywords: Child behavior; Questionnaire; Early detection;
Psychometric; Outpatient pediatrics.
EYBERG CHILD BEHAVIOR INVENTORY.
STANDARDIZATION OF THE SPANISH VERSION AND
ITS UTILITY IN PEDIATRIC PRACTICE
Abstract. Objective: Taking into account the high prevalence
of behavioral problems in the pediatric outpatient clinic, a need for
a useful and easy to administer tool for the evaluation of this
problem arises. The psychometric characteristics of the Spanish
version of the Eyberg Behavioral Child Inventory (EBCI), [in
Spanish Inventario de Eyberg para el Comportamiento del Niño
(IECN)], a 36-item questionnaire were established.
*Work carried out with the scholarship from the Catalan Pediatric Society “Antics
Presidents”
Patients and methods: The ECBI inventory/questionnaire was
translated into Spanish. The basis of the ECBI is the evaluation of
the child's behavior through the parents' responses to the
questionnaire. Healthy children between 2 and 12 years of age
were included and were taken from pediatric outpatient clinics
from urban and suburban areas of Barcelona and from our
hospital's own ambulatory clinic.
Results: The final sample included 518 subjects. The mean
score on the intensity scale was 96.8 and on the problem scale 3.9.
Internal consistency (Cronbach's alpha) was 0.73 and the test-
retest had an r of 0.89 (p<0.001) for the intensity scale and r =
0.93 (p<0.001) for the problem scale. Interrater reliability for the
intensity scale was r = 0.58 (p<0.001) and r = 0.32 (p<0.001) for
the problem scale. Concurrent validity between both scales was r
= 0.343 (p<0.001).
Conclusions: The IECN is a useful and easy tool to apply in
the pediatrician's office as a method for early detection of
behavioral problems.
Key words: Child behavior. Questionnaire. Mass screening.
Psychometrics. Ambulatory care.
Introduction
For years it has been recommended that pediatricians get
involved believe more in the diagnosis and treatment of the so-
called “new "morbidity in pediatrics" that encompasses the
problems of development, behavior and psychosocial. The
pediatrician must be able to detect behavioral alterations in
children during periodic check-ups, since these problems cover
approximately approximately 24 to 50% of all diagnoses in a
pediatric consultation (1) . Furthermore, they are a cause of concern
for parents and, in particular, mothers (2) . Despite this,
pediatricians usually have little knowledge regarding the
childhood behavior and a study suggests that they are unable to
detect them in up to 83% of the cases that are presented to them. (3)

1Sant Joan de Déu Hospital (Barcelona). 2 University of Florida (Gainesville.

USA.). 3 ABS Gavarra (Cornellá). 4 ABS Can Vidalet (Hospitalet). 5 ABS Sant
2Just (Sant Just Desvern)
3Correspondence: Santiago García-Tornel Florensa. Pediatric Service.
4Sant Joan de Déu Hospital. Pg. Sant Joan de Déu 2. 08950 Esplugues (Barcelona)
5Received: September 1997
Accepted: January 1998

VOL. 48 No. 5, 1998 Eyberg Inventory of Behavior in Children. Standardization of the Spanish version and its usefulness for the out-of-hospital pediatrician 475
 Behavioral disorders in childhood and adolescence Cence can
be divided into three categories: attention deficit disorder (with or
without hyperactivity); oppositional defiant disorder and conduct
disorder (4) . In the US, the behaviors that comprise these disorders
are closely interrelated (5,6) and are frequent in the general
population. It is estimated that its prevalence rate is 12% pa
476 S. García-Tornel Florensa et al.
children, (7) and are the most common cause of referrals of young
nes towards mental health services (8) . Different studies show that
untreated behavioral disorders persist and have repercussions on
the future life of the individual (9,10) . It has also been shown that
American children
SPANISH ANNALS OF PEDIATRICS
Appendix I Eyberg Inventory of Behavior in Children

Code:…………

Your information is confidential

Child's name: ..........................................................................
Age: Months: .................................. Years: ........................ Birthdate: ..................................................................................................
Person who fills out the questionnaire: Father □ Mother □ Today's date: ..............................................................................

Instructions: The following sentences describe the child's behavior. Please circle the number that best describes which of these
behaviors is most common in your child, and circle the “yes” or “no” box if this is a problem for you.

Never Rarely Ever Often Always Is this a problem for

you?
1. It takes time to get dressed 1 2 3 4 5 6 7 Y No
2. Slow to eat 1 2 3 4 5 6 7 eah Y No
3. He behaves badly at the table 1 2 3 4 5 6 7 eah Y No
4. He refuses the food they are served 1 2 3 4 5 6 7 eah Y No
5. He doesn't want to do housework 1 2 3 4 5 6 7 eah Y No
6. He is slow to get ready for bed 1 2 3 4 5 6 7 eah Y No
7. He refuses to go to bed on time 1 2 3 4 5 6 7 eah Y No
8. He doesn't obey the house rules 1 2 3 4 5 6 7 Y No
9. He does not obey until he is threatened with 1 2 3 4 5 6 7 eah Y No
punishment
10. He is defiant when given an order. 1 2 3 4 5 6 7 eah Y No
11. Argue about house rules 1 2 3 4 5 6 7 eah Y No
12. He gets angry when he doesn't get his way 1 2 3 4 5 6 7 eah Y No
13. He has tantrums 1 2 3 4 5 6 7 eah Y No
14. Responds badly to older people 1 2 3 4 5 6 7 eah Y No
15. Whines 1 2 3 4 5 6 7 eah Y No
16. Cry easily 1 2 3 4 5 6 7 eah Y No
17. Scream 1 2 3 4 5 6 7 eah Y No
18. He hits his parents 1 2 3 4 5 6 7 eah Y No
19. Break toys 1 2 3 4 5 6 7 eah Y No
20. He is not careful with his toys and other objects 1 2 3 4 5 6 7 eah Y No
21. Steal 1 2 3 4 5 6 7 eah Y No
22. Lie 1 2 3 4 5 6 7 eah Y No
23. Annoys other children 1 2 3 4 5 6 7 eah Y No
24. Argues with his friends 1 2 3 4 5 6 7 eah Y No
25. Argues with his brothers 1 2 3 4 5 6 7 eah Y No
26. He hits on children his age 1 2 3 4 5 6 7 eah Y No
27. He fights with his brothers 1 2 3 4 5 6 7 eah Y No
28. Constantly wants to attract attention 1 2 3 4 5 6 7 eah Y No
29. Interrupt 1 2 3 4 5 6 7 eah Y No
30. He is easily distracted 1 2 3 4 5 6 7 eah Y No
31. Pays attention for a short time 1 2 3 4 5 6 7 Y No
32. He doesn't finish his tasks 1 2 3 4 5 6 7 eah Y No
33. You have difficulty entertaining yourself 1 2 3 4 5 6 7 eah Y No
34. It is difficult for you to concentrate on one thing 1 2 3 4 5 6 7 eah Y No
35. He is too active or restless 1 2 3 4 5 6 7 eah Y No
36. Wet the bed 1 2 3 4 5 6 7 eah Y No
eah

considered normal, they usually show a marked nu group of
inappropriate behaviors (8,11) . The variety and tension of
behavioral disorders, more than their me Their presence are the
best indicators of their subsequent evolution (12) .
Parents are an undeniable and important source of information
in the assessment of inappropriate behavior in children. children
and adolescents (13) . Control of development and conduct The
evaluation of the child is usually done based on the medical
history and examination in the office, but this way of evaluating
the child has proven to be unsafe. Tests, questionnaires or scales
are specific questions answered directly by parents about
development, behavior, temperament, personality, and behavior.

VOL. 48 No. 5, 1998 Eyberg Inventory of Behavior in Children. Standardization of the Spanish version and its usefulness for the out-of-hospital pediatrician 477
psychosocial treatment of their children constitute a very attractive
and helpful strategy for the early detection of disorders. lathes,
with a low cost, both for the pediatrician and for society.
Additionally, they provide a reference point for send the child to
the specialist (14-18) .
Although these evaluation systems through parents have
limitations, the information obtained by the questionnaires
tionaries is very valuable. They provide a broad description of
different behaviors and, at subclinical levels, the pe diatra can
more easily determine when there is a problem ma. They also
provide quantifiable data, which can be compared be aligned with
the reference values, being a direct guide so about the normality or
imbalance of the child's behavior according to his or her
development. Finally, they are useful in determining the course
and effectiveness of treatment, since they allow a faithful and
repeated measurement of progress.
The Eyberg Child Behavioral Inventory (ECBI) is a question
nary for parents, widely used in the United States, designed to
measure child behavior problems between 2 and 16 years of age
(19)
. The ECBI was originally validated in 1980 in children and in
1983 in adolescents including ambulatory patients. laboratories of
a large urban Faculty of Medicine (20,21) . The reliability, stability
and discriminant and convergent validity, as well as sensitivity to
changes in behavior after treatment, have been established in
many studies (22) . Recently, the ECBI has been validated again
with a po representative population of North American children
and adolescents (23) .
The purposes of the present study are to obtain normal data
malized from a representative sample of children in Barcelona,
reference values for behavioral disorders and eva The basic
psychometric characteristics of the version are which we will call
the Eyberg Inventory of Behavior in Children (IECN). Overall,
the objective vo is to have a system of measuring children's
behavioral problems that can be administered and inter prepared
quickly and easily by pediatricians.
Material and method
Sample
Subjects were recruited from general pediatric clinics as of the
hospital as well as six local Primary Care centers located in
suburban areas of Barcelona. The total sample in included 518
children between 2 and 12 years old, with each age group suitable
neatly represented. The mean of the total sample was 6.8 years
(SD = 2.9). Boys were 50% and girls 49%; in less than 1% the sex
was not specified. In the sample, 9% of the children had some
medical problem, 3% had some minor neurological complication,
4% had been hospitalized in the past for some medical reason, and
7% had been premature.
Measures:
The IECN is a 36-item scale for parents, whose purpose is to
assess behavioral problems in children between 2 and 12 years of
age. The items are phrases that describe problems of
communication general behavior, not specific for a specific age,
selected from the most frequent complaints expressed by parents
478 S. García-Tornel Florensa et al.
drs in pediatric consultations. The 36 items are divided into two
scales: a) The intensity scale asks about the frequency frequency
of appearance of each behavior (phrase or item) from “never” (1) ,
to “always” (7) , and these frequency ranges are summed to obtain
a total intensity score that can be to go from 36 to 252. b) The
problem scale asks the pa teachers who identify problem
behaviors circling “yes” or “no” in response to the question: “Is
this a problem for you?” The sum of the “yeses”, which can range
from 0 to 36, provides a problem score. High validity and
reliability coefficients have previously been established in
children and adolescents in the United States.
Procedure:
The Spanish version was produced by a qualified bilingual
translator and was subsequently compared with the original by a
method. specialist in psychiatry without finding differences in the
meaning of the sentences in the Spanish version with respect to
the glesa. (Appendix I)
Upon arrival at the pediatrician's office, the nurse or
receptionist gave the parents: an information sheet as an informed
consent, another sheet for collecting family data and basic
anamnesis, and the IECN (Appendix I), ga guaranteeing the
anonymity of the participants. In addition, they were verbally
explained how to fill them out and also with The instructions were
in writing. Parents were asked to respond to both the information
sheets and the IECN in the classroom. waiting time and having
them returned to the receptionist or doctor co. Most of the
questionnaires were completed by mothers (n=449; 87%) and the
rest by fathers (n=47; 9%); In 22 (4%) the sex was not specified.
They were collected until each age group had at least 35 children.
In 21 participants their cues tionaries were excluded because they
had 5 or more items without res placed, both on the intensity scale
and on the problem scale. In 2 cases they did not complete the
intensity scale and 67 did not complete the problem scale because
they left 5 or more items blank. Instead, they were included in the
respective study of ca scale those who had answered at least one
of them completely.
Thirty-five of the mothers were randomly selected and asked
to complete the IECN a second time on the same child after a two-
week period; that data is used used for test-retest analysis. Fifty-
seven of the mothers who completed the IECN, but who were not
part of the test-retest, were asked to have the father also take the
test at the same time. my child, separately, and without more than
one session having elapsed flows between both. These data were
used in the reliability analyses.
Results
Analysis of the items:
SPANISH ANNALS OF PEDIATRICS
Table I Normative data for individual IECN items

Item # Item content Intensity scale % as a problem

Half D.S.
1. Takes time to get dressed 3,45 2,03 10,2
2. Slow to eat 3,38 2,10 19,8
3. He behaves badly at the table 2,75 1,61 13,4
4. Rejects the food that is served to him 2,75 1,57 13,4
5. Doesn't want to do housework 2,81 1,77 10,4
6. He is slow to get ready for bed 3,38 2,17 11,7
7. Refuses to go to bed on time 3,25 2,13 14,2
8. Does not obey the house rules 2,85 1,71 12,9
9. Does not obey until threatened with punishment 2,74 1,68 14,6
10. He is defiant when given an order 2,59 1,71 13,2
11. Argue about house rules 2,39 1,60 7,3
12. He gets angry when he doesn't get his way 4,20 1,81 17,5
13. Has tantrums 3,09 1,80 15,4
14. Responds badly to older people 1,49 0,98 5,4
15. whines 2,91 1,77 8,6
16. Cry easily 3,07 1,85 10,2
17. Shouts 2,86 1,71 12,7
18. Hits his parents 1,31 0,89 3,3
19. Break toys 2,01 1,56 5,4
20. He is not careful with his toys and other objects 2,72 2,03 7,9
21. Steal 1,11 0,59 1,9
22. lie 1,78 1,19 6,3
23. Annoys other children 1,75 1,91 5,4
24. Argues with his friends 2,17 1,35 4,6
25. Argues with his brothers 3,32 1,98 17,5
26. He sticks with children his age 1,81 1,25 5,2
27. He sticks with his brothers 2,54 1,76 14,4
28. Constantly wants to attract attention 3,23 1,87 11,9
29. Interrupts 3,27 1,71 14,6
30. Easily distracted 3,37 1,93 15,0
31. Pays attention for a short time 3,07 1,87 12,5
32. He doesn't finish his tasks 2,57 1,87 10,7
33. Has difficulty entertaining 2,04 1,58 7,7
34. Has a hard time concentrating on one thing 2,58 1,76 11,3
35. Is too active or restless 4,28 2,14 16,7
36. Wet the bed 1,85 1,74 6,3

Of all the scores obtained on the intention scale sity the Table II Correlations between IECN scores and
asymmetry was from -0.188 to 6.383, and the pointing goes rose demographic variables
from 46.062 to -1.176. Eight of the 36 items are not distributed
They were according to a normal law and corresponded to: Intensity scale Problem scale
“responds badly to older people”, “hits his parents”, “breaks toys
or other objects”, “steals”, “lies”, “bothers other children”, Age -0,09+ 0,04
“becomes hits children his age” and “wets the bed.” These items Sex -0,06 0,07
followed a positive asymmetry and with greater distribution in the Education:
center in a normal curve (leptokurtics), because they did not occur Of the mother -0,02 0,04
for many chas of these families. The average frequency is shown Of the father 0,05 0,24
+p < 0.05
in Table I. These assessments indicate that, on average, the com
behaviors evaluated by the IECN occur “rarely” or “almost once.”
Each item was reported as a problem by 2% to 20% of parents.
The most frequent behavior-

VOL. 48 No. 5, 1998 Eyberg Inventory of Behavior in Children. Standardization of the Spanish version and its usefulness for the out-of-hospital pediatrician 479
Table III Scaled Data for the Eyberg Behavior Inventory in Children and the Problem Scales according to age

SEX Distribution Problem Intensity

Age n male Female Half D.S. Half D.S.
2 37 28/9* 2,46 3,64 96,81 21,22
3 50 19/31 4,86 7,49 104,0 26,67
4 56 29/27 3,41 4,76 8 101,6 26,30
5 54 28/26 3,89 5,79 6 94,74 21,99
6 62 31/31 4,24 6,38 97,61 26,96
7 54 22/32 4,09 6,70 93,04 27,10
8 39 20/19 2,95 4,76 91,72 27,28
9 42 24/18 3,26 5,00 98,38 28,20
10 48 25/23 3,33 5,76 95,46 28,84
11 43 23/20 4,95 5,53 99,84 28,29
12 31 14/17 5,55 8,39 86,06 28,56
*The sample size distributions separated by sex presented statistical differences only for the age of 2 years, x 2 = 6.08, p = 0.014

most prominent was “slow to eat” (20%) while “ro ba” (2%) was
the least reported.
The correlations of each item with their total between the
frequency of the points and the score result of the intensity scale
varied from 0.22 for “wets the bed” to 0.63 for “he gets angry
when he does not get out.” with his.” Four items had a correlation
coefficient below 0.30 (items 2, 4, 21 and 36). The correlations,
on the problem scale ma, of each item with the total ranged
between 0.33 for “se in fada when he doesn't get his way” and
0.07 for “steals”. I day of the correlation of each item with the
total was 0.44 (SD=0.10) in the intensity scale, and 0.16
(SD=0.10) in the es problem cove. These results indicate that the
IECN scales are homogeneous.
Analysis of the scales:
Normalized scores
Intensity scale scores ranged from a low of 36 to a high of
186, with a mean of 96.8, a SD of 26.6, and a standard error of the
mean of 1.2. rate them tions of the problem scale ranged from 0 to
36, with a day of 3.93, a SD of 5.9 and a standard error of the
mean of 0.26. The intensity scale scores (skewness 0.16,
pointedness 0.51) were normally distributed, and the scores
tuations of the problem scale were not distributed according to a
normal law (asymmetry 2.2 and pointing 5.1) but were positively
biased.
Reliability analysis
Internal consistency : For the full sample, Cronbach's alpha
coefficient was 0.73 for the intensity scale and 0.85 for the
problem scale. These results indicate that the IECN is a measure
with internal consistency for conflict problems. conduct in our
country.
Test-retest reliability: Pearson correlation coefficients were
used to examine the relationship between the scores. initial IECN
tuations and the scores obtained two weeks later. The results
show that these coefficients Reliability scores were high and
statistically significant for both IECN scales. On the Intensity
Scale the co rrelation was r (35) = 0.89, p < 0.001, and on the
Problem Scale, the correlation was r (35) = 0.93, p < 0.001.
Interobserver reliability : Pearson correlation coefficients
were also used to examine the relationship tion between IECN
scores between fathers and mothers of the same child. The
correlations between the scores changes by the father and mother
were statistically significant catives on the Intensity Scale r (54) =
0.58, p < 0.001, and on the problem scale r (51) = 0.32, p < 0.05.
In this one it is ex Three cases were excluded because they did not
respond completely to the questionnaire. These results indicate
that the IECN is an es reliable cleat.
Validity analysis
Differences between the intensity scale and the pro scale
problem: the scores on both scales were significant vally
correlated with each other r (518) = 0.343, p < 0.001 in this
normative sample. The weak to moderate correlation suggests
that, although related, the two scales are measuring different
dimensions of behavior and are not mutually exclusive. tes.
Demographic differences in scores : used Pearson coefficients
were used to see the relationship between IECN scores and
demographic variables. As shown in Table II, the magnitude of
the correlation was low to insignificant. However, the correlation
between the scale that of intensity and the age of the children was
statistically significant nificative. For further evaluation of the
effect of age on the intensity scale, an analysis of variance was
performed using the intensity score as a dependent variable. te,
and age as an independent variable. Our results They found that
the relationship between ages was not significant F
(10,505)=1.44, p=1.58.
To examine in greater depth whether it was important
important for the interpretation of the IECN to separate the
normal data educational for boys and girls or for development age
groups development (2-6 years; 7-12 years), separate analyzes of
variance were carried out, one for the intensity scale, and one for

480 S. García-Tornel Florensa et al. SPANISH ANNALS OF PEDIATRICS

the problem scale. The results showed no effect significant
coughs for age groups, F (2,477) =2.4, p = 0.12, and for sex, F
(2,477) = 2.1, p = 0.15, on the intensity scale. There was also no
significant effect for age groups, F (2,422) = 0.39, p = 0.53, or for
sex, F (2,422) = 0.69, p = 0.405, on the problem scale. There was
no interaction effect between scales. Table III shows the me IECN
scoring day for gru samples pos of age; scores were not calculated
separately nes for boys and girls in each age group because the
total number in each group was small.
Difference scores based on sex of offspring tor:
To evaluate the effect of the sex of the parent on the scores
tuations, 47 mothers were randomly selected from the original
sample of 516, and their scores were compared ted with those of
47 parents from the original sample that included completed the
IECN. Student's t test for independent means showed that the
fathers' scores did not differ from those of the mothers neither on
the intensity scale t (92) = 0.20, p = 0.85, nor on the problem
scale t ( 92) = 0.91, p = 0.36. The mean score for the pa intensity
scale dres was 103.17 (SD=30.71), and the mean for the problem
ma was 5.1 (SD=6.6). For the randomly selected mothers, the
mean score for the intensity scale was 102.02 (SD=25.73) and for
the problem scale it was 3.87 (SD=6.25).
Discussion
The IECN is a short, easy-to-administer questionnaire.
interpret, answered by parents to detect communication problems
behavior in children that is widely used in the United States in
pediatric consultations and mental health centers. Information
from parents is particularly important in the evaluation of their
children's behavior problems, since they observe the child's
behavior in a wide variety of situations and are generally the ones
who perceive or intuit when where therapy is necessary.
Furthermore, a measure that is seen and easily administered and
interpretable by paediatricians, it can be very useful in health
centers or consultations in which the doctor has time limitations
that make consultations difficult. interviews and exhaustive
observation of a certain behavior (8) . It is important to be able to
have, from this moment ment in our country, of an instrument for
evaluating the child's behavior, as parents increasingly turn to the
pediatrician for help in solving problems with behavior in their
children.
To be useful, however, these parent-responded instruments
must have standardized values to be reliable. presentational and
reliability must be established within the population in which the
children to whom it is applied live. Demonstration of reliability
ensures that the scale is internally consistent and stable over time.
The results of this study show that the IECN is highly reliable for
use in Spanish children. The stability of the instrument indicates
that scores do not tend to change over time if the child does not
demonstrate a significant change in behavior. treatment, as can
occur with treatment. Various studies God in the United States
have shown that the IECN is a sensitive measure of the change
that occurs after direct treatment. specifically aimed at modifying
a behavioral disorder (8) . Future research with the es version will
be useful. cloth in this same sense.
VOL. 48 No. 5, 1998 Eyberg Inventory of Behavior in Children. Standardization of the Spanish version and its usefulness for the out-of-hospital pediatrician
The scaled data established in this study define the normal
range of behavior for children in this country, and is establishes
the upper limits above which should alert the pediatrician to the
need for further evaluation case and the possible treatment of the
child. In the USA different Different researchers have established
the cut-off point between va normal and abnormal values, of the
IECN, in a deviation it is standard above the average at all ages.
(4,8,24)
. In nues Another study has established a score of 124 on the
anxiety scale as one standard deviation above the mean. tension
and a score of 10 on the problem scale. Therefore, values higher
than these scores recommend a more complete evaluation of the
child's behavior, at least until more studies demonstrate that these
are the cut-off figures.
In a classic meta-analysis on different studies that show the
agreement between observers and the evaluations of behavioral
and emotional problems in children and/or adolescents (26) they
found that the average of said agreement in Between the scores of
fathers and mothers evaluating the child was 0.59 (p < 0.001).
The level of agreement between parents shown by the intensity
scale in the present study is comparable to those found in the
studies done by Achenbach (26) , and suggests that the IECN scores
in es The population is similar no matter which parent completes
the questionnaire.
The fact that IECN scores are independent teeth of variables
such as who is the person who fills out the questions tionary, sex,
age of the child, or the educational level of the parents, indicate
that the interpretation of the IECN results does not require
separate norms for boys and girls at different ages nor does it
require considering other variables that may They affect parents.
This allows the use of a cut-off score for the problem scale and
the intensity scale. a pun Simple cut-off situation is an important
characteristic in the efficiency of the evaluation and in the
interpretation of the scales for a quick and timely exchange with
parents in the consultation. pediatrician's office.
The IECN can be very useful as a screening measure in the
pediatrician's office (27) . Behavioral problems are common
alterations frequently expressed by parents in periodic check-ups.
This is a question brief river with easy to understand instructions
and points. Parents can respond to both IECN scales in about 5
minutes and the pediatrician or nurse can obtain the score in 1 to 2
minutes.
The joint interpretation of the two IECN scales can to provide
important information regarding the parental tolerance towards
the child's behavior. For example, a parent who assesses that his
child presents problems with a lower intensity than average, but
with a high number of behaviors that represent a “problem” for
him, may mean that this parent has a low level of tolerance.
tolerance toward your child's normal behavioral problems. In this
case you need more advice on what the con normal behavior of a
child and how to understand it, which plina. On the other hand, if
a child scores high on the intensity scale and low on the problems
scale, it may mean that the parent is excessively harsh. lerant, or
soft. In this case, a dis discussion about how to set certain limits
and rules. So, in addition In addition to the information about the
481
seriousness of a problem and the information that can be given to
parents about specific behaviors with which they want help, the
IECN can also provide suggestions on treatment. treatment
appropriate to the type of family.
Since the reliability and homogeneity of the IECN scales in
this population are independent of age or sex, it is demonstrated
that these scales function psychometrically in a similar way, both
in a Spanish area and in the US (22). . It seems appropriate to
propose future studies with samples after broader and more
diverse, to examine the discriminant and predictive validity of the
scales, as well as a confirmation that the score of 124 for the
intensity scale and 10 for the problems scale, is the limit for
screening for neither children requiring treatment, as the next
important step in the standardization of the Spanish IECN.
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SPANISH ANNALS OF PEDIATRICS
VOL. 48 No. 5, 1998 Eyberg Inventory of Behavior in Children. Standardization of the Spanish version and its usefulness for the out-of-hospital pediatrician 483