The Assessment Checklist for Adolescents (ACA) is a 105-item, caregiver-report, psychiatric rating scale that measures behaviours, emotional states, traits, and manners of relating to others, as manifested among 12 to 17 year-old young people in care, as well as young people who are adopted from care or who have a history of maltreatment. The ACA was designed to measure a broad range of mental health difficulties observed among young people in care, that are not adequately measured by standard rating instruments, such as the CBCL, SDQ and Conners scales.

The ACA has seven clinical scales and two low self-esteem scales, that were empirically-derived through factor analysis:

Clinical scales

1. Non-reciprocal interpersonal behaviour

2. Social instability / behavioural dysregulation

3. Dysregulated emotion / distorted social cognition

4. Dissociation / trauma symptoms

5. Food maintenance behaviour

6. Sexual behaviour

7. Suicide discourse.

Low self-esteem scales

1. Negative self-image

2. Low confidence

Score profile sheets, clinical and elevated score ranges

The ACA provides a total clinical score, a total low self-esteem score, and scores for the seven clinical scales and two low self-esteem scales. ACA score profile sheets include normative data (derived from a sample of 11 to 18 year-olds in long-term foster and kinship care), as well as clinical ranges and elevated score ranges. Clinical range scores are highly predictive of psychiatric impairment, while sub-clinical elevated range scores indicate possible psychiatric impairment and a need for further mental health assessment, or periodic monitoring.

Translations
The ACA has not yet been translated into other languages

Psychometric properties
The ACA’s content was largely derived from the Assessment Checklist for Children (ACC). Fifteen ACC items were modified to better reflect adolescent difficulties, and 25 additional items were derived using a combination of inductive and deductive strategies. Item and factor analyses were carried out on scores from a 136-item research instrument, obtained for 230 young people residing in long-term care (as part of the NSW Children in Care study). These data were supplemented by ACC scores obtained for 142 adolescents residing in treatment foster care in Ontario, Canada. A robust 7-factor model was identified among a core of 73 clinical item scores, accounting for 51% of score variance. Four of the factors replicate ACC clinical scales (non-reciprocal interpersonal behaviour; sexual behaviour problems; food maintenance behaviour;and suicide discourse), and three are unique to the ACA (social/behavioural dysregulation; Dysregulated emotion / distorted social cognition; and dissociation / trauma symptoms). The ACA also contains two empirically-derived low self-esteem scales (low confidence; negative self-image) that are shared with the ACC. Initial data indicate that the ACA has good content, construct and criterion-related validity, as well as high internal reliability (Cronbach’s alpha ranged from .73 to .89 for the clinical scales, and alpha = .95 for the total clinical score).

Read more about the ACA’s development, structure and psychometric properties in the following preprint manuscript:

Tarren-Sweeney, M. (2013). The Assessment Checklist for Adolescents – ACA:  A scale for measuring the mental health of young people in foster, kinship, residential and adoptive care. Children and Youth Services Review, 35, 348-393.

Assessment Checklist for Adolescents - Short Form (ACA-SF, 37 items)
A 37-item short form of the ACA was developed primarily for use as a research instrument and as a relatively brief treatment monitoring measure. It excludes the low self-esteem scales and the suicide discourse scale. The full version of the ACA is recommended for comprehensive mental health assessment, and the Brief Assessment Checklist for initial mental health screening.

Read about the development and psychometric properties of the ACA-SF