The Assessment Checklist for Children (ACC) is a 120-item, caregiver-report, psychiatric rating scale that measures behaviours, emotional states, traits, and manners of relating to others, as manifested among 4 to 11 year-old children in care. The ACC was designed to measure a broad range of mental health difficulties observed among children in care, children adopted from care, and maltreated children, that are not adequately measured by standard rating instruments, such as the CBCL, SDQ and Conners scales.

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

Clinical scales

1. Sexual behaviour

2. Pseudomature interpersonal behaviour

3. Non-reciprocal interpersonal behaviour

4. Indiscriminate interpersonal behaviour

5. Insecure interpersonal behaviour

6. Anxious-distrustful behaviour

7. Abnormal pain response

8. Food maintenance behaviour

9. Self-injury (self-injury index + pica index)

10. Suicide discourse

Low self-esteem scales

1. Negative self-image

2. Low confidence

Score profile sheets, clinical and elevated score ranges

The ACC provides a total clinical score, a total low self-esteem score, and scores for the ten clinical scales and two low self-esteem scales. ACC score profile sheets include normative data (derived from a sample of 5 to 10 year-old boys and girls 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
German, Norwegian and Romanian language translations have been completed.
Portuguese, Russian, Serbian, Spanish and Swedish translations are being developed.

Psychometric properties
The ACC’s clinical content was systematically derived using a combination of deductive and inductive strategies, with the aim of identifying all clinically significant problems experienced by children in alternate care that are not adequately measured by the Child Behavior Checklist (CBCL). Content validity was reviewed by clinicians and foster parents, and its construct validity is strongly supported by estimates of factorial and concurrent validity. The ACC also demonstrates criterion-related validity, namely that: 1.Scores are highly sensitive to children’s risk exposure; 2.Scores are strongly differentiated by children’s age at entry into care; and 3.The instrument differentiates between clinic-referred and non-referred children and young people in care. The ACC’s clinical scales have high internal consistency (Cronbach’s alpha = 0.70 - 0.96).

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

Tarren-Sweeney, M. (2007). The Assessment Checklist for Children – ACC:  A behavioral rating scale for children in foster, residential and kinship care. Children and Youth Services Review, 29, 672-691

Assessment Checklist for Children - Short Form (ACC-SF, 44 items)
A 44-item short form of the ACC was developed primarily for use as a research instrument and as a relatively brief treatment monitoring measure. It excludes the low self-esteem scales, the suicide discourse scale and the pica index from the self-injury scale. The full version of the ACC 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 ACC-SF