Child & Adolescent Symptom Inventory-5

(CASI-5)

Ages: 5 to 18 Years

Completion Time: Approximately 10-20 Minutes

Reading Level: Fifth Grade (Flesch-Kincaid)

The Child & Adolescent Symptom Inventory-5 (CASI-5) is a behavior rating scale for evaluating the symptoms of DSM-5 emotional and behavioral disorders among children and adolescents between 5 and 18 years old who are attending elementary, middle, or secondary school. The CASI-5 is a combination of the Child Symptom Inventory (CSI) and the Adolescent Symptom Inventory (ASI) and was developed for clinicians and researchers who worked with both children and adolescents and who preferred one symptom inventory for the entire age range. There are both parent- and teacher-completed versions. The CASI-5: Parent Checklist contains 173 items for over two dozen emotional and behavioral disorders, and the CASI-5: Teacher Checklist contains 125 items. For each disorder there is an Impairment question (i.e., the degree to which symptoms interfere with the youth’s social or academic functioning). The CASI-5 can be read to the parent by a qualified clinician thus serving as a structured clinical interview. The CASI-5 can be scored to derive symptom count cutoff scores (based on a diagnostic model) or symptom severity scores (T scores based on a dimensional model). Scoring is quick and easy with user-friendly score sheets. The CASI-5, which was published in 2013, replaces the CASI-4R.

Disorders

The CASI-5 assesses symptoms of the following disorders:  *AD/HD  *oppositional defiant disorder  *conduct disorder  *generalized anxiety disorder  *social anxiety disorder  *separation anxiety disorder  *schizoid personality  *schizophrenia  *major depressive episode  *persistent depressive mood  *manic episode  *autism spectrum disorder  *autistic disorder  *Asperger’s disorder  *social communication disorder  *anorexia  *bulimia  *peer aggression. There are one or two key symptoms of each of the following disorders: *adjustment disorder  *acute stress disorder  *obsessive-compulsive disorder  *specific phobia  *panic disorder  *selective mutism  *motor tics  *vocal tics  *somatic symptom disorder  *hair pulling  *skin picking  *disruptive mood dysregulation disorder  *elimination disorders  *avoidant restrictive food intake  *binge eating  *substance use.

Components 

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.

CASI-5 Symptom Severity Profile score sheets (dimensional model) can be purchased for the CASI-5 Parent Checklist and the CASI-5 Teacher Checklist. The Profiles present T scores and corresponding raw scores for each diagnostic category with symptom severity cutoffs, separately, for children and adolescents, males and females, parents and teachers.

The Child Symptom Inventory 4 Screening and Norms Manual reviews DSM diagnostic criteria and describes research, scoring guidelines, normative data, and clinical applications for symptom count (categorical) and symptom severity (dimensional) scores for children 5-12 years old. The Adolescent Symptom Inventory 4 Screening and Norms Manual provides the same information for adolescents. 

The CASI Deluxe Kit contains the following: 25 CASI-5 Parent Checklists, 25 CASI-5 Teacher Checklists, 25 symptom count cutoff score sheets for children, 25 symptom count cutoff score sheets for adolescents, 50 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.

Research

CASI-5 subscale scores demonstrate satisfactory test-retest reliability, show a high degree of correspondence with psychiatric diagnoses, and correlate well with other commonly used dimensional scales. Low to moderate correlations between parent and teacher ratings underscore the value of obtaining information from both informants when conducting clinical evaluations. An extensive annotated bibliography of studies that used at least one Checkmate Plus assessment tool to include the CASI can be accessed here.

Scoring

The CASI-5 can be scored to derive four different scores (see also Scoring):

  • Symptom Count Cutoff scores based on the number of symptoms necessary for DSM diagnoses,

  • Symptom Severity scores based on a dimensional model that uses normative data to generate T scores,

  • Impairment Cutoff scores that indicate whether the youth is impaired by the symptoms of a specific disorder, and

  • Clinical Cutoff scores which are a combination of the Symptom Count Cutoff score and the Impairment Cutoff score.

How CASI-5 Differs from Prior Versions

The CASI-5 replaces the earlier CASI-4R. The CASI-5 includes all of the items from both the original Child Symptom Inventory-4 (CSI-4) and the Adolescent Symptom Inventory-4 (ASI-4), which were published in 1994 and 1997, respectively. The CASI-4 was revised in 2005 to create the CASI-4R, which included an impairment question for each major disorder in order to determine the extent to which the symptoms of the disorder interfered with daily routines and social functioning.

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 changes in symptoms or names of a few disorders. The CASI-5 was published in 2013 to reflect these changes, each of which are reviewed below. 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. There are no new norms for the CASI-5 because no new multi-item disorders were added to the DSM-5 revision, and the symptoms of the remaining disorders were essentially unchanged.

New Disorders & New Items

There are several new disorders in the DSM-5 version of the Child and Adolescent Symptom Inventory-5. They are disruptive mood dysregulation disorder, avoidant/restrictive food intake disorder, binge eating disorder, and social (pragmatic) communication disorder. In addition, a limited prosocial emotions specifier was added to conduct disorder (Category Cz: with limited prosocial emotions). Three one-item disorders were added to Category E: excoriation disorder (skin picking), trichotillomania (hair pulling), and selective mutism; the latter two disorders appeared in DSM-IV but were not included in the CASI-4R. Finally, four new items were added to autism spectrum disorder. 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, autistic disorder and Asperger’s disorder symptom count cutoff and other scoring algorithms were validated by extensive research.

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.

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).