Early Childhood Inventory-5

(ECI-5)

Ages: 3 to 6 Years

Completion Time: Approximately 10-15 Minutes

Reading Level: Seventh Grade (Flesch-Kincaid)

The Early Childhood Inventory-5 (ECI-5) is a behavior rating scale for DSM-5 emotional and behavioral disorders among preschool-aged children between 3 and 6 years old who are not yet attending elementary school (including kindergarten). There are both parent- and teacher-completed versions. The ECI-5: Parent Checklist contains 126 items for over two dozen emotional and behavioral disorders, and the ECI-5: Teacher Checklist contains 103 items. For each multi-item disorder there is an Impairment question (i.e., the degree to which symptoms interfere with the youth’s social or academic functioning). The ECI-5 can be read to the parent by a qualified clinician thus serving as a structured clinical interview. The ECI-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 ECI-5, which was published in 2014, replaces the earlier ECI-4R.

Disorders

The ECI-5 assesses the symptoms of the following disorders:  *AD/HD  *oppositional defiant disorder  *conduct disorder  *peer aggression  *separation anxiety disorder  *generalized anxiety disorder  *major depressive episode  *persistent depressive disorder  *social anxiety disorder  *sleep problems  *elimination problems  *posttraumatic stress disorder  *reactive attachment disorder  *autism spectrum disorder  *autistic disorder  *Asperger's disorder. There are one or two key symptoms of each of the following disorders:   *specific phobia  *obsessions & compulsions  *motor tics  *vocal tics  *selective mutism  *hair pulling  *skin picking  *adjustment disorder  *acute stress disorder  *feeding problems  *disinhibited social engagement disorder.

Components 

The ECI-5 Parent Checklist and the ECI-5 Teacher Checklist are sold separately in packages of 50 checklists. ECI-5 Symptom Count Cutoff score sheets (categorical scoring) are included. Parent and Teacher ECI-4 Checklists are available in Spanish and are keyed to the English-language version item-by-item.

ECI-5 Symptom Severity Profile score sheets (dimensional scoring) can be purchased for the ECI-5 Parent Checklist and the ECI-5 Teacher Checklist, separately. The Profiles present T scores and corresponding raw scores for each diagnostic category with symptom severity cutoffs. There are separate Profiles for boys and girls.

The ECI-4 Screening Manual reviews DSM diagnostic criteria and describes research, scoring guidelines, and clinical applications for categorical scoring. The ECI-4 Norms Manual presents normative data and describes research, scoring guidelines, and clinical applications for dimensional scoring.

The ECI-5 Deluxe Kit contains the ECI-4 Screening Manual, the ECI-4 Norms Manual, 25 ECI-5 Parent Checklists, 25 ECI-5 Teacher Checklists, 50 symptom count cutoff score sheets for categorical scoring (with scoring instructions, cutoff scores, and rule out diagnoses), and symptom severity profile score sheets (T scores) for dimensional scoring of Parent (tablet of 25) and Teacher (tablet of 25) Checklists.

Research

ECI-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 research studies that used at least one Checkmate Plus assessment tool to include the ECI can be accessed here.

Scoring

The ECI-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 use normative data to generate T scores,

  • Impairment Cutoff scores indicates whether the child 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 ECI-5 Differs from Prior Versions

The ECI-5 replaces the earlier ECI-4 and the ECI-4R. The ECI-4 was originally published in 1996 and included the symptoms of DSM-IV-defined disorders. The ECI-4 was revised in 2010 to create the ECI-4R by adding an impairment question for each multi-item disorder in order to determine the extent to which symptoms 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 ECI-5 was published in 2014 to reflect these changes, each of which are reviewed below. The ECI-5 includes all the original ECI-4R items (with their respective item numbers) to ensure a seamless transition from the ECI-4R to the ECI-5. There are no new norms for the ECI-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

Two, one-item disorders were added to Category E of the ECI-5: excoriation disorder (skin picking) and trichotillomania (hair pulling).

Two new items were added to autism spectrum disorder. The DSM-IV-based scoring rules for autistic disorder and Asperger’s disorder were maintained in the ECI-5 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. Nevertheless, we added two items to Category M (Mz1 and Mz2) of the ECI-5 to reflect the changes in DSM-5.

Lastly, the two types of reactive attachment disorder, inhibited and disinhibited, were redefined as separate disorders in DSM-5; namely, reactive attachment disorder and disinhibited social engagement disorder, respectively. 

New Item Numbers

As noted above, the ECI-5 includes all the original ECI-4R items (with their respective item numbers) to ensure a seamless transition from ECI-4R to ECI-5.  All new ECI-5 DSM-5-referenced symptom items are denoted with the letter z.