Background: Challenging behaviour, especially in intellectual disability, covers a wide range that is in need of further
evaluation.
Aim: To develop a short but comprehensive instrument for all aspects of challenging behaviour.
Method: In the first part of a two-stage enquiry, a 28 item scale was constructed to examine the components of
challenging behaviour. Following a simple factor analysis this was developed further to create a new short scale, the
Problem Behaviour Check List (PBCL). The scale was subsequently used in a randomised controlled trial and tested
for inter-rater reliability. Scores were also compared with a standard scale, the Modified Overt Aggression Scale
(MOAS).
Results: Seven identified factors - personal violence, violence against property, self-harm, sexually inappropriate,
contrary, demanding and disappearing behaviour – were scored on a five point scale. A subsequent factor analysis
with the second population showed demanding, violent and contrary behaviour to account for most of the variance.
Inter-rater reliability using weighted kappa showed good agreement (0.91; 95% CI 0.83-0.99). Good agreement was
also shown with scores on the MOAS scale and a score of 1 on the PBCL showed high sensitivity (97%) and specificity
(85%) for a threshold MOAS score of 4.
Conclusions: The PBCL appears to be a suitable and practical scale for assessing all aspects of challenging behaviour.