Infant-Toddler Checklist(ITC)

What is the Infant-Toddler Checklist (ITC) test

ITC introduction

The Infant-Toddler Checklist (ITC) is a Checklist and tool need to completed by parents or caregivers. This checklist was prepared and designed to find out potential communication problems in children. Aged from 6 to 24 months.

It has a wonderful. It is particularly useful for early detection of language and social development issues. If the caregivers find out the issue, they can give timely interventions when necessary. This checklist can identify different aspects of development in infants and toddlers.

Purpose and Structure of ITC

The Infant-Toddler Checklist(ITC) is a userful checklist. It is part of the Communication and Symbolic Behavior Scales. The ITC mainly focuses on understanding communication skills, social interaction, and symbolic play in infants and toddlers.

These behaviors aspects will indicate different level of difficulty of chilren to learn and talk. The checklist consists of a series of items. All the parents or caregivers complete the list of checklist based on their daily observations of the child’s behavior and details.

if the caregiver stay with the child most of the day, it will get a more accurate score of the checklist.

Key Features of ITC

• Parent-Reported: The ITC is filled out by parents or caregivers, making it a practical tool for gathering information about a child’s communication behaviors in natural settings.
• Age Range: The checklist is applicable for children from 6 to 24 months, capturing critical developmental milestones during this formative period.
• Focus Areas: The ITC assesses various aspects of communication, including:
  • Social Interaction: How the child engages with others.
  • Gestures: Use of gestures to communicate needs or interests.
  • Vocalizations: Sounds made by the child that may indicate attempts at communication.

Application of ITC

Early identification of communication delays through tools like the ITC is crucial because it allows for timely interventions that can significantly improve outcomes for children. Addressing these issues early can enhance language development, social skills, and overall developmental progress.

What are the common uses of the ITC in early childhood development?

1. Screening for Communication Delays:
   1. The ITC serves as a broadband screener for various communication delays, including difficulties in language, social interactions, and symbolic behavior. This checklist helps identify and find out children with potential developmental issues. They may need further evaluation or intervention services.
2. Monitoring Developmental Progress:
   1. The ITC can be used periodically to monitor a child’s communication skills over time. Caregivers are encouraged to complete the checklist every three months to track development and identify any emerging concerns promptly
3. Raising Awareness Among Caregivers:
   1. By utilizing the ITC, parents and caregivers become more informed and careful about developmental milestones about the communication. This awareness can lead to proactive engagement in their child’s development and timely interventions if needed. It is a wonderful time to know more about children in detail.
4. Facilitating Early Intervention Services:
   1. The results from the ITC can guide healthcare professionals and educators in making informed and key decisions about referrals for specialized services and intervention. The early intervention is almost useful. Based on the decisions, children can receive appropriate support as early as possible.
5. Research Applications:
   1. The ITC is widely used in both clinical and research settings to study early childhood communication development and the efficacy of intervention strategies. Its standardized format allows for consistent data collection across diverse populations.

Who can use this ITC test?

This wonderful tool Infant-Toddler Checklist (ITC) is created for children aged 6 to 24 months. The parents, caregivers, childhood educators need to finish the questionnaire to get the total score and get the final conclusion.

How to get the ITC score

1. Complete the Checklist: The caregiver (a parent or someone who regularly interacts with the child) fills out the checklist by marking responses for each question based on the child’s behavior:
   1. Not Yet (0 points)
   2. Sometimes (1 point)
   3. Often (2 points)
2. Calculate Raw Scores: Each question contributes to different clusters of communication skills. Tally the points based on the responses to derive raw scores for each cluster:
   1. Emotion and Use of Eye Gaze
   2. Use of Communication
   3. Use of Gestures
   4. Use of Sounds
   5. Use of Words
   6. Understanding of Words
   7. Use of Objects
3. Composite Scores: From the raw scores, calculate composite scores for:
   1. Communication Composite
   2. Expressive Speech Composite
   3. Symbolic Composite
4. Total Score: Sum all the composite scores to get a Total Score. Be careful you follow the details and criteria of how to calculate the score.
5. Interpret Scores: Compare the Total Score and composite scores against established cut-off criteria:
   1. A score below the 10th percentile or more than 1.25 standard deviations below the mean indicates potential concerns and may warrant further evaluation. So the people who complete the checklist should pay attention to the cut-off score.
6. Follow-Up: If any scores fall into the concern range, it is recommended to monitor the child’s development and possibly repeat the checklist in three months

What are the different subscales of the ITC

1. Social Composite

• This subscale evaluates the child’s social communication skills, including:
  • Eye contact
  • Responding to social cues
  • Initiating interactions with caregivers

2. Speech Composite

• This component assesses the child’s verbal communication abilities, focusing on:
  • Use of sounds and vocalizations
  • Production of words
  • Clarity and frequency of speech

3. Symbolic Composite

• This subscale focuses on the child’s understanding and use of symbols in communication, which includes:
  • Use of gestures (e.g., waving, pointing)
  • Pretend play with objects
  • Understanding and following simple commands

How to interpret the ITC scores?

1. Components of the ITC

The ITC provides three composite scores along with a total score:

• Social Composite: Assesses social communication skills.
• Speech Composite: Evaluates verbal communication abilities.
• Symbolic Composite: Focuses on the use of symbols and gestures in communication.
• Total Score: An overall assessment combining all three composites.

2. Scoring System

Each item on the checklist is rated on a scale:

• Not Yet (0 points)
• Sometimes (1 point)
• Often (2 points)

	Not Yet	Sometimes	Often
Normal item	0	1	2
	none	1-2	3-4	2-8	Over 8
Item With numbered choices	0	1	2	3	4

Scores from each category are summed to generate composite scores.

3. Cut-Off Values

To interpret the scores, compare them against established cut-off values:

• A score below the 10th percentile in any composite indicates potential concerns regarding communication development.This is a key signal. Caregivers need to pay attention.
• Specific cut-off values can vary by age group; for example, North American norms suggest:
  • Social Composite: 17 points for 17 months, 18 points for 18 months. It was related to children’s age.
  • Speech Composite: 6 points for 17 months, 7 points for 18 months. This small difference all parents need to be careful.
  • Symbolic Composite: 12 points for both age groups.
  • Total Score: 36 for 17 months, 38 for 18 months

4. Sensitivity and Specificity

The ITC has demonstrated varying levels of sensitivity and specificity in identifying communication delays:

• Sensitivity refers to the tool’s ability to correctly identify children who have communication difficulties.
• Specificity refers to its ability to correctly identify those without difficulties. For instance, sensitivity can range from approximately 77% to 93%, depending on age and context, while specificity may vary as well

5. Next Steps Based on Scores

• If scores lower the cut-off values, it is a signal to consult with a healthcare professional or other related expert for further evaluation and potential intervention strategies and plan.
• Overall, the parents or caregivers need to find out and seek a more accurate outcome and get a useful method.
• Regular monitoring using the ITC can help track developmental progress over time.

ITC Subscale Scores

1. Social Composite

• Purpose: Measures social communication skills, including eye contact and engagement with others. Eye contact is a basic skill of communication.
• Cut-off Score: Generally, a score below 17 points for 17-month-olds and 18 points for 18-month-olds indicates potential concerns. For other ages, parents need to find the match score.

2. Speech Composite

• Purpose: Assesses verbal communication abilities such as sound production and word usage. It is a key ability.
• Cut-off Score: A score below 6 points for 17-month-olds and below 7 points for 18-month-olds suggests possible delays.

3. Symbolic Composite

• Purpose: Evaluates the use of gestures and understanding of symbolic communication.
• Cut-off Score: A score below 12 points is generally concerning for both age groups (17 and 18 months).

4. Total Score

• Purpose: Provides an overall assessment of communication abilities by combining scores from all subscales.
• Cut-off Score: A total score below 36 points for 17-month-olds and below 38 points for 18-month-olds indicates potential developmental issues.

Is the ITC test reliable and valid?

Reliability of the ITC

1. Internal Consistency:
   1. The ITC demonstrates strong internal consistency, with coefficients ranging from 0.87 to 0.93 for subscale scores and total raw scores. This indicates that the items within each subscale are measuring a similar construct effectively
2. Test-Retest Reliability:
   1. The test-retest reliability coefficients for the ITC also show good reliability, ranging from 0.65 to 0.88. This suggests that the scores remain consistent over time when no significant changes in the child’s communication abilities occur
3. Generalizability Theory:
   1. Studies applying generalizability theory to the ITC have further supported its reliability by examining various sources of measurement error, providing a comprehensive understanding of its reliability across different contexts and populations

Validity of the ITC

1. Construct Validity:
   1. Confirmatory factor analyses have indicated and shown that the ITC tool effectively measures distinct constructs about the communication skills. It was a great evidence to support the construct validity. The model fit indices (e.g., CFI, TLI, RMSEA) suggest that the theoretical model aligns well with observed data
2. Criterion-Related Validity:
   1. The ITC has been shown to effectively identify children with communication difficulties, with sensitivity rates reported as high as 85% and specificity around 59% when compared to clinical assessments. This demonstrates its utility in clinical settings for identifying children who may need further evaluation.
3. Convergent Validity:
   1. The ITC has shown strong associations with other established measures of communication development, indicating convergent validity. For example, correlations with other communication scales support its effectiveness in assessing similar constructs

The Infant-Toddler Checklist(ITC) test

Emotion and Eye Gaze

1. Do you know when your child is happy and when your child is upset?
   1. Not Yet
   2. Sometimes
   3. Often
2. When your child plays with toys, does he/she look at you to see if you are watching?
   1. Not Yet
   2. Sometimes
   3. Often
3. Does your child smile or laugh while looking at you?
   1. Not Yet
   2. Sometimes
   3. Often
4. When you look at and point to a toy across the room, does your child look at it?
   1. Not Yet
   2. Sometimes
   3. Often

Communication

1. Does your child let you know that he/she needs help or wants an object out of reach?
   1. Not Yet
   2. Sometimes
   3. Often
2. When you are not paying attention to your child, does he/she try to get your attention?
   1. Not Yet
   2. Sometimes
   3. Often
3. Does your child do things just to get you to laugh?
   1. Not Yet
   2. Sometimes
   3. Often
4. Does your child try to get you to notice interesting objects—just to get you to look at the objects, not to get you to do anything with them?
   1. Not Yet
   2. Sometimes
   3. Often

Gestures

1. Does your child pick up objects and give them to you?
   1. Not Yet
   2. Sometimes
   3. Often
2. Does your child show objects to you without giving you the object?
   1. Not Yet
   2. Sometimes
   3. Often
3. Does your child wave to greet people?
   1. Not Yet
   2. Sometimes
   3. Often
4. Does your child point to objects?
   1. Not Yet
   2. Sometimes
   3. Often
5. Does your child nod his/her head to indicate yes?
   1. Not Yet
   2. Sometimes
   3. Often

Sounds

1. Does your child use sounds or words to get attention or help?
   1. Not Yet
   2. Sometimes
   3. Often
2. Does your child string sounds together, such as uh oh, mama, gaga, bye bye, dada?
   1. Not Yet
   2. Sometimes
   3. Often
3. About how many of the following consonant sounds does your child use: ma, na, ba, da, ga, wa, la, ya, sa, sha?
   1. None
   2. 1-2
   3. 3-4
   4. 5-8
   5. over 8

Words

1. About how many different words does your child use meaningfully that you recognize (such as baba for bottle; gaggie for doggie)?
   1. None
   2. 1-3
   3. 4-10
   4. 11-30
   5. over 30
2. Does your child put two words together (for example, more cookie, bye bye Daddy)?
   1. Not Yet
   2. Sometimes
   3. Often

Understanding

1. When you call your child’s name, does he/she respond by looking or turning toward you?
   1. Not Yet
   2. Sometimes
   3. Often
2. About how many different words or phrases does your child understand without gestures? For example, if you say “where’s your tummy” “where’s Daddy,” “give me the ball,” or “come here,” without showing or pointing, your child will respond appropriately.
   1. None
   2. 1-3
   3. 4-10
   4. 11-30
   5. over 30

Object Use

1. Does your child show interest in playing with a variety of objects?
   1. Not Yet
   2. Sometimes
   3. Often
2. About how many of the following objects does your child use appropriately: cup, bottle, bowl, spoon, comb or brush, toothbrush, washcloth, ball, toy vehicle, toy telephone?
   1. None
   2. 1-2
   3. 3-4
   4. 5-8
   5. over 8
3. About how many blocks (or rings) does your child stack?
   1. None
   2. 2 blocks
   3. 3-4 blocks
   4. 5 or more
4. Does your child pretend to play with toys (for example, feed a stuffed animal, put a doll to sleep, put an animal figure in a vehicle)?
   1. Not Yet
   2. Sometimes
   3. Often