Development of an Instrument to Assess Problem Behavior in First Grade Students Prenatally Exposed to Cocaine. Part II: Validation.

In Part I, the initial development of a preliminary tool, the PROBS-14, was reported. The tool was developed and initially tested through a consensus process that tapped the perceptions of early education teachers. Concurrent validity between the PROBS-14 and the Conners' Teacher Rating Scale (CTRS) was established with factor analysis, yielding a hyperactivity-conduct factor, composed of PROBS items and all but two of the CTRS subscales, and a central processing factor, composed of PROBS items and the remaining CTRS scales. The purpose of Part II was to further establish concurrent validity of the PROBS-14 with known pediatric behavior measures (TRF, CTRS) and to ascertain if the PROBS-14 better predicts a cocaine behavioral effect. A sample of 468 African American children with known cocaine exposure (n = 200) and control status (n = 268) were evaluated. Factor analyses produced results similar to those reported in Part I, with PROBS items accounting for problem behavior variance beyond that accounted for by the TRF, and more specific than that accounted for by the CTRS. Additionally, children prenatally exposed to cocaine, particularly those exposed late in pregnancy, differed significantly from controls on the PROBS total, central processing scale, and several PROBS items. The PROBS instrument offers a promising brief measure of child problem behaviors with adequate concurrent and predictive validity, and which outperforms the TRF and CTRS in discriminating prenatal cocaine exposure status.