Early Literacy Research Library (ELRL) - Metric

Brief Infant-Toddler Social and Emotional Assessment (BITSEA)


Access: FREE/Open Access

evaluation focus

Social-Emotional Behavior Problems and Delays

applicable ages

12-36 months; 1-3 years

available language(s)

English, Spanish (Spain), Japanese (Japan), Dutch (Netherlands), and Turkish (Turkey).


FREE somewhere else


The Brief Infant-Toddler Social and Emotional Assessment (BITSEA) is an instrument that can be used to briefly screen children’s social or emotional behavior problems and competencies. This brief instrument is based on the Infant Toddler Social Emotional Assessment (ITSEA); both the BITSEA and ITSEA were designed to identify deficits or delays in these domains. Authors advise administering the ITSEA in follow-up for children with positive scores on the BITSEA.


ITSEA Areas Assessed (Briggs-Gowan 2004):

    • Internalizing
    • Externalizing
    • Dysregulation
    • Competence
    • Social Relatedness
    • Maladaptive
    • Atypical

Sample Items (Briggs-Gowan 2004):

    • Is restless and can’t sit still.
    • Hits, bites, or kicks you.
    • Does not make eye contact.
    • Has less fun than other children.
    • Refuses to eat.
    • Wakes up at night and needs help to fall asleep again.
    • Cries or throws tantrums until exhausted.
    • Is affectionate with loved ones.
    • Follows rules.
    • Looks for you (or other parent) when upset.
    • Hugs or feeds dolls or stuffed animals.

2 Scores Generated:

    • Problem Total Score
    • Competence Total Score

2 Forms Available:

    • Parent Form
    • Childcare Provider Forms

Administration Format: Questionnaire

Administration: 6 minutes | Scoring: 5 minutes | Total Time: ~11 minutes


Reliability (Briggs-Gowan 2004):

    • Test-retest: excellent
        • BITSEA/P correlation intraclass coefficient = 0.87
        • BITSEA/C intraclass correlation coefficient = 0.85
    • Interrater Agreement: good
        • Parent-Parent intraclass correlation coefficient = 0.68 (BITSEA/P), 0.61 (BITSEA/C)
        • Parent-Provider intraclass correlation coefficient = 0.59 (competence), 0.28 (problems)


Validity (Briggs-Gowan 2004):

    • BITSEA problems:
        • correlated with concurrent evaluator problem ratings
        • correlated with scores from the Child Behavior Checklist (CBCL/1.5-5)
        • predicted CBCL/1.5-5 and ITSEA problem scores one year later
    • BITSEA measures of competence:
        • correlated with concurrent observed competence
        • predicted later ITSEA competence measures
    • Discriminant Validity:
        • Only 23% of high BITSEA problem scorers had delayed vocabulary
        • Combined BITSEA problem/competence cutpoints identified 85% of subclinical/clinical CBCL/1.5-5 scores, while maintaining acceptable specificity (75%)

Source: https://www.nctsn.org/print/507

Available for Download
(Must Register for an Account to Download): https://eprovide.mapi-trust.org/instruments/brief-infant-toddler-social-emotional-assessment

supporting literature

Briggs-Gowan, M.J., Carter, A.S., Irwin, J.R., Wachtel, K., Cicchetti, D. V. (2004) The Brief Infant-Toddler Social and Emotional Assessment: Screening for Social-Emotional Problems and Delays in Competence. Journal of Pediatric Psychology, 29(2), 143-155.
PDF: BITSEA – 1 – Briggs-Gowan 2004
Link: https://academic.oup.com/jpepsy/article/29/2/143/926026?login=true

Karabekiroglu, K., Briggs-Gowan, M.J., Carter, A.S., Rodopman-Arman, A., Akbas, S. (2010) The Clinical Validity and Reliability of the Brief Infant-Toddler Social and Emotional Assessment (BITSEA). Infant Behavior and Development, 33(4), 503-509.
PDF: BITSEA – 2 – Karabekiroglu 2010
Link: https://www.sciencedirect.com/science/article/pii/S0163638310000810?via%3Dihub

Kruizinga, I., Jansen, W., Mieloo, C., Carter, A. S., Raat, H. (2013) Screening Accuracy and Clinical Application of the Brief Infant-Toddler Social and Emotional Assessment (BITSEA). PLoS One, 8(8),e72602.
PDF: BITSEA – 3 – Kruizinga 2013
Link: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0072602