Screening for mental health issues among individuals affected by disparities due to language, literacy, or education is a challenging public health problem. The lack of valid information obtained from self-response scales reduces the opportunity to learn about the prevalence of disorders and implement early interventions. To address these issues, we added pictorial descriptions to the Child Behavior Checklist (CBCL), which is a widely used scale for assessing psychosocial and behavioral problems among children. Our intent was to demonstrate that the pictorial version of the CBCL had equivalent psychometric properties as the original CBCL and helped users comprehend the questions. Challenges included designing a pictorial version of the CBCL using images that did not alter the content of the questions but rather helped users better understand them. We observed that the two versions of the scale had equivalent psychometric properties. Therefore, the use of pictorial scales can improve respondent comprehension and enable a better understanding of individuals affected by communication disparities.