Behavior Rating Scales

1. Behavior Rating Scales Exceptional Education Department

2. Objectives • How to complete behavior scales • How to interpret Behavior Scales and apply the information to writing IEPs, FBA and BIP (if applicable) and determine programming and supports for students.

3. Scales to be covered • BRIEF • CAB • BES • ABES/ABAS • GARS

4. BRIEFWhat is Executive Function? • Executive function is a set of mental processes that helps connect past experience with present action. People use it to perform activities such as planning, organizing, strategizing, paying attention to and remembering details, and managing time and space

5. Methods of assessing ef Micro Macro Performance Tests Structural & Functional Imaging Genetics Observations

6. Behavioral Definitions for the Clinical Scales Inhibit: Control impulses; stop behavior Shift: Move freely from one activity/situation to another; transition; problem-solve flexibly Emotional Control: Modulate emotional responses appropriately Initiate: Begin activity; generate ideas Working Memory: Hold information in mind for purpose of completing a task Plan/Organize: Anticipate future events; set goals; develop steps; grasp main ideas Monitor: Check work; assess own performance

7. Ratings on the BRIEF • N if the behavior is Never a problem • S if the behavior is sometimes a problem • O if the behavior is often a problem

8. Parent form • Materials: Parent Form and a pen/pencil • Parent Form is filled out by a parent; preferably, by both parents • Parent must have recent and extensive contact with the child over the past 6 months • Form must be explained to parent • Ratings must be explained • Preferably form should be completed by phone or in person

9. Teacher form • Can be filled out by any adult with extended contact with the child in an academic setting; typically a teacher • Minimum familiarity is 1 month best practice is 6 weeks • Multiple ratings across classrooms may be useful for comparison purposes (2 scales) • Teachers should complete the forms independently

10. Interpreting the form • All results should be viewed in the context of a complete evaluation • High scores do not indicate “A Disorder of Executive Function” • Problems may be developmental or acquired and, thus, are suggestive of differing treatment approaches • Must have an impact statement showing impact in the educational environment

11. Implementing strategies The purpose of the BRIEF is to identify areas of weakness in the area of Executive Functioning Inhibit:, Shift:, Emotional Control, Initiate, Working Memory, Plan/Organize and Monitor Based on the results, your job is to teach strategies and add accommodations and modifications to the IEP to help with deficits in Executive Functioning skills.

12. Examples of accommodations/modifications and services for IEPs General Strategies Take step-by-step approaches to work, rely on visual organizational aids. Use tools like time organizer computers or watches with alarms. Prepare visual schedules and review them several times a day. Ask for written directions with oral instructions whenever possible. Plan and structure transition times and shifts in activities. Managing Time Create checklists and "to do" lists, estimating how long tasks will take. Break long assignments into chunks and assign time frames for completing each chunk. Use visual calendars to keep track of long term assignments, due dates, chores, and activities. Use management software such as the Franklin Day Planner, Palm Pilot, or Lotus Organizer. Be sure to write the due date on top of each assignment.

13. Strategies Managing Space and Materials Organize work space Minimize clutter Consider having separate work areas with complete sets of supplies for different activities Schedule a weekly time to clean and organize the work space Managing Work Make a checklist for getting through assignments. For example, a student's checklist could include such items as: get out pencil and paper; put name on paper; put due date on paper; read directions; etc. Meet with a teacher or supervisor on a regular basis to review work troubleshoot problems.

14. Behavior strategies • 1.) clear expectations • 2.) positive incentives • 3.) predictable consequences • Daily behavior chart to monitor behavior • Prewarning before transitions to a new activity or location • Boundaries for unstructured times (PE, Recess,bus) • Opportunities for a break • Structured rewards • Calm down area if needed • Social skills instruction

15. BRIEF • Review BRIEF report for additional strategies and recommendations • Look at each area on the BRIEF and determine which areas are the most significant • Add information to the IEP to address specific areas noted on the BRIEF: • Inhibit (Think before acting) Shift(Transition) Emotional Control(Control feelings and reactions to include temper), Initiate (begin a task) Working Memory (Remembering verbal directions), Plan/Organize (homework, projects, events) and Monitor (monitoring • time, and self)

16. Behavior evaluation scale (bES) The Behavior Evaluation Scale - Third Edition provides results that assist school personnel in making decisions about eligibility, placement, and programming for students with behavior problems who have been referred for evaluation. The scale yields relevant behavioral information about students regardless of handicapping conditions, and therefore may be used with students who have learning disabilities, mental retardation, physical impairments, and other handicapping conditions. Ratings-data required to complete scale 1-Not personally observed or is developmentally advanced for age group 2-Less than once a month 3-Approximately once a month 4-Approximately once a week 5-More than once a week 6-Daily at various times 7-Continuously throughout the day

17. Used to rule out a behavior disorder when determining eligibility The BES-3 is based on the IDEA definition of emotional disturbance/behavioral disorders which makes it particularly useful in the assessment of students who are suspected of having behavior disorders. The BES-3 was factor analyzed to create the following factor clusters (subscales): Learning Problems, Interpersonal Difficulties, Inappropriate Behavior, Unhappiness/Depression, and Physical Symptoms/Fears.

18. Learning problems The Learning Problems subscale assesses behaviors conducive to learning, study habits, assignment and homework completion, work habits, academic performance, memory and comprehension skills, and skill in following oral and written directions. It represents the students who do not respond to traditional learning experiences and are not successful in learning without special attention or assistance in the school environment. The understanding is that the learning difficulty is behavioral, thus constituting its inclusion in the need to consider the failure to learn, without other explanation, as a behavior disorder.

19. Interpersonal difficulties The Interpersonal Difficulties subscale assesses social skills conducive to the formation of positive relationships with peers and teachers. Items within this subscale include such behaviors as fighting, inappropriate comments, agitation or provocation of other students, withdrawn behavior, and lack of acceptance by the student’s peers. It encompasses the inclusion of behaviors ranging from the inability to make or keep friends to the acting out/aggressive behavior which interferes with resolving conflict, etc.

20. Inappropriate behaviors The Inappropriate Behavior subscale is an all encompassing one which represents behavior atypical in the context of the educational environment. It is this area which represents attendance, stealing, predictability, sexual behavior, cheating, rule-following, etc. Much of this characteristic deals with the inability to conform to expected patterns of behavior necessary for social/employment success in society. Stability, responsibility, dependability, etc., are behaviors measured by this characteristic.

21. Unhappiness/depression The Unhappiness/Depression subscale provides a measure of the more subtle indicators of emotional/behavioral problems represented by a pervasive mood of dissatisfaction and negative feelings resulting from personal or school related experiences. This subscale includes behaviors such as avoidance of group activities, self-blame, difficulty accepting suggestions or constructive criticism, suicidal comments, lack of affect (i.e., smiling or laughing), apparent fatigue, apathy, frowning, scowling, and overly critical or pessimistic comments directed at oneself.

22. Physical symptoms/fears The Physical Symptoms/Fears subscale provides a measure of behaviors representing a negative reaction to personal or school experiences. In many cases the behaviors demonstrated under this characteristic constitute a phobic level of response to environmental problems. Included in this subscale are behaviors such as complaints about physical illnesses, self-injury, excessive concern related to family or school problems, temper tantrums, nervous habits, unusual speech habits, tremors, stammering, shaking, or excessive fears

23. Bes-3 results • If the BES-3 results are in the Significant range, a behavior disorder cannot automatically be ruled out. • Additional scales should be used to determine if there is a behavior disorder. CABs or BRIEFS are available as well as other scales (see chart of available scales). • Results from the BES-3 can be incorporated into the students IEP and programming.

24. ABES-70 and below is significant The ABES is an adaptive behavior evaluation scale measuring the following adaptive skill areas: Communication Skills, Self-Care, Home Living, Social Skills, Community Use, Self-Direction, Health and Safety, Functional Academics, Leisure, and Work Skills. For students age 5 to 18 years.

25. Ratings Ratings 0-Not developmentally appropriate for age 1-Does not demonstrate the behavior or skill 2-Is developing the behavior or skill 3-Demonstrates the behavior or skill inconsistently 4-Demonstrates the behavior or skill most of the time 5-Demonstrates the behavior or skill consistently Read each quantifier with the item before rating the item. EXAMPLE: Adjusts his/her behavior to the social situation (e.g., at a party, lunch with friend, lunch with adults, etc.)

26. ABAS II-70 and below is significant *Use for lower functioning students Ages-5-21 Parent and Teacher form Ratings 0-Is not able 1-Never or Almost Never When Needed 2-Sometimes When Needed 3-Always or Almost Always When Needed Check if you Guessed-(if 4 or more interview the respondent) If necessary, select a different rater that has more knowledge of the individual. Areas Communication Community Use Functional Academics School Living Health and Safety Leisure Self-Care Self-Direction Social (Work) *BEST if used for student that are ID or have Autism

27. Linkage of goals to adaptive behavior scales For social and functional goals, consider domains, subscales and individual items numbers. According to the ABES completed on 9/2 by Johnny’s classroom teacher, Johnny’s total adaptive score yielded a result of 65. Scores are reported in Standard Scores with 90-110 being considered within the average range and 65 being in the significant range. Johnny’s scores on the social domain fell within the significant range. Johnny does not demonstrate the behavior or skill to be able to adjust behavior to expectations of different situations (e.g., classrooms, recess, etc.) This impacts his ability to interact with his peers in the general education classroom. The goal on the IEP should be linked to the domain, subscale and item number. EX: By May of 2013, when transitioning to different social environments including from the classroom to recess and specials, Johnny will correctly display the appropriate set of behaviors for the given environment in 3 out of 5 opportunities.

28. Clinical Assessment of Behavior The CAB offers a balanced theoretical framework of both competence-based qualities and problem-based concerns for the CAB scales and clusters, making it useful for evaluating adaptive strengths and clinical risks in children and adolescents. The CAB assesses behaviors that reflect current societal concerns and issues about youth and their behavior (e.g., bullying, aggression, executive function, gifted and talented). It includes both Parent and Teacher Rating Forms, thus providing a multisource, multicontext assessment of children and adolescents behaviors. Psychological Publications, INC.

29. Uses a Five-point Item response format • Always - Very Frequently • Often • Occasionally • Rarely • Never • 130 and Above is Significant

30. Clinical Scale Definitions Internalizing Behaviors Scale (INT) Assesses behaviors directed toward oneself (e.g., behaviors related to depression, anxiety, and somatization - cries easily; is easily startled; is emotionally fragile Externalizing Behaviors Scale (EXT) Assesses problematic conduct directed toward others, including rule-breaking behaviors - insults others; is difficult to manage; ignores rules Critical Behaviors Scale (CRI) Assesses behaviors associated with serious psychopathology and sociopathy - uses illegal drugs; hallucinates; expresses an unusual interest in Satan

31. Adaptive Scale Definitions Social Skills Scale (SOC) Assesses interpersonal interactions with peers and adults - listens attentively to others; is considerate of others; annoys others Competence Scale (COM) Focuses on cognitive and language development and ability to get needs met - has poor judgment; is easily confused; learns new things easily Adaptive Behaviors Scale (ADB) Assesses developmental progress and degree of independence - dresses self; reliably makes simple purchases; prepares simple meals for self

32. Clinical interpretation • Quantitative and Qualitative Interpretation Process • 5-Step Interpretation Process • Consider CAB total scale score (i.e., CAB Behavioral Index) • Consider CAB scale and cluster scores individually and in combination • Compare scale and cluster scores acquired from different sources (e.g., parents/teachers) • Explore clinically informing items • Contrast student’s performance on the CAB forms, scales, and clusters in light of other available information

33. Areas on the CAB Clinical Clusters Anxiety, Depression, Anger, Aggression, Bullying, Conduct Problems, Attention Deficit/Hyperactivity, Autistic Spectrum Behaviors, Learning Disability , Mental Retardation If a particular area such as bullying is significant use that to write a behavior goal in the IEP or for a goal in the BIP. EX: PLOP-The CAB, Clinical Assessment of Behavior was completed by two of Mary’s teachers and mother. All three scales indicated that Bullying was an area of concern. The scores are reported in standard scores with a score of 130 or above in the significant range. All three scales yielded a score of 130 and above in the area of Bullying. (Describe the behavior in more detail to include #s based on data ) Write an annual goal to decrease the behavior in measurable terms. On the FBA, indicate that behavior scales were completed and significant. If aggression is an area of concern you can write a goal on the BIP (verbal and or physical aggression to include hitting, biting, and cursing) and an appropriate replacement behavior.

34. Emotional disturbance defined • Disabilities Education Act (IDEA), Public Law 101-476 defines SED as: “…one or more of the following characteristics over a long period of time and to a marked degree that adversely affects educational performance– • (A) An inability to learn that cannot be explained by intellectual, sensory, or health factors; • (B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers; • (C) Inappropriate types of behavior or feelings under normal circumstances; • (D) A general pervasive mood of unhappiness or depression; • (E) A tendency to develop physical symptoms or fears associated with personal or school problems."

35. Programming for students with a behavior Disorder • Students that qualify for Special Education services in the area of ED must have a BIP • Data collection on behavior goals must be ongoing and reported every 9 weeks • Student must receive social skills instruction with a special education teacher and services should be listed under Special Education Services • Supplementary aides and services should include necessary behavior strategies (cool off place, daily behavior chart, BIP, visual and verbal cues, prompting etc.) • The IEP should contain information about behavior scales and sections of the • Behavior scales that are considered in the significant range • Goals and behavior programming should correlate with data from the FBA and Behavior scales

36. Must-have Supports in an IEP for students with an emotional disability 1.) Services from Special Education teacher to address behavior 2.) FBA data and BIP that addresses current behavior 3.) Supplementary aides and services to address behavior supports 4.) Research based strategies and program to address target behaviors

37. GARS-2 Subscales Stereotyped behaviors-Rocksback and forth, flaps hands or fingers, stares at hands Communication-repeats words or phrases, babbles, looks away or avoids looking at speaker when name is called Social Interaction-withdraws, becomes upset when routines are changed

38. Examples of Goals Item #1- Stereotyped behaviors Avoids eye contact; looks away when eye contact is made Goal: Establish eye contact Within 3 seconds of the command, “look at me,” student will look at teacher. When the student’s name is called, within 3 seconds student will look at teacher When a signal is given (e.g., ringing of a bell, clapping of hands, blinking of lights), within 3 seconds student will look at teacher When the teacher says, “Stop,” within 3 seconds student will look at teacher Communication #21-Does not ask for things he or she wants Goal 1: Ask for things he or she wants. Given a selection of more than two items that most children desire (e.g., candy, popcorn potato chips, soda) and asked, “What do you want?” student will indicate the item that he or she wants by pointing to it. (CAP to be determined by teacher) Social Interaction #33-Withdraws, remains aloof, or acts standoffish in group situations Goal:-When requested by the teacher, “Student , come join out group,” student will go to the group where teacher is. (Cap to be determine by teacher).

39. references • ADHD - Jarratt et al., 2005; Loftis, 2005; Viechnicki, 2005; Lawrence et al., 2004; Blake- Greenberg, 2003; Palencia, 2003; Kenealy, 2002; Mahone et al., 2002. • Reading disorders - Gioia et al., 2002; Pratt, 2000. • Autism spectrum disorders - Gilotty et al., 2002; Gioia et al., 2002. • Bipolar disorder vs. ADHD - Shear et al., 2002. • Tourette’s syndrome - Mahone et al., 2002; Cummings et al., 2002. • Traumatic brain injury - Landry et al., 2004; Brookshire et al., 2004; Gioia et al., 2004; Mangeot et al., 2002; Vriezen et al., 2002; Jacobs, 2002. • Media violence exposure -Kronenberger et al. 2005. • Galactosemia- Antshel et al., 2004. • Childhood onset MS - McCann et al., 2004. • Psychological Publications, INC.