Behavioral Evaluation

Behavioral evaluation actually includes a variety of procedures, such as a Functional Behavior Assessment (FBA), rating scales completed by parents and teachers, and direct clinical observation. The actual procedures used depend on the problem being evaluated. More complex, severe, or long-lasting problems are likely to involve more complex evaluation, whereas relatively simple or recent problems may use a simpler evaluation process. As a general rule of thumb, a specific problem (such as tantrums) will likely feature an interview, tracking the behavior for a short period of time, and a rating scale. On the other hand, a more severe or long-lasting problem (or a potential disorder such as ADHD) will likely include tracking the behavior, rating scales, direct clinical observation and possibly an FBA.

Functional Behavior Assessment
A Functional Behavior Assessment (FBA) involves observing the specific problem behavior (the "target behavior") within the natural setting for a period of time and recording what occurs immediately before and after the problem behavior. The events that occur before the behavior are called the "antecedent" and the events that occur after the behavior are called the "consequence." FBA is important for behaviors that seem to lasting for a long time and are not responding to other attempts to modify the behavior. This process helps identify events or things in the environment that may actually trigger or maintain the behavior, especially when these things are not obvious. An FBA can be a very time-consuming process. It often involves observing the target behavior for an hour or more and recording occurrences of the behavior at intervals (for example, every 5 minutes).

Rating Scales
Because the psychologist cannot observe the child in all settings or for periods as long as the parents and teachers, rating scales are often given to parents and teachers. Rating scales are useful because they make it easy to report specific information about a child's behavior at home and at school. Rating scales also provide information about a child's emotional and social functioning. The answers provided by parents and teachers are compared to the answers of thousands of other parents and teachers to see if the child is showing behavior that is significantly different from what is normal. The scales can be frustrating for parents and teachers because the statements and answer options may not quite line up perfectly with what is observed. Some scales include space for additional information to be provided. When extra space is not available, parents and teachers should feel free to offer extra information on a sheet of paper or by speaking with the psychologist directly.

Direct Clinical Observation
The psychologist may also wish to directly observe the child within the clinic. Some of these observations may be part of a structured behavioral observation (such as in the Autism Diagnostic Observation Schedule), while others may be informal observations. Direct observation can provided extremely useful information for the psychologist, and most psychologists should ask to directly observe the child at some point when evaluating for a possible disorder. Observations are typically conducted over a period of approximately 1 hour, but they may be longer if a child is having difficulty becoming comfortable in the clinical setting and this interferes with the observation. If the parents are in the room during the evaluation, the psychologist may ask for them to remain uninvolved unless otherwise requested. This request is important because the psychologist may need to see how the child responds to a specific situation, and the child's behavior could be accidentally influenced by the parent. In other cases, the parents may be asked to wait outside of the evaluation room during the observation. This is also important for similar reasons and is not meant to be rude to the parents.