Health BehaviorAssessment
Mr. Lema, Isaac
Clinical Psychologist
23rd November 2015
Learning Objectives
Understand the meaning of assessment andprinciple of measurement
Familiarize with different methods used inbehavioral assessment
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Outline
Introduction
Behavioral Assessment Context in ClinicalSetting
Assessment Tools
Principles of Measurement
Assessment on Learning Theories
Skinner’s Analysis of Behavior
Problems in Assessment
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Introduction
Assessment is the process of gatheringinformation about peoples symptoms and thepossible causes of those symptoms
Information to inform diagnosis
Diagnosis label attached to a set of symptomsthat tend to occur with one another
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Behavioral Assessment Contextin Clinical Setting
Differs from traditional assessment in 3 ways
1.Interested in samples of behavior, notbehavior as a sign of internal processes
In behavioral assessment, test / interviewresponses are interpreted as “samples” ofbehavior that are thought to generalize to othersituations
In traditional assessment, interpret test data as“signs” of internal processes
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Behavioral Assessment Context inClinical Setting …
2.Functional Analysis, a very concrete method,is employed to understand behavior
3.Assessment is an ongoing, active part of allphases of treatment
Not just always in the back of clinician’s mind, asin other types of treatment
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Functional Behavioral Analysis/ Functional Analysis
Derived from Skinner’s work with SR learning
SORC model
ABC model (very similar)
Isolates a target behavior for analysis andunderstanding in a very concrete, prescriptmanor
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SORC Model for Conceptualizinga Behavior
S = stimulus or “antecedent” factors whichoccur before target behavior
O = organismic variables relevant to targetbehavior
Physical / medical / cognitive / psychologicalaspects of the client; that are relevant to treatingthe target behavior
R = the response; the target behavior
C = consequences of target behavior
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Example of SORC model
S – Stimulus: a child is ignored by her peers inclass
O – Organismic: the child has previously beendiagnosed with ADHD)
R – Response: She increases the volume of hervoice (i.e., yells)
C – Consequences: her peers pay attention toher, some role their eyes
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Skinner’s Analysis of Behavior
ABC of operant conditioning
Antecedents (the stimulus conditions)
Behaviors (or operant)
Consequences (what happens as a result ofthe operant behavior – reinforcement orpunishment)
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Assessment Tools
Clinical interviews or initial interview
Unstructured
Structured
Test / screening tools
Checklists, rating scales, self rating scale
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Method Studying Behavior
Observation
Naturalistic or Controlled Observation
Assess deficits in skills or way of handlingsituations
Controlled Performance Techniques
Self-Monitoring
Role-playing
Inventories, Checklists
Cognitive-Behavioral Assessments
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Method Studying Behavior …
Self monitoring
Keep track of the number of times per day s/heengages in a specific behavior and the conditionsunder which this behavior happens
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Behavioral Interviews
Behavioral interviews: ask questions focusedon target behaviors
Goal: help clinician gain general perspective ofproblem behavior and the variables thatperpetuate it
Understand antecedent factors
May use structured diagnostic interview
Not different from traditional interview in format,only in focus
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Principles of Measurement
Reliability
Consistency of an individual’s score on repeatedtesting provided that the property being testedhas not changed (Sims & Hume,1984)
Validity
Ability of a test to measure what is claimed tomeasure (Sims & Hume,1984)
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Principles of Measurement …
Prevalence
The total number of existing cases among thewhole population
Incidence
Number of new cases of a disease during aspecified period of time related to the number ofpersons at risk of contracting the disease
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Principles of Measurement …
Prevalence
A single point in time (point prevalence) or
Over a period of time (period prevalence) andexpressed as a percentage or when very small,as per 1000 population
Prevalence is expressed as a percent, e.g. theprevalence of smoking in the S.A. in 1999 was24%, or as a decimal, 0.24
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Principles of Measurement …
Prevalence is a “cross-sectional” measure, i.e.it is measured at one point in time
Prevalence includes both “old” and “newcases”, i.e. both people who began smokingprior to 1999 and those who just began in1999
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Principles of Measurement …
Prevalence is a measurement of the burden ofillness
Unlike incidence, it provides an estimate ofthe burden of disease
If the prevalence of Type II diabetes is 3% inthe U.S, that suggests that 7.65 million (0.03 X255 million) people have this disease, asubstantial number
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Principles of Measurement …
Incidence
It may be measured either as a risk or as arate
Is the probability that a person initially freefrom the disease develops it at some timeduring the period of observation
Expressed as a percentage or per 1000persons
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Principles of Measurement …
The incidence rate is the rate of contractingthe disease among those still at risk e.g.diarrhea
Because the incidence measures the numberof NEW events, it provides an index of thespeed or velocity of propagation of a diseasein a population
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Principles of Measurement …
Changes in incidence over time, either up ordown, suggest that a disease may be waxingor waning in importance.
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Challenges to validity andReliability
Reliability & validity influenced by
complexity of behavior observed
level of training, experience of observer(s)
unit of analysis chosen & coding system used
influence of observation on target(problematic) behavior
generalizability of observations to othersettings/situations
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How to Study Child Behavior
1.Chart method
Plotting a misbehavior
2.Graph method
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Problems in Assessment
It is often difficult to obtain accurateinformation on children’s problems becausechildren are unable to report their thoughtsand feelings
Parents and teachers may provide informationabout children
They can be biased in their own assessment ofchildren’s symptoms and needs
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Problems in Assessment …
When the clinician and patient / client arefrom:
Different culture
Language difficulties
Cultural expectations
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Conclusion
Grows from Behavior Theory / LearningTheory
Aspects of it can be easily combined withother forms of assessment
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References
Gross, R. (2010) Psychology the Science of Mind andBehaviors 6th edition; Macmillan Company
Richard, G (2010) Psychology The Science of Mind andBehaviour; 6th Edition. Hodder education
Santrock John W. (2006) Educational Psychology; secondedition. Mc Graw Hill Publisher
Sims, ACP & Hume, WI (1984) Lecture Notes on BehavioralSciences
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