Clinical Assessment of Behavioral Adjustment in Pediatric Patients: A Preliminary Case Series Review

Principal Investigator: Keith Slifer

In pediatric rehabilitation settings, behavioral consultants see patients with a wide range of medical conditions, mental health diagnoses, and presenting problems. The Pediatric Behavioral Adjustment Scale (PBAS) is a new scale developed to objectively measure child affect and behavior during rehabilitation demands and therapies, and to evaluate the effect of behavioral and medical interventions.

This project will present de-identified clinical outcome data on a series of clinical cases treated in recent years at the Kennedy Krieger Institute. These patients were referred for behavioral assessment and evaluated by behavioral therapists and/or members of the interdisciplinary rehabilitation team using the PBAS scale. De-identified data from these patients will be used to illustrate the application of the PBAS to evaluate the efficacy of various treatments (e.g., medication management, desensitization, antecedent management, escape extinction) among patients with diverse diagnoses and presenting problems (e.g., autism and needle phobia, traumatic brain injury and agitation, sleep apnea, and non-compliance with respiratory support) using various designs (e.g., changing criterion, AB, multiple-baseline across setting).

Each case was pursued to assist the individual child undergoing behavioral assessment and intervention. These cases were not pursued to attempt to acquire generalizable knowledge, but for the benefit of the patients involved. Data will be presented that summarize the clinical utility of the PBAS as a widely applicable measure of child behavior, affect and intervention effects. Results will be discussed in regard to the demonstrated clinical utility of this scale that is based on applied behavior analysis methodology, which is well established as an effective clinical tool. The clinical results also will be discussed in relation to the need for future research to formally establish the validity, reliability, and usefulness of this scale for clinical practice and research.