Assessing Behavior through Observation

Introduction

Assessing behavior through observation can be vital in understanding the cause and the impact certain behaviors are having on an individual as well as those around them. In addition, observation can determine what behavior is the issue if the issue has not been predetermined. Observation can occur in a professional setting, a school setting, a home setting, or even a work setting. Observation can also be done by non-professionals, people such as caregivers to the elderly, children, and people with cognitive impairments, to name a few. Observation is a necessity in regards to assessing behavior, especially if the person being observed is not aware they are being observed and will act more naturally.

Professional Observation

Professional observation of behavior can include counselors, psychologists, psychiatrists, teachers, doctors, and caregivers. Anyone is able to observe behavior and take notes can observe behavior. However, professional observation means that there is analysis occurring in tandem with the observation. Professionals are able to make observations at any point, whether they are interacting with you in a simple conversation or if they are observing you in a clinical setting or a more comfortable setting for the person being observed, like a home setting. There are many ways in which professionals can engage in assessing behavior through observation.

Anecdotal (ABC) Recording

Anecdotal Recording is observation of behavior in addition to the observation of behavior leading up to and following the displayed behavior that was the object of the observation. This type of observation is conducted under a predetermined period of time. By observing behavior leading up to and following the actual intended observed behavior, it can lead the observer to understand not only the cause of the behavior but the impact the behavior has on the person being observed. This type of observation can lead to quantitative data as well as qualitative data that can be used in conjunction with one another to analyze the behavior and set forth the path that will be utilized to treat said behavior.

Interval Recording

Partial-Interval Recording

Partial-Interval Recording is when the observer decides on two time limits for observation. The first time limit will be the main overall observation and the second it the smaller observation time frame which can be as little as thirty seconds long. The observer will then write if the behavior they are watching was exhibited in the smaller time frame. This type of observation is often done with the aid of computer programs but can be accomplished manually with the use of a stop watch.

Whole-Interval Recording

Whole-Interval Recording allows the observer to make more detailed observations. If a behavior occurs using this method the observer is able to record the behavior. Unlike the Partial-Interval Recording, the behavior is only documented if it lasted the entirety of the observed time. In Whole-Interval Recording behavior is documented no matter how long the duration of the behavior.

Momentary Time Sampling

Momentary Time Sampling is when the observer observes for only the predetermined behavior and in predetermined amounts of time. The predetermined amounts of time are extraordinarily brief and in between the observation time frames, the observer is free to observe the world around the person being observed. This means that very little of the behaviors are being observed and documented. This style of observation has severe limitations for data gathering for analyzation in regards to the observed behaviors of a client and addressing those behaviors constructively.

Event or Frequency Recording

In Event recording the observer will set a predetermined amount of time for the observation to occur. During this predetermined amount of time every time the behavior is observed it is recorded. Therefore, if the behavior occurs multiple times within the time frame each occurrence is documented. This allows the observer to determine the frequency of behavior as well as the impact the behavior is having on the person being observed.

One issue with Event or Frequency Recording is that the definition of behaviors must be clearly understood and defined by the observer. If behavior is not clearly defined it is much more difficult to determine if the behavior is occurring, when it started or when it ceased. Definitions must be set across multiple professions so that things like observations can be conducted in a more scientific manner that will lead to correct data being acquired.

Duration Recording

In Duration Recording the observer waits for the behavior to start and then times said behavior. There can be a predetermined set time for the observation to occur. This style of observation can help determine if the behavior being observed is an issue in regards to how long the behavior lasts. It can provide frequency data to the observer as well as the duration data. The data is then totaled and used to determine the average amount of time the behavior is occurring.

Latency Recording

Latency Recording is utilized by the observer to determine how long after an event the behavior starts and when the behavior stops. For example, this can be utilized by a teacher. If a teacher observes that morning work must be commenced and a student begins to cry, the teacher can determine that the morning work may be triggering the behavior. This is especially more telling if the behavior ceases when recess is announced. This helps observers determine triggers and helps determine what stops the behavior or initiates compliance. For example, if the teacher offers a special pencil to the crying student and the student stops crying and does their morning work, the action of giving the child a special pencil has brought about compliance.

Observation by Caregivers

Caregivers are parents, grandparents, aunt/uncles, babysitters, nannies, certified nursing assistants, in-home health aides, companions, and day care employees (child daycare or adult daycare). They can also include nurses and licensed practical nurses as well. Caregivers spend a great deal of time with the person or people they are caring for. They know normal behavior from abnormal behavior and are best equipped to provide detailed information to medical professionals in regards to any changes in behavior or behavior they are viewing as troubling. Observations provided by caregivers may provide consequential information that professional observation may not pick up because caregivers know their charges very well.

Cognitive Issues

Cognitive issues can result from aging. For example, elderly people may face a decline in their cognitive abilities. In addition diseases such as Alzheimer’s and Dementia can also play havoc on a person’s cognitive abilities. Other types of medical issues that cause cognitive impairment include Parkinson’s disease, Multiple Sclerosis, Stroke, Autism, and Down Syndrome.  There are also cognitive delays that result from issues unrelated to aging or disease. For example, brain injury can cause cognitive impairment.

Cohen-Mansfield Agitation Inventory

This test is given by caregivers. For example, certified nursing assistants working in health care facilities will answer the questions regarding a patient/client. The results of this test, which looks for physically aggressive behavior, physically non-aggressive behaviors and verbal aggression in the elderly patients, helps to determine possible diagnoses. This test is utilized to determine if a patient may have Alzheimer’s or Dementia symptomology. Certified nursing assistants are often the ones who fall victim to aggressive behavior both physical and verbal as they are directly caring for the patients every day and are equipped to determine if behavior like this is new or has been occurring for a long period of time.

Behavior Checklist

Caregivers can fill out a behavior problem checklist. This checklist provides a list of behaviors and asks the caregiver to answer whether or not the behavior is a problem. For example, an elderly patient living in a nursing facility who continues to try to leave the facility in their pajamas, at night, in the dead of winter can be viewed as a problematic behavior that needs to be examined and the cause must be determined as their safety and well-being is at risk because of the behavior. It can also determine what may seem like a problem but really is not, like a patient may be in a bad mood and verbally aggressive but the cause can later be determined to be that he was upset because his children had promised to visit and did not.

Behavioral Competence Inventory

The Behavioral Competence Inventory is one hundred and ten questions. The answers are include yes, no, and not applicable. Caregivers are asked to fill out the inventory in regards to things such as self-care or social interactions, to name a few. The behavioral competence inventory is used to determine if a patient may have dementia. If there are many yes answers to questions such as they forget to eat, they aren’t aware of their surroundings, no longer speak to people they used to speak with, can no longer dress themselves, or get lost easily the patient may need further testing. Caregivers, especially adult children caregivers, know their parents very well and can tell when behavior is no longer within the realm of normal for their loved one.

Children

Professionals can and do observe the behaviors of children all the time. Observation can help a child get a diagnosis of Autism very early in life when interventions can play the most effective role for them. However, parental and other caregiver observation is very important. Parents and other caregivers of children know their children better than anyone. Behaviors are often topics of discussion for parents and caregivers, because often times they relate to milestones. However, when new and troubling behavior begins parents and caregivers are often to the first to recognize there is an issue. On the other hand, troubling behavior could also be unintentionally overlooked by parents or caregivers simply because they are too close to the child or children and cannot see the bad behavior because they want to see their child or children in the best light possible at all times.

Observe

It is important for parents or caregivers to observe their child or children. When new behavior begins observation can help the parent or caregiver determine if the behavior was a short lived reaction to a stimulus or a behavior that is setting itself in to be a part of the child’s normal every day behavior. For example, a child being upset for being pushed in the sand at the playground and screaming may be a behavior that is not repeated. A child who screams at the top of their lungs every time it is bath time, and does not stop screaming until bath time is over, is a much more troubling behavioral change. It is important for a parent or caregiver to determine fleeting behavior from behavior that is setting in as routine for a child.

The sooner bad behavior is addressed in a child the easier it is to address rather than letting the child engage in bad behavior for months or years before attempting to address it. At that point it will be much more difficult to address the troublesome behavior. Waiting a great deal of time once the bad behavior starts can result in more interventions needed. It can also result in a longer amount of time needed for interventions to be successful.

Take Notes and Stay Organized

When the troubling behavior begins it is important for the parents or caregivers to write down the day, time, and duration of the bad behavior. Keep the information recorded very organized. This will help to see if the behavior is improving or worsening. It will also tell you if the behaviors duration is getting longer or more frequent.

Share Observations with Necessary Professionals

The reason it is important for parents and caregivers to take notes and stay organized is because it will help the child or children if the time comes for medical professionals to become involved due to the behavior. For example, if a parent tells the pediatrician that their daughter has started throwing tantrums to get her way; the doctor will make a note of it in the child’s medical file. However, if the parents gives a detailed timeline of tantrums their daughter is throwing and it details the length of time for each tantrum and what she is physically doing during the tantrum, such as smacking herself in the head, the doctor can see there may be an issue that needs addressing as soon as possible. The more details a doctor is given the better equipped they will be to help the child who is exhibiting the troubling behavior.

If there is an issue a medical doctor feels that they need to address they often times will send a questionnaire for the child’s teacher to fill out in regards to observed behavior in the classroom. This will help the doctor determine if the behavior is only occurring at home, in which case the trigger may be at home and thus can be determined and addressed, or if the behavior is occurring at home and at school (Fryling, Johnston, & Hayes, 2011). If the behavior is occurring at home and at school the trigger for that behavior may be more difficult to determine, but it is information that the medical professional needs in order to help them make an accurate diagnosis or to set up an appropriate intervention program.

Discussion

It is vitally important to note that observations made by caregivers are in no way a medical diagnosis and are not substitutions for professional observation or intervention. It is very easy in modern times for parents or caregivers to search symptoms on the internet and diagnose issues based on what the search engine provides them. This is not a substitute for professional evaluation. Professional evaluation should be sought out when the troubling behavior first manifests.

Professional evaluation used in conjunction with caregiver observation can help determine the cause or causes of the troubling behavior in a very efficient manner. Caregivers may see behaviors that professionals are not seeing. For example, if an elderly person is only exhibiting behaviors at night but is professionally observed in the morning the professional may not see the troubling behavior. However, if the professional is given the information based on the observations made by the caregivers they can arrange to observe the person when the troubling behavior typically manifests.

In regards to children the best way to utilize observation is to combine observation by their parents or caregivers, their teachers, and a professional. This way the professional has access to information representing the full scope of the child’s day (Booren, Downer, & Vitiello, 2012). This especially important because children may not have the vocabulary or understanding to aide in their own treatment plans depending on their age. The more information a professional has in regards to a child’s troubling behavior the better equipped they will be to help the child.

Conclusion

Observation can be difficult if the person who is being observed is aware that they are being observed. Those who are aware that they are being observed can change their behavior in order to avoid any potential intervention or treatment to treat a troubling behavior they may have. When people are being observed but are not aware that they are being observed they will act more naturally and the data being collected by the observer will be more accurate. The difficult issue in regards to this is informed consent. A person must give informed consent (or a guardian must give informed consent) to be observed. Once informed consent is given a person is aware they are being observed. But if informed consent is not given it is considered an ethical violation.

Observation can provide qualitative, as well as, quantitative data to the observer. Qualitative data can be triggers that cause the troubling behavior or things that stop the behavior. Quantitative data can include the number of times the troubling behavior is documented throughout the observational period. Both the qualitative and quantitative data is necessary in order to fully understand the troubling behavior. In addition, the understanding of the data also helps in regards to intervention and treatment options that may be available to the person exhibiting the troubling behavior.

While it is important that a professional is utilized for observation and potential diagnosis, the importance of caregivers cannot be understated. Caregivers are with their charges every day and know them very well. When professionals work in conjunction with caregivers the patient has a better chance at receiving the assistance that they need or a diagnosis that can help them cease the troubling behavior, or at the very least help them and their caregivers to understand why the behavior is occurring. Sometimes a person’s behavior is because they are sun downing which is something that is associated with Alzheimer’s disease of which there is no cure, but it can give the caregiver and the patient an answer which is sometimes all a professional can do.

References

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