Behavior Assessment System for Children (BASC)

1
Behavior Assessment System for Children (BASC)

• R. W. Kamphaus, Ph.D.
• The University of Georgia

2
Acknowledgements

• Cecil R. Reynolds, BASC senior author
• Mark Daniel and Rob Altmann of AGS
• Co-researchers Andy Horne, Carl Huberty, and
  Michele Lease of UGA, Jean Baker of Michigan
  State, Christine DiStefano of Louisiana State
  University, Linda Mayes of Yale Child Study
  Center, David Pineda of Universidad de Antioquia
• Student research team members Anne Winsor, Ellen
  Rowe, Jennifer Thorpe, Cheryl Hendry, Amanda Dix,
  Erin Dowdy, Anna Kroncke, Sangwon Kim, Robert
  Brown, Tracey Troutman.
• Alumni research team members Drs. Nancy Lett,
  Shayne Abelkop, Martha Petoskey and Ann Heather
  Cody
• Research is supported in part by grant number
  R306F60158 from the At-Risk Institute of the
  Office of Educational Research and Improvement of
  the United States Department of Education, to R.
  W. Kamphaus, J. A. Baker, A. M. Horne.

3
Multimethod

• Structured Developmental History (SDH)
• Student Observation System (SOS)
• Teacher Rating Scales (TRS)
• Parent Rating Scales (PRS)
• Self-Report of Personality

4
Objectives

• Learn five assessment uses unique to history
  taking
• Use the SOS to take a 15 minute classroom
  observation
• Write and describe clinically significant
  findings for the PRS, TRS, and SRP
• Explain the impact of child culture and sex on
  TRS and PRS results
• Describe a TRS-based 7 cluster classification
  system of child behavioral adjustment status and
  its use for screening and classifying risk for
  school problems
• Describe research findings regarding the use of
  the BASC as a program evaluation too.
• Summarize research findings regarding the use of
  the BASC to classify cases of ADHD.

5
History Taking SDH

• Identifying age of symptom onset (e.g. ADHD)
• Developmental course (e.g. LD)
• Assessment of etiology (e.g. Thyroid condition)
• Treatment or intervention design (e.g. Prozac
  related relapse or Cheryls head banging)
• Assessment of risk and resilience factors (e.g.
  family resemblance, peers, recreation)
• Documentation of educational or other impairment
  (e.g. grades, productivity, test scores,
  relations with parents, school attendance)

6
Student Observation System (SOS)

• Both adaptive and maladaptive behaviors are
  observed
• Multiple methods are used including clinician
  rating, time sampling, and qualitative recording
  of classroom functional contingencies
• A generous time interval is allocated for
  recording the results of each time sampling
  interval (27 seconds)
• Operational definitions of behaviors and time
  sampling categories are included in the BASC
  manual
• Inter-rater reliabilities for the time sampling
  portion are high which lends confidence that
  independent observers are likely to observe the
  same trends in childs classroom behavior (see
  Lett Kamphaus, 1997).

7
SOS

• Part A - Treatment/IEP Planning frequency,
  range, and disruptiveness of classroom behavior
• Part B - Treatment/Program evaluation of
  effectiveness (track change with ADHD Monitor
  software)
• Part C - Functional analysis of antecedents,
  behavior, and consequences (e.g. teacher position)

8
SOS Scales

• Adaptive Scales
• Response to teacher
• Work on school subjects
• Peer interaction
• Transition movement

• Behavior Problem Scales
• Inappropriate movement
• Inattention
• Inappropriate vocalization
• Somatization
• Repetitive motor movements
• Aggression
• Self-injurious behavior
• Inappropriate sexual behavior
• Bowel/bladder problems

9
Using Part B

• There is typically no need to select target
  behaviors to observe
• schedule the observation period at a time of day
  and, in a class, where problems are known to be
  of teacher or parent concern so that target
  behaviors can be observed. In addition, the
  examiner may want to also observe in a class
  where problems are not present
• Use an observer who is already familiar to the
  school, or introducing himself or herself to the
  teacher ahead of time
• Develop a timing mechanism (PDA software
  available April, 2003)

10
Cecilia - Age 8, Optimal Response to Ritalin
11
SOS Functional Assessment

• Frequency - Part A ratings of NO, SO, or FO. Part
  B frequencies.
• Duration - Part B ratings of percentage of time
  engaged in behavior.
• Intensity - Part A ratings of disruptive and Part
  B ratings of relative frequency.
• Antecedent Events - Part C teacher position and
  behavior.
• Consequences - Part C teacher change techniques.
• Ecological Analysis of Settings - Observations at
  various times of school day. PRS ratings.
• Use three classroom observations to establish
  trajectory of behavior

12
TRS Details

• Discourage having two or more teachers complete
  the same form collaboratively
• Norms extend to age 2 years 6 months
• General, gender, and clinical norms available for
  TRS, PRS, SRP
• When needed help teachers define a never
  response as a behavior that they have not seen or
  experienced
• Advise teachers to rate most recent behavior
• When a current teacher is not available a teacher
  from the past academic year may provide a good
  estimate (see next slide)

13
TRS Reliability and Validity

• Traits that are considered stable are rated
  consistently by teachers over a 2 to 8 week
  interval (Reynolds Kamphaus, 1992). A study of
  three clinical samples produced median
  test-retest values of .89, .91, and .82 for
  preschool, child, and adolescent levels.
• Different teachers rate the same child similarly
  (Reynolds Kamphaus, 1992). A sample of 30
  children was rated by two teachers each within a
  few days of one another. Interrater coefficients
  were variable ranging from a low of .53 for
  social skills to .94 for learning problems. Most
  clinical scales had adequate reliabilities such
  as aggression .71, anxiety .82, attention
  problems .68, and learning problems. 94.
• Teacher internal consistency coefficients are
  higher than those for either parents or
  adolescent self-reports (Reynolds Kamphaus,
  1992).

14
Behavior is stable as rated by different
teachers TRS-C Means, 1996-2000
15
TRS Reliability and Validity

• Teacher ratings are better able to diagnose the
  subtypes of ADHD than classroom observations by
  independent observers (Lett Kamphaus, 1997).
  The TRS was significantly better than the SOS at
  differentiating non-disabled, ADHD combined type,
  and ADHD combined type plus conduct problem
  groups with about a 70 accuracy rate.
• Teacher ratings are significantly associated with
  adjustment to school (Baker, Kamphaus, Horne,
  Project ACT Early)
• Teacher ratings are predictive of adjustment six
  years later (Verhulst et al., 1994)

16
Discipline Reports for Physical Aggression by
Type for ACT Early Year 3 Reported in Proportions
of Sample
17
TRS

• Hyperactivity (impulsivity)
• Aggression (verbal or physical)
• Conduct Problems (delinquency 6-18 only)
• Anxiety (worry, nervousness)
• Depression (sad, unhapppy)
• Somatization (physical complaints)
• Attention Problems
• Learning Problems (academic problems 6-18 only)

• Atypicality (hyperactivity, odd behaviors,
  psychoticism)
• Withdrawal (avoidance of social interactions)
• Adaptability (4-11) (adjusts easily to change)
• Leadership (especially interpersonal skills)
• Social Skills
• Study Skills (6-18)
• Patterning
• Consistency
• Fake Bad (F)

18
Schwean, Burt, Saklofske (1999)
Items on the Atypicality scale of the BASC are
relevant to several different interpretations,
with many describing behaviors that parallel
those seen in a hyperactive-impulsive disorder
(e.g., daydreams, complains about being unable to
block out unwanted thoughts, stares blankly,
babbles to self, sings or hums to self, rocks
back and forth). Several examples will help
illustrate this point. Although we typically
think of inattentive children as daydreamy.
Research has noted that one of the most common
observations made by elementary school teachers
about hyperactive children is that they appear to
be daydreaming (Goldstein Goldstein, 1992).
Hyperactive-impulsive children are also often
known to talk excessively and to hum or make odd
noises (American Psychiatric Association, 1994
Barkely, 1990). Moreover, irrelevant and
purposeless gross bodily movements (i.e.,
hyperactivity) can easily be confused with more
stereotypic motor behaviors. (p. 59)
19
George - ADHD Combined TypeComorbid with MR
20
Under-diagnosis of ADHD in Children with MR

• Pearson and Annan (1994) concluded,Findings
  suggest that chronological age should be taken
  into consideration when behavior ratings are used
  to assess cognitively delayed children for ADHD.
  However, the results do not support guidelines
  stating that mental age must be used to determine
  which norms should be applied when such children
  are evaluated clinically. (p. 395)
• The use of mental age as a consideration in
  making the ADHD diagnosis for children with
  mental retardation may result in the denial of
  somatic and behavioral treatments that are known
  to have demonstrated efficacy (Reynolds
  Kamphaus, 2002).

21
PRS Details

• Audiotape administration
• Spanish edition available
• Norms to age 2 years 6 months
• Fifth grade reading level
• Mothers and fathers produce similar average raw
  scores
• Parent feedback form available for PRS, TRS, and
  SRP results

22
Parent/Caregiver Ratings

• Primary caregiver and/or person who knows the
  childs problems best will indicate more problems
• Parent ratings are also predictive of behavior
  problems six years later (Verhulst et al., 1994)
• Parent ratings of behavior are predicted by early
  temperament (Nelson et al., 1999)

23
PRS

• Hyperactivity
• Aggression
• Conduct Problems (6-18)
• Anxiety
• Depression
• Somatization
• Attention Problems

• Atypicality
• Withdrawal
• Adaptability (4-11)
• Leadership
• Social Skills
• Patterning
• Consistency
• Fake Bad (F)

24
Lynn - ADHD Ritalin therapy at school, Mother is
primary caregiver
25
SRP Details

• Validity Scales include Patterning, Consistency,
  Lie (L) (12-18), Fake Bad (F), Validity (V)
• Third grade reading level
• Spanish version available
• Children and adolescents may know themselves
  better that parents or teachers (see next slide)

26
SRP-C Type 9, Internalizing yoked ratings (7.4
of 6-11 year olds, 47 f/53m)
27
SRP - Clinical and Adaptive Scales

• Depression
• Somatization
• Anxiety
• Atypicality
• Sense of Inadequacy (feels unsuccessful in
  school)
• Social Stress (tension around peers)
• Locus of Control (rewarded or punished by others)
• Sensation Seeking (12-18) (risk taking)

• Attitude Toward Teachers
• Attitude Toward School
• Relations with Parents
• Interpersonal Relations (friendships)
• Self-Esteem
• Self-Reliance (dependability)

28
Maryann - Depression, Conduct Disorder, Cognitive
Deficit

• At age 17 she has history of suicide attempts,
  runaway behavior, STDs, dental decay, academic
  failure, family dissolution, problems in foster
  care. She currently admits to suicidal ideation.

29
Jonathan - Depression, Polysubstance Dependence

• A high school senior, he is hospitalized for a
  suicidal attempt. He was previously treated for
  addiction to alcohol at age 14. Now, at age 17,
  he abuses alcohol, marijuana, heroin, and other
  drugs.

30
SRP Facts

• Child ratings are virtually uncorrelated with
  adult ratings
• Teachers are unaware of many child problems
  especially those of an internalizing nature
  (Kamphaus Frick, 2002)
• Children with cognitive delay may be less able to
  respond untruthfully
• Adolescents in juvenile detention are known to
  report high rates of psychopathology
  (Stowers-Wright, 2000)

31
Ratings Interpretation (Kamphaus Frick, 2002)

• All raters possess some evidence of predictive
  validity
• Simple Scheme - All indicators of problems
  weighted equally (e.g. teacher and child ratings
  of depression weighted equally)

32
Ratings Interpretation

• Identify all scales with T scores in the at-risk
  range (Tgt60)
• Confirm or disconfirm the importance of each with
  available evidence
• Collect additional evidence as needed
• Draw conclusions regarding classification,
  diagnosis, and intervention

33
Ratings Interpretation

• 70 Functional impairment in multiple settings,
  Often diagnosable condition
• 60-69 Functional impairment in one or more
  settings, sometimes diagnosable condition
• 45-59 No functional impairment or condition
• lt45 Notable lack of symptomatology

34
Aggression Scale Interpretation (Reynolds
Kamphaus, 2002)
35
BASC IDEA

• Impaired relations Withdrawal, Atypicality,
  Social Stress, Interpersonal Relations, Social
  Skills, Relations with Parents
• Inability to learn Learning Problems
• Inappropriate behavior Atypicality, Withdrawal
• Unhappiness/depression Depression, Sense of
  Inadequacy
• Physical symptoms/complaints Somatization

36
Karen - Substance abuse, conduct disorder, bipolar

• 14 year old female 9th grader with normal
  development until 1996
• Academics declined, began spending large amount
  of time with peers and smoking marijuana and
  drinking alcohol
• Hx of day and residential treatment, truancy,
  drug paraphernalia at school
• Avg IQ and achievement

37
Karen Maternal Ratings
38
Karen SRP

• Att to School 71
• Att to Teach 55
• Sensation 60
• Atypicality 41
• Locus of C 50
• Somatization 39
• Social Stress 38
• Anxiety 47

• Depression 49
• Sense of In 45
• Relations Par 30
• Interpersonal 57
• Self-Esteem 58
• Self-Reliance 46
• Critical - I just dont care anymore

39
Stefan - Emotional Distrubance

• 10 year old fifth grade child with history of
  poor organization, work incompletion, resistance
  to teacher direction, anger outbursts, low
  frustration tolerance
• Intelligence and achievement are average except
  for below average scores in written expression
  including spelling
• Chaotic family background with loss

40
Stefan SRP

• Att to School 64
• Att to Teach 84
• Atypicality 48
• Locus of C 68
• Social Stress 60
• Anxiety 55

• Depression 68
• Sense of In 78
• Relations Par 10
• Interpersonal 31
• Self-Esteem 34
• Self-Reliance 36
• Critical - Sometimes I want to hurt myself

41
Stefan Teacher Ratings
42
Stefan Parent Ratings
43
Effects of Culture and Sex

• Cross-cultural studies have shown small mean
  differences between at least 13 cultural groups
  for the CBCL (Crijnen et al., 1997) and 4 for the
  BASC (Kamphaus et al., 2000)
• Sex differences, in direct contrast, are large
  and in the same direction in all countries
  studied (Crijnen et al., 1997 Kamphaus et al.,
  2000)

44
Effects of Culture
45
Effects of Child Sex
46
Cross-Cultural Assessment Strategies

• Collect test scores and ratings from parents and
  recent teacher from country of origin or previous
  U.S. school
• Use three classroom observations two weeks apart
  to establish trajectory of behavior
• Defer special education classification until
  child has been in school system long enough to
  develop linguistic competencies and friendships
• Seek second opinion from psychologist with
  cultural knowledge to reduce tendencies toward
  under or over-diagnosis (Kamphaus Frick, 2002)
• Use history taking to clarify standardized test
  and rating scale results

47
BASC and Treatment/Outcome Evaluation
(SRP/TRS/PRS)

• Significant effects were shown for a therapeutic
  adventure program with the SRP-A (Faubel, 1998)
• Effects have been shown for child cancer
  (Challinor, 1999 Shelby, 1999), and rheumatoid
  arthritis (Wutzke, 1999 Youseff, 1999)

48
BASC and Risk Assessment

• A person-oriented approach may be used to
  identify children at risk for behavioral problems
  (Project ACT Early Baker, Horne, Kamphaus,
  1996-present Petoskey, 2000)
• Typologies of behavioral adjustment are
  associated with important child outcomes (Baker,
  Kamphaus, Horne, in press)
• Types of adjustment replicate in numerous samples
  for differing SES and cultural groups (Pineda, et
  al., 199 Kamphaus et al., 2000 Kamphaus
  DiStefano, in press)
• Most children with significant behavior problems
  are not served by special education or other
  service delivery system (Kamphaus et al., 1997)

49
Person-Oriented Methodology

• The concepts of average child and average
  environment have no utility whatever for the
  investigation of dynamics ...An inference from
  the average to the particular case is
  impossible (Lewin, 1931, p. 95 cited in
  Richters, 1997)
• Child behavior problems are dimensionally
  distributed in the population and much
  variability is associated with subsyndromal
  behavior problems that nevertheless produce
  functional impairment (Hudziak, et al., 1999
  Scahill, et al., 1999 Cantwell, 1996)
• teachers cope with a high degree of variability
  in their classrooms By capturing this
  variability it may be possible to design
  interventions that ameliorate the risk of failure
  for some groups of children (Speece Cooper,
  1990, p. 119)

50
TRS-C Type 1 Well-Adapted (34)
Note. 61 Female
51
TRS-C Type 2Average (19)
Note. 43 African American
52
TRS-C Type 3 Disruptive Behavior Problems (8)
Note. 78 Male 30 African-American
53
TRS-C Type 4 Learning Problems (12)
Note. 60 Male 33 African American
54
TRS-C Type 5 Physical Complaints/Worry (11)
Note. 60 Female
55
TRS-C Type 6General Problems-Severe (4)
Note. 67 Male
56
TRS-C Type 7 Mildly Disruptive (12)
Note. 70 Male 25 African-American
57
School Services by Type
58
Peer Social Status (A. Michele Lease, in press)
Type 1 Type 2 Type 3 Type 4 Type 5 Type 6 Type 7
Likeability .86 -.40 -1.76 -1.72 1.15 -2.54 -.98
Friendships 2.2 .83 .43 .36 1.37 .50 .25
Center (MDS) .03 .01 .87 .88 -.73 1.39 .29
59
Prevalence of Type by School1999 - 2000
60
Prevalence of Types in Four Samples
61
Disciplinary Actions by Type
62
Services and Disciplinary Actions by Type
63
Well Adapted Pathway
64
Disruptive Pathway
65
Behavior and Achievement Relations Annie Winslet

• Annie has always had problems with behavior at
  school. In fact, two of her teachers have rated
  her as the Disruptive Behavior Problem type over
  the course of five years of elementary school. In
  other words, her problems began early and they
  persisted. How might this pattern of adjustment
  impact her academic achievement?

66
Dowdy Erin

• Dowdy is the youngest Erin family member. He has
  been identified by teachers as pretty
  well-behaved during the first five years of
  schooling. He did, however, have a particularly
  problematic year for unknown reasons. His teacher
  that year rated him as a Type 3, Disruptive
  Behavior Problems. Now his parents want to know
  if his behavior is causing achievement problems.

67
Amanda Kroncke

• Amanda is a very sweet child who has never had
  behavior problems at school. She has always
  gotten along well with others and achieved well
  in school. In at least two of her first five
  years of schooling she has been rated by a
  teacher as a Type 1 (Well Adapted) or 2
  (Average). Shes a great kid who is unlikely to
  have achievement problems.

68
Definitions of Chronicity

• Group 1 Chronic Disruptive Behavior Group.
  Children in the Chronic Disruptive Behavior group
  were rated by two or more teachers as being in
  the DBP cluster. In other words for at least two
  of the five years sampled, these children fell in
  the DBP Cluster.
• Group 2 Intermittent Disruptive Behavior Group.
  Children in the Intermittent Disruptive Behavior
  Group had at least one but not more than one year
  in which a teacher rated them as being in the
  Disruptive Behavior Problems Cluster. Cluster
  membership in other years was not accounted for
  so that children could have belonged to any other
  cluster, (Average, Mild Behavior Problems,
  Learning Problems, etc.) in alternate years.
• Group 3 Average/Well-Adapted Group. Children in
  the Well-Adapted Group were rated by teachers as
  being in either the Average or Well-Adapted
  clusters for at least two of the five years
  sampled.

69
Chronicity of Behavior Problems and Mathematics
Achievement
70
Chronicity of Behavior Problems and Mathematics
Achievement
71
Chronicity of Behavior Problems and Reading
Achievement
72
Chronicity of Behavior Problems and Reading
Achievement
73
Risk/Resilience Systems

• Ann Mastens review Ordinary Majic concluded
  (2001, American Psychologist) that most children
  develop behavioral adaptive repertoires, and that
  three components contribute to child development
• Socioeconomic Status
• Intelligence
• Relationships with parents and teachers
• How do ACT Early data fit Mastens prediction?

74
Roberts Research

• Selected a sample of 58 children from the ACT
  Early pool of approx. 800 children over a
  one-year period.
• The children were in 2nd-4th grade in Spring
  2000, and 3rd-5th grade in Spring 2001.
• Children were in one of three patterns
  well-adapted, disruptive behavior problems,
  and changers
• Well-adapted and disruptive kids stayed in their
  respective categories from one year to the next.
• Changers were rated by the first teacher as
  disruptive but had a better rating by their next
  teacher the following year.

75
Results Teacher and Child Relationship Mean
Scores
76
Seven Types and Two Constructs
77
Levels of need
Family School Peers Community
Severe Psychopathology Disruptive Behavior
Problems
Intervention
Learning Problems Physical
Complaints/Worry Mildly Disruptive
Secondary and Tertiary Prevention
Primary Prevention
Well-Adapted Average
The roles of related services based on behavior
type
78
ADHD Monitor (Kamphaus Reynolds, 1998)

• Ratings by parent, teacher, and classroom
  observer of
• Hyperactivity
• Internalizing
• Adaptive Skills
• Attention Problems
• Change is plotted in T score units
• Macintosh version under development

79
References

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80
References

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81
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82
References

• Kamphaus, R. W., Jiménez, M. E., Pineda, D. A.,
  Rowe, E. W., Fleckenstein, L., Restrepo, M. A.,
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• Pineda, D. A., Kamphaus, R. W., Mora, O.,
  Restrepo, M. A., Puerta, I. C., Palacio, L. G.,
  Jiménez, I., Mejía, S., García, M., Arango, J.
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• Petoskey, M.D., Kamphaus, R. W., A. Michele
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  dimensional typology of child behavior.
• Kamphaus, R. W., DiStefano, C. A. (in press).
  Evaluación Multidimensional de la Psicopatología
  Infantíl. Revista de Neuropsicología,
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• Crijnen, A. A. M., Achenbach, T. M., Verhulst,
  F. C. (1997). Comparisons of problems reported
  by parents of children in 12 cultures Total
  problems, externalizing, and internalizing.
  Journal of the American Academy of Child and
  Adolescent Psychiatry, 36(9), 1269-1277.

83
BASC Contacts/Information

• www.bascforum.com includes sample cases, research
  bibliography, and discussion centers for BASC
  users
• Project ACT Early, Anne Pierce Winsor,
  annewinsor_at_prodigy.net, Randy Kamphaus, Principal
  Investigator, rkamp_at_arches.uga.edu
• American Guidance Service, 4201 Woodland Road,
  P.O. Box 99, Circle Pines, MN 55014-1796 1 800
  328 2560 www.agsnet.com
• Department of Educational Psychology at The
  University of Georgia, www.coe.uga.edu/edpsych/
• PSYCAN Corporation,12-120 West Beaver Creek Road,
  Richmond Hill, Ontario, L4B 1L2, 1 800 263 3558
• A clinicians guide to the BASC. Guilford
  Publications www.guilford.com