Clinical Assessment of Child and Adolescent Personality and ...

chapter 8 behavioral observations207In summary, the FICS is an example ofan observation system designed to assess achild’s behavior in the home environmentand to assess parent–child interactionalpatterns in which the behavior is embedded.The FICS is generally most usefulfor younger children (10 and under). Also,most of the psychometric informationavailable for the FICS is for the aversivebehaviors assessed by the TAB. This is notas severe a limitation as one might think,however, given that these aversive behaviorshave proven to be quite important tounderstanding and treating children withconduct problems (Patterson, 1982).Structured Observation of Academicand Play SettingsMilich, Roberts, and colleagues (Milich,1984; Milich, Loney & Landau, 1982;Roberts, Ray, & Roberts, 1984) developedan observational system (StructuredObservation of Academic and Play Settings[SOAPS]) to assess behaviors associatedwith ADHD in a clinic playroomanalog setting. In this system, a clinicplayroom is designed with age-appropriatetoys, four tables, and a floor dividedinto 16 equal squares by black tape. Thechild is placed in two situations. Free Playinvolves the child being placed alone inthe room and allowed to play freely withthe toys. The Restricted Academic PlayroomSituation involves the child beingrequested (1) to remain seated, (2) tocomplete a series of academic tasks, and(3) not to play with any of the toys.Each observational situation lasts for 15min. A combination of event recording andtime sampling is used in this observationsystem. Event recording is used to determinethe total number of grids crossedfor the entire observational period. Thatis, the number of times that a child movescompletely from one square of the dividedroom into another is counted. Eventrecording is also used to determine thenumber of times the child shifts his or herattention from one task to another duringthe entire observational period. A 5-sectime sampling procedure is used to observeother target behaviors. These include theproportion of 5-sec intervals that the childis out of his or her seat, fidgeting, noisy,and on task. In addition, a 5-sec time samplingis used to determine the numberof intervals that the child was observedtouching forbidden toys. Also during theacademic task, the number of items completedis recorded.This observational system is useful inclinical assessments of ADHD for a numberof reasons. First, it is a relatively easy touse observational system. As a result, highinter-observer reliability has been obtainedfor most categories with minimal observertraining. Second, categories from this systemhave been correlated with clinicians’diagnoses of ADHD, they have differentiatedADHD children from aggressiveand other clinic-referred children (Milichet al., 1982), and they have been relativelystable over a 2-year period (Milich, 1984).Third, a modified version of this task hasbeen shown to be sensitive to treatmentwith stimulant medication (Barkley, 1988).ConclusionsIn this chapter, we have attempted to summarizeboth the advantages and disadvantagesof direct observations of behavior aspart of a comprehensive clinical assessment.Although there are some limitations,direct observations are a useful componentto many assessment batteries. Probablythe biggest limitation to the clinical utilityof direct observations is the time and costinvolved in conducting behavioral observationsappropriately. We have attempted tooutline some of the major considerations indeveloping and using observational systemsso that clinical assessors can (1) evaluate