01 Functional Cognitive Behavior Assessment

Practice Assessment

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A functional cognitive behavior assessment [FCBA] is considered a vital part of any psychological evaluation for either mental health or educational issues. The process not only provides a clinical team with considerable information about the nature of the child interactions with peers and child managers, but it begins to develop insight into the ‘inner logic’ of the child and the people in the child’s ecosystem.

The facilitator of this process should have some basic skills and knowledge that include, but are not limited to:

  • Group facilitation skills
  • Basic understanding of the Antecedent-Behavior-Consequence [ABC] structure
  • Basic understanding of the Thinking-Feeling-Acting structure
  • Additional interest and concern with attribution and expectancy theory
  • Ability to use Creative Thinking skills to reframe perspectives

The process of FCBA includes essentially five [5] steps, which include:

  • Data Collection
    • Initial Line of Inquiry
    • Observation of the child
    • Observation of the Child Managers [See Teacher Expectation and Student Achievement materials for one possible model]
    • Individual Surveys [Core Beliefs Inventory, Perceptions, Locus of Control, etc. (See Attached)]
  • Reformulation of hypotheses about the child’s ‘inner logic’ or cognitive thought processes that includes cognitive errors and core beliefs about self, others and future prospects [including attributions of success/failure]
  • Design of intervention protocols
  • Implementation of intervention protocols
  • Evaluation of impact of intervention

CASTing a new FUNCTIONAL ASSESSMENT

Because of the interactive qualities of interpersonal relationships, wherein the other often initiates and/or maintains the thoughts, feelings and behaviors of the child, we strongly advocate that the FCBA be oriented toward testing the whole ecosystem. In this urging, we have developed language and concepts to address this preferred process.

DEFINITIONS:

Community Assessment/Support Team [CAST]: this is a designation of the group specifically brought together to explore a disruptive situation and to seek resolution.

Community: this is a designation that is used to define a group of people who know each other, interact with each other on a regular basis, are interested in a single purpose and/or who live, work and/or play together.

Community Serenity: this is a designation that indicates a community at peace. Such a community has no interaction that rises to a level that seeks remedy outside of the community itself. This is not a ‘perfect’ community, but one that is reasonably comfortable with itself.

Disruption: occurs when a ‘difference that makes a difference’ occurs giving new information that is unsettling to part or all of the community. In other words, the interaction between or among the people of the community is disturbed in a manner that causes someone in the community to wish to seek resolution outside of the community itself.

Scholar: this is a designation for the person who is defined by the [CAST] as needing to address an attitude [group of thoughts about a particular subject] or interactive behavior that is disruptive to another person in the community and disrupting or maintaining the disruption of the community serenity.

Tutor: this is a designation for the person who is assigned to teach the mental, interpersonal or behavioral skills required to help the scholar address the disruption of the community serenity.

Skill Curriculum: this is a definition of the specific protocol, technique or procedure to be taught by the Tutor to the Scholar and includes the schedule of events and expected termination date.

NOTE: A scholar and a tutor may be the same person, but not using the same skill curriculum. In other words, a person in the community may need to change an attitude/behavior that is disruptive or maintaining a disruption in the community, while at the same time using a different skill curriculum to teach another person how to change an attitude or behavior. In the final analysis, all members of the community are prone to the potential of disruptive or maintenance behaviors and all may be capable to providing support to other members of the community.

Criteria: these are the measurement indicator(s) defined by the CAST that will be used to determine whether the outcome has been met.

Outcome Expectation: This is a definition of the expected consequence of the teaching/learning process defined by the CAST as meeting the needs of restoring community serenity.

INTRODUCTION

A child is selected for assessment because of ‘information’ about attitudes or behaviors that are affecting social performance obtained by the community. Described by Gregory Bateson as ‘the difference that makes a difference’, this information has made a difference to the child managers and has reached a level of concern that they believe requires a referral.

The process of assessment is a dangerous one. Regardless of the components being assessed, there is a tendency to find what you are looking for. The influence of confirmatory evidence is particularly strong when both variables are asymmetric because information about the nonoccurrence of one the variables is likely to be ignored. Such negative or null instances have been shown to be particularly difficult to process according to Gilovich [1991].

He goes on to point out that people exhibit a parallel tendency to focus on positive or confirming instances when they gather, rather than simply evaluate, information relevant to a given belief or hypothesis. When trying to assess whether a belief is valid, people tend to seek out information that would potentially confirm the belief over information that might disconfirm it.

The tendency apparently need not stem from any desire for the hypothesis to be true. The danger is increased with the ambiguity of the task. Thus, it is relatively easy to rate the height and/or weight of the individual without bias, but difficult to decide whether or not that person requires help. To err is human, and the humane error in this case is generally thought to be an assumption of need. That is the nature of the relationship. “If your only tool is a hammer, everything begins to look like a nail [Twain].” This is followed by a labeling designation and some intervention process, that may be self defeating if the child senses no need. There are also a variety of other human information processing problems that also need to be considered. These include haphazard detail, the influence of experience, ignoring complexity, the need for closure, and inadequate self correction [Carlson – 1993].

Reducing this dangerous tendency of assessment requires a shift in our social institutions from power-based structures and practices to relationship-based structures and practice; that itself is supportive of a change from a deficit model, in which the beneficent outside power rescues an individual from weaknesses, to a capacity building model in which individuals rescue themselves based on their own strengths and relationships in the community. These processes give more power for finding solutions to those most directly involved and decrease reliance on distant authority. These new decision makers represent the child’s community, in the sense that these are the people who have the greatest common interest in seeing that the behavior of the child is effective and efficient in establishing mutually satisfying and gratifying relationships with peers and adults.

The process that is described here is one that is to be carried out by a group of people composed primarily of those people who know the child and/or are charged with the supervision of the child. This ‘community’ would include, but not be limited to:

  • the child;
  • the child’s parents and other family members;
  • the child’s teachers and other involved school personnel [e.g., guidance counselor];
  • any other professional and/or natural support person who relates to the child;
  • a person who is unaffiliated with the child, family or school, but is knowledgeable about the nature of child/adult relations;
  • a facilitator who can lead the process of assessment.

Depending upon the nature of the specific focus, the Community Assessment /Support Team [CAST] may include victims and/or their parents who may have particular concerns about the nature of the change that is expected to occur.

The most important issue for this CAST to understand is that challenging behaviors serve a function for the child and are context specific. The second most important issue is to understand that they, in fact, are the context. The purpose of the CAST is to assess the situation and develop support for the child and/or his victims [people adversely affected by the behaviors] and to find the means to reconcile all parts of the community. The process, therefore is one of examining not only the performance of the child, but the performance of those who manage the child as well.

PROCESS

1 The first action taken by the CAST is to identify the attitudes and behaviors that are of concern. This requires an understanding that behaviors do not occur outside of a relationship. A child cannot be characterized as ‘aggressive’; but a relationship can. The meaning of communication is in the response it elicits. The good intentions of the sender are not what was acquired by the receiver if the response is aggression. Resistance is a comment about the communicator. Thus, if the child’s behavior is unacceptable, one must understand the internal/ external context of the situation and address both intent and outcome. The articulation of the dilemma should include both the behavior that has signaled ‘difference’ and the circumstances in which the behavior occurs.

This stage of the community assessment is culminated by the development of a statement of the dilemma, which should indicate:

• specifically what attitudes and behaviors are problematic;
• to whom are these attitudes and behaviors problematic;
• if the behaviors are not problematic to the child who performed them, what are the attitudes that determine the behaviors;
• what are the antecedents and consequences of the behavior [attitudes and behavioral responses of others] and are they problematic to the child?

Thus, a statement of the dilemma might be as follows:

John tends to fight whenever his personal space is encroached upon. This behavior is of particular concern to his peers, teachers and parents. This behavior is not particularly of concern to John. However, John dislikes being kept after school when such incidents occur at school and dislikes being ‘grounded’ when the incidents occur at home. He perceives his behavior as being justified by the actions of the person who encroached, and therefore, sees the consequences as being unjust.

The development of this statement is an attempt to make the dilemma conscious and available to all stakeholders, so that the CAST can attend to it properly. The fact that the statement must be negotiated in a manner in that the wording satisfies all stakeholders helps to minimize the processing errors usually found in the assessment process.

A dilemma is defined as a necessary choice between equally undesirable alternatives or a perplexing predicament. This seems to describe the community alternatives available at a time when they are seeking outside help. The child may need to change; the community may need to change; or both may need to change. The choices made by the CAST about how to seek restoration of community relationships may be seen as difficult, but such choices need to be made.

2 Once the CAST has agreed on and established a statement of the dilemma, it shall seek to collect information that will help all stakeholders understand the nature of the predicament and to create solutions. Three formal patterns of data collection are available that will only be briefly described here,

Initial Inquiry – the first part of the functional cognitive behavior assessment entails a formal inquiry of all stakeholders to review the setting events, antecedents, behavior response and consequences. It is of particularly importance to define these contexts both from an internal and external perspective: what was the child thinking when the stimulus incident happened, the behavior happened and the consequence happened. You will note that the example statement of the dilemma implies that the child feels victimized rather than victimizing. What do the child manager’s think in these situations. If the child managers think that the child is incapable of achieving some competence required by the community, s/he may then be acting in a way that ‘bends over backwards’ to please the child – but is received by the child as patronizing, which interpretation causes the child to seek to establish him/her self as powerful – wherein s/he select the offensive behavior. The inquiry, if properly used, can begin to infer these thoughts through ‘leakage’ of the self talk that occur routinely, but may increase at time of crisis. In order to ensure that this objective is met, it is important that the standard Line of Inquiry include questions that seek to address cognitive errors such as, but not limited to, magnifying, personalization, overgeneralization, ‘shoulds’, predicting, mindreading, etc. Such a Line of Inquiry CBAT#01-001 is included in the Appendix.

Observation – there are standard observation forms that should be updated in a similar manner. While many child observation forms are available, the only child manager observation forms we are aware of are included in the materials of Teacher Expectation and Student Achievement [TESA]. These include observation of variables such as Response Opportunities [equitable distribution, individual help, latency, delving, higher-level questioning]; Feedback [affirm/correct, praise, reasons for praise, listening, accepted feelings]; Personal Regard [proximity, courtesy, personal interest and compliments, touching, and desist]. Both of these forms should be expanded to include observations of cognitive errors through verbal ‘leakage’ of automatic thoughts. This will require both general observation [listening] and a ‘briefing’ pattern that asks specific question about what the child/child manager was thinking when specific incidents occurred.

Surveys: There are a variety of surveys that can be used to address both the behavioral and cognitive aspect of the dilemma. While the behavioral surveys are quite well known, particularly in school settings, the Beck Depression Inventory [which one needs to purchase] CBAT#01-002, The Perception Inventory CBAT#01-003 [Teresa Cathers, Kansas University Medical Center], The Attribution Style Inventory CBAT#01-004, The Assertiveness Survey NO. 1 CBAT#01-005, The Assertiveness Survey NO. 2 CBAT#01-006, The Maudsley Obsessive-Compulsive Inventory CBAT#01-007, The Core Beliefs Inventory CBAT#01-008 [adapted by McKay & Fanning from Jeffry Young’s Schema Questionnaire], and the Nowicki-Strickland Locus of Control Scale CBAT#01-009 are just a few surveys to get at thoughts, beliefs and attitudes. [These are included in the Appendix]

CAUTION: extreme caution should be used when choosing to use a survey. The titles and language of these surveys send a message that contains information. The information may be new to the individual.

You and I belong to a species with a remarkable ability: we can shape events in each other’s brains with exquisite precision. Simply by making noises with our mouths, we can reliably cause precise new combinations of ideas to arise in each other’s minds. Steven Pinker [1994]

By shaping a person to begin to believe that s/he has certain cognitive states that might be attributed to abnormality, the assessor changes the manner in which s/he thinks about him/herself and others. If, in the process, the client accepts a deficit model attribution, the assessor has created through the process of interaction the very diagnosis s/he seeks to uncover.

For this reason, it is strongly encouraged that the assessor understands the concepts of the tests and seek the information through informal conversation rather than through formal testing. Some validity may be lost; but then again, the validity of the test may be based on its instigation of the crippling thoughts rather than the discovery of them.

3 Once the CAST has acquired data, it will analyze the data and develop an hypothesis regarding what motivates and maintains the dilemma.

Since this is a self-reflective process, this is a difficult phase. One reason for including the non-involved participant is to ensure that the community members equally share the responsibility for the dilemma and not focus only on the performance of the child.

Skills of reflection concern slowing down our own thinking processes to avoid the leaps of abstraction that occur when we move from direct observation [concrete data (I see the child strike someone)] to generalizations [abstract data (the child is aggressive)] so quickly that we never think to test them. Such ‘leaps’ often slow learning since most of us are not disciplined in distinguishing what we observe directly from generalizations we infer from our observations and we become stuck on the personal aspects of the general thought. Nothing undermines openness more surely than certainty. You must develop the mind of a beginner; “The mind of the beginner is empty, free of the habits of the expert, ready to accept, to doubt, and open to all the possibilities.” [Suzuki – 1970] Reciprocal inquiry means that everyone will make his/her thinking explicit and subject to public examination. This creates an atmosphere of genuine vulnerability. The goal is no longer to ‘win the argument’, but to find the best argument. If you believe that your solution is right, you cannot proceed. If you believe that your solution is best, it can be improved.

It is important for the CAST to understand the principles of cognitive behavior management in this analysis. The basic rule is that thought creates feeling that instigates behavior. However, the basic training of the principles is available elsewhere and will not be explicated here.

The data collected will include antecedent conditions of both slow and fast triggers, which may be external [environmental] or internal [mental] contexts in which a situation occurs. It is important for the CAST to note that the internal/external designations are relative or, perhaps more specifically relational, since the internal/ mental context of the child managers sets the external/environmental conditions of the child.

This implies that the mental context of the child manager is every bit as important to the dilemma as the mental context of the child, for it is the mental context of the child manager that has determined the consequences of the child’s interactions with other members of the community. The dilemma is an interactive situation characterized by faulty outcome that the community would like to change.

Data must be gathered in a manner that focuses on all major community participants and used by the entire CAST to determine where the fragments of the disruption lie. The major actor in the disruption may be only responding to a circumstance beyond his/her control. Defiance may be the easiest example. It is difficult to be defiant to someone who makes no demands, but offers choices. On the other hand, one who makes adamant demands is literally asking for a defiant response.

The major hypothesis therefore may be concerned with the child and the other community members and require changes is each or both in order to test the hypothesis and correct the outcomes.

4 The next step for the CAST is to create a Plan of Change. In order to have an effective plan of change, it is important that the CAST know what outcomes they can all agree are desirable. If, for example, the school would like outcome A, and the family would like outcome B, and the child would like outcome C; an effective plan is unlikely to occur.

Thus, the plan of change must begin with a negotiation of outcome expectations that include personal preferences and a clear definition of criteria that will be used to determine whether the outcome has been met. Well formed outcomes must satisfy at least six conditions; they must be:

  1. Stated in the Positive: The outcome will specifically need to answer what is a preferred replacement to the thought/behavior that the CAST wants to change.
  2. Appropriately specific and contextualized
  3. Verifiable (in sensory experience): If this change actually does occur, how will you know it?
  4. Initiated and maintained by the persons making the change
  5. Secondary gain taken care of: whatever secondary gains that might have occurred despite the negatives needs to be specifically addressed.
  6. ‘Ecological’: One should think of a person as being a part of a system. A change that seems desirable in and of itself will have ramifications throughout that system, and perhaps also throughout the relationships and other systems the subject is a part of. It is essential to check not only that the desired change be worthwhile, but that all its consequences be worthwhile

It is important that the CAST examine all of the evidence concerning the performance of all of the players including, but not limited to the child, the child managers, the peers and siblings including victims or bullies. Each of these may require a component in the plan of change in order to meet the overall goals created to resolve the identified dilemma.

This process of self-examination is part of a change process. Most habitual thoughts that create attitudes about specific ‘others’ are not conscious and simply recognizing that such thoughts and attitudes may exist in oneself is the beginning of a corrective process. This is not always easy, however, and it will be important that the CAST members are both confrontational and comforting to a person who may need to address such issues. The teacher who does not believe that a child can learn and therefore acts in a manner to self-fulfill that prophecy might be appalled to learn that s/he has behaved in such a manner and seek to deny the thought, even in light of behavioral evidence.

The plan of change will need to identify specific interventions that are to take place, the intent of the interventions, and the time schedule for implementation. These interventions may be provided by natural or professional people and may be provided to any member of the CAST.

When the plan of change directs actions to be taken with a secondary or tertiary client, the child serving systems create a new dilemma – how is such a plan to be funded? This potential needs to be addressed by the Memorandum Of Understanding required by IDEA 1997 as amended and/or other community resources.

5 Finally, the CAST needs to schedule specific times to review the impact of the plan of change and to revise components as necessary based on an evaluation of effectiveness. Using the criteria and outcome expectations defined in step 4, the CAST will determine how they are doing and modify as necessary or congratulate each other for the successful implementation and results.