and afternoon. In this way, a more reliable and
stable estimate of the child’s level of behavior prob-
lems in the classroom can be obtained. Table 9-2
provides sample items from the DOF (Mc-
Conaughy & Achenbach, 2009). Research has
demonstrated that direct observations can be very
useful in developing diagnostic formulations. In a
sample of 310 children aged 6 through 12 years,
McConaughy and colleagues (2010) revealed that
the DOF helped identify youth with ADHD even
after accounting for the predictive value of parent
and teacher rating scales of inattentiveness and
hyperactivity.
Hospital Observation. Observation techniques
have long been used in such settings as psychiatric
hospitals and institutions for those with mental
retardation. The sheltered characteristics of these
settings have made careful observation of behavior
much more feasible than in more open, uncon-
trolled environments.
An example of ahospital observationmeasure is
theTime Sample Behavior Checklist(TSBC) devel-
oped by Gordon Paul and his associates (Mariotto
& Paul, 1974). It is a time-sample behavioral check-
list that can be used with chronic psychiatric
patients. Time-sample means that observations are
made at regular intervals for a given patient. Obser-
vers can make a single 2-second observation of the
patient once every waking hour. Thus, a daily
behavioral profile can be constructed on each
patient. Interobserver reliability for this checklist
has typically been quite high, and scales such as
the TSBC are helpful in providing a comprehensive
behavioral picture of the patient. For example,
using the TSBC, Menditto et al. (1996) documen-
ted how a combination of a relatively new antipsy-
chotic medication (clozapine) and a structured
social learning program (Paul & Lentz, 1977)
helped significantly decrease the frequency of
inappropriate behaviors and aggressive acts over a
6-month period in a sample of chronically mentally
ill patients on an inpatient unit. More recently,
Salinas, Paul, and Springer (2008) used the TSBC
scores to index over 400 patients’overall level of
functioning on inpatient units and found that the
TSBC scores were most strongly and significantly
related to discharge-readiness decisions by staff
compared to ratings of paranoia and of patient hos-
tile belligerence.Controlled Observation
Naturalistic observation has a great deal of intuitive
appeal. It provides a picture of how individuals actu-
ally behave that is unfiltered by self-reports, infer-
ences, or other potentially contaminating variables.
However, this is easier said than done. Sometimes
the specific kind of behavior in which clinicians are
interested does not occur naturally very often. Much
time and resources can be wasted waiting for the
right behavior or situation to happen. The assessment
of responsibility-taking, for example, may require
day after day of expensive observation before the
right situation arises. Then, just as the clinician is
about to start recording, some unexpected“other”
figure in the environment may step in to spoil theT A B L E 9-2 Sample Items from the Direct
Observation Form (DOF) of the
Child Behavior Checklist
- Argues
- Defiant or talks back to staff
- Cruel, bullies, or mean to others
- Disturbs other children
- Physically attacks people
- Disrupts group activities
- Nervous, high-strung, or tense
- Apathetic, unmotivated, or won’t try
- Shy or timid behavior
- Stares blankly
- Unhappy, sad, or depressed
- Withdrawn, doesn’t get involved with others
NOTE: All items are rated on a scale of 0 to 3 for the specified observation
period. 0 no occurrence; 1 very slight or ambiguous occurrence;
2 definite occurrence with mild to moderate intensity/frequency and less
than 3 minutes total duration; 3 definite occurrence with severe intensity,
high frequency, or greater than 3 minutes total duration.
SOURCE: Copyright © 1986. T. M. Achenbach; Center for Children, Youth,
and Families; University of Vermont, 1 South Prospect Street, Burlington,
VT 05401. Reprinted with permission.
264 CHAPTER 9