In This Issue:

How To Conduct a Functional Behavior Assessment

&

How To Identify Possible Symptoms of Neglect

CONDUCTING A FUNCTIONAL BEHAVIORAL ASSESSMENT

Identifying the underlying causes of behavior may take many forms; and, while the Amendments to IDEA advise a functional behavioral assessment approach (which could determine specific contributors to behavior), they do not require or suggest specific techniques or strategies to use when assessing that behavior. While there are a variety of techniques available to conduct a functional behavioral assessment, the first step in the process is to define the behavior in concrete terms. In the following section we will discuss techniques to define behavior.

IDENTIFYING THE PROBLEM BEHAVIOR

Before a functional behavioral assessment can be implemented, it is necessary to pinpoint the behavior causing learning or discipline problems, and to define that behavior in concrete terms that are easy to communicate and simple to measure and record. If descriptions of behaviors are vague (e.g., poor attitude), it is difficult to determine appropriate interventions. Examples of concrete descriptions of problem behaviors are:

PROBLEM BEHAVIOR CONCRETE DEFINITION

Trish is aggressive

Trish hits other students during recess when she does not get her way

Carlos is disruptive

Carlos makes irrelevant and inappropriate comments during class discussion

Jan is hyperactive

Jan leaves her assigned area without permission

Jan completes only small portions of her independent work

Jan blurts out answers without raising her hand

It may be necessary to carefully and objectively observe the student’s behavior in different settings and during different types of activities, and to conduct interviews with other school staff and caregivers, in order to pinpoint the specific characteristics of the behavior.

Once the problem behavior has been defined concretely, the team can begin to devise a plan for conducting a functional behavioral assessment to determine functions of the behavior. The following discussion can be used to guide teams in choosing the most effective techniques to determine the likely causes of behavior.

POSSIBLE ALTERNATIVE ASSESSMENT STRATEGIES

The use of a variety of assessment techniques will lead teams to better understand student behavior. Each technique can, in effect, bring the team closer to developing a workable intervention plan.

A well developed assessment plan and a properly executed functional behavioral assessment should identify the contextual factors that contribute to behavior. Determining the specific contextual factors for a behavior is accomplished by collecting information on the various conditions under which a student is most and least likely to be a successful learner. That information, collected both indirectly and directly, allows school personnel to predict the circumstances under which the problem behavior is likely and not likely to occur.

Multiple sources and methods are used for this kind of assessment, as a single source of information generally does not produce sufficiently accurate information, especially if the problem behavior serves several functions that vary according to circumstance (e.g., making inappropriate comments during lectures may serve to get peer attention in some instances, while in other situations it may serve to avoid the possibility of being called on by the teacher).

It is important to understand, though, that contextual factors are more than the sum of observable behaviors, and include certain affective and cognitive behaviors, as well. In other words, the trigger, or antecedent for the behavior, may not be something that anyone else can directly observe, and, therefore, must be identified using indirect measures. For instance, if the student acts out when given a worksheet, it may not be the worksheet that caused the acting-out, but the fact that the student does not know what is required and thus anticipates failure or ridicule. Information of this type may be gleaned through a discussion with the student.

Since problem behavior stems from a variety of causes, it is best to examine the behavior from as many different angles as possible. Teams, for instance, should consider what the “pay-off” for engaging in either inappropriate or appropriate behavior is, or what the student “escapes,” “avoids,” or “gets” by engaging in the behavior. This process should identify workable techniques for developing and conducting functional behavioral assessments and developing behavior interventions. When considering problem behaviors, teams might ask the following questions.

IS THE PROBLEM BEHAVIOR LINKED TO A SKILL DEFICIT?

Is there evidence to suggest that the student does not know how to perform the skill and, therefore cannot? Students who lack the skills to perform expected tasks may exhibit behaviors that help them avoid or escape those tasks. If the team suspects that the student “can’t” perform the skills, or has a skill deficit, they could devise a functional behavioral assessment plan to determine the answers to further questions, such as the following:

Does the student understand the behavioral expectations for the situation?
Does the student realize that he or she is engaging in unacceptable behavior, or has that behavior simply become a “habit”?
Is it within the student’s power to control the behavior, or does he or she need support?
Does the student have the skills necessary to perform expected, new behaviors?
Does the student have the skill, but, for some reason, not the desire to modify his or her behavior?

Sometimes it may be that the student can perform a skill, but, for some reason, does not use it consistently (e.g., in particular settings). This situation is often referred to as a “performance deficit.” Students who can, but do not perform certain tasks may be experiencing consequences that affect their performance (e.g., their non-performance is rewarded by peer or teacher attention, or performance of the task is not sufficiently rewarding).

If the team suspects that the problem is a result of a performance deficit, it may be helpful to devise an assessment plan that addresses questions such as the following:

Is it possible that the student is uncertain about the appropriateness of the behavior (e.g., it is appropriate to clap loudly and yell during sporting events, yet these behaviors are often inappropriate when playing academic games in the classroom)?
Does the student find any value in engaging in appropriate behavior?
Is the behavior problem associated with certain social or environmental conditions?
Is the student attempting to avoid a “low-interest” or demanding task?
What current rules, routines, or expectations does the student consider irrelevant?

Addressing such questions will assist the IEP team in determining the necessary components of the assessment plan, and ultimately will lead to more effective behavior intervention plans. Some techniques that could be considered when developing a functional behavioral assessment plan are discussed in the following section.

Techniques for Conducting the Functional Behavioral Assessment

Indirect assessment. Indirect or informant assessment relies heavily upon the use of structured interviews with students, teachers, and other adults who have direct responsibility for the students concerned. Individuals should structure the interview so that it yields information regarding the questions discussed in the previous section, such as:

In what settings do you observe the behavior?
Are there any settings where the behavior does not occur?
Who is present when the behavior occurs?
What activities or interactions take place just prior to the behavior?
What usually happens immediately after the behavior?
Can you think of a more acceptable behavior that might replace this behavior?

Interviews with the student may be useful in identifying how he or she perceived the situation and what caused her or him to react or act in the way they did. Examples of questions that one may ask include:

What were you thinking just before you threw the textbook?
How did the assignment make you feel?
Can you tell me how Mr. Smith expects you to contribute to class lectures?
When you have a “temper tantrum” in class, what usually happens afterward?

Commercially available student questionnaires, motivational scales, and checklists can also be used to structure indirect assessments of behavior. The district’s school psychologist or other qualified personnel can be a valuable source of information regarding the feasibility of using these instruments.

Direct assessment. Direct assessment involves observing and recording situational factors surrounding a problem behavior (e.g., antecedent and consequent events). An evaluator may observe the behavior in the setting that it is likely to occur, and record data using an Antecedent-Behavior-Consequence (ABC) approach. (Appendix A shows two examples of an ABC recording sheet.)

The observer also may choose to use a matrix or scatter plot to chart the relationship between specific instructional variables and student responses. (See Appendix B for examples). These techniques also will be useful in identifying possible environmental factors (e.g., seating arrangements), activities (e.g., independent work), or temporal factors (e.g., mornings) that may influence the behavior.

These tools can be developed specifically to address the type of variable in question, and can be customized to analyze specific behaviors and situations (e.g., increments of 5 minutes, 30 minutes, 1 hour, or even a few days). Regardless of the tool, observations that occur consistently across time and situations, and that reflect both quantitative and qualitative measures of the behavior in question, are recommended.

Data analysis. Once the team is satisfied that enough data have been collected, the next step is to compare and analyze the information. This analysis will help the team to determine whether or not there are any patterns associated with the behavior (e.g., whenever Trish does not get her way, she reacts by hitting someone). If patterns cannot be determined, the team should review and revise (as necessary) the functional behavioral assessment plan to identify other methods for assessing behavior.

Hypothesis statement. Drawing upon information that emerges from the analysis, school personnel can establish a hypothesis regarding the function of the behaviors in question. This hypothesis predicts the general conditions under which the behavior is most and least likely to occur (antecedents), as well as the probable consequences that serve to maintain it. For instance, should a teacher report that Lucia calls out during instruction, a functional behavioral assessment might reveal the function of the behavior is to gain attention (e.g., verbal approval of classmates), avoid instruction (e.g., difficult assignment), seek excitement (i.e., external stimulation), or both to gain attention and avoid a low-interest subject.

Only when the relevance of the behavior is known is it possible to speculate the true function of the behavior and establish an individual behavior intervention plan. In other words, before any plan is set in motion, the team needs to formulate a plausible explanation (hypothesis) for the student’s behavior. It is then desirable to manipulate various conditions to verify the assumptions made by the team regarding the function of the behavior. For instance, the team working with Lucia in the example above may hypothesize that during class discussions, Lucia calls out to get peer attention. Thus, the teacher might make accommodations in the environment to ensure that Lucia gets the peer attention she seeks as a consequence of appropriate, rather than inappropriate behaviors. If this manipulation changes Lucia’s behavior, the team can assume their hypothesis was correct; if Lucia’s behavior remains unchanged following the environmental manipulation, a new hypothesis needs to be formulated using data collected during the functional behavioral assessment.

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What is Neglect?

This is not an easy question. In general, neglect is an act of omission. It is the failure of a child’s primary caretaker to provide adequate food, clothing, shelter, supervision, and medical care. But what is adequate? And is it neglect if the primary caretaker is simply unable to provide for the child’s needs, or must the caretaker “willfully” deprive the child? And is it neglect only if the child has suffered harm, or if the child is potentially at harm? And are there other types of deprivation not mentioned above-such as a failure to provide for a child’s educational or emotional needs-that also should be classified as neglect? Both legal and research professionals struggle with these questions. In this issue of the Classroom Management Series the topic is Neglect.

LEGAL DEFINITIONS

The Federal Child Abuse Prevention and Treatment Act (CAPTA) provides minimum standards for definitions. CAPTA states,
“The term ‘child abuse and neglect’ means, at a minimum, any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm” (42 U.S.C.A. §5106g(2) (West Supp. 1998).

Using this minimum standard as a foundation, each State provides its own definitions for child abuse and neglect. There are three places in State statutes in which abuse and neglect are defined: (1) reporting laws for child maltreatment, (2) criminal codes, and (3) juvenile court statutes (U.S. Department of Health and Human Services, 2000).

A review of State reporting laws reveals that neglect frequently is defined by the States as deprivation of adequate food, clothing, shelter, or medical care (U.S. Department of Health and Human Services, 2000). However, there is great variation among the States in operationalizing their definitions, which contributes to the lack of clarity on a national level. For example, approximately one-fifth of the States do not define neglect separately from abuse. Of those that do define neglect separately, some also define particular types of neglect, such as abandonment or medical neglect. In addition, many States address related issues in their statutes such as parental incapacity (i.e., parent is hospitalized or incarcerated) or injurious environments (i.e., child is exposed to criminal activity in the home). Most States also specify exemptions or issues to be taken into consideration, including religious exemptions for medical neglect and financial considerations for physical neglect (U.S. Department of Health and Human Services, 2000).

Beyond State reporting laws, various State regulations, policies, and procedures provide guidance for child welfare professionals to determine whether or not neglect has occurred. Various agencies and workers interpret these guidelines as they make decisions about which reports to investigate, and which investigations will result in interventions. Clearly, there is no universal legal or practice definition of child neglect.

RESEARCH DEFINITIONS

There is little agreement among researchers regarding a conceptual or operational definition of neglect. Researchers lament this situation because a lack of consensus makes it difficult to compare findings across studies and difficult to apply findings to child welfare professionals’ interventions (Black & Dubowitz, 1999; Zuravin, 1991). In addition to using various definitions, researchers also have used a variety of methods to measure neglect, including observations of the home, specific behavioral criteria, medical history, self-report measures, interviews, case record abstractions, and CPS case findings (Black & Dubowitz, 1999; Zuravin, 1999).

One important element of a child neglect definition or classification system is the identification of behaviors or conditions that are considered “neglectful.” Some behaviors seem universally classified as neglect by researchers. These include:

Inadequate nutrition, clothing, or hygiene
Inadequate medical, dental, or mental health care
Unsafe environments
Inadequate supervision, including use of inadequate caretakers
Abandonment or expulsion from the home (Barnett, Manly & Cicchetti, 1993; Sedlack & Broadhurst, 1996).

However, many behaviors may be categorized differently by different classification systems. Table 1 illustrates this using examples from two widely known classification systems: the Third National Incidence Study of Child Abuse and Neglect (NIS-3) (Sedlack & Broadhurst, 1996) and the Maltreatment Classification System (MCS) developed by Barnett, Manly and Cicchetti (1993).

In addition to identifying behaviors that are considered neglectful, there are other considerations regarding a definition of neglect. These include:

Should there be evidence of harm, or does neglect include endangerment of a child’s health or welfare?
Should the caretaker’s intent to harm be a consideration?

Many researchers, including Zuravin (1991), propose that endangering a child’s health or welfare should be included in any definition of neglect, and that a caretaker’s intent to harm or culpability should not be a consideration.
These differences highlight the challenges posed in comparing findings across studies that have used varying definitions of neglect. For example, when examining the rates of child neglect over time, a change in the numbers may not solely represent an actual increase or decrease in the number of children affected, but may partially be accounted for by a change in the definition.

Recognizing these difficulties, Federal agencies have been leading efforts to develop clear research definitions and a measurement tool to collect data on child maltreatment.

Throughout the 1990s, Congress mandated a number of Federal agencies to increase their focus on the problem of child abuse and neglect. The National Institutes of Health (NIH) created the Federal Child Abuse and Neglect Working Group (co-chaired by the National Institute on Mental Health and the National Institute for Child Health and Human Development [NICHD]). The Working Group began work in 1998 to develop clear classification systems and operational definitions for all types of child maltreatment, including child neglect, that can be used by researchers and also overlap with existing legal and clinical definitions. The Working Group is continuing to pursue this effort.

In 1994, the Federal Interagency Task Force on Child Abuse and Neglect challenged its Research Committee to address definitional issues confronting the child abuse and neglect research community nationally. The committee had representatives from several DHHS agencies (e.g., NIH, Centers for Disease Control, Substance Abuse and Mental Health Services Administration) and from other departments (e.g., Defense, Education, Interior, and Justice). The efforts of this group focused on developing a data collection system that could be used by researchers to define and identify all types of child abuse and neglect. By 1999, these efforts resulted in an instrument entitled the Child Maltreatment Log.7 This instrument is being field tested in two 17-month pilot projects that were initiated in September 2000. Once the results of the pilots are analyzed, the instrument will be revised and disseminated for use by the research community.

The goals of these projects are to offer researchers a common definition and measurement tool so that the findings of various studies can be compared and the studies can be replicated, both of which contribute to a stronger knowledge base. In the field of child neglect, many researchers and policy makers consider this to be an important step in building our knowledge about the problem, the factors associated with it, and how to address it.

SPOTLIGHT ON CHRONIC NEGLECT

One issue in defining child neglect involves consideration of “incidents” of neglect versus a pattern of behavior that indicates neglect. Zuravin (1991) recommends that some behaviors should present a “chronic pattern” to be considered neglectful. Examples include lack of supervision, inadequate hygiene, and failure to meet a child’s educational needs. This suggests that rather than focusing on individual incidents that may or may not be classified as “neglectful,” one should look at an accumulation of incidents that may together constitute neglect. “If CPS focuses only on the immediate allegation before them and not the pattern reflected in multiple referrals, then many neglected children will continue to be inappropriately excluded from the CPS system” (English, 1999). For example, a family exhibiting a pattern of behavior that may constitute neglect might include frequent reports of not having enough food in the home or keeping older children home from school to watch younger children. In most CPS systems, however, the criteria for identifying neglect focuses on recent, discrete, verifiable incidents.

In recognition of this issue, the Missouri Division of Family Services (n.d.) has assigned one of its CPS staff as a “Chronic Neglect Specialist.” This office defines chronic neglect as “… a persistent pattern of family functioning in which the caregiver has not sustained and/or met the basic needs of the children which results in harm to the child” (p. 3). The focus here is what Dr. Patricia Schene calls “accumulation of harm.” She states that instead of focusing on individual incidents as they occur, one should look at an accumulation of experience, or the cumulative effect on children of repeated incidents, when determining whether neglect exists.

A study conducted by England (1988) found that many children who had been referred to CPS for neglect did not receive services because their cases did not meet the criteria for “incidents” of neglect. However, he found that all of these children had, in fact, suffered severe developmental consequences.

POVERTY AND CHILD NEGLECT

Numerous studies have linked poverty to an increased risk of child neglect (Nelson, Saunders & Landsman, 1993). A number of factors may explain the association. Before reviewing these factors, though, it is important to note that most poor families do not neglect their children (Dubowitz, 1996).
Dubowitz (1999) cites numerous studies that identify many of the stressors associated with poverty. These include unemployment (citing American Humane Association, 1988), single parenthood (citing Nelson, et al., 1994), housing instability or frequent moves (citing Gaudin, Polansky, Kilpatrick & Shiltron, 1993), depleted or high risk communities (citing Zuravin, 1989), household crowding (citing Zuravin, 1986), limited access to health care, and exposure to environmental hazards such as lead paint or dangerous neighborhoods. Pelton (1994) states that “for people living in poverty, the probability of child abuse and neglect is largely dependent on the extent of one’s ability to cope with poverty and its stressors” (p. 153).

Pelton offers an additional perspective on the link between poverty and neglect. He states that impoverished families often live, though not by choice, in neighborhoods with high crime rates and in homes that present environmental hazards such as exposed wiring, lead paint, or insecure windows. “[I]n the presence of these conditions, impoverished parents have little leeway for lapses in responsibility, whereas in middle-class families, there is some leeway for irresponsibility, a luxury that poverty does not afford” (p. 155).

Approximately one-third of the States provide room in their definitions of neglect for consideration of a family’s financial means (U.S. Department of Health and Human Services, 2000). These caveats usually address the family’s access and response to available services that may help to alleviate the neglectful conditions. For example, if a family living in poverty was not providing adequate food for their children, it may only be considered neglect if the parents were made aware of food assistance programs but did not use them.

SUBSTANCE ABUSE AND CHILD NEGLECT

Some CPS agencies estimate that substance abuse is a factor in as many as 70 percent of all the child neglect cases they serve (Gaudin, 1993). But what is the connection between substance abuse and neglect, specifically?

A number of researchers have explored the relationship between parental substance abuse and child neglect. They have found that substance abusing parents may divert money that is needed for basic necessities to buy drugs and alcohol (Munkel, 1996). Parental substance abuse may interfere with the ability to maintain employment, further limiting the family’s resources (Magura & Laudet, 1996). The substance abusing behaviors may expose the children to criminal behaviors and dangerous people (Munkel, 1996). Substance abusing parents may be emotionally or physically unavailable and not able to properly supervise their children, risking accidental injuries (Wallace, 1996). Children living with substance abusing parents are more likely to become intoxicated themselves, either deliberately, by passive inhalation, or by accidental ingestion (Munkel, 1996; Wallace, 1996). Heavy parental drug use can interfere with a parent’s ability to provide the consistent nurturing and care giving that promotes children’s development and self-esteem (Zuckerman, 1994). According to Magura and Laudet, “Substance abuse has deleterious effects on virtually every aspect of one’s life and gravely interferes with the ability to parent adequately” (p. 198).

Drug-affected Newborns. The issue of drug-affected newborns has long been a concern in the United States. The most recent statistics indicate that in 1999, 5.5 percent of pregnant women used some illicit drug during pregnancy, translating into approximately 221,000 babies that had the potential to be born drug exposed (National Institute of Drug Abuse, 1999).

Although some studies have found few enduring effects from prenatal drug exposure, others have found that it may result in physical and neurological deficits, growth retardation, cardiovascular abnormalities, and long-term developmental abnormalities (Sagatun-Edwards & Saylor, 2000), including learning and behavior problems (Zuckerman, 1994) and language delays (Harrington, Dubowitz, Black & Binder, 1995).

While no State mandates drug testing of all new mothers, many hospitals test babies when maternal drug use is suspected (Sagatun-Edwards & Saylor, 2000). What to do about the problem is complicated by legal and ethical considerations including concerns about a woman’s rights regarding her own body and concerns about laws applying to children and not fetuses (Dubowitz & Black, 1996). However, Wallace (1996) cites the Michigan Court of Appeals as stating that “… a newborn suffering narcotics withdrawal symptoms as a consequence of prenatal maternal drug addiction may properly be considered a neglected child within the jurisdiction of the … court” (p. 92). Sagatun-Edwards and Saylor found that States often are responding to the problem either by authorizing juvenile court intervention to protect the child or by criminalizing the behavior and demanding punishment and drug treatment for the mother. In fact, at least five States now include drug-affected newborns in their State statutes under the definition of neglect (U.S. Department of Health and Human Services, 2000) and the NIS-3 includes drug-affected newborns in its research definition of neglect (Sedlack & Broadhurst, 1996).

Another implication for the child welfare field is that drug-exposed newborns are often left in the hospital by their parents; these babies often are referred to as “boarder babies.” The most recent statistics come from a study conducted by the Child Welfare League of America in 1992. This study found that as many as 85 percent of boarder babies had been exposed to drugs in utero (Magura & Laudet, 1996). Boarder babies often are referred to CPS agencies as abandoned children and placed into foster care.

DOMESTIC VIOLENCE AND CHILD NEGLECT

There has lately been increasing attention paid to the relationship between domestic violence and child maltreatment. Shepard and Raschick (1999) found that in 35 percent of a sample of child neglect cases, domestic violence had occurred in the home. Some States now include exposure to “injurious environments,” including domestic violence, in their State statute definitions of neglect (U.S. Department of Health and Human Services, 2000). However, there is still much controversy over whether exposure to domestic violence is itself a form of child neglect.

The term “failure to protect” often is used in these cases, although it is not found in the child maltreatment statutes directly, but rather in legal and child welfare literature (Magen, 1999). The term often is used in reference to an abused mother’s inability to protect her child from exposure to violence in the home. Many researchers and practitioners, however, believe the responsibility should be on the abuser, not on the victim of domestic abuse (Magen, 1999; Shepard & Raschick, 1999). In fact, Magen states that leaving the abusive situation is not always the safest option for an abused mother and her children, because the abuser may lash out at this time. Shepard & Raschick conclude that “too often there are no easy answers for how to best ensure the safety of children when their mothers are victims of domestic violence” (p. 154).

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