Understanding the Purpose of an Initial Assessment
The initial assessment is the foundation of effective behavioral consulting. It is the first comprehensive evaluation a behavioral consultant conducts with a new client, and its quality directly impacts the effectiveness of all subsequent interventions and treatment plans. A thorough initial assessment gathers critical information about the client's behavior patterns, history, environment, strengths, and challenges.
The primary goals of an initial assessment are to identify and define target behaviors, understand the antecedents and consequences that maintain those behaviors, establish baseline measurements for tracking progress, identify the client's strengths and resources, and develop preliminary treatment recommendations. Without a well-conducted initial assessment, behavioral interventions risk being misguided, ineffective, or even counterproductive.
Whether you are working with children with developmental disabilities, adults with mental health challenges, organizational behavior issues, or any other behavioral concern, the principles of a thorough initial assessment remain consistent. This guide walks you through each component of the assessment process.
Preparing for the Assessment
Proper preparation is essential for conducting an effective initial assessment. Before meeting with the client, there are several steps you should take to ensure the assessment is comprehensive and productive.
Review Referral Information: Examine all available information provided in the referral, including the reason for referral, previous evaluations or assessments, medical records, educational records, and any previous treatment history. This background information helps you formulate initial hypotheses and determine which assessment tools and methods will be most appropriate.
Select Assessment Tools: Based on the referral information and the client's demographics, choose appropriate assessment instruments. These may include standardized behavior rating scales, adaptive behavior assessments, functional behavior assessment tools, and interview protocols. Common instruments include the Behavior Assessment System for Children (BASC), the Vineland Adaptive Behavior Scales, the Aberrant Behavior Checklist, and the Motivation Assessment Scale.
Prepare the Environment: Ensure the assessment location is comfortable, private, and free from distractions. If you are conducting a home or school observation, coordinate with the relevant parties to minimize disruption while ensuring you can observe the client in their natural environment.
Gather Consent: Before beginning any assessment, obtain informed consent from the client or their legal guardian. The consent form should explain the purpose of the assessment, what it involves, how the information will be used, and the client's rights regarding confidentiality and data privacy.
Conducting the Interview
The clinical interview is typically the most important component of the initial assessment. It provides rich qualitative information that standardized tools alone cannot capture.
Client Interview: When possible, interview the client directly to understand their perspective on the presenting concerns. Ask open-ended questions about their daily routines, challenges, goals, and what they hope to gain from behavioral consulting. For clients who are nonverbal or have limited communication abilities, use alternative methods such as visual supports, choice boards, or observation-based assessments.
Caregiver and Stakeholder Interviews: Interview parents, teachers, employers, caregivers, or other significant individuals who interact regularly with the client. These interviews provide essential information about the client's behavior across different settings and with different people. Ask about the frequency, duration, and intensity of target behaviors, as well as the situations in which behaviors are most and least likely to occur.
Behavioral History: Gather a detailed behavioral history, including when concerning behaviors first appeared, how they have changed over time, what interventions have been tried previously, and what results those interventions produced. Understanding the history of a behavior helps identify patterns and potential maintaining variables.
Conducting Direct Observations
Direct observation is a cornerstone of behavioral assessment. Observing the client in their natural environment provides objective data about behavior patterns that interviews and rating scales may miss.
Structured Observations: Plan observations during times when target behaviors are most likely to occur. Use a systematic observation protocol that captures the frequency, duration, latency, and intensity of target behaviors. Record antecedents (what happens before the behavior), the behavior itself, and consequences (what happens after the behavior) using an ABC data collection format.
Unstructured Observations: Spend time observing the client during routine activities without a specific focus. This allows you to notice patterns and environmental factors that you might not have anticipated. Pay attention to the physical environment, social interactions, transitions between activities, and the client's engagement levels.
Baseline Data Collection: Establish baseline measurements of target behaviors before any intervention begins. This data serves as the comparison point for measuring the effectiveness of future interventions. Collect baseline data over multiple sessions and settings to ensure it is representative of the client's typical behavior patterns.
Functional Behavior Assessment
The functional behavior assessment (FBA) is a systematic process for identifying the function or purpose that a behavior serves for the client. Understanding the function of behavior is essential for developing effective interventions.
Behaviors typically serve one of four functions: gaining attention from others, escaping or avoiding demands or unpleasant situations, accessing tangible items or preferred activities, or achieving sensory stimulation. An FBA uses interviews, rating scales, and direct observation data to determine which function or functions are maintaining the target behavior.
In some cases, you may need to conduct a functional analysis, which involves systematically manipulating environmental variables to test hypotheses about behavioral function. Functional analyses provide the most definitive information about behavioral function but require careful planning and ethical consideration, particularly when working with behaviors that could pose safety risks.
Writing the Assessment Report
The assessment report is the formal document that summarizes your findings, conclusions, and recommendations. A well-written report should be clear, comprehensive, and actionable.
Include the following sections in your report: identifying information and referral reason, assessment methods used, background and history, behavioral observations, results of standardized assessments, functional behavior assessment findings, summary and clinical impressions, and recommendations for intervention. Write the report in clear, jargon-free language that can be understood by all stakeholders, including parents and teachers who may not have behavioral expertise. Present data using tables and graphs where appropriate, and ensure that your recommendations are specific, measurable, and directly linked to your assessment findings.
The initial assessment sets the trajectory for the entire consulting relationship. Investing the time and effort to conduct it thoroughly ensures that your interventions are well-targeted, your progress measurements are meaningful, and your clients receive the best possible outcomes.
