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Behavior rating scales are one of the oldest assessment tools used in mental health, education, and research. These scales typically assess problem behaviors, social skills, and emotional functioning; are widely employed in the assessment of personality development, adaptive behavior, and social-emotional functioning; and aid in diagnostic decision making and in planning treatment and education. These well-proven scales are easy to administer, score, and interpret and have become an integral part of the clinical and school assessment of children and adolescents.

A variety of behavior rating scales are available for use in clinical practice and research. The majority of behavior rating scales are intended for use with children, though a handful can be used with adults. The use of behavior rating scales in the evaluation of adult clients is gaining popularity. There are a number of advantages of using behavior rating scales: They quantify and systematically organize client information, administration and scoring is generally quick and easy, most allow for comparison of ratings across respondents and/or settings, and because these are norm-referenced instruments, the client's symptoms and behaviors can be compared with those of his or her peers.

Behavior rating scales help clinicians obtain information from parents, teachers, and others about a client's symptoms and functioning in various settings, which is necessary for an appropriate assessment for a number of disorders as well as for treatment monitoring. Such instruments are generally only one component of a comprehensive evaluation, which commonly includes direct observation of the client, objective and projective measures, and interviews. Most behavior rating scales are normed using nationally representative samples, but they also often include clinical norms as well, which allows for a variety of behavior comparisons. Ideally, the rating scale used should be normed to similar client populations, so results indicate if a client's skill, behavior, or emotional status is typical or significantly different from that of peer groups.

Uses of Behavior Rating Scales

The most common use of behavior rating scales is in the diagnosis of mental and behavioral disorders. The content of behavior rating scales often conforms to Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria, though it often differs in the way the symptoms are quantified as well as in the way the symptoms are combined. In the educational setting, these scales are also used to help determine eligibility for special education and other programs. In addition, they are used to plan interventions and to monitor symptoms and behavior during and following treatment.

There is ample empirical support for the validity of using behavior rating scales for diagnostic and placement decision making. However, the use of these scales in planning interventions and monitoring client progress has not yet been adequately validated. Because of this, behavior rating scales should never be the sole method used to monitor response to treatment, though behavior rating scales do have a place as one piece of a multimodal method. For example, direct observations and rating scales are considered the best methods to evaluate the effects of medication trials on a child's behavior. When used in conjunction with direct observations, behavior rating scales may give an indication of differences in behavior across settings or differences in the perception of the client's behavior by significant others in his or her life. It is always important to ensure that the scale is appropriate for this use. If a behavior rating scale is used to monitor a behavioral intervention, care should be taken to make sure the scale aligns with this goal. Many scales monitor reductions in negative behaviors, but most lack items that measure positive replacement behaviors.

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