Clinical Assessment of Behavior

The Clinical Assessment of Behavior (CAB) is a comprehensive, third-party rating scale for the behavioral assessment of children and adolescents ages 2 to 18 years. The two parent forms (a 170-item CAB—Parent Extended form and a 70-item CAB—Parent form) and the 70-item teacher form (CAB—Teacher) allow for a balanced assessment of both adaptive and clinical (i.e., maladaptive) behaviors across various settings, contexts, and raters. With a single set of items spanning the age range of 2 to 18 years, the CAB permits a longitudinal evaluation of symptoms throughout the course of an individual's treatment, without the introduction of potentially incompatible instruments into the evaluation process as the individual ages.

The CAB structural content includes 3 adaptive and 3 clinical scales and 2 adaptive and 10 clinical clusters. Whereas the CAB scales were designed to reflect “broad brush” psychosocial adjustment domains, CAB clusters reflect specific areas of exceptionality or disorder. Table 1 illustrates the exceptionalities, disorders, and conditions assessed by the CAB scales and clusters across the three forms. Table 1 also presents coefficient alpha reliability indices for each scale and cluster for the standardization sample. With its close alignment to the diagnostic criteria of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.), legislative mandates of the Individuals with Disabilities Education Act, and a context-dependent model of psychosocial adjustment, the CAB augments the diagnosis of childhood and adolescent psychiatric disorders with comprehensive behavioral content.

The CAB forms require an eighth-grade reading level of respondents and 5–10 minutes to complete the CAB-P and CAB-T forms (the CAB-PX requires 10–20 minutes). Because it is brief and easy to read, the CAB can be completed by raters without the aid of psychologists, thus rendering the evaluation process more efficient than if parents and teachers were to be interviewed. Furthermore, the CAB is computer scored and interpreted, and the resulting data are profiled and reported for professional interpretation and use.

A relatively unique application of the CAB is the ability for professionals to use its data to identify specific behaviors associated with educationally relevant exceptionalities (e.g., mental retardation, learning disabilities, giftedness and talent, attention deficit disorder, and attention deficit/hyperactivity disorder).

Too often, educational exceptionalities are diagnosed with only ability measures (e.g., intelligence tests, achievement tests, perceptual/motor tests) and without questioning whether a student's behaviors are consistent with the considered diagnosis. The CAB allows third-party respondents to indicate the frequency with which they observe the child or adolescent demonstrating behavioral characteristics associated with specific educational exceptionalities. Such information provides a multisource, multicontext way to corroborate referral information and ability test data with behavioral indices.

Standardized on more than 2,100 parents and 1,600 teachers, the CAB normative sample is highly representative of the U.S. population. An examination of the extent to which students' behavioral functioning is associated with their demographic characteristics (age, gender, race/ethnicity, parents' educational levels) revealed that generally 3% or less of the variance in the CAB parent-generated ratings was associated with the demographic attributes evaluated. Approximately 9% or less of the variance in teachers' ratings was associated with demographic attributes. These empirical findings, along with comparable reliability coefficients for all age, gender, and ethnic/racial groups, suggest that the CAB may provide the basis for an equitable behavioral assessment regardless of a student's age, gender, race/ethnicity, or socioeconomic status.

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