The Inadequacy of Formal Measures of Child Adjustment During Residential Treatment

Abstract

A review is presented of twenty years of effort to evaluate change in response to residential treatment. Educational achievements, intelligence, sociometric standing, diagnosis, behavioral symptomatology, and developmental attainments were all employed at various times to assess improvement-with minimal success. The agency now principally relies on team evaluation of developmental objectives, a return to the technique of twenty years ago. Problems encountered with each measure are discussed.

Introduction to Treatment Outcome

“…A study of adjustment during residential treatment found that the inter-rater reliability of staff ratings on behavioral rating scales was sometimes as low as .42 (Mordock, 1986). According to Lewis (1988), "whether or not behavior is disturbing is always to some extent a function of the context in which it occurs and the expectations held by other participants in the interaction" (p. 102).…”

“…Stated another way, children may behave differently depending on the person with whom they are interacting. Children's bchavior may also differ substantially from one setting to another (Mordock, 1986;Achenbach, 1994). For example, some children may behave aggressively when in academic settings but have no trouble in peer interactions on the playground.…”

“…For example, some children may behave aggressively when in academic settings but have no trouble in peer interactions on the playground. Therefore, it is important that outcomes be evaluatcd by several persons who play different roles in the lives of the children being assessed (Mordock, 1986).…”

“…prompted admission of a child or adolescent to a hospital or rcsidential care facility may reappear upon discharge (Mordock, 1986).…”