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Administration and Scoring
Administration
The ABS is an observational as opposed to a self-report measure. The ABS
has been shown to be reliable and valid when based on therapists' 30-minute
observation periods, or primary nurses' perceptions based upon an 8-hour
shift (Corrigan, 1989). Ratings based on 10-minute observation periods
by psychology assistants or a rehabilitation nurse have also been found
to be reliable. However, serial monitoring must be done with comparable
observations, as it has been found that ratings during 10-minute observation
periods are not comparable to ratings based on 8-hour shifts.
Observers make a rating of one to four for each of the
fourteen items. In validation, nurses and therapists were trained by sharing
impressions and asking feedback during a trial-use period. Written descriptions
of ratings for each item, with examples, are available from Drs. Corrigan
and Bogner at Ohio State University.
A rating of "1" is ascribed when the behavior in the item is
not present. Ratings of "2," "3," and "4"
indicate the behavior is present and differentiate the degree or severity.
Degree can be a function of either the frequency with which the behavior
occurs or the intensity of individual occurrences.
Raters should be instructed that the basis for establishing the degree is the extent to which the occurrence of the behavior described in the item interferes with functional behavior that would be appropriate to the situation:
- We suggest a rating of "2" or "slight" be ascribed when the behavior is present but does not prevent the conduct of other, contextually appropriate behavior. Patients may redirect themselves spontaneously or the continuation of the agitated behavior does not preclude the conduct of the appropriate behavior.
- A rating of "3" or "moderate" indicates the individual may need to be redirected from an agitated to an appropriate behavior, but is able to benefit from such cueing.
- A rating of "4" or "extreme" is ascribed when the individual is not able to engage in appropriate behavior due to the interference of the agitated behavior, even when external cueing or redirection is provided.
Scoring
The Total Score is calculated by adding the ratings (from one to four)
on each of the fourteen items. Raters are instructed to leave no blanks;
but, if a blank is left, the average rating for the other fourteen items
should be inserted such that the Total Score reflects the appropriate
possible range of values. The Total Score is the best overall measure
of the course of agitation (Corrigan, 1989; Corrigan & Bogner, 1994).
Subscale scores are calculated by adding ratings from the component items:
- Disinhibition is the sum of items 1, 2, 3, 6, 7, 8, 9 and 10.
- Aggression is the sum of items 3, 4, 5 and 14. (It is not an error that Item #3 is in both scores.)
- Lability is the sum of items 11, 12 and 13.
In order to allow subscale scores to be compared to
each other and to the Total Score, it is recommended that an average item
score for each factor be calculated and multiplied by fourteen. This procedure
provides subscale scores with the same range as each other and the Total
Score, which is useful for graphic presentation.