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Agitated Behavior Scale Rating Form
Agitated Behavior Scale
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Patient |
________________________________ |
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Observ. Environ. |
________________________________ |
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Rater/Disc. |
________________________________ |
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Period of Observation: |
From_____am/pm at Date___/___/___ |
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To_____am/pm on Date___/___/___ |
At the end of the observation period indicate whether the behavior described in each item was present and, if so, to what degree: slight, moderate or extreme. Use the following numerical values and criteria for your ratings.
1 = absent: the behavior is not present.
2 = present to a slight degree: the behavior is present but does not prevent the conduct of other, contextually appropriate behavior. (The individual may redirect spontaneously, or the continuation of the agitated behavior does not disrupt appropriate behavior. )
3 = present to a moderate degree: the individual needs to be redirected from an agitated to an appropriate behavior, but benefits from such cueing.
4 = present to an extreme degree: 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.
DO NOT LEAVE BLANKS.
___ 1. Short attention span, easy distractibility, inability to concentrate.
___ 2. Impulsive, impatient, low tolerance for pain or frustration.
___ 3. Uncooperative, resistant to care, demanding.
___ 4. Violent and or threatening violence toward people or property.
___ 5. Explosive and/or unpredictable anger.
___ 6. Rocking, rubbing, moaning or other self-stimulating behavior.
___ 7. Pulling at tubes, restraints, etc.
___ 8. Wandering from treatment areas.
___ 9. Restlessness, pacing, excessive movement.
___ 10. Repetitive behaviors, motor and/or verbal.
___ 11. Rapid, loud or excessive talking.
___ 12. Sudden changes of mood.
___ 13. Easily initiated or excessive crying and/or laughter.
___ 14. Self-abusiveness, physical and/or verbal.
___Total Score