Date of Award
8-2026
Degree Type
Thesis
Degree Name
Master of Science
Department
Psychological Science
Program
Psychological Science (MS)
First Advisor/Chairperson
Dr. Jacob Daar
Abstract
Individuals with neurodevelopmental disabilities often engage in challenging behaviors that interfere with daily functioning and community participation. Many standardized assessments focus on indirect, descriptive measurements that emphasize frequency, while providing limited information about medical severity, ongoing management strategies, and functional outcomes. This misalignment may limit the clinical utility of assessments, as scores may not consistently align with medical necessity criteria or arguments supporting the maintenance of current treatments. The first study extends on Reyes-Martín et al. (2022), which reviewed 24 assessments of challenging behaviors, by further evaluating assessment characteristics relevant to clinical decision-making and treatment justification. Findings highlight variability across measures and gaps in the extent to which assessments capture functional impact, safety risks, and other clinically relevant dimensions necessary for determining medical necessity. To address these limitations, the second study introduces and evaluates a novel behavior assessment designed to improve alignment with medical necessity standards and clinical decision-making. In this pilot study (n = 6), the Contextually-Sensitive Challenging Behavior Assessment (CSCBA) emphasizes objective measurement of level of harm, level of support required, and participation restrictions. Spearman’s rank-order correlations are used to examine associations between CSCBA variables and scores from the Vineland Adaptive Behavior Scales - Third Edition, Behavior Problems Inventory - Short Form, and Child and Adolescent Scale of Participation. Preliminary findings suggest that the CSCBA scores may capture clinically meaningful information beyond subjective severity ratings and frequency-based reporting. The findings support the need for further evaluation of the measure’s validity and clinical utility in larger samples.
Recommended Citation
Walker, Madison S., "Investigation of a Novel Behavioral Assessment of Challenging Behavior in the Context of Medical Necessity and Disability Theory" (2026). All NMU Master's Theses. 931.
https://commons.nmu.edu/theses/931
Access Type
Open Access
Signed signature page
Included in
Applied Behavior Analysis Commons, Child Psychology Commons, Developmental Psychology Commons