Direct Observation Methods

Social Behavior

The Social Behavior Coding System (Guevremont & Foster, 1993) focuses on four categories of peer interactions:

1. Positive Behaviors: These include cooperative work and on-task, compliant and pro-social behaviors - such as smiling and laughing.
2. Negative but Non-aggressive Behaviors: These involve the violation of rules, non-compliance and general disruption.
3. Aggressive Behaviors: These refer to both physical and verbal aggressive acts, although they need not occur simultaneously. Examples include hitting another child, destroying or damaging one's own or others' property and swearing.
4. Non-interactive Behaviors: These involve not intermingling with peers and adults - as in playing alone or not smiling at others.

Adaptive Behavior

A child with ADHD also may show deficits in adaptive functioning (Patterson, 1982; Roizen, Blondis, Irwin, & Stein, 1994; Sikora, Vora, Coury, & Rosenberg, 2012). Too frequently, children and adolescents with ADHD are involved in mishaps and accidental injuries (Cuffe, Moore, & McKeown, 2005; Matheny & Fisher, 1984). Adaptive functioning refers to skills that allow the individual to be more self-managing, that is, to be able to responsibly take care of him or herself. More specifically, this refers to:

• General self-help skills: the managing of everyday needs, such as eating, dressing and understanding and using time.
• Interpersonal skills: include cooperating and the reciprocal relationships of trusting others.
• Motor skills: these skills are broken down into gross motor skills (such as walking, skipping, jumping rope, running or riding a bicycle) and fine motor skills (such as buttoning one's shirt, zipping one's coat, or manipulating pens, pencils and paintbrushes).
• Communication skills: which allow one to understand what is being directed toward one (receptive skills, such as comprehending a verbal instruction to open one's book to a certain page) and to be understood as the communicator (expressive skills, such as requesting a particular food in a cafeteria).
• Social responsibility skills: involving the degree to which responsible supervising adults permit the child to wander.

A child who is deemed to be highly responsible socially is more likely to be asked to do particular chores, or to be allowed out of the adult's sight for relatively extended periods of time, under the assumption that the child will not get into trouble (Barkley, 1997b).

There are a number of adaptive behavior inventories and questionnaires available with acceptable psychometric properties. A comprehensive but time-consuming way of assessing adaptive behavior is the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) (Sparrow, Cicchetti, & Balla 2005). The ineland-II is appropriate for the birth-to-90-year-old group and is administered as an interview with a respondent familiar with the child. The assessment lasts 20-60 minutes. Four domains describe the person's adaptive functioning. The domains are:

• Communication
• receptive
• expressive
• written language
• Daily living skills
• personal
• domestic
• community
• Socialization
• interpersonal relationships
• play and leisure time
• coping skills
• Motor skills
• fine
• gross

A maladaptive behavior index (which measures internalizing and externalizing behaviors) is also provided. An alternative to the Vineland-II is the Normative Adaptive Behavior Checklist (NABC) (Adams, 1984). The NABS is a checklist, so it does not take up any of the clinician's time; typically, the parents will complete this form.

Children with ADHD perform less well than their peers on individually administered achievement tests (Barkley et al., 1990; Jitendra, DuPaul, Someki, & Tresco, 2008); their performance in their daily classroom tasks and homework assignments is also inconsistent (Barkley, 1990b; Power, Werba, Watkins, Angelucci, & Eiraldi, 2006; U.S. Department of Education, 2006).

It is in these areas that intervention with academic behaviors is most likely to be needed. For example, in one study 75% of children with ADHD were underachieving in reading, spelling and mathematics; furthermore, 33% were a full grade behind in two academic areas (Cantwell, 1986). These findings were replicated in New Zealand and showed similar trends: Eighty percent had learning problems and approximately fifty percent had difficulties in at least two academic areas (McGee & Share, 1988). More recent data indicates that 30% of students with ADHD repeat one or more grades (Heward, 2013). These problems do continue into adolescence: One study found that three times as many adolescents with ADHD had failed a grade as had their normal peers (Barkley, 1990b).