Maine Department of Health and Human Services Quality Improvement Services Children’s Habilitation Assessment Tool (CHAT) Training for Targeted Case Managers Revised January 2011

Purpose of Child and Adolescent Screening and Assessment Tools  To guide and support clinical decision making on the appropriate level and intensity of services and supports that a child and family may need;  To support and inform the development of ISPs;  To monitor child/youth progress on identified functional and strength areas overtime;  To guide and inform caseload and resource planning activities;  To monitor effectiveness of planned interventions and guide program and system planning activities

Children’s Habilitation Assessment Tool (CHAT)Characteristics  Developed to assess the degree of behavioral and functional challenges in children /adolescents with Intellectual Disabilities/Autistic Spectrum Disorders  Completed by Case Manager via interview with parent/care giver most involved in the child/adolescents treatment planning.  The CHAT is easy to complete and can be administered with minimal training.  Measures the level of functional challenges in three domains: Behavioral, Social Skills and Life Skills  Items are rated using a 5-point scale from (0) never, (1)occasionally, (2) sometimes, (3) most of the time and (4) all of the time  Separate functional scales are obtained by summing the rating on each individual domain  The Total Functional Score is also generated by summing total scores on Behavioral, Social Skills and Life Skills.

Children ’s Habilitation Assessment Tool (CHAT) Characteristics  Preliminary reliability demonstrated strong internal consistency reliability for each scale and for the total scale(all items together)  Inter–rater reliability assessed on a similar pilot instrument demonstrated that two raters appropriately trained on the pilot and with similar knowledge of the child generate consistent ratings.

Children’s Habilitation Assessment Tool (CHAT) Behavioral Assessment Scale  This section assesses the extent to which the child/adolescent exhibits challenging behaviors in six behavioral areas.  Using the scale, rate the frequency to which the child exhibits each of these six type of challenging behaviors(aggression, self injurious, destruction, safety awareness, interfering behaviors, and verbal abuse).  The ratings are based on observed behaviors over the preceding 3 months.  Each behavior is rated on a five point scale (0) never (1) occasionally, (2) sometimes, (3) most of the time and (4) all of the time.

Children’s Habilitation Assessment Tool (Chat) Behavioral Assessment Scale Definitions  Aggression: Physical contact with another person with the intent to hurt (i.e., hitting, kicking, punching, slapping, biting, throwing objects).  Self injurious Behavior: Non-accidental behavior towards self that are potentially harmful or causes physical damage to the body (i.e., biting, scratching, banging head, pinching, ingesting harmful substances, attempted suicide).  Destruction of Property: Any purposeful behavior that damages property (i.e., punch holes in wall and doors, fire setting, breaking furniture, etc.).

Children’s Habilitation Assessment Tool (Chat) Behavioral Assessment Definitions  Safety Awareness: Any behaviors that jeopardizes safety ( i.e., bolting into the street, running away, tantrums, impulsive behaviors, etc.).  Interfering Behaviors:Behaviors that significantly interfere with normal daily activities (i.e., obsessions, compulsions, self stimulation,or other bizarre behaviors).  Verbal Abuse: Speaking to others in an extremely malicious, abusive, or intimidating manner (i.e., swearing, name calling, screaming, threatening language etc.).

Children’s Habilitation Assessment Tool (CHAT) Social Skill Assessment Scale  This section assesses the child’s behavior across common social situations, and is not designed to assess for social/recreational need.  Using the scale, rate the frequency in which the child requires external assistance and support to maintain behaviors appropriate to the child ‘s age and developmental level in each of the following settings: public, social, recreational and home.  The ratings are based on observed behaviors over the preceding 3 months.  Each behavior is rated on a five point scale (0) never (1) occasionally, (2) sometimes, (3) most of the time and (4) all of the time.

Children’s Habilitation Assessment Tool (CHAT) Social Skills Assessment Definitions  Public Settings: community settings where most of the people are unknown to the child, (i.e., stores, walking down the street, and other public settings).  Social Settings: Settings where the child interacts with others (i.e., parties, social gatherings, activities with friend/peers etc.).  Recreational Settings: Settings where the child participates in a recreational activity (i.e., sports program, camp, recreational center, gym, etc.).  Home Setting: In the child’s /family members place of residence.

Children’s Habilitation Assessment Tool (CHAT) Life Skills Assessment Scale  The section assesses the extent to which the child/adolescent requires support in five life skill areas.  Using the scale, rate the frequency to which the child requires assistance and support (i.e., verbal cues or hand over hand assistance) in the following life skills: toileting, dressing, grooming, eating and independent living skills.  The ratings are based on observed life skills over the preceding 3 months.  Each life skill is rated on a five point scale (0) never (1) occasionally, (2) sometimes, (3) most of the time and (4) all of the time.

Children’s Habilitation Assessment Tool (CHAT) Life Skills Assessment Definitions  Toileting: All activities associated with using the toilet (i.e.,sitting, flushing, wiping, use of toilet paper, etc.).  Dressing: All activities associated with dressing (i.e., use of fasteners, dressing, keeping clothing on, choosing clothing for weather, special occasions, etc).  Grooming: Activities associated with basic hygiene (i.e. bathing, combing hair, shaving, brushing teeth, washing hair, etc).  Eating : All activities associated with eating (i.e., use of utensils, drinking, swallowing, chewing food, rate of food consumption, table manners, etc.).  Independent Living skills: Activities of daily living (i.e., household chores, cooking, safety skills, community skills, self help skills, etc.).

Children’s Habilitation Assessment Tool (CHAT) Life Skills Assessment Scale  The section assesses the extent to which the child/adolescent requires support in five life skill areas.  Using the scale, rate the frequency to which the child requires assistance and support (i.e., verbal cues or hand over hand assistance) in the following life skills: toileting, dressing, grooming, eating and independent living skills.  The ratings are based on observed life skills over the preceding 3 months.  Each behavior is rated on a five point scale (0) never (1) occasionally, (2) sometimes, (3) most of the time and (4) all of the time.

Children’s Habilitation Assessment Tool (CHAT) How to complete the Behavior Rating  The rater circles the appropriate scale number for each behavior listed and then enters the score in the Behavioral Rating column on the right hand side of page.  The individual behavioral ratings are summed to obtain a Combined Behavior Total.  Only one answer per Behavior is acceptable.  The ratings are based on observed behaviors over the preceding 3 month period.

Children’s Habilitation Assessment Tool (CHAT) How to complete the Social Skills Rating  The rater circles the appropriate scale number for each Social Skill listed and then enters the score in the Social Skills Rating column on the right hand side of page.  The individual Social Skills ratings are summed to obtain a Combined Social Skills Total Score.  Only one answer per Social Skill area is acceptable.  The ratings are based on observed social skills over the preceding 3 month period.

Children’s Habilitation Assessment Tool (CHAT) How to complete the Life Skills Rating  The rater circles the appropriate scale number for each life skill listed and then enters the score in the Life Skills Rating column on the right hand side of page.  The individual Life Skills ratings are summed to obtain a Combined Life Skill Total.  Only one answer per Life Skill area is acceptable.  The ratings are based on observed life skills over the preceding 3 month period.

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