Principles of behavioral assessment and management.

Pediatricians are often the first professionals to which parents turn for advice regarding their children's behavioral problems. The most frequently reported problems are related to oppositional behavior (eg, tantrums, noncompliance), sleep/bedtime behavior, and attention-deficit/hyperactivity. Although traditional psychological assessments include an evaluation of cognitive and memory abilities, academic achievement, adaptive functioning, and behavioral/emotional functioning, the volume of information that is obtained from traditional measures may have limited use in pediatric settings. Therefore, behavioral assessments are often used to determine the precipitating events and consequences that maintain the behavior problem. The ABC model and the principles of reinforcement and punishment are tantamount to the assessment and management of behavior problems. The variables that are targeted in a behavioral assessment are guided by the assumption that antecedent and consequent factors are important sources of variance in behavior and behavior problems. Behavioral assessments guide behavioral interventions, which are designed to modify variables that trigger, maintain, or mediate problem behaviors.