Issues and Practice Regarding Behavioural Outcome Measurement Undertaken by a Specialised Service Provider

The Kemsley Division has been providing a specialised service for people with acquired neurological damage and challenging behaviour problems for over two decades. This paper reviews some of the methods used to evaluate behavioural outcome. After a brief description of the rehabilitation programme, comments are made regarding potential limitations in the applicability of some of these methods which weaken a group approach to the measurement of behavioural outcome. The non-homogeneous nature of the participant population is highlighted, and it is argued that because of this behavioural outcome measurement should be undertaken at the level of the individual. Examples of how this is undertaken using single case study methodology are described, including use of both TELER (Treatment Evaluation according to Le Roux) and the Overt Aggression Scale—Modified for Neurorehabilitation. The validity of self-report in behavioural outcome measurement is also briefly considered. Finally, the dilemma created by the need to reflect outcome at the group level to enable sufficient resources to be made available to brain injury services is discussed.