Ecologically Valid Assessment. Behavior and Cognition in Children with Neurodevelopmental Disorders

Behavior is the visible result of a long and complex series of processes. The manifestation of behavior combines and summarizes a series of internal and external messages while making a decision. This generally consists of one or more actions that limit the number of available options and trigger a series of specific consequences. From the research perspective, each decision is a discrete and visible event that, when repeated many times and carefully observed, serves as the basis for behavioral assessment. Through experimen design, we can create situations or scenarios in which we get an organism to display its behavior in a relatively controlled situation when faced with stimuli planned by us. The accumulation of hits, errors, and omissions, and response time are examples of measurements we can make when studying behavior. By comparing these measurements with values taken from a very large group of people and considering aspects such as age, we can make judgments about our individual performance.

Behavioral assessment is particularly important when we want to determine whether a behavior is maladaptive enough to be considered a disorder. A disorder is an alteration in physical or mental function; in psychiatric terms, it denotes a behavioral disturbance that causes dysfunction and has no single cause. Psychiatric disorders are generally considered behavioral disorders because they involve problems in the way we make decisions. One group of particular interest is neurodevelopmental disorders. This classification encompasses a diverse group of childhood-onset conditions characterized by delays or difficulties in meeting motor, cognitive, social, and language developmental milestones. The most notable examples of these disorders are attention-deficit/hyperactivity disorder and autism spectrum disorder.

AN ECOLOGICALLY VALID ASSESSMENT CAN PROVIDE THE PHYSICIAN OR PSYCHOLOGIST WITH MORE INFORMATION ABOUT THE CHALLENGES PATIENTS MAY FACE

Assessing behavior and cognition in children with neurodevelopmental disorders can inform us not only about deficits they may display, but also about their unique way of processing information and perceiving the world. This is where the advantages of an ecologically valid assessment come in—one that includes experiences, behavior, and emotional moods in real time and in the subject’s normal environment—as opposed to traditional assessments that attempt to construct situations or scenarios rooted in events or challenges that individuals face in their daily lives. One criticism of traditional assessments is that they are often constructed from the perspective of the interests of the researcher or evaluator, and therefore, the objectives of the problems posed during testing and the decisions the individual must make are unrelated to their interests or context. Instead an ecologically valid assessment can make performance results easier to interpret, more understandable to the subject’s community, and can provide the physician or psychologist with more information about the challenges patients may face.


We must recognize that ecologically valid assessments are not a panacea. Ecological validation is not always desirable. Sometimes, highly artificial situations or situations that severely restrict stimuli and reduce the possibilities for response variation are necessary to answer some research questions. Nor is this a characteristic that may or may not be present; it is possible to achieve a balance by having a certain degree of ecological validity coexisting with artificial circumstances, or by sacrificing a bit of reality or everyday life to achieve greater control over the variables.

At the Psychopathology and Development Unit of UNAM’s Institute of Biomedical Research, in collaboration with the country’s most important psychiatric institutions, such as the National Institute of Psychiatry Ramón de la Fuente Muñiz, and the Children’s Psychiatric Hospital Doctor Juan N. Navarro, we conduct research focused on developing assessment tools based on ecological validation. Among the most successful examples is a large-scale search task, in which participants must perform full-body movements to find as many balls as possible in a given time. The potential location of balls is marked by cones in the search area, which can be up to 50 by 70 meters. Decisions have real consequences, since choosing an incorrect search strategy that leads participants to search in places they have been before means that finding more balls will be more costly in terms of calories and time. Another task we have also developed involves using wooden blocks to build the tallest tower possible. This task attempts to simulate the decisions children make when engaging in behaviors both entertaining and risky, such as climbing a tree. Many children enjoy this activity, but many also climb beyond their capabilities or to dangerous heights. These decisions often result in accidents with skin injuries or even broken bones, so we can’t have them climb trees, but we can have them make decisions in a similar context. When building a tower using wooden blocks, they can choose how much to increase the tower’s height, how to arrange the pieces, or how stable their construction is. The tower can collapse due to the cumulative decisions participants make; we can observe and measure these behaviors, and if the tower falls, no one is hurt.

With research like the mentioned above, we believe it is possible to understand how children with neurodevelopmental disabilities make decisions, opening a window into the challenges they face in their daily lives. The knowledge generated by these tools can help avoid the circumstances that contribute to adversity, as well as expand the range of tools used to evaluate treatments.

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