L-M Fergus Falls Behavior Rating Sheet

Abstract

The L-M Fergus Falls Behavior Rating Sheet (L-M FFBRS) is a standardized assessment tool, originally developed in 1951, designed for the objective measurement of the behavior of psychiatric patients. This instrument is particularly valuable in clinical settings where patients exhibit behavioral difficulties such as mutism, unintelligible speech, hyperactivity, or severe withdrawal, making them challenging to assess using traditional psychometric measures. The scale is structured to be comprehensive yet efficient, assessing eleven distinct areas of patient functioning based on observation by ward staff. Its key design criteria include ease of use by untrained raters, quantifiability, and sensitivity to changes in patient behavior over time.

Keywords

Behavior rating scale, Psychiatric assessment, Mental hospitals, Patient functioning, Behavioral observation, Institutionalized patients, Lucero and Meyer, Fergus Falls.

Authors

Rubel J. Lucero, Bill T. Meyer.

Purpose

The primary purpose of the L-M FFBRS is to provide a quick, objective, and quantifiable method for evaluating the observable behavior of patients in mental hospital settings. It was specifically created to overcome the limitations of subjective staff reports and complex psychological tests that often fail to capture the behavior of severely disturbed or non-verbal patients.

The scale serves multiple functions, including monitoring patient progress, assessing responsiveness to treatment interventions (such as insulin or electroshock therapy), and providing data suitable for research purposes. Its design prioritizes ease of use, ensuring that it can be effectively administered by ward aides and staff who may not possess specialized training in standardized assessment tools.

Construct

The L-M FFBRS measures the construct of observable, adaptive, and maladaptive behaviors demonstrated by institutionalized psychiatric patients within their daily ward environment. Rather than focusing on internal psychological states or subjective symptoms, the scale quantifies actions and reactions across key domains of daily living and social interaction.

The scale is divided into eleven specific behavioral categories, covering critical areas such as work participation, self-care, social responsiveness to peers and staff, and psychomotor activity. The resulting scores provide a comprehensive profile of the patient’s functional status and level of cooperation.

Validity

The structured format and clear behavioral descriptions employed by the L-M FFBRS lend themselves to high face validity. The scale items directly reflect behaviors that clinicians and ward staff consider essential indicators of patient functioning and recovery within a hospital setting. The scale’s ability to provide objective measures of behavior suggests that it successfully measures the intended construct for use in institutionalized populations, particularly those difficult to evaluate by standard methods.

Reliability

The L-M FFBRS demonstrated high inter-rater reliability during its initial development. This is a crucial feature for any behavior rating scale, as it indicates that the assessment results are consistent regardless of which staff member (e.g., nurse or aide) completes the observation. The descriptive checklist format minimizes subjective interpretation, ensuring that the quantifiable results are reliable measures of the observed behavior.

Factor Analysis

The source documentation does not provide details regarding formal factor analysis conducted on the L-M FFBRS. Given its early development date (1951), the scale structure relies on rational item grouping based on clinical relevance, dividing the assessment into eleven empirically relevant behavioral domains.

Instrument

Test Type: Observer-rated behavior rating scale.

Format: Primarily a checklist format using five descriptive options per behavioral category, supplemented by several open-ended questions requiring narrative input regarding specific patient activities or physical ailments.

Language Available: English (Original).

Population Group: Psychiatric patients (Institutionalized).

Age Group: Adults (Implied by the context of mental hospital residency and treatments like ECT/Insulin therapy).

Population Details: Specifically targets patients whose conditions (e.g., mutism, extreme negativity, hyperactivity, or unintelligible speech) render them unsuitable for self-report or traditional interview-based psychometric testing.

Test Methodology: Observational rating by nursing staff or psychiatric aides over a specified period, focusing on the patient’s most frequent behavior during that time frame. The scale assesses eleven aspects of behavior.

Keywords

Psychological instruments, Mental health assessment, Clinical observation, Ward behavior, Inter-rater consistency, Functional status.

Authors

Author ORCID Identifier: Not available.

Affiliation Email addresses: Not available.

Correspondence Address: Not available.

Permissions & Fee and Test Year

The scale was first published in 1951. Specific current permissions and fees must be sought from the journal publisher (Wiley Periodicals, Inc.) or the authors’ estates, as the original research article is likely protected by copyright.

Reference’s

Lucero, Rubel J., & Meyer, Bill T. (1951). A behavior rating scale suitable for use in mental hospitals. Journal of Clinical Psychology, 7, 250-254. doi: https://dx.doi.org/10.1002/1097-4679(195107)7:3 3.0.CO;2-G

Items of the L-M Fergus Falls Behavior Rating Sheet

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

Instructions: At the top of the Behavior Rating Sheet fill in as much informasion as can be found on the ward. Below you will find eleven different groups of descriptions of a par?cular type of behavior. Place a check (X) by the descrip?on that comes closest to telling how this par?cular pa?ent has behaved for _________________. If the pa?ent’s behavior has changed in this period, then check the descripsion which tells how the parent has behaved most of the ?me. If the parent’s behavior is evenly divided, then check two descrip?ons (or more, if necessary). Look at each group separately, do not try to give an overall impression at any 1me because, as you well know, a certain parent may be a very good worker but he may not speak at all. If you feel that you don’t know enough about a certain bit of behavior (example, you haven’t seen the parent eat) then leave that part out, it is far more important to have true descripsuons than to have many descriptions. There will be other descrip?ons that you will have to leave out. (Examples: if parent isn’t ge Wng insulin or electric treatments, you There are blanks under some of the groups. Fill them in as per instruc?ons.

Name                                                             Hospital Number        Age             Sex         Marital Status          Date

Diagnosis                                                      Time on Present Ward               Ward               Religious Preference

A. Work

• Does no work—refuses—extremely nega?vis?c.
• Does a li_le work with a lot of urging. Constant supervision is necessary.
• May have a regularly assigned job—and supervision may be necessary.
• Enthusias?c par?cipa?on in all types of work—asks for work.
• Normal interest in work—i.e., interested in some kinds of work more than others (will do other kinds than main interest if called upon to do so).

If works, at what and how many hours a day ________________________________________________.

B. Response to meals

• Has to have special a_en?on, as eats too much, spoon fed or tube fed.
• Eats by self, is sloppy—may need coaxing.
• Eats by self using knife, fork, and spoon properly. May show some finickyness.
• Passes and asks for things to be passed, but will not carry on table conversa?on.
• Would not stand out among normal people for ea?ng habits.

C. Response to other pa(ents

• Stays all alone or may strike out at other pa?ents.
• Will be with other pa?ents only for a short while and with urging.
• Some signs of friendliness—speaks to pa?ents—may have a friend.
• Some spontaneity in making contacts with other pa?ents. May ini?ate play or work of a social rela?vely high order type (card game, washing dishes).
• Helpfulness expressed toward other pa?ents—or non-­‐hos?le recogni?on of their being mentally ill and making allowances.

D. Response to psychiatric aides and nurses

• Nega?ve—hos?le (can include striking)—doesn’t do anything requested.
• Will do a few things if asked or pushed—shows no open hos?lity.
• Will do most things when asked—will ask for simple things—”I want my toothbrush.”
• Extremely coopera?ve—will do anything when asked.
• Normal give and take rela?onship. Speaks spontaneously to nurses about things of no immediate importance (weather, baseball games, etc.).

E. Response to doctors, social workers, psychologists

• Hos?le
• Passively nega?vis?c (would rather not have anything to do with them but will not resist).
• Will speak when spoken to.
• Seeks advice.
• Understands, accepts, and asks for therapy.

F. Response to electric or insulin therapy

• Hos?le—etc.
• Anxious, apprehensive, but not overly hos?le.
• Passively accepts.
• Accepts posi?vely—(May say, “I feel be_er ager”).
• Asks for, understands necessity for.

G. Occupa(onal therapy and recrea(onal therapy (walks don’t count)

• Does not par?cipate at all—nega?vis?c—hos?le.
• Par?cipates with urging for short periods.
• Par?cipates when asked—some spontaneity.
• Shows interest—par?cipates in all types wholeheartedly without discrimina?ng very much between different types—looks forward to.
• Interested in many varied ac?vi?es—normal selec?vity (likes some kinds more than others).

What pa?ent is most interested in ________________________________________________.

H. AMen(on to dress and person

• Has to be dressed—needs special a_en?on of one kind or another.
• Dresses self but is sloppy.
• Some interest in looks—too much lips?ck, fairly neat.
• Cares about looks and dress. Will ask for makeup or shaving equipment inconsistently (not an overall balance).
• Normal (for culture)—would not stand out in a crowd.

I. Psychomotor ac(vity (not including going to the bathroom or meals)

• Stays in one place unless pushed, or hyperac?ve (seclusion necessary, etc.).
• Moves around a li_le (one chair to another) or if hyperac?ve, the ac?vity is not of a type making seclusion or other restric?ons necessary.
• Some ac?vity resul?ng from the influence of the illness (moves around because voices say to) and some purposeful behavior.
• Behavior mainly purposeful. S?ll moves around a li_le fast or a li_le slow.
• Normal ac?vity—would not stand out among normal people

(If hyperac?ve or stays in one place, which one?) ________________________________________________.

J. Speech

• Mute or speaks a lot but it doesn’t make sense.
• A few words that make sense (“yes” or “no”).
• Speaks in short, clear sentences, “Can I have my toothbrush?”
• Speaks normally except a li_le fast or slow.
• Speaks normally.

(If mute or senseless talk, which one) ________________________________________________.

K. Toilet behavior

• Un?dy any?me during the day and/or more than twice a week nightly.
• Un?dy once or twice a week nightly—brushes teeth and washes only when told to do so.
• Not un?dy—toilet behavior somewhat sloppy—brushes teeth and washes once a day without being
• Toilet behavior normal except for being too neat or too much ?me spent at one thing or occasionally
• Toilet behavior normal.

1. List below anything physically wrong with parent’s arms or
2. List below anything physically wrong with parent’s hearing, sight, and speech
3. List below any physical illness that parent