{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T13:27:21Z","timestamp":1770989241243,"version":"3.50.1"},"reference-count":49,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&R"],"published-print":{"date-parts":[[2026,2]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Challenging behavior (CB) following acquired brain injury (ABI) has a direct impact on safety, the rehabilitation process, and societal participation. Early behavior management in inpatient rehabilitation (IPR) settings guided by appropriate assessment tools is critical for maximizing gains in IPR and successful community integration of individuals with CB following ABI.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess the validity and reliability of the Overt Behavior Scale\u2013In Session (OBS\u2010INS), a behavioral assessment tool created for the measurement of CB following ABI in IPR.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Mixed\u2010methods study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n An IPR facility that specializes in brain injury rehabilitation.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Nineteen of 54 adults (\u2009\u226518\u2009years of age) admitted under the services of the primary investigator following ABI (8 sustained a traumatic brain injury, 10 sustained a cerebral vascular accident, and 1 sustained an anoxic brain injury) participated in the validation of the OBS\u2010INS. Twenty trained clinicians participated in assessing the reliability of this measure.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Not applicable.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n OBS\u2010INS Clinical Weighted Severity ratings were compared to the Agitated Behavior Scale (ABS), Disability Rating Scale (DRS), and the Berg Balance Scale for convergent and divergent validity. Inter\u2010 and intrarater reliability were determined following video\u2010rating sessions with trained clinicians. Clinicians also completed a study\u2010specific questionnaire determining the utility of the OBS\u2010INS in improving interdisciplinary communication, intervention selection, and discharge planning.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A strong positive correlation was found between the OBS\u2010INS CWS and ABS scores (\n r<\/jats:italic>\n \n s<\/jats:italic>\n <\/jats:sub>\n \u2009=\u2009.815,\n p<\/jats:italic>\n \u2009<\u2009.001) with a strong correlation between the OBS\u2010INS CWS and DRS discharge scores (\n r<\/jats:italic>\n \n s<\/jats:italic>\n <\/jats:sub>\n \u2009=\u2009.409). Interrater reliability (intraclass correlation coefficient\u2009=\u20090.982; [.929\u20131.00]) was excellent, and intrarater reliability (\n r<\/jats:italic>\n \n s<\/jats:italic>\n <\/jats:sub>\n \u2009=\u2009.825,\n p<\/jats:italic>\n \u2009<\u2009.001) was strong. Most clinicians (85%) reported that the OBS\u2010INS was effective in measuring CB following ABI and was beneficial for interdisciplinary communication.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The OBS\u2010INS is a valid and reliable tool for assessing CB in individuals with ABI in IPR and promotes effective interdisciplinary communication.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pmrj.13448","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T14:51:28Z","timestamp":1755615088000},"page":"162-172","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Overt Behavior Scale\u2013In Session: A behavioral assessment tool for individuals with acquired brain injury in the inpatient rehabilitation setting"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1412-4220","authenticated-orcid":false,"given":"Ileana","family":"Herrin","sequence":"first","affiliation":[{"name":"TIRR Neurobehavioral Program TIRR Memorial Hermann Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsey","family":"Harik","sequence":"additional","affiliation":[{"name":"TIRR Neurobehavioral Program TIRR Memorial Hermann Houston Texas USA"},{"name":"Department of Physical Medicine and Rehabilitation McGovern Medical School at UTHealth Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Larkin","sequence":"additional","affiliation":[{"name":"TIRR Neurobehavioral Program TIRR Memorial Hermann Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8156-9060","authenticated-orcid":false,"given":"Grahame","family":"Simpson","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Faculty of Medicine and Health University of Sydney Sydney New South Wales Australia"},{"name":"John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Falco","sequence":"additional","affiliation":[{"name":"TIRR Neurobehavioral Program TIRR Memorial Hermann Houston Texas USA"},{"name":"Department of Physical Medicine and Rehabilitation McGovern Medical School at UTHealth Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chynah","family":"Blankenship","sequence":"additional","affiliation":[{"name":"TIRR Neurobehavioral Program TIRR Memorial Hermann Houston 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