Together, our team sorted through the entire DSM-V, ICD-10, rating scales and evidence-based interventions to identify over 1,000 shapeable behaviors. We then resolved any duplicates, followed by modifying the language to be more colloQuial. We grouped the remaining behaviors based on their similarities, instead of by diagnostic criteria because behaviors are rarely specific to a single disorder. These behavioral groupings were then reviewed by child psychiatrists, one of TokenLogger’s key target audiences. From this process, the Electronic Lexicon of behavioral Expressions, the ELLE, was created.
The Elle includes 479 individual behavioral items that can be tracked in TokenLogger with the aim of increasing or decreasing their frequency, as is appropriate. These behaviors are arranged into 63 Clusters, or focused underlying groups of related behaviors. These clusters constitute 10 Behavioral Domains.
The 10 Domains organize behaviors by similarities, rather than by diagnosis.
These domains cover a broad range of phenomena. For example: obsessions and habits in the 3rd domain: Behavior, memory and body image in the 6th domain: Cognition, eating and sexual behavior in the 8th domain: Health.
Determining which of the 479 items are relevant for a specific child can be a daunting task. In order to assist in this process, we developed the Strengths and Resilience Questionnaire, the SRQ. This broad range screening instrument addresses the 63 previously identified clusters.
The 63 SRQ dimensions are rated by clinicians, parents, teachers, or others, along a continuum, with each pole being an extreme and “typical” hovering around the center of the dimensional rating line. As a screening tool, the SRQ identifies clusters that may require further exploration or intervention. TokenLogger is one of the possible intervention tools.
In this example, the raters identified a child functioning on the left extreme of the Attention/Concentration scale. This suggests that the child struggles with being unfocused. We can also see the raters placed the child near the center for the rest of these clusters because planning and organization, memory, and self-concept are not perceived as problematic areas. Since the Attention/Concentration cluster is problematic in our example, the items in this cluster will appear in the TokenLogger applet to be retrospectively and prospectively tracked. Let’s see how that works!
Let’s take a look at the Tokenlogger applet inside Mindlogger!
Here’s the activity page where you choose to track behaviors in real time, log behaviors that happened in the past, or redeem tokens earned.
Like all MindLogger activities, these can also be scheduled in advance and started by tapping on a push notification sent to the user’s phone.
Let’s track some behaviors in real time. (clicks track prospectively)
The preset session lengths can be easily modified as needed on the mindlogger applet builder. Let’s choose 10 minutes. (clicks 10 minutes)
Now you can tap on the buttons to log behaviors as they happen.
Let’s say you observed your child concentrating.
Once a behavior is logged, you can use the round button on the right to add background information.
The time is filled automatically from when you tapped the behavior button earlier. We’ll use the 2D slider to add distress and impairment associated with this instance of the behavior.
Let’s take a closer look at the diamond shaped 2D slider.
The bottom of the diamond represents no distress and no impairment, the left corner is high distress, but no impairment, the top is both high distress AND high impairment, and the right corner is no distress but high impairment. The user can place and drag the green dot anywhere in the diamond to rate these two scales simultaneously with one quick gesture.
(clicks back to behavior screen)
Now we’ll return to tracking behaviors as they happen.
(show time elapse screen)
(timer to 8:11, behaviors a logged)
You can also pause the session as needed.
(show adding background info for a behavior)
Adding background information won’t restart the timer, but the timer will restart when you log a behavior again.
(show a new behavior being logged and timer starting again)
(timer reaches 10:00, behavior buttons are deactivated)
Time’s up! We can no longer log new behaviors for this session, but we can use this time to finish adding some background information.
Let’s hit next.
Now we’ll add location information for this session.
Let’s hit next.
We can now examine a summary of the tokens earned this session.
Behaviors in blue are those we want to increase in frequency; tokens are rewarded each time a behavior is recorded.
Behaviors in purple are those we want to decrease in frequency; tokens accrue for these behaviors over time. The less these behaviors occur, the more tokens are earned.
Tokens are also awarded for completing behavior background information.
(hit next and return to activity page)
(open data tab)
Tokens and behavior frequency can be tracked by visiting the TokenLogger data tab.
Clinicians or caregivers are also able track a child’s progress by viewing TokenLogger data on an interactive dashboard in the web-based MindLogger admin panel. This data can be exported into a report which can then be stored within a user’s electronic medical record.