Illinois Administrative Code
Title 89 - SOCIAL SERVICES
Part 144 - DEVELOPMENTAL DISABILITIES SERVICES
Table B - Staff Intensity Scale

Once or More Per:

Day

Week

Month

Year

Coercive Sexual Behavior

1) Touches or grabs others' genitals without their consent and/or is aggressively affectionate but will cease engaging in behavior(s) upon request.

______

______

______

______

2) Intimidates (without injuring) another to engage in sexual behaviors not including penetration of bodily orifices.

______

______

______

______

3) Intimidates (without injuring) another to engage in sexual behaviors including penetration of bodily orifices.

______

______

______

______

4) Injures victim in the course of a sexual attack which may or may not include penetration of bodily orifices.

______

______

______

______

Once or More Per:

Day

Week

Month

Year

Offensive Bodily Exposure

1) Engages in partial or full nudity or genital exposure in view of others in inappropriate locations within the treatment setting only.

______

______

______

______

2) Exposes self (not including genitals) in a manner offensive to others when outside the treatment setting.

______

______

______

______

3) Exposes self (including genitals) in a manner offensive to others when outside the treatment setting.

______

______

______

______

Once or More Per:

Day

Week

Month

Year

Suicide Threats and Attempts

(These behaviors imply purposeful suicidal action as opposed to self-injurious actions or pica behavior devoid of conscious suicidal intent.)

1) Threatens to commit suicide, may or may not be specific how and does not attempt to injure self (e.g., states, "I'm going to kill myself," but does not follow statement with action).

______

______

______

______

2) Purposefully engages in behavior that could be fatal, with or without precursory threats, but discontinues behavior upon verbal intervention without injuring self.

______

______

______

______

3) Purposefully engages in behavior that could be fatal, with or without precursory threats. Injures self, or is prevented from self-injury only by physical staff intervention.

______

______

______

______

Once or More Per:

Hr.

4 Hrs.

Day

Week

Month

Pica

1) Mouthing and licking of non-food objects or compulsive and excessive eating and/or drinking of food and liquids.

______

______

______

______

______

2) Consumption of non-food objects in volume small enough to be not life-threatening, e.g., small pieces of rubber, plastic or fabric, soil, small nuts and bolts, grass, etc.

______

______

______

______

______

3) Consumption of life-threatening materials such as paint, cleaning compounds, soap, boiling liquids, sharp objects, large objects that may cause alimentary blockages, or small objects (as in subsection (d)(2) above) in large enough volume to be life-threatening.

______

______

______

______

______

Once or More Per:

Day

Week

Month

Verbal Abuse

1) Uses mocking and teasing language.

______

______

______

2) Uses language hostile in tone (e.g., sarcastic or intimidating) or content, whether obscene or not; may yell or scream threats of violence without designating a specific person as a target.

______

______

______

3) Directly and explicitly threatens specific others with physical harm or violence.

______

______

______

Once or More Per:

Day

Month

6 Mo.

Mania

Engages in constant activity marked by bizarre behavior, incoherent speech and a nasty response if ignored or crossed.

______

______

______

Once or More Per:

Day

Month

6 Mo.

Inappropriate Affect

Displays emotional tone that is incongruent in general form or degree, with the idea, object or thought accompanying it. Lack of emotional tone ("flat" affect) or incongruent and changing emotional tone ("labile" affect).

______

______

______

Once or More Per:

Day

Week

Month

Manipulative Behavior

1) Circumvents authority by asking successive individuals in authority the same question/request until receiving the desired answer or permission.

______

______

______

2) Exchanges items of unequal values to own benefit, e.g., trading a candy bar to get a coat.

______

______

______

3) Lies about others to get them into trouble or to obtain a self-serving goal; or uses another person as an agent to perform unlawful, unacceptable or dangerous acts.

______

______

______

Once or More Per:

4 Hrs.

Day

Week

Month

Physical Assault

1) Light striking, kicking, pushing of others that is purposeful, but does not appear to cause pain to the target person.

______

______

______

______

2) Purposeful attack of others that causes reddening of the skin of the target person.

______

______

______

______

3) Purposeful attack of others that causes superficial injury or injuries requiring medical attention.

______

______

______

______

4) Attacks with intent to cause severe injury (e.g., broken bones) using potentially lethal force with or without use of weapon.

______

______

______

______

Once or More Per:

Day

Week

Month

6 Mo.

Property Theft

1) Takes others' belongings of little or no monetary value or importance - may be indicative of hoarding.

______

______

______

______

2) Steals for personal use; or steals belongings of moderate or greater monetary value or importance (advance planning is involved); may barter or sell goods taken.

______

______

______

______

Once or More Per:

Day

Week

Month

Substance Abuse

1) Uses alcohol or non-addictive substances to become intoxicated.

______

______

______

2) Has an alcohol dependency.

______

______

______

______

3) Is addicted to a controlled substance.

______

______

______

______

Persons who use tobacco products or alcohol at levels that do not produce intoxication should not be scored on this item.

Check box if condition is present regardless of frequency.

Once or More Per:

Day

Week

Extreme Irritability

1) Acts fretful or annoyed in an overly reactive manner to an extent that interferes with own social functioning and/or upsets others.

______

______

2) Displays anger in an overly reactive manner that staff perceive as potentially resulting in physical aggression.

______

______

Once or More Per:

Min.

Hour

4 Hrs.

Day

Hyperactivity

1) Moves about area continuously in a somewhat predictable and moderately-paced manner.

______

______

______

______

2) Moves around area continuously in a seemingly random and very rapid manner.

______

______

______

______

3) Bounces up and down or is in and out of chair/ place/work station continuously.

______

______

______

______

Once or More Per:

Day

Week

Month

Temper Tantrums

1) Makes inconsequential verbal threats and/or cries loudly, jumps up and down or stamps feet when angered.

______

______

______

2) Threatens others physically when upset and/or curses and kicks or hits objects briefly.

______

______

______

3) Yells loudly, thrashes about, kicks, cries and presents what appears to be an imminent danger to others.

______

______

______

Once or More Per:

Day

Week

Month

6 Mo.

Wanders, Roams, Runs Away

1) Wanders away from immediate supervision but returns when called.

______

______

______

______

2) Runs away or wanders out of sight and does not return when called even though still within hearing distance.

______

______

______

______

3) Sneaks away for hours or longer.

______

______

______

______

Once or More Per:

Week

Depression or Excessive Withdrawal

1) Is under-responsive to normal social interactions; inactive; may be quiet and unusually passive.

______

2) Rejects contact with others; refuses formerly preferred reinforcers; may be inactive, quiet and passive; refuses to eat.

______

Once or More Per:

Day

Month

6 Mo.

Year

Hallucinations

Talks or acts as if experiencing sensory events that others do not (e.g., hearing voices) at various times and places and to an extent that it disrupts or interferes with socially adaptive responses.

______

______

______

______

Once or More Per:

Day

Month

6 Mo.

Year

Delusions

Talks about ideas and events that have no basis in fact and, in spite of evidence to the contrary, to an extent that it disrupts or interferes with his or her socially adaptive responses.

______

______

______

______

Once or More Per:

Day

Week

Month

6 Mo.

Year

Fire-Setting

1) Plays with matches, open flames and/or cigarette lighters. May have accidentally set objects on fire; potential small danger to self or others.

______

______

______

______

______

2) Collects or locates flammable materials, such as paper or leaves, to use in setting small fire; or starts fires in contained vessels, such as waste-baskets, garbage cans. Overall potential moderate danger to others.

______

______

______

______

______

3) Sets a large fire, such as a bed or draperies, which has the potential for burning a room or a building; may or may not use an accelerant.

______

______

______

______

______

Once or More Per:

Min.

4 Hrs.

Day

Self-Injurious Actions

1) Purposefully inflicts a blow or bite to self that causes reddening of the skin.

______

______

______

2) Purposefully inflicts a blow or bite to self that causes superficial injury requiring medical attention.

______

______

______

3) Purposefully inflicts on oneself a blow that causes severe injury (e.g., broken bone) or a bite that removes a large amount of tissue.

______

______

______

Once or More Per:

4 Hrs.

Day

Week

Handles/Plays With Bodily Wastes

1) Plays or touches rectum or genitals; small amount of fecal materials or urine found on hands.

______

______

______

2) Smears feces or urine on own clothing and body; hoards feces on person or in room.

______

______

______

3) Smears feces or urine on others or on nearby objects.

______

______

______

4) Eats feces or urine.

______

______

______

Once or More Per:

Day

Week

Month

6 Mo.

Property Destruction (excluding firesetting).

(Please note that the primary maladaption here is property destruction rather than self-injurious actions or assaults that may also cause property destruction.)

1) Purposefully damages own or others' property resulting in a projected negligible or minor repair/replacement cost.

______

______

______

______

2) Purposefully damages own or others' property with a projected major repair/replacement cost.

______

______

______

______

Once or More Per:

Day

Week

Month

Resists Supervision

1) Will not comply with staff request to act in a considerate manner (e.g., plays radio too loud, cuts in line) or refuses to comply with staff instructions to correct behaviors or engage in behaviors affecting self in a minor way (e.g., with not bathe regularly, will not brush teeth).

______

______

______

2) Refuses to comply with demands to cease behavior or to cooperate, thus significantly disrupting ongoing activities or the living unit in general.

______

______

______

3) Refuses to cease behavior constituting imminent and significant danger to self or others.

______

______

______

Once or More Per:

Min.

Hour

4 Hrs.

Day

Stereotypical Behavior

Repetitive motor or verbal activity, including self-stimulation, which does not serve meaningful purposes (e.g., string twirling, bizarre limb or body movements, rocking, repeated verbalizations; DOES NOT INCLUDE self injurious behavior or masturbation.

______

______

______

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