VIDBE-Q Volume 65 Issue 2
58
intellectual/cognitive disabilities (65-68%), and complex health care needs (51-
53%) (NCDB, 2019).
Children with multiple disabilities often have complex physical, sensory,
developmental and health challenges which can have a significant impact on their
"availability for learning." This term may be used generally to describe readiness
or attention, but specifically, it refers to the biobehavioral states that are necessary
in order to process information and experiences. Biobehavioral states encompass
the combination of internal and external factors that influence the condition of a
person at any particular moment (also referred to as "arousal" or "alertness").
Guess and colleagues (1988; 1990) addressed the subject of biobehavioral
state assessment for students with the most profound multiple disabilities in over
10 research studies between 1988-1996. Their Behavioral State Observation Scale
(1988; 1993), adapted in part from Brazelton's (1978) Neonatal Behavioral
Assessment Scale and Wolff's (1959) observations on infant arousal states, used
nine major behavior state codes: Asleep-Inactive, Asleep-Active, Drowsy, Daze,
Awake Inactive-Alert, Awake Active-Alert, Awake-Active/Stereotypy,
Crying/Agitated, and Seizures (Richards & Richards, 1997). Munde et al.'s
literature review (2009) analyzed a number of studies addressing "alertness in
individuals with profound intellectual and multiple disabilities." This review shows
many subsequent adaptations of Guess' scale and coding system, as well as varied
