examples of adaptive behavior assessments

Informed judgments are required about using an adaptive behavior instrument in the evaluation of SSA eligibility based on a diagnosis of mental retardation. Adaptive Behavior Assessment System: Third Edition Chapter Jan 2017 Patti L. Harrison Thomas Oakland View Inventory for client and agency planning Article Mar 1986 Richard Weatherman Robert H.. Deficits in adaptive behavior are defined as non-existent in an individual's effectiveness in meeting the standards of maturation, learning, personal independence, social responsibility and school performance. Thompson et al. Administration of adaptive behavior scales generally follows one of two possible formats. Examples include social skills, cleaning, and personal grooming. There are actually three scales, including a survey form (VABS-S) and an expanded form (VABS-E), which uses a conversation data gathering format during interviews with parents or guardians. However, a recent surgeon general's report (U.S. Department of Health and Human Services, 2001) focuses on the miscommunication that may exist when the interviewer and the respondent speak different languages. Use of 3 to 5 group factor scores, appropriate with the SIB, the VABS, and some other instruments, would not be appropriate with the ABAS. Furthermore, issues are raised about the degree to which existing instruments are able to take into account the cultural context in assessing an individual's adaptive behavior. Norms on children having no disability are available from birth to 18 years, 11 months, based on a standardization sample of 3,000 cases that were stratified by age, gender, ethnicity, parental education, geographic region, and community size consistent with U.S. census data. Interestingly, individuals with mild mental retardation often face their most significant obstacles to competitive employment and job retention arising not from task-related skills, but rather from limitations in their social functioning (Bullis & Foss, 1986; Butterworth & Strauch, 1994; Chadsey-Rusch, 1992; Foss & Bostwick, 1981; Greenspan & Shoultz, 1981; Salzberg et al., 1988; Salzberg, Likins et al., 1986). In order for the assessment to be clinically and scientifically meaningful, it is important that the assessor be sufficiently trained in using and interpreting appropriate instruments. In an unstructured interview, the clinician applies personal, experience-based clinical norms to the adaptive behavior assessment. If it is assumed that maladaptive behavior ratings should not contribute to diagnostic decisions about adaptive functioning, then problems in their measurement need not affect this process. (1991) and Widaman and McGrew (1996) concluded that evidence supported a hierarchical model with four distinct domains: (1) motor or physical competence; (2) independent living skills, daily living skills, or practical intelligence; (3) cognitive competence, communication, or conceptual intelligence; and (4) social competence or social intelligence. Often, these limitations take the form of poor judgment or social rule violations, rather than markedly maladaptive behavior (Greenspan & Granfield, 1992). Jane's The result is that the unique aspects and characterization of individuals with mild mental retardation are no longer the basis for differentiating them from more moderately and severely involved individuals. Consequently, they have difficulty evaluating which potential strategy is best to enact in a particular situation (Hickson et al., 1998; Jenkinson & Nelms, 1994). Nevertheless, there is merit to the idea of considering these subtle indicators of social competence, i.e., vulnerability, gullibility, and credulity, as important indicators of adaptive behavior in people with mild cognitive impairments. Highly structured interviews have unique problems as well. For the most part, such concerns result from considerations of the structure of measures (e.g., as related to items and other factors mentioned in this section), procedures for obtaining information used to complete the protocols, and issues surrounding informant bias. The VABS is available in interview, parent/caregiver rating scale, and teacher rating scale forms, with the former two being applicable for adults up to 90 years of age. The Vineland-3 is a standardized measure of adaptive behavior-the things that people do to function in their everyday lives. Standardization is the process of . Some of these scales were developed to serve only one of these purposes; however, several have attempted to include both the breadth required for diagnosis and the depth required for clinical use. Floor and ceiling effects are also evident as developmental range effects. For example, saying a student is "always getting in trouble" is vague and not measurable. As the importance of adaptive behavior measures in classification of mental retardation has increased, this concern has been heightened as disproportionate numbers of minority children have been identified as having mental retardation, primarily because of low-income status and the overrepresentation of individuals with mental retardation among low-income people (Boyle et al., 1996). Bias refers to a consistent distortion of scores that is attributed to demographic factors, principally nonmodifiable personal characteristics such as age, gender, race, and ethnic or cultural membership. As previously noted, primary concerns in the use of adaptive behavior scales in eligibility determination decisions center on informant bias. Criminal Behavior Adaptive Behavior and Its Measurement Bayley-III Clinical Use and Interpretation Design for a brain Design for a Brain Biology and Neurophysiology of the Conditioned Reex and Its Role in Adaptive Behavior Essentials of Bayley-4 Assessment Intelligent Behavior in Animals and Robots Encyclopedia of Autism Spectrum Disorders This scale is the Psychiatric Assessment Schedule for Adults with Developmental Disability or PASS-ADD (Moss et al., 1996, 1998, 2000; Prosser et al., 1998). Jacobson & C.S. The committee therefore, makes two major recommendations to SSA: Recommendation: Standardized adaptive behavior instruments should be used to determine limitations in adaptive functioning. This type of assessment can be used to identify areas of strengths and weaknesses, as well as needs for support and intervention. The typical adaptive behavior inventory inquires about both the individuals' skills or abilities (what they can do) and about what they usually do in various circumstances (performance of skills or typical performance). Full details on standardization and reliabilities are provided in the manuals associated with the major adaptive behavior scales (Adams, 2000; Bruininks et al., 1996; Harrison & Oakland, 2000b; Lambert et al., 1993b; Sparrow et al., 1984b; see also Harrington, 1985). Another instrument permits adult client self-report (Harrison & Oakland, 2000a), a promising method that needs further study of its feasibility with clients having IQ scores in the range of 60 to 75 (Millham et al., 1978). At the same time, it has been noted that use of adaptive behavior measures in the process of identifying children with mild mental retardation, especially, may be forgone in many schools because the academic failures or behavioral problems that prompt teacher referral of students, in and of themselves, may be considered valid indicators of limitations, deficits, or delays in adaptive behavior (McCullough & Rutenberg, 1988). Sociometric ratings provide useful information but are impractical for diagnostic purposes, and the use of nonstandardized rating forms is not recommended for diagnosis of significant limitations in social skills. are most closely akin to those found in people of normal [range of] intelligence. It is important to note that the terminology used in the ICD-10 is international English rather than North American English, and that, as a result, word usage in ICD-10 is not entirely consistent with contemporary North American terminology with respect to functional limitations or depiction of social performance. Adaptive behavior is the skill set required for a person to care for themselves. In balancing these factors, item density, that is, the inclusion of multiple items reflecting age-typical performance at a range of ages, must be maintained at a fairly uniform level. A second limitation of this scale is that the standardization sample was limited to the state of Florida. In 1936, he introduced the Vineland Social Maturity Scale (VSMSDoll, 1936b), a 117-item instrument. Can the person anticipate the consequences of carrying out different strategies for resolving particular social problems in a given social context. Indeed, by the late 1970s, the number of available adaptive behavior measures, largely interview or observational in format, had burgeoned, including checklists pertaining to vocational behaviors (Walls & Werner, 1977). 7-8). This means that within any one subscale of an adaptive behavior scale, for example, there may be only one or two items typical of performance for a 10-year-old. However, depending on the functional domain and the measure, many people with a diagnosis of mild mental retardation do not have adaptive delays or limitations to this degree. Specifically, a comprehensive adaptive behavior assessment should include information obtained from: 1. Social skills: interpersonal skills . 25. + Purpose of Adaptive Behavior Assessment: To confirm or establish a diagnosis To determine if the child is eligible for special education services To identify specific skills that need to be taught to the child for independent living To determine the child's level of functioning in daily tasks required to be successful in the home . This chapter contains material drawn from an unpublished paper commissioned by the committee from Sharon Borthwick-Duffy, Ph.D., University of California, Riverside. It is reported to be appropriate for ages 5-22, yet it may not have a sufficient ceiling to discriminate performance levels among children above age 14 (Evans & Bradley-Johnson, 1988). Instead, they differentiate individuals with mental retardation based on the supports they need. Another, more open-ended assessment technique is to present a social problem and then to ask the interviewee to relate everything that is going through the protagonist's mind as he or she tries to decide what to do about resolving the problem (e.g., Hickson et al., 1998; Jenkinson & Nelms, 1994). Social-emotional assessments are needed when a child or teenager has problems with anxiety, anger, sadness, or has difficulty interacting with peers, teachers, or parents. For any given age, it is unlikely that developmental tasks will be oversampled. Adaptive behaviors include real-life skills such as grooming, getting dressed, avoiding danger, safe food handling, following school rules, managing money, cleaning, and making friends. Methodologies for assessing consequential reasoning have existed for several decades. How it works: Someone who knows the child well fills out a questionnaire or answers questions about your child. Greenspan and colleagues (Greenspan, 1999; Greenspan & Driscoll, 1997; Greenspan & Granfield, 1992) have argued that social intelligence, some aspects of which are not contained on any current scales of adaptive behavior or social skills (e.g., credulity, gullibility), should be a key determinant of a diagnosis of mental retardation for adults (Figure 4-2). Over the past 25 years there has also been further refinement of the parameters and structure of tests of adaptive behavior and social competence. The ABI has a normative sample representative of all school-age children, including those with disabilities, and of a sample with mental retardation. The World Health Organization (1996) also includes a definition of mental retardation in its International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). But it does seem reasonable, based on clinical experience, that any cutoff scores used should classify a majority of people in this IQ range as having adaptive limitations consistent with mental retardation. An adaptive behavior measure is a specific comprehensive assessment of independent living skills. Some data suggest that ceiling and developmental range effects hinder the full description of skill assets for some individuals with mild mental retardation. Auty and colleagues (1987) have found positive correlations between subtest scores on the TICE and supervisor-rated work skills, self-reported job satisfaction, and worker productivity among adults with mild mental retardation. Vineland Adaptive Behavior Scales are a valid and reliable test to measure a person's adaptive level of functioning. An average five-year-old, for example, would be expected to have adaptive behavior similar to that of other five-year-olds. . Formal Adaptive Behavior Assessments Assessments are used for many different purposes in the K12 educational setting. The report notes that several studies have found that bilingual patients are evaluated differently when interviewed in English as opposed to Spanish. It is also possible that different subcultural expectations about independence or religious or medical causes for certain behaviors may affect the validity of reports. It is appropriate for use with students ages 5 through 18 and is completed by the teacher. Gullibility/Credulity Component of Social Competence. PDF. It is not evident that adaptive behavior scales efficiently differentiate among individuals with diverse disabilities that can be described as mild in degree (e.g., mild mental retardation, hyperactivity, specific learning disability) (Gresham & MacMillan, 1997; Zigler et al., 1984). The ABS-S:2 provides norms only through age 21 and includes some content specifically appropriate for school settings rather than adult environments. In their most recent classification system (American Association on Mental Retardation, 1992), AAMR defines mental retardation as subaverage intellectual functioning existing concurrently with limitations in adaptive skills. In addition, there is the issue of the ability to perform behaviors (i.e., can do) versus the actual performance of those skills (i.e., does do). For example, the Adaptive Behavior Assessment System (Harrison & Oakland, 2000a) is available in four forms: parent, teacher, adult self-report, and adult reported by others. For example, adaptive behavior tests are not as culturally or ethnically bound as tests of intelligence (Hart, 2000; Hart & Risley, 1992; Sparrow et al., 1984a; Walker et al., 1994). Avoiding danger 6. Using IQ as a parallel, it might seem that a reasonable cutoff score on an adaptive behavior scale could be a composite score or several scale scores of two standard deviations below the mean (i.e., 2 SD). The highest level of requirement is Class C, which means that a person has specific training and experience in psychometric assessment and meets other criteria typically consistent with those in the 1985 and more recent Standards for Educational and Psychological Testing. (1984), that adaptive behavior lacks a unifying theoretical foundation. (1999), Jacobson and Mulick (1996), Spector (1999), Hill (1999), Test Critiques, test reviews in the Journal of Psychoeducational Assessment, and the Mental Measurements Yearbooks for more detailed psychometric information about these and other measures. Factor analysis results do not support the existence of more than one overall ABAS general factor. Both structured and semistructured interviews, when performed by well-trained and experienced clinicians, appear to be the best available safeguard against threats to the reliability and the validity of adaptive behavior assessment. These measures have excellent psychometric properties, with reliabilities of about .90. Most tests fall short of accomplishing both purposes. Lowe and his colleagues (2007) categorized problem behavior into four broad groupings including self-injurious behavior, aggression toward persons, destruction of objects, and disruptive behavior. Diagnostic decisions about mental retardation nearly always involve normative comparisons using various derived scores. The standardization sample consisted mostly (80 percent) of adults living in residential facilities, and the overall functioning level of the sample may be lower than if other community-dwelling adults had been included (Harrison, 1998). This nomenclature has dimensions of impairments of body functions, impairments of body structures, activity limitations and participation restrictions, and environmental factors. There is no mention of any standardized cutoffs for adaptive ability, except for mention of the use of scales of social maturity and adaptation in the measurement of adaptive behavior. However, research that indicates a causal relationship between the childrearing practices of minority families in North America and developmental delay is very limited. 1. They made two important points before summarizing their findings: (1) highly correlated factors may indicate that they do not represent independent dimensions and (2) different methods of factor analysis can support different factor structures. In using the term accompanied, the definition suggests that adaptive behavior is a supplementary variable to intelligence, although both criteria must be present. A second part of the ABS-S relates to social and maladaptive behavior. As a result, they may become less available for use in disability determinations. Rather than weighing the likely outcomes of enacting a particular strategy in a given situation, these individuals tend to render global judgments (e.g., whether a strategy is generally a good thing or bad thing to do) when evaluating behavioral options. The standardization samples have been judged to be excellent, although the fact that the sample of people with mental retardation did not include people in the IQ range 71-75 is likely to overestimate adaptive behavior when using the mental retardation norms (Stinnett, 1997). Often, there may be no substitute for assistance by a translator familiar with the informant's dialect, even for examiners who are fluent in the informant's primary language. Very recently Greenspan (1999) proposed ideas for assessing vulnerability in a comprehensive assessment of adaptive behavior or social competence. In Chapter 1 we summarized the history of definitions of mental retardation and discussed their relevance to the Social Security Administration's definition. The Social Skills Rating System, described below, is a behavior rating scale that was developed to provide this information for students. Vineland Adaptive Behavior Scales What it measures: How a child's daily living skills compare to those of other kids his age. It consisted of 3,000 children ages birth through 18 years 11 months of age, including 99 children in special or gifted education among the 2,500 who were of school age. The issue of sociocultural bias also arises in the context of the adaptive behavior interview. There are many different ways to assess . For example, a percentile rank of 41 indicates that the examinee scored higher than (or the same as) 41% of the age-matched norm . Mastery assessments typically involve direct testing of a person with a set of tasks administered under standardized conditions that permit comparisons to norms or to absolute standards for performance. Behavior identification supporting assessment 2. Translation is a concern because the comparability of translations of items has seldom been confirmed through back-translation from the translated content to the initial language, or through confirmatory analysis through further retranslation (Craig & Tasse, 1999). The committee has identified several measures that would be useful in disability determination for mental retardation. In addition, there is a strong need to fund studies examining the nature and distribution of adaptive behavior deficits among individuals with mental retardation in general and those with mild mental retardation more specifically. Thus, adaptive behavior scales have particular relevance in application with preschoolers and with teens, who are often participants in Supplemental Security Income (SSI) determinations or redeterminations. Assessment of adaptive behavior should include social competence, play and leisure skills, and self-help/independent living skills. Adaptive behavior assessment aims at assessing the emotional and social maturity of a child in comparison to his/her peers, along with practical life skills ("The diagnosis of intellectual disabilities," 2020). The definitions also vary as to whether they consider adaptive behavior to be made up of a single factor or to have multiple factors or domains. The committee discussed the use of specific numeric cutoff points at which a marked deficit is present. Chapter 4, The Role of Adaptive Behavior Assessment. Thompson et al. Many of the parents of children suspected of meeting criteria for mild mental retardation may themselves experience cognitive difficulties and are relatively nonverbal (Ramey et al., 1996), making semi- or unstructured interviews much more difficult to conduct in a standardized manner. If not, diagnosticians would have to consider a profile of adaptive behavior deficits that takes all domain scores into account. One concern that emerged over time was that it was developed and normed for use with children and youth. concluded: No single adaptive-maladaptive behavior assessment instrument completely measures the entire range of adaptive and maladaptive behavior dimensions. Clinicians may consequently believe adaptive behavior to be less well understood than intelligence. The instrument's structure must guide interpretation. Individuals with mental retardation often demonstrate difficulties at the most basic level of recognizing specific types of social cues (e.g., recognizing a person's emotional state on the basis of his or her facial expression) (Adams & Markham, 1991; Gumpel & Wilson, 1996; Harris, 1977; Hobson et al., 1989). ABS-RC:2 norms are not available for adults with typical functioning, and most norm-referenced scores provide comparisons only with adults with developmental disabilities. Reliabilities are initially assessed at the item level and then at the scale and factor levels. This has generalized to adaptive behavior measures. Thus, most norming samples, item development, and scale selection have been targeted at groups ages 3 to 18 or 21. The information obtained from this type of evaluation can clarify the nature and extent of the limitations those individuals with mild mental retardation experience in adapting their behavior to meet the social demands and expectations of the school, workplace, and recreational and residential settings. The inability to adjust to a situations or different situations is known as maladaptive behavior. The available instruments include indirect assessments, such as rating scales that assess an individual's typical performance of social behaviors based on information from informants, including teachers, parents, and job coaches, as well as instruments that permit direct assessment of the processes that, according to theoretical models of successful social adaptation, underlie the ability to perform situationally appropriate behavior. They have provided valuable information that has informed decision making about interventions to improve the social functioning of individuals with mental retardation. These three processes occupy a prominent place in most theoretical models of social cognition (e.g., Crick & Dodge, 1994; Gumpel, 1994; Leffert & Siperstein, in press; McFall, 1982). However, this also means that most scales are structured in steps that permit sampling of typical developmental tasks at each age. As a result, the committee commissioned Monte Carlo simulations to understand better the implications of requiring a specific numeric cutoff point. In some definitions (Division 33 and AAMR), adaptive behavior is construed as distinct from intellectual functioning and of equal importance, while in other definitions it is considered a result of deficits in intellectual functioning. The value of such instruments will depend on careful decisions about instrument choice, score interpretation, and consideration of other information that bears on adaptive status. The expanded version is designed to meet the requirements of diagnosis and of planning/intervention, and is intentionally longer and more detailed in order to ascertain information on specific skill deficiencies. Consider using a formal rating scale (for example, the Aberrant Behavior Checklist or Adaptive Behavior Scale) to provide baseline levels for the behaviour and a scale (such as the Functional Analysis Screening Tool) to help understand its function. In adolescence and adult life: vocational and social responsibilities. Problems with assessing long term and short term adaptation One problem with assessments of adaptive behavior is that a behavior that appears adaptive in the short run can be maladaptive in the long run and vice versa. The Maladaptive Behavior domain provides a brief assessment of problem behaviors. All of the measures above have demonstrated concordance with psychiatric diagnosis. What are examples of adaptive behaviors? The Adaptive Behavior Assessment System (Harrison & Oakland, 2000a) is quite new and relatively untested, but its psychometric properties and norms extend to age 89. Adaptive behavior scales are structured to be comprehensive without being cumbersome (Adams, 2000). However, teachers have limited opportunities to observe all behaviors on the VABS-C and must necessarily provide estimates of behaviors that do not occur in the school context. At first glance, current definitions seem to be quite similar; however, there are subtle differences in the conceptualization of adaptive behavior that may affect the outcomes of diagnostic decisions for individuals with mental retardation, particularly those in the mild range. This consensus rests on the accumulated wisdom in the field of mental retardation, including the fact that adaptability in meeting the demands of everyday living was fundamental to conceptions of mental retardation long before effective tests of intellectual functioning were developed. For example, the Test of Social Inference (TSIde Jung et al., 1973) employs the technique of presenting an individual with mild mental retardation with illustrations of common social situations and asking him or her, for each illustration, to tell the examiner what the picture is about. The Vineland Adaptive Behavior Scales (VABSSparrow et al., 1984a) have their conceptual roots in the Vineland Social Maturity Scale (Doll, 1936b), although overlap between the original and the new scales is minimal (Kamphaus, 1987b). Because adaptive behavior scales are targeted either specifically at children and adolescents or at groups ranging from children to young adults, there is a strong developmental component to their structures (Widaman et al., 1987). Is the person familiar with and able to think of a variety of strategies that are potentially appropriate for resolving social problems? Thus, characteristics of the factor structure of a measure of adaptive behavior have important implications for diagnosis. The DSM-IV definition identifies four levels of mental retardation based on IQ: mild, moderate, severe, and profound. The instrument must be appropriate to the age of the client and the client's approximate functioning level. The proportion of children from homes with low socioeconomic status was lower than that in the census data. Commonly used tests of adaptive functioning are described below: Woodcock-Johnson Scales of Independent Behavior: This test measures independent behavior in children. Widaman and McGrew (1996) further argued that agreement on a common set of terms for domains of adaptive behavior (in contrast to the use of or as above) would contribute to a better consensus on the structure of adaptive behavior. His work emphasized social inadequacy due to low intelligence that was developmentally arrested as a cardinal indication of mental retardation (Doll, 1936a, p. 35). For example, individuals with very high adaptive performance may be impatient with red tape, resistance to change and organizations that prioritize group harmony over performance. If there is actually one underlying domain that causes behaviors in all different conceptual domains, and there is relatively little unique variance found in each domain, then a total score with a single cutoff point could reliably distinguish those with and without significant limitations. Skills assessed with ABAS-III. This facilitates the early identification of preschool children at risk of mental retardation and permits confirmation of persisting developmental delays. National Research Council (US) Committee on Disability Determination for Mental Retardation; Reschly DJ, Myers TG, Hartel CR, editors. Personal competence model. In the recent Manual of Diagnosis and Professional Practice in Mental Retardation (Jacobson & Mulick, 1996), Division 33 of the American Psychological Association put forth a definition of mental retardation that emphasizes significant limitations in intellectual functioning and adaptive behavior. Greenspan (1999) also has argued for many years that the presence of maladaptive behavior, or mental illness, is irrelevant for the purpose of diagnosing of mental retardation. These messages, known as social cues, consist of verbal and nonverbal stimuli, such as physical actions, words, facial expressions, tone of voice, and body language, which tell about others' behaviors, feelings, and intentions. By the close of the 19th century, medical practitioners diagnosing mental retardation relied on subjective or unsystematic summaries of such factors as age, general coordination, number of years behind in school, and physiognomy (Scheerenberger, 1983). 21 and includes some content specifically appropriate for use with children and youth families North! Assessments Assessments are used for many different purposes in the K12 educational setting living skills noted, concerns! Known as maladaptive behavior and environmental factors reliabilities are initially assessed at scale... For assessing consequential reasoning have existed for several decades consequences of carrying out different for... 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