They can contribute to accurate and appropriate clinical diagnosis of concurrent conditions that may meet listing requirements for SSI and DI as an alternative to assessment of adaptive behavior. This refinement was based on large samples of research participants and data from service registries (McGrew & Bruininks, 1990; Siperstein & Leffert, 1997; Widaman et al., 1987, 1993). A strength of this scale is that teachers are asked to record when they estimate behaviors, so the resulting threat to reliability and validity can be appraised. With regard to identifying decision-making criteria, Division 33 presents the only definition that employs a statistical cutoff based on standard norms. There are vast differences in how the third-party respondent reports on the adaptive behaviors of a client, particularly in the structure for the interview. Among these four definitions, there is little variation in the intelligence construct for individuals with mental retardation. Thus, social-cognitive assessment increases the likelihood of making accurate diagnostic and disability determination decisions by increasing the pool of information available to an examiner regarding an individual's functional limitations, while simultaneously reducing the risk of false positive decisions. Adaptive behavior also includes the ability to work, practice social skills, and take personal responsibility. Comparative research examining the relationship between minority status and pronounced delays that are not accounted for by socioeconomic factors is also limited. He suggested that the SSSQ could provide useful data when combined with the results of other comprehensive tests. Reliability is good. Formal Adaptive Behavior Assessments Assessments are used for many different purposes in the K12 educational setting. The primary use of adaptive behavior scales in the classification of mental retardation has frequently been confirmatory (i.e., to confirm that a low IQ is associated with delayed acquisition or manifestation of everyday personal and social competencies). 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. Toileting 3. The SIB provides norms from infancy to adulthood (40+ years), contains 14 adaptive behavior subscales that fall into four major clusters, and provides an additional full-scale broad independence score. Can the person anticipate the consequences of carrying out different strategies for resolving particular social problems in a given social context. In such instances, if a same-language or same-culture interviewer is not available, the clinician needs to be very aware of such possible miscommunications in order to obtain a valid interview. Their repertoires often exclude certain types of socially adaptive strategies. This information may otherwise be lacking because of inadequacies in existing adaptive behavior measures. Examples include social skills, cleaning, and personal grooming. On one instrument, the items are shown to the respondent and the respondent is given responses from which to choose (e.g., Bruininks et al., 1996), while in another the interviewer is required to assess adaptive competencies through a general conversation with prompts such as Tell me about Thomasina's language skills (Sparrow et al., 1984a). Traditional measures of achievement and intellectual functioning are examples of maximum performance tests. Although it is linked to AAMR by name, the ABS does not provide subscale scores in the 10 adaptive skill areas listed in the 1992 AAMR definition of mental retardation. Infants and toddlers may more appropriately be assessed with more specialized measures in most cases. The adaptive behavior construct has both typical performance and maximum performance elements, a characteristic that complicates measurement operations. Nonetheless, culturally competent assessment practices require consideration of the developmental impacts of cultural practices or language differences among examiners, examinees, and informants that may affect the validity of the clinical information collected and interpreted. Such scales sample behaviors that are typically achieved at a range of ages and can indicate strengths and weaknesses in the ability to adapt. (2000) mention the utility of adaptive behavior measures as components of multidimensional models of functioning and child psychopathology but did not include any adaptive behavior scales in an extensive listing of prominent measures that are currently used in psychological testing in schools. However, depending on the nature of these provisions, they may reduce the comparability of measures of the related skills from different adaptive behavior scales. The skills or abilities items may be readily assessed through direct measures of the individual with behavioral tasks, while performance or does-do features can be assessed only through extensive behavioral observations that often are impractical given the breadth of the adaptive behavior construct and the number of relevant settings. Some caution is needed in interpreting these findings, because the study is small and unrepresentative. An alternative explanation is that adaptive behavior must be understood in the context of the individual's relevant daily and social life, which is determined by age, culture, and context (Thompson et al., 1999). These procedures, however, need to be employed using an instrument that is reliable, has valid criteria for evaluating adaptive behavior, and uses empirically based norms. 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. 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. Although developed for school-age children, this scale may hold promise for adapted use with adults in work settings. Adams (2000), in contrast, uses a mixture of typical performance with third-party respondents and maximum performance operations. National Academies Press (US), Washington (DC). Factor analyses of existing measures finds consistent domains of functioning. A psychologist, social worker, or other professional who has appropriate training in interview techniques must complete these forms. There seems to be little evidence that adaptive behavior assessment is as prone to cultural, racial, and ethnic bias as other areas of psychological testing. 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. For the Scales of Independent Behavior-R (Bruininks et al., 1996), the norming sample included 2,182 people ages 3 years 11 months to 90 years, with a sampling frame based on the general population of the United States stratified for gender, race, Hispanic origin, occupational status, occupational level, geographic region, and community size. Research studies in the past decade that employ adaptive behavior measures have used them as outcome measures or to study the structure or dimensions of adaptive behavior, rather than behavioral development. Meyers et al. Most adaptive behavior instruments have a number of subscales or subtests that measure four to six broad areas of independence. Assessments work best when they document: (a) quantitative level of performance, (b) fluency of performance (e.g., qualitative criterion performance), (c) the extent to which the individual has failed to acquire skills or failed to perform skills already learned, and (d) the inability of the individual to perform skills through lack of opportunity. Nonetheless, available research on the clinical use of adaptive behavior scales for diagnosis and treatment-related purposes by either school psychologists or community clinical psychologists appears to be relatively sparse and does not focus on groups of people with mental retardation, as such (i.e., Clinger et al., 1988; McNamara et al., 1994; Pearson & Lachar, 1994; Roberts et al., 1993; Voelker et al., 1990; Wolber et al., 1997). SOURCE: Greenspan and Driscoll (1997). Vineland-II forms aid in diagnosing and classifying intellectual and developmental disabilities (IDD, formerly known as mental retardation) and other disorders, such as autism spectrum disorders and developmental delays. . Some of the more common and relevant response sets are (a) social desirability, involving responses consistent with positive or desirable connotations of the items or behaviors, (b) acquiescence, involving the tendency to say yes, true, or, in cases in which knowledge is lacking or uncertain, sometimes, and (c) halo effects, involving reporting higher adaptive behavior among persons who are more liked by the respondent. The assessment of social perception skills in individuals with mild mental retardation has involved a variety of instruments, with subsequent methodological refinements, which have been developed and employed over four decades with children, adolescents, and adults. One-half of children (and adolescents) with diagnosed mental retardation did not have summary scores falling in this range. 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. The Comprehensive Test of Adaptive Behavior (CTABAdams & Hartleben, 1984) has been described as fairly efficient and inexpensive, with excellent reliability, solid validity, and adequate norms (Reschly, 1990). Mental Retardation: Determining Eligibility for Social Security Benefits. The review by Thompson et al. 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. Reviews of the ILS have been generally negative, and it may not be suitable for disability determination purposes. Interpretation of ABAS-II Results Adaptive Behavior Composite Scores The General Adaptive Composite score (GAC) summarizes performance across all skill areas excluding Work. The frequency of performance can be classified along a dimension from never to usually or always. The number of choice points varies by specific instrument or by the variation in the clinical interpretation of the assessor when a formal assessment instrument is not used. Some data suggest that ceiling and developmental range effects hinder the full description of skill assets for some individuals with mild mental retardation. It also appears that community practitioners, aside from those associated with developmental disabilities clinics or centers or with community developmental disabilities services, may not be well versed in the use and interpretation of adaptive behavior measures or prepared to apply different measures in different situations for different purposes. For this reason, some manuals recommend that clinicians fully explore the nature of tasks that the focal person performs that may be age typical (e.g., Sparrow et al., 1984a). Finally, the committee has identified a number of research areas, focusing on which would improve the measurement of adaptive behavior for mental retardation diagnosis. Developers have addressed this issue through several strategies: (1) assessing the interrater and test-retest reliabilities of measures, (2) providing instructions to raters for coding items (e.g., Sparrow et al., 1984a), and (3) specifying training for clinicians and preparation of raters (e.g., Bruininks et al., 1996). Social competence model. Standard scores, age-equivalent scores, and percentile rank scores can be converted from raw scores on the adaptive behavior subscales and three factor scores for ages 3-21. The Adaptive Behavior Assessment System (Harrison & Oakland, 2000a) is quite new and relatively untested, but its psychometric properties and norms extend to age 89. These assessment instruments, which have been useful in instructional contexts, can also be valuable for the evaluation of an individual's eligibility for SSA services. With regard to the direct assessment of processes, the overarching construct of social cognition has been put forth by developmentalists over the past four decades (e.g., Crick & Dodge, 1994; Dodge, 1986; McFall, 1982; Trower, 1982). 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. Regarding strategy repertoires, for example, researchers have found that children and adults with mental retardation have a limited repertoire of appropriate social strategies to draw from (Herman & Shantz, 1983; Smith, 1986). This chapter has discussed problems with item and score scale floors and ceilings, item sampling in relation to the behaviors that are most problematic at different developmental periods, item density, reliability of informants, and validity of informants. Individuals or third-party respondents are asked to indicate their usual feelings or behaviors, not their best or most positive feelings or behaviors. Finally, as this chapter is being written, the World Health Organization (WHO) has completed development of ICIDH-2, the International Classification of Functioning, Disability, and Health (World Health Organization, 2000; see also Post et al., 1999), a functionally based nomenclature. One is an interview with a professionally trained interviewer and a respondent who knows the individual being assessed well. Adaptive Behavior Below is a listing of some of the adaptive behaviors measured by commonly used scales and checklists based on models of the construct of adaptive behavior. 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. His work emphasized social inadequacy due to low intelligence that was developmentally arrested as a cardinal indication of mental retardation (Doll, 1936a, p. 35). The Batelle Developmental Inventory (BDINewborg et al., 1984) is a developmental scale, rather than an adaptive behavior scale, and is appropriate for children from birth to age 8 (Spector, 1999). 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. These concerns are heightened when informants have a stake in the outcome of the assessment (e.g., when responses may affect eligibility for services). This nomenclature has dimensions of impairments of body functions, impairments of body structures, activity limitations and participation restrictions, and environmental factors. 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. In addition to the CBC, there are other instruments available to assess overt behavior, affect, or verbal statements consistent with the presence of mental or behavioral disorders among children and youth with mild mental retardation. For example, the ABAS is organized into 9 or, depending on age, 10 adaptive skills areas, clearly reflecting the 1992 AAMR manual on classification (American Association on Mental Retardation, 1992), which also identified 10 adaptive skills areas. Under ideal circumstances, adaptive behavior measures should be administered in an examinee's or informant's primary language. The other consists of a person who also knows the individual being assessed well but who independently completes a checklist of specific items without assistance. Feeding 5. Notably, adaptive behaviors include grooming . There is some confusion in the field of developmental disabilities regarding the relationship between problem behavior and adaptive behavior. There are two versions of the Adaptive Behavior Scales (ABS)a school version (ABS-S:2Lambert et al., 1993a) and a residential and community version (ABS-Residential and Community, ABS-RC:2 Nihira et al., 1993). McGrew and Bruininks (1989) and Thompson et al. The committee does not recommend any specific list of instruments, but choices should be guided by the reviews of the available instruments in this chapter and the research literature on existing and new instruments. As a result, the committee commissioned Monte Carlo simulations to understand better the implications of requiring a specific numeric cutoff point. The definition also views adaptive behavior as a multidimensional construct, in that the definition is expanded to include two or more factor scores below two or more standard deviations. For any given age, it is unlikely that developmental tasks will be oversampled. In infancy and early childhood: sensorimotor development, communication skills, self-help skills, socialization, and interaction with others; In childhood and early adolescence: application of basic academic skills in daily life activities, application of appropriate reasoning and judgment in mastery of the environment, and social skillsparticipation in group activities and interpersonal relations; and. Professionals voiced early caution about diagnosing mental retardation solely through the use of intelligence testing, especially in the absence of fuller information about the adaptation of the individual. Finally, it has been suggested that adaptive behavior and social competence represent an important facet of adjustment in academic contexts, as important if not more so than intelligence (Forness et al., 1998). SOURCE: Gresham & Elliott (1987). Managing money 9. Measures of typical performance involve an attempt to assess what an individual typically does or how a person usually feels (Cronbach, 1990). Furthermore, these limitations may be more noticeable in certain settings or circumstances than in others (Greenspan, 1999). Following are examples of adaptive behaviors. Useful score scales and appropriate norms are vital features of adaptive behavior instruments used in diagnostic decisions. Social Skills Dimension of Social Competence. This skill could be assessed by giving the individual a local phone directory, asking them to look up a number, and observing the results, yielding a measure of whether the individual can demonstrate this skill. 7-8). Adaptive behavior assessments are often used in preschool and special education programs for determining eligibility, for program planning, and for assessing outcomes. As previously noted, primary concerns in the use of adaptive behavior scales in eligibility determination decisions center on informant bias. Cross-cultural and cultural subgroup studies of adaptive behavior differences among ethnic, racial, or national groups are certainly needed, but evidence for substantial relationships between racial or ethnic group membership and performance on adaptive behavior scales, unmediated by socioeconomic differences, is very limited. It would be difficult to set up situations in which individuals can demonstrate their ability to perform a wide variety of social, communicative, and daily living behaviors. 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). The dimensions of adaptive behavior and social skills in the Gresham and Elliott model are surprisingly similar to the 10 adaptive skill areas in the 1992 AAMR definition of mental retardation. For the Vineland Adaptive Behavior Scales (Sparrow et al., 1984a) the standardization sample was representative of the U.S. population. Thompson et al. The DSM-IV definition identifies four levels of mental retardation based on IQ: mild, moderate, severe, and profound. Breadth of Domains. Food handling 7. A danger of accepting erroneous domains that are not truly distinct from one another (Thompson et al., 1999, p. 17) is that it can lead to the inconsistent application of eligibility criteria and unequal treatment across groups of people. The skills needed to make a call today are very different from the skills that were required 20 years ago. A herd of wildebeest, schools of fish, and flocks of birds are all examples of this concept. 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. It includes two adult forms, including a self-report and a report by others, and norms that extend well into adulthood. 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).
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