examples of adaptive behavior assessments

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. An adaptive behavior measure is a specific comprehensive assessment of independent living skills. They also found that it was not the selection of the instrument that determined the number of factors. The evaluation is done with the purpose of determining whether a person demonstrates sufficient capacity to function independently . 8 Special Education Assessments Find out about what tests are used to diagnose or help students with special needs. (Chapter 3 provides details on the development of intelligence assessment.). That is, current science suggests that there are various domains of behavior that form the construct of adaptive behavior. Among these four definitions, there is little variation in the intelligence construct for individuals with mental retardation. The ABS-S:2 provides norms only through age 21 and includes some content specifically appropriate for school settings rather than adult environments. Principal Comprehensive Adaptive Behavior Measures and Their Characteristics. Scores on the revised version of this measure, the CTAB-R, are based on a standardization sample that includes four of five regions of the United States (Adams, 2000). Several studies have shown significant and meaningful correlations between the BDI and other measures of cognitive, adaptive, language, and social functioning, with samples of children with and without disabilities (Bailey et al., 1998). One may think of adaptive behavior as a constellation of skills that allow a person to function effectively every day at home, school, work, and in the community. In the 19th century, mental retardation was recognized principally in terms of a number of factors that included awareness and understanding of surroundings, ability to engage in regular economic and social life, dependence on others, the ability to maintain one's basic health and safety, and individual responsibility (Brockley, 1999). Even a statement such as "Emily is aggressive toward her peers" is too vague to target for intervention. In the United States there have been significant concerns about the relationship between ethnicity or racial origin and performance on intelligence tests (Neisser et al., 1996). 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. Diagnostic decisions about mental retardation nearly always involve normative comparisons using various derived scores. In conjunction with the ICIDH-2, WHO has developed the World Health Organization Disability Assessment Schedule II (WHODAS II), which, in its most extensive form, contains 36 items tapping domains of: (1) understanding and communicating, (2) getting around, (3) self-care, (4) getting along with others, (5) household and work activities, and (6) participation in society. The advantage of the method is that it frees the clinician from using a set of criteria that may be perceived as restrictive. Psychoeducational. An average five-year-old, for example, would be expected to have adaptive behavior similar to that of other five-year-olds. It also differs from other adaptive behavior scales because it is administered as a test directly to the individual and, as such, does not measure typical performance in real life. Haring (1992) found this to be an advantage in terms of its excellent reliability but noted that there were concerns about validity. 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). Additional discussion is provided in Chapter 3. by. (1999) reviewed studies that reported factor analyses of adaptive behavior measures. Use of a telephone is a common item on communication subdomains of many adaptive behavior inventories. Doll objected to the definition of mental retardation in terms of mental age, which had proven problematic in IQ testing (because it resulted in classification of a significant proportion of the population). There are at least 200 published adaptive behavior instruments that have been used for diagnosis, research, program evaluation, administration, and individualized programming. In the mastery approach, examinees are encouraged to do their best, and testing conditions are designed to elicit maximum performance. For example, a percentile rank of 41 indicates that the examinee scored higher than (or the same as) 41% of the age-matched norm . The most widely used measures use a typical performance approach involving third-party respondents (Bruininks et al., 1996; Harrison & Oakland, 2000b; Lambert et al., 1993b; Sparrow et al., 1984b), although several differences exist among the response formats for items in these measures. In addition, mitigating current circumstances (not speaking English) or past history (absence of schooling) were often ignored in the beginning years of intelligence testing (Kerlin, 1887; Wilbur, 1882). The following areas by age should be adopted by SSA: Current science also suggests that several measures of adaptive behavior tap into these domains. No mention is made of the degree of severity of adaptive deficits for each of these levels, nor of the number or types of impaired adaptive behavior domains at each level. Formal Adaptive Behavior Assessments. Through the assessment of strategy generation, researchers have been able to evaluate an individual's fund of social knowledge (i.e., his or her repertoire of social strategies), as well as the ability to adapt to varied social situations by generating situationally appropriate strategies. Comprehensive, convenient, and cost-effective, this behavior rating scale . Moreover, the ABAS is appropriate for use with children (age 5 and older) as well as adults. (1995) found that only 13 percent of respondents in the sample of clinical psychologists engaged in ability testing as part of their clinical practice, but 66 percent engaged in intellectual assessment. Her true score is likely to fall within the range of 68-76 at a 95% level of confidence. 25. 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. 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. In Chapter 1 we summarized the history of definitions of mental retardation and discussed their relevance to the Social Security Administration's definition. At present, a variety of assessment instruments have been employed in research and clinical settings that attempt to capture these individuals' social limitations. These data are presented in Chapter 5. The issue of sociocultural bias also arises in the context of the adaptive behavior interview. Because clinicians are encouraged to utilize multiple measures in diagnosis, these other measures may be useful in providing supplemental or complementary information. By eliciting information about an individual's performance of these processes, the examiner can increase the likelihood of detecting impairments in social functioning that often characterize this population. Smith (1989) cited many problems with the norm tables but concluded the ABI could contribute some information to the determination of mental retardation. 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). For example, assessments are used during classroom instruction to measure students' learning related to the academic content, and different assessments are used to measure students' overall cognitive, physical, or social . These results become increasingly unreliable and invalid as the number of guesses increases. The review by Thompson et al. Their work in this area sparked broadened interest in measurement of adaptive behavior among practitioners serving people with mental retardation (Doll, 1927; Kuhlman, 1920; Porteus, 1921; Scheerenberger, 1983). Gullibility/Credulity Component of Social Competence. It includes activities such as walking, talking, eating, socializing and grocery shopping. Often, these limitations take the form of poor judgment or social rule violations, rather than markedly maladaptive behavior (Greenspan & Granfield, 1992). NOTE: When assessed as mean or total scores, row differences were significant at p < .0001 with t-tests for matched samples. Also, English language norms may be lower than the typical performance of a same-age child in another culture. 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 so doing, AAMR ignores the substantial theoretical and empirical foundation that validates the difference between individuals with mild mental retardation and other individuals with mental retardation (MacMillan et al., in press). Additional measures of social cognition or social skills and issues relevant to social skills assessment of people with mental retardation have been discussed further (Bell-Dolan & Allan, 1998; Blacher, 1982; Blake & Andrasik, 1986; Jackson et al., 1981; Matson et al., 1983; Meyer et al., 1990; Monti, 1983; Smith & Greenberg, 1979; Van Hasselt et al., 1981). In addition to rating skill performance, raters also specify whether each skill is critical to success in the environment in which the child is observed, i.e., school or classroom. A marked limitation is not represented by the number of areas in which social functioning is impaired, but rather by the overall degree of interference in a particular area or combination of areas of functioning. To some extent, inclusion of participants representative of the general population, including racial and ethnic minorities, in norming samples should mitigate against biases in scoring of adaptive behavior scales. Furthermore, these limitations may be more noticeable in certain settings or circumstances than in others (Greenspan, 1999). 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. The ABS-S was standardized on population samples of people with and without mental retardation. This use may result from concerns among clinicians about the robustness of adaptive behavior measures. 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. NOTE: AAMR-ABS = American Association on Mental Retardation Adaptive Behavior Scales-School version (Lambert et al., 1993a); Residential and Community version (Nihira et al., 1993); ABAS = Adaptive Behavior Assessment System (Harrison & Oakland, 2000a); SIB-R = Scales of Independent Behavior-Revised (Bruininks et al., 2000); VABS = Vineland Adaptive Behavior Scales (Sparrow et al., 1984c). Adaptive behavior is behavior that is positive and functional to the individual. 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). 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). Interview methods recommended for different measures vary from high to low structure. In contrast, the other definitions employ more qualitative terms, which are open to interpretation in describing deficits and limitations in adaptive behavior. 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. (5) $6.99. What is an adaptive score? . Test publishers use criteria to determine whether professionals and others may purchase testing materials (e.g., protocols, kits, scoring manuals). Indeed, this latter approach is consistent with guidance already noted from the Social Security Administration. A more recent study by Watkins et al. assessment of Jane's adaptive behavior. 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. Gifted Testing. Greenspan and Driscoll (1997) proposed a dual nature of competence. They suggest that intelligence, as measured by IQ, is typically viewed as an independent variable that predicts outcomes, whereas personal competence is the combination of what individuals bring to various goals and challenges as well as their relative degree of success in meeting those goals and challenges (p. 130). In the definitions that imply a multifactor construct, deficits in adaptive behavior must be specified in a certain number of areas/domains. As a result, the committee commissioned Monte Carlo simulations to understand better the implications of requiring a specific numeric cutoff point. In fact, as noted above, in the construction of adaptive behavior scales, such oversampling is typically avoided. By contrast, maladaptive 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. Social These skills help us to get along well with others. Hill (1999) also emphasized that behaviors that interfere with a person's daily activities, or with the activities of those around him or her, should be considered maladaptive behavior, not the lack of adaptive behavior. High correlations with intelligence tests suggest it may be a duplication of this construct. One of the key themes throughout the DSM-IV definition is the cultural aspect of adaptive behavior. 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. 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. The VSMS, which measured performance of everyday activities, was the primary measure used to assess adaptive behavior, social competence, or social maturity for several decades. This chapter contains material drawn from an unpublished paper commissioned by the committee from Sharon Borthwick-Duffy, Ph.D., University of California, Riverside. In contrast, there is no mention of a standardized score or cutoff point for operationalizing any significant limitations in adaptive behavior, even though it is suggested that one or more instruments be used to assess different domains from one or more reliable independent sources (p. 40). 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). Specifically, a comprehensive adaptive behavior assessment should include information obtained from: 1. Although the assessment of intellectual functioning has a longer history (e.g., first standardized test was developed in 1905) than the measurement of adaptive behavior, standardized tests of adaptive behavior have progressed significantly since the first such scale was published (Vineland Social Maturity Scale, Doll, 1936).The first version of the Vineland instrument consisted of items . Adaptive behavior also includes the ability to work, practice social skills , and take personal responsibility. 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). Toileting 3. There is a much larger number of scales that do not have extensive norms but may nonetheless be suitable as a means of gathering and summarizing information that can be assessed on a clinical basis. Generally, adaptive behavior assessment involves obtaining information from parents, legal primary caregivers, or even teachers about a child with a learning disability to determine their strengths and weaknesses and how well they can perform independently at home, school, and in the community. Adaptive behavior scales were not among the types of measures (or named measures) that respondents identified as important for the training of future practitioners. The term concurrently suggests an interdependent relationship in which both constructs are equally important. These measures have excellent psychometric properties, with reliabilities of about .90. Student assessment results from formal, standardized assessment tools are often statistically based and can be very difficult for families to understand. The distinction between maximum performance and typical performance assessments might be illustrated with some common adaptive behavior items. (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. The Vineland-3 is a standardized measure of adaptive behavior--the things that people do to function in their everyday lives. Both legislative action and judicial decisions at the federal level have focused on concerns that parents may misinform clinicians regarding their children's skills in order to obtain SSI benefits. Vineland Adaptive Behavior Scale (VABS): This test measures the social skills of people from birth to 19 years of age. 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. It should also be noted, however, that there is no gold standard against which cutoff scores could be appraised, or research from which a true proportion of people with observed IQs in the range of approximately 65-75 who manifest adaptive limitations consistent with mental retardation may be directly projected. This framework, reiterated in 1983, described adaptive behavior limitations consisting of significant limitations in an individual's effectiveness in meeting the standards of maturation, learning, personal independence, or social maturity that are expected for his or her age level and cultural group, as determined by clinical assessment and, usually, standardized scales (Grossman, 1983, p. 11). concluded: No single adaptive-maladaptive behavior assessment instrument completely measures the entire range of adaptive and maladaptive behavior dimensions. Children without mild mental retardation were most likely to have adaptive behavior skills consistent with marked limitation in the domains of communication, health and safety, and self-direction. Current measures evidence acceptable interrater and test-retest reliability, with consistency scores at levels of .90 and above (seldom at a level below .80) for clinical and normative subgroups, partitioned by age and clinical variables. Referring to the dual purpose of adaptive behavior scales, Spreat (1999) concluded that it is unrealistic to think that the same test can be used for program evaluation, diagnosis, classification, and individual programming (p. 106). 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. Research with children and adolescents with mental retardation has found that they also have difficulty integrating information from multiple cues in order to interpret a social situation (Brosgole et al., 1986; Doman, 1967; Gomez & Hazeldine, 1996; Leffert & Siperstein, 1996; Leffert et al., 2000; Maheady et al., 1984). Whereas situational and functional assessment are appropriate in intervention design for maladaptive behavior or behavior disorders or problems, norm-referenced or criterion-referenced instruments are appropriate for initial assessment (Reschly, 1992). The social domain is particularly important to assess for individuals with mild mental retardation because prominent limitations that these individuals experience are often in the domain of interpersonal relationships, rather than in skill domains that are not predominantly social in nature (e.g., activities of daily living, motor skills). Instead, it may be possible to establish only that their skills are superior to those achieved by other young adults with mild mental retardation, and they may sometimes fall in the normal range of performance of similar age peers. 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. One must consider not only general competencies across relevant domains but also the level, quality, and fluency of those behaviors. The 1992 AAMR definition requires that an individual show significant limitations in at least 2 of the 10 adaptive skill areas. The disadvantage is that each clinician imposes his or her own subjective criteria, a process that threatens both the reliability and the validity of the assessment. This allows the rater to obtain a complete picture of the adaptive functioning of the person being assessed. + 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 . The definition speaks to the presence of significant limitations in intellectual functioning and significant limitations in adaptive behavior, which exist concurrently. What is adaptive Behaviour assessment? The skills needed to make a call today are very different from the skills that were required 20 years ago. The proportion of children from homes with low socioeconomic status was lower than that in the census data. The Vineland Adaptive Behavior Scales are undergoing revision, and a new edition should be available within one to two years. 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