The quality of performance may be somewhat more subjective, but a key feature is the appropriateness of a given level of adaptive behavior performance. Although each scale described has both strengths and weaknesses, each has impressive psychometric characteristics and is highly recommended for use in eligibility determination and diagnosis. It can be a habit picked up at an early age or can be a behavior that starts after a major life change, illness, or traumatic event. For example, a percentile rank of 41 indicates that the examinee scored higher than (or the same as) 41% of the age-matched norm sample. The instrument's structure must guide interpretation. Measures of behavioral functioning or responsiveness of children younger than 36 months have not been strengths of many adaptive behavior measures. The social-cognitive processes and the approaches that are used to measure them can also inform and enrich the interviews that examiners conduct with individuals with mild mental retardation and other informants. concluded: No single adaptive-maladaptive behavior assessment instrument completely measures the entire range of adaptive and maladaptive behavior dimensions. 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). Reviews of the ILS have been generally negative, and it may not be suitable for disability determination purposes. 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). Reprinted with permission. 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). In recent years, existing operational definitions of adaptive behavior and techniques for measuring adaptive behavior have been criticized as being inadequate for determining the presence of significant limitations in individuals with mild mental retardation. Floor and ceiling effects are also evident as developmental range effects. Assessments. 25. It allows the individual to relieve anxiety. Does the person recognize that a social problem has occurred? Regarding the ability to adjust one's social strategies to fit the needs of a particular social situation, children with mild mental retardation often fail to use information from the specific social cues present in the social situation to guide their search for appropriate strategies (Leffert et al., 2000). For example, saying a student is "always getting in trouble" is vague and not measurable. 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. Very recently Greenspan (1999) proposed ideas for assessing vulnerability in a comprehensive assessment of adaptive behavior or social competence. 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 adaptive behavior scales described above have been consistently identified in research and practice reports as meeting criteria of technical excellence in measurement. The determination of whether adaptive deficits are marked in character requires clinical interpretation informed in part by the data provided by the scoring of adaptive behavior measures. 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. 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). Physical/developmental and vocational/community dimensions were found less often. The issues of cross-cultural, racial, ethnic, and subcultural biases are of concern to some who view many aspects of adaptive functioning as culturally determined (Boyle et al., 1996; Valdivia, 1999for a general discussion see the section Sociocultural Biases). Indeed, this latter approach is consistent with guidance already noted from the Social Security Administration. 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. Overall, the construct of social cognition represents the cognitive aspects of social functioning. Jane's For example, an individual with mild mental retardation may be familiar with the routines and may benefit from the supports that staff provide in the supervised apartment program in which he lives. Some (e.g.,Valdivia, 1999) have suggested that age norms are arbitrary and reflect white, middle-class childrearing standards, and that developmental attainments are affected by culturally different skills and expectations. These domains vary by age, consistent with the development of adaptive behavior. Norms are available to age 18 for the ABES and to age 12 for the parent scale. 1. Principal Comprehensive Adaptive Behavior Measures and Their Characteristics. . This nomenclature has dimensions of impairments of body functions, impairments of body structures, activity limitations and participation restrictions, and environmental factors. There is evidence that the ABI has adequate construct, content, and criterion-related validity, as well as internal reliability, but no data were provided on interrater reliability. Question Guide for the Assessment of Social-Cognitive Processes. 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). For example, the SIB-R has four factors (Motor Skills, Social Interaction and Communication Skills, Personal Living Skills, and Community Living Skills) that are combined to yield a Broad Independence score. Traditional measures of achievement and intellectual functioning are examples of maximum performance tests. The adaptive behavior construct has both typical performance and maximum performance elements, a characteristic that complicates measurement operations. Often, these limitations take the form of poor judgment or social rule violations, rather than markedly maladaptive behavior (Greenspan & Granfield, 1992). To the extent that SSSQ data can predict entry or retention of competitive, gainful employment among people with mental retardation, it may have utility. 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 contrast to the studies above, which focus more on general clinical practice, direct surveys of school psychologists have disclosed that adaptive behavior scales are among the measures used most frequently. These data are presented in Chapter 5. In fact, semistructured interviews require the highest level of professional expertise, as the questioning and interpretation of answers requires a high level of training. 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. An adaptive behavior measure is a specific comprehensive assessment of independent living skills. Interpretation of the results of instruments must consider the possible influence of unintentional response sets as well as more deliberate efforts to raise or lower the adaptive behavior results in order to achieve certain outcomes. Nonetheless, it should always be recognized that items in adaptive behavior measures represent a sampling of items that have passed reliability and validity screens, rather than a complete characterization of adaptive behavior. 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. 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. Looking up a phone number is a relevant item for that subdomain. One of the key themes throughout the DSM-IV definition is the cultural aspect of adaptive behavior. 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). They have provided valuable information that has informed decision making about interventions to improve the social functioning of individuals with mental retardation. Their repertoires often exclude certain types of socially adaptive strategies. Moreover, the ABAS is appropriate for use with children (age 5 and older) as well as adults. Interpretation of ABAS-II Results Adaptive Behavior Composite Scores The General Adaptive Composite score (GAC) summarizes performance across all skill areas excluding Work. 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. 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). For the Adaptive Behavior Assessment System (Harrison & Oakland, 2000a), the norming groups for 5- to 21-year-olds included 1,670 (parent form) to 1,690 (teacher form) children; for 16- to 89-year-olds, the norming groups included 920 (rated by others) to 990 (self-report) adults without disabilities throughout the United States. Some scales contain provisions for alternative items or alternative performance of items. Refusal to perform a task that a person is capable of doing is also a reflection of problem behavior and should not be considered in relation to adaptive behavior. 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. 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. What are examples of adaptive behaviors? Best-practice guidelines require that clinicians using adaptive behavior measures employ those that are culturally compatible and have suitably contemporary and age-related norms. 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. 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. 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. Feeding 5. The second social-cognitive process is the generation of strategies for resolving social problems. Greenspan (1999) argues that the victimization of people with mental retardation, observed in social and economic exploitation, is a more central (and generally more subtle) problem that goes to the heart of why people with mental retardation are considered to need the protections (ranging from in-home services to conservators) associated with the label (p. 69). 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. Professionals call this life skills social competence, or adaptive behavioral functioning. 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. Thus, to the extent that a young adult with mild mental retardation has selected skills that are well developed relative to others, it may not be accurate to describe those skills in developmental terms. An appropriate respondent, knowledgeable about the examinee, is required for most adaptive behavior instruments. One of the key themes throughout the DSM-IV definition is the cultural aspect of adaptive behavior. 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. 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. Adaptive behavior has been an integral, although sometimes unstated, part of the long history of mental retardation and its definition. Vineland Adaptive Behavior Scales What it measures: How a child's daily living skills compare to those of other kids his age. Norms for age birth to 5 years are expected to be available in 2002. Because clinicians are encouraged to utilize multiple measures in diagnosis, these other measures may be useful in providing supplemental or complementary information. 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. Some organizations are too rigid for adaptive performers such that they are likely to leave. The SIB-R manual addresses many of the issues that make the scoring interpretation of adaptive behavior scores challenging, including physical disability, the use of adaptive equipment, alternative communication methods, tasks no longer age appropriate, partial performance of multipart tasks, lack of opportunity due to environment or safety, and cognitive ability to understand social expectations for performing behaviors. 8. 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. Commonly used tests of adaptive functioning are described below: Woodcock-Johnson Scales of Independent Behavior: This test measures independent behavior in children. AAMR departs significantly from other organizations by eliminating the grouping of individuals with mental retardation into levels of severity. 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. There is considerable overlap in adaptive behavior attainment among children with mild mental retardation and matched peers. 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). Here are some of the behavior assessments that are commonly used. Even in those domains in which the greatest differences in attainment are evident, between 24 and 48 percent of children with mild mental retardation do not have adaptive limitations meeting a standard of marked limitation in those domains (although many may have such limitations in other domains). Specifically, instruments such as the TSI, the Social Problem-Solving Test (Castles & Glass, 1986), and the TICE have been successfully employed with this population for the purposes of determining where to begin instruction in social skills and documenting the improvements that have resulted from instructional interventions. Furthermore, these limitations may be more noticeable in certain settings or circumstances than in others (Greenspan, 1999). Making a phone (or video) call is an example of adaptive behavior that changed over time. Highly structured interviews have unique problems as well. Adaptive behavior measures are useful in the identification of limitations concurrent with an IQ significantly below average. The Scales of Independent Behavior (SIB-RBruininks et al., 1984) is a component of the Woodcock-Johnson Psycho-Educational Battery. In the characterization of mild mental retardation, the ICD-10 guide points out that, some degree of mild mental retardation may not represent a problem. It goes on to state that the consequences will only be apparent if there is also a noticeable emotional and social immaturity. This statement implies that for individuals with mild mental retardation, intellectual deficits are apparent only when represented by problems in adaptive behavior (emotional and social immaturity). Vineland Adaptive Behavior Scale (VABS): This test measures the social skills of people from birth to 19 years of age. If not, diagnosticians would have to consider a profile of adaptive behavior deficits that takes all domain scores into account. The Adaptive Behavior: Street Survival Skills Questionnaire (SSSQLinkenhoker & McCarron, 1983) was designed to assess adaptive behavior in youth from age 9 years and adults with mild to moderate mental retardation. The subscales are similar to general adaptive behavior scales, but there is a greater emphasis on skills required to function in community settings than on basic adaptive skills. 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). (Harrison & Boney, 2002). Skills assessed with ABAS-III. Recent studies with these individuals have documented limitations in their reasoning about the consequences of strategies that make it difficult for them to select a social strategy that is appropriate for a given social situation. This has generalized to adaptive behavior measures. The definition speaks to the presence of significant limitations in intellectual functioning and significant limitations in adaptive behavior, which exist concurrently. Among the very large number of adaptive behavior scales on the market, very few have adequate norms and reliability to diagnose mental retardation in people with IQs in the questionable range (e.g., 60-80). 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