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Social Behavior and Personality, Volume 48, Issue 4, e8938
https://doi.org/10.2224/sbp.8938
www.sbp-journal.com
The Life Skills Assessment Scale: Norms for young people aged 17–19
and 20–22 years
David Pearson1, Fiona Kennedy1, Vishal Talreja2, Suchetha Bhat2, Katherine Newman-Taylor3
1National Health Service, United Kingdom
2Dream A Dream Nongovernmental Organization, Bengaluru, India
3Psychology Department, University of Southampton, United Kingdom
How to cite: Pearson, D., Kennedy, F., Talreja, V., Bhat, S., & Newman-Taylor, K. (2020). The Life Skills Assessment Scale: Norms for
young people aged 17–19 and 20–22 years. Social Behavior and Personality: An international journal, 48(4), e8938
Severe poverty, adversity, and malnutrition have irrefutable negative
effects on the development and mental health of children and young
people. The Life Skills Assessment Scale (LSAS), is a 5-item impact
assessment scale developed in India, that provides a simple, yet valid
and reliable, instrument to assess life skills of disadvantaged children
and young people, with age norms of 8–16 years. In the present study,
in Bengaluru, India, we used observational data obtained from 656
disadvantaged young people to extend the LSAS age norms to 17–19
and 20–22 years age groups, resulting in a simple, valid, and reliable
assessment tool for children and young people aged from 8 to 22 years.
Keywords
life skills; failure to thrive;
extreme poverty; severe
adversity; disadvantaged
young people; Life Skills
Assessment Scale;
developing countries;
nongovernmental
organizations
The global levels of extreme child poverty are not precisely known, as there is no standard definition of
poverty nor is there a consistent approach to the collection of data. However, available figures show that,
globally, from approximately 40% to 47% of children live with the effects of extreme poverty, surviving on
less than US$2 per day: This percentage equates to hundreds of millions of children, of whom 30% are in
India (Olinto, Beegle, Sobrado, & Uematsu, 2013; United Nations International Children’s Emergency
Fund/World Bank, 2016; World Bank, 2018) where the current study took place. A key indication of
extreme poverty is failure to thrive, commonly observed as stunted growth. Failure to thrive is associated
with a wide range of long-term mental health and developmental issues. For example, it was estimated in
the HUNGaMa Survey Report (Naandi Foundation, 2011) that in India the growth of up to 59% of all
children under 5 years of age was stunted. Further, it was stated in the Indian government’s Children in
India 2012 Statistical Appraisal (Ministry of Statistics and Programme Implication, 2012) that 48% of
children in India under 5 years of age were affected by this condition. More recently, it was reported in the
National Family Health Survey-4 in India (NFHS-4; International Institute for Population Sciences, 2017)
that the 2015/2016 survey figures recorded that the growth of 38% of children under 5 years of age was
stunted. NFHS-4 also stated that this rapid decline over the last decade appears to have stalled. However,
globally both the World Bank (2018) and Geoghegan (2017) in a report for the Save the Children
organization have stated that the number of children experiencing severe adversity is increasing as they are
living in conflict areas and as members of displaced populations.
It is important to recognize that failure to thrive can happen in all stages of development and is associated
with long-term or lifelong effects (Homan, 2016; Martorell, Rivera, Kaplowitz, & Pollitt, 1992). Stunted
growth at 5 years of age will generally lead to problems in later development. Research examples include
findings that stunted growth at 2 years of age can be linked to cognitive deficits at 9 years of age (Berkman,
Lescano, Gilman, Lopez, & Black, 2002) and at 8 years and 11 years of age (Daniels & Adair, 2004; Mendez
CORRESPONDENCE David Pearson, The Boulders, Quarr Road, Ryde PO33 4EL, UK. Email: dr.pearson@yahoo.co.uk
© 2020 Scientific Journal Publishers Limited. All Rights Reserved.
Pearson, Kennedy, Talreja, Bhat, Newman-Taylor
& Adair, 1999). Hoddinott et al. (2013) found in their longitudinal research that stunted growth at 72
months was associated with cognitive deficits in people aged from 25 to 42 years. Even if failure to thrive is
completely remediated at a young age, the effects can continue for a generation as those 5-year-olds develop
into adulthood. Although failure to thrive mostly comes about because of poor nutrition, even if adequate
nutrition is available, adversity can also cause failure to thrive. Severe adversity for a child can involve
being a refugee, living in a war zone, being abandoned, receiving institutional care, or having poor care
arrangements.
Thousands of nongovernmental organizations (NGOs) provide interventions designed to ameliorate the
negative effects of severe adversity, ranging from large multinational organizations to small local shelters
caring for a handful of children or young people. Interventions to address malnutrition include
supplementary feeding, and health- and social-improvement programs. Common life-skills interventions to
address developmental and psychological needs include the teaching of life skills, programs in sports,
creative arts, computer skills, and language skills, provision of camps, and mentoring. These interventions
are designed to enhance development by facilitating young people’s ability to interact with others, by
building up their skills, and enabling them to recognize and manage their emotions. A workable way to
measure the outcome of interventions has been problematic. Although the physical measurement of weight
and height is straightforward, it is much more difficult to measure developmental or psychological change.
Staff in most NGOs use nonstandardized common sense measures (e.g., how many times does a young
person attend programs or go to school), personal judgments, or just assume that interventions have
worked. The Life Skills Assessment Scale (LSAS) is a simple, reliable, and valid measure of life skills
interventions, which is currently in use in numerous developing countries (Kennedy, Pearson, Brett-Taylor,
& Talreja, 2014). This study took place in India, but as the LSAS construction was based on child and
adolescent development, it is culture and intervention generalizable. The LSAS does not assess any given
activity but uses the notion of age-appropriate behavior in any activity or situation. As the LSAS is
development-centered and culture and intervention free, it is generalizable to disadvantaged children and
young people in developing countries outside India. NGO staff and facilitators have reported that young
people aged up to about 22 years are using the programs, but the LSAS only had norms for those up to 16
years, so standardized assessments were not possible. Thus, in the current study we have added norms for
the 17–19 and 20–22 years age groups.
Effects of Severe Childhood Adversity and Failure to Thrive
The terms extreme adversity, extreme poverty, and failure to thrive can be confusing. Extreme adversity can
be experienced in many ways, and extreme poverty is an example of extreme adversity and can also cause
failure to thrive or stunted growth. The probability of malnutrition being experienced by children and young
people living in severe poverty is, of course, very high.
Failure to thrive isdefinedasachildnotgrowingatapredeterminedrateasmeasuredbyagrowthchart.
Growth charts cover development from birth to approximately 20 years of age (Centers for Disease Control
and Prevention, 2000). Normally, children and young people grow in a set pattern, and growth charts are
used to plot individual height, weight, and head circumference against a set standard. Stunted growth is
used as a key indicator of failure to thrive as it is apparent and easy to measure using a standardized growth
chart. Many disadvantaged children’s and young people’s growth patterns are abnormal in that they show
changes in, or deviations from, the expected patterns of growth shown on the chart (e.g., below the 3rd or
5th percentile on a growth chart or crossing major percentiles), and these changes and/or deviations
generally indicate failure to thrive. Although organic failure to thrive is most often caused by malnutrition
(Homan, 2016), nonorganic failure to thrive can be caused by a range of severe adverse experiences.
Nonorganic failure to thrive is defined as a failure of growth with no organic reason, for example,
abandonment, trauma, or abuse. However, the damaging effects of failure to thrive on development are the
same whether the cause of the failure is organic or nonorganic. The effects of experiencing severe adversity
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Social Behavior and Personality: an international journal
and failure to thrive have been recognized for over a century (Holt, 1897) and have been irrefutably linked to
attachment disorders, cognitive impairment, emotional and behavioral issues, neuropsychological
abnormalities, and diagnoses of physical and mental-health disorders (see examples in Table 1). In the
1960s, failure to thrive was linked to a reactive attachment disorder that is included in the fifth edition of the
American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (2013), which
reflected its connection with developmental delay and mental health problems (Schwartz, 2000).
Depending on the prevailing culture in which such issues occur, they may be described as symptoms of
disorder or illness or as life-skills problems. The description/diagnosis may also depend on the services
available in that location, that society’s perceptions, and the strength of the medical model. We conducted
the current study in India where these issues are perceived as life-skills problems.
As cognitive impairment (see Table 1) describes an impact on areas such as children’s attention, memory,
and information processing, it becomes very difficult, if not impossible, for children or young people whose
growth is stunted or who have failed to thrive to reach individual capacity in learning, education, or
vocational skills. United Nations International Children’s Emergency Fund (2009) described this situation
as one of diminished learning capacity and poor school performance and Geoghegan (2017) of Save the
Children described it as a lifetime of lost opportunities in education. Attachment disorder difficulties are
associated with individuals being unable to tolerate closeness, attaching quickly to possibly inappropriate
others, being unable to assert themselves, and experiencing emotion regulation difficulties, such as, being
highly sensitive/insensitive to stress, lacking the ability to self-soothe and calm, and experiencing extreme
inappropriate emotions. High anxiety levels may be interpreted as aggression, social withdrawal, avoidance,
and absconding. At best, these issues make it difficult for the child or young person to thrive in the context
of 21st century demands and, at worst, they establish the key foundations of future mental health issues.
Table 1. Examples of the Effects of Severe Childhood Adversity and Failure to Thrive
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Pearson, Kennedy, Talreja, Bhat, Newman-Taylor
Life Skills Assessment Scale
A simple, valid, reliable, and accessible assessment instrument is needed for staff in NGOs to use to
determine if their programs are effective in combating the effects of adversity. The LSAS 8–16 is currently in
use in developing countries. However, NGO personnel have recognized that young people stay in programs
and need care and support beyond 16 years of age, as they attempt to thrive. Thus, our aim was to construct
norms of 17–19 and 20–22 years age groups.
The LSAS is a five item, 5-point impact scale based on the World Health Organization’s (1997) definition of
life skills (see Kennedy et al., 2014 for a full description) as follows: “Psychosocial competence is a person’s
ability to deal effectively with the demands and challenges of everyday life. It is a person’s ability to maintain
a state of mental well-being and to demonstrate this in adaptive positive behavior while interacting with
others, his/her culture and environment.” The five life skills that the LSAS is designed to assess are:
interacting with others, overcoming difficulties and solving problems, taking initiative, managing conflict,
and understanding and following instructions.
Data based on observers’ responses to items concerning these five simple skills can provide a wide range of
information, in a similar way to children’s developmental milestone assessments. They should not be seen
as five discrete assessments but rather as indicators of areas of competence. For example, an observer can
carry out a simple milestone assessment by asking a child to build a column of four play bricks. This is not
intended as an assessment of the child’s play-brick-column-building ability but rather to enable the observer
to assess the child’s fine motor skills and perception. The LSAS statements are often described as tips of the
iceberg indicating broader areas of competence. Each item (dimension) is assessed on a 5-point Likert scale:
1=does not yet do,2=does with lots of help,3=does with some help,4=does with a little help,5=does
independently. Numbers can be attached to the Likert points, as shown above, for processing. However,
when a simple scoring sheet is used, or when young people are assessed, we found it more effective not to
have the numbers on the sheet as this could create an examination or pass/fail perception (see Appendix).
As the LSAS was based on child and adolescent development together with age-appropriate life skills, it is
culture and program free.
Uses of the Life Skills Assessment Scale
The LSAS has multiple uses depending on the type of assessment that is required by the user. It can be used
to assess individual children, groups of children, and overall performance of programs or interventions. This
means that the most effective programs can be identified and offered to individuals or groups of children
and young people.
Individual young person assessment. An individual’s score can be compared to a normative score to
ascertain if she or he is functioning in line with the population norm, or below (one standard deviation or
more below the mean), or doing well (one standard deviation or more above the mean) in comparison with
young people of the same age.
Life skills profiles can be produced to assess current strengths and development needs, for example, a young
person may be able to take the initiative without help, but may need a lot of help in managing conflict
without becoming aggressive. The assessment can be used interactively as appropriate with that young
person individually and/or with carers, parents, teachers, and NGO staff to provide a program or
intervention designed specifically to improve that young person’s management of conflict without becoming
aggressive.
The effects of life skills programs or interventions on an individual can be assessed using the LSAS.
Individual scores at Time A can be compared with scores at Times B or C, to assess progress on one of the
five skills individually or on overall life skills. These results can be used to provide empirical evidence of
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Social Behavior and Personality: an international journal
progress and the assessor can then congratulate the individual on that progress, and/or can be used to
choose further interventions/programs to build on this achievement. Alternatively, reductions in scores at
Times B or C can be used as alerts that the current program or intervention is not meeting the needs of the
young person and the individual who is working with the young person needs to give further attention to
program/intervention selection.
An assessment based on the LSAS can be simply completed with a pen or pencil and the scoring sheet (see
Appendix). If computing facilities are available graph-type representations are easily produced. A sample
graph for an individual young person is shown in Figure 1.
Groups of young people or population assessment. The assessment can be used in a similar way for
groups of young people or for populations by combining scores as in the above description. Graph
representations can also be produced.
Outcome assessment and program comparison. A program or intervention can be evaluated through a
comparison of the progress of groups of young people over time to assess if their life skills have improved
and if the program or intervention is effective or ineffective.
The effects of the different programs on individual life skills can be assessed. In this assessment, programs’
strengths are highlighted and this enables the assessor to offer the most effective program according to the
needs of the young people. For example, a computer-skills program may encourage the young person’s
development of the life skill of taking initiative and solving problems, but may not contribute to the
development of conflict-management skills.
A comparison of available programs with each other is useful to assess which type of program is the most
effective for an individual young person in development both of overall life skills and of each specific life
skill. This may be particularly useful when programs are being set up and developed to ensure that
individual needs are met.
Who can use the Life Skills Assessment Scale?
Because of the simplicity of the assessment procedure, it can be used at various levels by any person
individually or by staff in organizations that provide interventions to disadvantaged young people. The data
can provide feedback to the young people themselves, and to their families. Other stakeholders who benefit
from feedback may include teachers, researchers, funding bodies, partner organizations, and policymaking
bodies.
Impact of a Program on an Individual Young Person
The progress of Saanvi, who lived in institutional care is shown in Figure 1, at the time of entry into the
program (Time 1) and after attendance at daily evening sessions (Time 2). At Time 1, Saanvi scored poorly
for overall life skills compared with her peer group. After 6 weeks (Time 2), Saanvi showed an overall
significant increase in the score for life skills (1.4–2.6). However, Saanvi’s life-skill in interaction with others
had not changed, according to the LSAS. The staff member working with Saanvi arranged for her to attend a
program that had been shown by increases in the score for this skill in the LSAS to be successful at
improving the ability of the individual to interact with others. As similar graphs can be produced to
illustrate the impact and efficacy of whole programs, this can be valuable when a decision is being made
about which program(s) would meet specific needs of individuals or groups of young people.
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Pearson, Kennedy, Talreja, Bhat, Newman-Taylor
Figure 1. Preprogram and postprogram scores of Saanvi, a young woman.
Method
Ethical Considerations
All data collection took place during induction sessions that are a part of NGOs’ normal activities. Three of
the observers/raters were paid an honorarium of Rs1,000 (approximately £10/US$12) per day to cover
personal expenses.
Participants
Participants were 656 young people in two age groups 17, 18, and 19 years (n=378)and20,21,and22years
(n= 278), approximately equally gender divided (see Table 2). The makeup of the participant group was
designed to reflect the general population of disadvantaged young people in India. Although the majority of
participants were selected from an urban area, there was a mixture of rural and urban families, as rural
families are rapidly migrating to formal (buildings) and informal (tents, temporary shelters) urban
developments. Participants were from three groups: in formal education, not in a system, and in shelter
care. Formal education is a wide description that includes preuniversity college through to part-time
vocational training. Participants were in low cost or free courses, and came from poor socioeconomic areas,
including slums. The term not in a system refers to young people who are not registered as being in
education or formal employment, and includes young people who are street sellers, married and involved in
family care, or informal laborers. The shelter-care group included young people who are in, or have recently
left, shelter care, including orphanages, and those in conflict with the law. The figures in Table 2 are
approximate as some participants may belong to more than one group, for example, they may be on a
vocational course and living in a shelter or institution.
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Table 2. Demographic Characteristics of the Young People
None of the young people had previously taken part in an NGO program designed to enrich or ameliorate
the effects of adversity. Young people who opportunistically arrived at resource centers were recruited
before the programs began, and were told to come back in a few days time when an induction session would
be held before the programs started. The induction session was used to orientate the young person and
collect data. At the resource centers programs are provided, such as reading and writing, and using a
computer, and advice on vocational skills, money skills, and life skills, and the centers also serve as a safe
place to be during the day where semistructured interactions take place. It is normal practice to have an
orientation session before programs start to ensure that the young people’s needs will be met in the
proposed programs and that they are participating in the most appropriate programs for their needs.
We also arranged for observers to go to education establishments, shelters, villages, and slum communities.
We organized activities at which data could be gathered. The activities were a part of the normal work of the
participating NGO and often formed the preprogram introduction. Observation of activities to check that
programs meet the needs of the participating communities is usual practice for NGOs. Entry to programs
was open to all participants.
Observers/Raters
There were 13 adult observers comprising six men and seven women, some of whom came from
disadvantaged backgrounds themselves. They were all involved in NGO-type programs, but not at the
centers being used for the research and not in that geographic area. Observers had no knowledge of the
purpose of the study but were simply asked to observe an activity.
Procedure
We agreed on a standard activity based on the host NGO induction session in Bengaluru, India. We formed
a steering group to establish the proportion of young people aged between 17 and 22 years needed to
represent the population of disadvantaged young people (see Participants section). Young people living in
shelter-type accommodation were offered a taster induction session that they could voluntarily join. During
the observations, up to 20 young people took part in any one session. After the nonparticipant observers had
assessed some sessions using the LSAS, they went to various locations where the sessions were organized.
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Pearson, Kennedy, Talreja, Bhat, Newman-Taylor
All available participants took part in the sessions and were assessed. The observers found that the young
people did not generally exclude themselves from sessions. A pair of observers who did not communicate
with each other collected interrater reliability data (two groups with 24 young people in each) during a
session held at the same time for both groups. We also collected discriminant validity data during the
induction sessions, with 24 disadvantaged young people and 24 advantaged young people from high-
socioeconomic-level families in each of the two age groups. As it would not have been appropriate to offer
the advantaged group an NGO induction-type session in the format used with disadvantaged young people,
during these sessions the “advantaged” group took part in a football match. This activity was seen as
acceptable, as football is a game that crosses cultures and societies, and thus no group had an advantage. We
assessed reliability with a test and retest, with an interval of 14 days between the two tests.
Statistical Analysis
Participants in the validation study comprised 656 young people aged between 17 and 22 years (M=18.93,
SD = 1.64). As a visual inspection of histogram, boxplots, stem and leaf diagrams, and normality tests
suggested nonnormal distribution of data, we used nonparametric statistics. We calculated the mean,
standard deviation, and Cronbach’s alpha for the overall average scale score and for each item. Cronbach’s
alpha with item deleted was used to test if each item made an individual contribution to the overall score.
Mann-Whitney U and Wilcoxon W tests were used to test any differences between the two age groups of
17–19 years and 20–22 years. We also used the Mann-Whitney U test to assess gender differences within
age groups. Finally, we calculated interrater and test-retest reliability using the Ftest and Wilks’ Δ to test
differences, and to calculate discriminant validity.
Results
Descriptive Statistics for the Life Skills Assessment Scale
Descriptive statistics (mean and standard deviation) were produced for the overall score for the LSAS and
for each LSAS item. The mean and standard deviation for the LSAS 8–16 years are included in Table 3 for
comparison.
Table 3. Descriptive Statistics for the Life Skills Assessment Scale for 8–16 and 17–22 years
Note. LSAS = Life Skills Assessment Scale.
Data were analyzed to produce nonnormative scores (mean and standard deviation) for the two age groups
(see Table 3). The Mann-Whitney U and Wilcoxon W tests showed a significant difference between age
groups (z=-5.05,p< .001), with women (vs. men) scoring higher in the age group 17–19 years (p< .001).
There were no gender differences in the 20–22 age group.
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Reliability and Validity
The instrument showed excellent internal reliability (Cronbach’s α = .92), which was not improved by
removing individual items. Thus, we considered that the overall score (average of the five subscales) could
be used for remaining analyses. Interrater reliability was good (r=.76,p< .001) and test-retest reliability
was excellent (r=.95,p< .001; Koo & Li, 2016). Regarding discriminative validity, a significant difference
was found between the LSAS scores of the advantaged (vs. disadvantaged) groups (Δ = .18, p< .001),
indicating that the LSAS (17–22 years) can discriminate between advantaged and disadvantaged young
people.
Discussion
Statistical Properties of the Life Skills Assessment Scale
As descriptive statistics for the 17–19 and 20–22 age-group norms were similar to the norms for the 8-16
age group (see Table 3), the LSAS can be used seamlessly for practical everyday use with children and young
people aged from 8 to 22 years. Results showed good reliability and validity of the scale.
Practical Considerations When the Life Skills Assessment Scale is Being Used
As the LSAS is observer rated, there is a need for some observer interpretation regarding age
appropriateness and the amount of help needed to complete a task. As the statistical analysis indicated that
observers are generally able to do this reliably, the scale can be used with confidence. We also found this to
be the case for the original LSAS 8–16, which has now been used with disadvantaged children in many
countries in the developing world. If desired, an explanatory session can be held or role-play scenarios acted
out with new observers so that any questions about its administration can be raised. A free short web-based
induction is available.
Use of Normative Data from the Life Skills Assessment Scale
In practical use, if a single life skill is being assessed, an individual score can change only in units of 1, owing
to the scale structure. However, for multiple life skills assessments or assessment of multiple young people,
the normative data of M=2.7,SD = 0.74 can be used to make comparisons across time, groups, or
programs. For example, a movement of 1.0 for an individual life skill would indicate a clear improvement or
deterioration in the skill. For multiple life skills assessments or assessment of multiple young people
(perhaps if overall efficacy of a program is being considered), we would consider a figure of 0.74
(approximately one standard deviation) as indicating a significant change. We recommend that when the
LSAS is used for research, individual standard deviations are used to reliably assess precise change. The
distribution of women’s scores in the 17–19 years group (vs. men) showed higher scores. Although the
differences were modest and not relevant for practical use, this can be examined in future research.
Generalizability of the Life Skills Assessment Scale
Data for this study were gathered solely from disadvantaged young people in Bengaluru and surrounding
areas in India. Although this is rapidly becoming an area with an urban population, because of economic
migration locally and nationally, the young people came from a mixture of urban and rural backgrounds. We
suggest that, as this scale is development-centered, it can be used worldwide with disadvantaged children or
young people who are taking part in life-skills programs, as has been the case for the LSAS 8–16 years in
various developing countries. All children negotiate the same developmental milestones and need an
environment that enables them to do so. In all cultures, adversity and unmet basic needs result in similar
developmental problems that can continue into adulthood (Hoddinott et al., 2013). However, as established
life-skills assessment instruments (Nollan, Horn, Downs, Pecora, & Bressani, 2002) were developed for use
in countries in the Western world, they are not designed to assess the impact of severe adversity, for
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Pearson, Kennedy, Talreja, Bhat, Newman-Taylor
example, severe poverty and malnutrition in developing countries. Although we cannot guarantee that the
norms will be exactly the same in all developing countries, we expect them to be very similar. This has been
confirmed by the use already made of the LSAS 8–16, as confirmed by the not-for-profit organization,
HundrED, whose goal is to help improve education by encouraging pedagogically sound, ambitious
innovations to spread across the world (HundrED.org, personal communication, November 9, 2019).
Research is currently underway by the authors to establish confirmation of the accuracy of the age norms in
other developing countries.
Summary
Our results showed that the LSAS is a simple, quick, yet reliable and valid instrument for use to measure life
skills of disadvantaged young people in developing countries. These data can be added to the reliable and
valid LSAS 8–16 to make a seamless assessment from 8–22 years. We believe that the LSAS is a unique
standardized life skills measure for this age group.
Acknowledgements
The authors acknowledge the tireless contributions of Kanthi Krishnamurthy, Annie Jacob, Khushboo
Kumari, Sheetal Lydia Prasad, and Chandrasekhar.
No author has any financial or similar interest in connection with this study, and all authors contributed
voluntarily. There was no specific funding for the study and there is no charge for the assessment sheet.
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