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Adaptive Behavior and Functional Life Skills Across the Lifespan: Conceptual and Measurement Issues

Authors:

Abstract

Adaptive behavior is an important construct that is involved in the diagnosis and determination of the severity of a number of neurodevelopmental disorders. Adaptive behavior is also associated with greater independence and overall quality of life. Adaptive behavior is defined as the skills that are learned and performed to meet the everyday demands of one’s community or society. The number and complexity of adaptive behaviors needed to meet these demands increase with chronological age. Higher levels of adaptive behavior are associated with more positive life outcomes and improved quality of life. This chapter presents a number of conceptual issues regarding the construct of adaptive behavior, its importance in the field of intellectual disability and other neurodevelopmental disorders, and presents a review of key measures that can be used to assess adaptive behavior and inform on the development and evaluation of teaching and interventions that target increasing adaptive behavior.
RUNNING HEAD: Adaptive Behavior
Adaptive Behavior and Functional Life Skills Across the Lifespan:
Conceptual and Measurement Issues
Marc J. Tassé, PhD
Nisonger Center
The Ohio State University
Tasse.1@osu.edu
File name: AB Chapter - Tasse PREPRINT VERSION
35 pages (double-spaced)
9,100 words
May 5, 2020
To appear in: Russell Lang & Peter Sturmey (Eds), Evidenced-Based Practices for Teaching Adaptive
Behavior to People with Intellectual and Developmental Disability across the Life Span. New York: Springer
Publishing.
Adaptive Behavior 2
Abstract
Adaptive behavior is an important construct that is involved in diagnosis and determination
of the severity of a number of neurodevelopmental disorders. Adaptive behavior is also associated
with greater independence and overall quality of life. Adaptive behavior is defined as the skills that
are learned and performed to meet the everyday demands of one’s community or society. The
number and complexity of adaptive behaviors needed to meet these demands increase with
chronological age. Higher levels of adaptive behavior are associated with more positive life
outcomes and improved quality of life. This chapter presents a number of conceptual issues
regarding the construct of adaptive behavior, its importance in the field of intellectual disability and
other neurodevelopmental disorders, and presents a review of key measures that can be used to
assess adaptive behavior and inform on the development and evaluation of teaching and
interventions that target increasing adaptive behavior.
Keywords:
Adaptive behavior, adaptive skills, adaptive functioning, functional skills, assessment,
testing, teaching.
Adaptive Behavior 3
Adaptive Behavior and Functional Life Skills Across the Lifespan:
Conceptual and Measurement Issues
Adaptive behavior involves skills that people learn throughout their life and put forth to
meet the demands and expectations of their environment and society at large. Adaptive behavior is a
broad construct that encompasses practical skills (e.g., self-care, toileting, cooking, cleaning, caring
for one’s home, money concepts, and work skills), social skills (e.g., interpersonal skills, managing
one’s emotions, ), and conceptual skills (e.g., functional academics, communication skills, concept of
time, money management, and self-direction; American Psychiatric Association, 2013; Schalock et
al., 2010; Tassé et al., 2012). The complexity of the adaptive behavior increases with chronological
age and the onset of diverse social roles and responsibilities (e.g., going to school, participating in
sports and leisure activities, maintaining friendship, dating, independence/interdependence, financial
responsibilities, following rules, social responsibilities, employment, raising children, etc.).
Impairment in adaptive behavior is a crucial diagnostic criterion for a number of
neurodevelopmental disorders, including autism spectrum disorder (American Psychiatric
Association, 2013) and intellectual disability (APA, 2013; Schalock et al., 2010; World Health
Organization, 2002). The presence of deficits in adaptive behavior is also present in a number of
other conditions, including attention deficit/hyperactivity disorder, emotional and behavioral
disorders, hearing and motor impairments, communication disorders, and learning disabilities
(Harrison & Oakland, 2003). Research has shown that the strength of adaptive skills is a strong
predictor of success of post-high school outcomes for students with disabilities (Dell’Armo & Tassé,
2019). Conversely, the loss of adaptive skills in aging adults is an early indicator of age-related
decline (Takata et al., 2013) and the onset of dementia in persons with Down syndrome (Zigman,
Schupf, Urv, Zigman, & Silverman, 2002; 2009).
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Deficits in adaptive behavior are attributable to a number of independent and overlapping
variables. Some of these factors include: (a) opportunities to develop/learn a skill/behavior, (b)
opportunities to perform or practice a learned skill, (c) intrinsic or extrinsic motivation to perform a
learned skill when called upon, (d) the awareness that a particular skill or behavior is needed in a
particular situation, (e) physical or mental health problems, and/or (f) brain disease or impairment.
One’s context also influences significantly a person’s adaptive behavior, situationally (e.g., in a
demand setting where the person is rewarded for emitting a specific adaptive behavior) or
permanently (e.g., growing up in a severely impoverished environment where there was a paucity of
opportunities to learn adaptive skills).
Although the concept of adaptive behavior has evolved over time, it remains remarkably
similar to the definition initially proposed by American Association on Intellectual and
Developmental Disabilities (AAIDD) more than 50 years ago (see Heber, 1959). Heber (1959),
initially proposed introducing this concept into the diagnostic criteria of intellectual disability in a
draft version of the American Association on Mental Deficiency’s (now AAIDD) terminology and
classification manual. Heber defined this second diagnostic criterion as deficits in at least one of the
following: maturation, learning, and social adjustment” (see Heber, 1959; p. 3). After receiving
feedback and comments from the field, Heber (1961) revised slightly the AAIDD diagnostic criteria
for intellectual disability proposed in 1959 and formally introduced in the definition of intellectual
disability the concept of “adaptive behavior.Heber described the concurrent impairments in
adaptive behavior as consisting of deficits in one of the three previously mentioned domains:
maturation, learning, and/or social adjustments (see Heber, 1961; p. 3). The Diagnostic and
Statistical Manual for Mental Disorders (DSM) incorporated AAIDD’s (Heber, 1961) proposed
construct of adaptive behavior in its 2nd revision of the DSM, published in 1968 (DSM-II; American
Psychiatric Association, 1968).
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Fast forward 50 years, and our current diagnostic definitions of intellectual disability look
surprisingly similar to these two earlier definitions of AAIDD (Heber, 1961) and DSM-II (American
Psychiatric Association, 2013; Tassé et al., 2016). The current AAIDD definition (see Schalock et
al., 2010) and DSM-5 (APA, 2013) both require the presence of significant impairments in adaptive
behavior when diagnosing intellectual disability and operationalize it as the presence of deficits in
one or more of the following: conceptual (aka learning), social (aka social adjustment), and/or
practical adaptive skills (aka maturation).
Disorders Associated with Deficits in Adaptive Behavior
There are a number of conditions and situations in which the assessment and teaching of
adaptive behavior is a critical and essential component of the clinician’s or educator’s responsibility.
Before we discuss some of these specific conditions, it is important to point out that the presence of
problem behavior may at times coexist in a person who has deficits in adaptive behavior. First, we
much mention that problem behavior (e.g., aggression, stereotypy, elopement, etc.) are not
necessarily “maladaptive” or purposeless, nor are problem behavior and adaptive behavior on
opposite sides of the same construct. Problem behavior can, in fact, be very “adaptive” and serve as
an effective response to the person’s environment and the contingencies in the environment (e.g.,
scream to get someone’s attention, hit a teacher to get out of a task, etc.). Problem behaviors most
often serve a function (e.g., get something, avoid something, communicate a desire, sensory
regulation) and a function-based intervention will use teaching and reinforcing of alternative
behaviors to replace the problem behavior. Often, these alternative behaviors are adaptive skills.
For example, if the function of a student’s problem behavior of slapping a classmate is motivated by
a desire to escape the demands of the classroom by being removed from the classroom contingently
on the aggressive behavior, perhaps an alternative behavior to this aggression might be to teach the
Adaptive Behavior 6
student to ask for help, or communicate (e.g., words, picture/symbol, sign language) more
effectively when he/she is feeling overwhelmed by a the task or demand that is too difficult.
Incorporating the teaching of alternative adaptive skills should be considered an essential
component of all behavior change interventions. Research has shown that conducting parent
training that focuses on enhancing adaptive behavior and behavior management strategies results in
improved adaptive behavior and a reduction in challenging behaviors (Scahill et al., 2012; Scahill et
al., 2016). There is a growing body of research that has shown that poor adaptive behavior in
childhood is a barrier to achievements in social relationships, inclusion, independence, and
employment (Bruininks, Hill, & Morreau, 1985; Davis, Shurtleff, Walker, Seode;, & Duguay, 2004:
Papazoglou, Jacobson, & Zabel, 2013).
Developmental Disabilities
Developmental disabilities is an administrative definition at the federal level that defines a
level of human functioning that determines individuals eligible for federal and state disability
benefits (e.g., early intervention, waiver services for community based services, social security
supplemental income, etc.). The definition for developmental disabilities is found in U.S. legislation
entitled Developmental Disabilities Assistance and Bill of Rights Act (DD Act; PL 106-402, 2000) that is
operationalized based on the person’s level of functioning rather than on the presence of specific
conditions or disorders (meaning it is largely based on the person presenting certain prescribed
functional deficits). Developmental disabilities is not a condition defined in either the DSM (DSM-5;
American Psychiatric Association, 2013) or the International Classification of Diseases (ICD-10;
World Health Organization, 1992). The DD Act (2000) defines developmental disabilities as
follows:
“(A) … a severe, chronic disability of an individual that:
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i. is attributable to a mental or physical impairment or combination of mental and physical
impairments;
ii. is manifested before the individual attains age 22;
iii. is likely to continue indefinitely;
iv. results in substantial functional limitations in 3 or more of the following areas of major
life activity:
1. Self-care.
2. Receptive and expressive language.
3. Learning.
4. Mobility.
5. Self-direction.
6. Capacity for independent living.
7. Economic self-sufficiency; and
v. reflects the individual’s need for a combination and sequence of special, interdisciplinary,
or generic services, individualized supports, or other forms of assistance that are of
lifelong or extended duration and are individually planned and coordinated.
(B) Infants and young children. An individual from birth to age 9, inclusive, who has a substantial
developmental delay or specific congenital or acquired condition, may be considered to have a
developmental disability without meeting 3 or more of the criteria described in clauses (i)
through (v) of subparagraph (A) if the individual, without services and supports, has a high
probability of meeting those criteria later in life.” (DD Act, 2000; pp. 1683-1684)
It is important to note that a person’s cognitive ability is not a criterion in diagnosing a
developmental disability. Rather, its determination rests largely on the presence of deficits in
adaptive behavior, or what is called “areas of major life activity” in the DD Act.
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Autism Spectrum Disorder
Autism spectrum disorder is a life-long neurodevelopmental disorder that has an onset
during early childhood. It is characterized by significant deficits in social communication skills and
the presence of restrictive and repetitive behavior and/or interests (American Psychiatric
Association, 2013). Deficits in social communication include skills such as social and emotional
reciprocity, interpersonal skills, emotion recognition and sharing, non-verbal communication skills,
eye contact, friendship and relationship skills, etc. Deficits in social skills and communication deficits
are core features of autism spectrum disorder (see DSM-5).
People with autism spectrum disorder present with varying levels of severity in symptoms
and functioning across the social and communication skills continuum as well as the severity of their
stereotypic behavior, behavioral rigidity, restrictive interests and activities, and sensory behaviors.
The DSM-5 proposed three levels of severity of autism spectrum disorder, based on the intensity of
supports needed around the person’s social communication deficits and their restricted and
repetitive behaviors. Hence, interventions almost always focus on teaching and enhancing these
adaptive skills to impact the core features of autism spectrum disorder and directly reduce the
severity of the condition and ameliorate the prognosis.
Intellectual disability
Adaptive behavior is perhaps best associated as a core feature of intellectual disability. The
condition of intellectual disability has long been conceptualized as consisting of problems in
adapting to societal demands and expectations, along with deficits in intellectual abilities. Adaptive
behavior has been an essential diagnostic criterion of intellectual disability for more than 50 years
(see American Psychiatric Association, 1968; Heber, 1961). Even before adaptive behavior was
included as a diagnostic criterion, Tredgold (1937; p. 4) described it as follows: “[Intellectual disability]
Adaptive Behavior 9
is a state of incomplete mental development of such a kind and degree that
the individual is incapable of
adapting himself to the normal environment of his fellows
in such a way to maintain existence
independently of supervision, control or external support.” [emphasis mine]. Edouard Seguin as early as the
mid-1800s differentiated the severity levels of intellectual disability on the basis of a combination of
deficits in intellectual ability and adaptive functioning (see Scherenberger, 1983).
An important assumption that is defined as essential to the application of the definition of
intellectual disability put forth by AAIDD stipulates the following: “With appropriate personalized
supports, the life functioning of the person with intellectual disability will improve.” (Luckasson et
al., 1992; Schalock et al., 2010; Schalock, Luckasson, & Tassé, in press). We argue that the most
important form of ongoing support is lifelong instruction. People with intellectual disability, as well
as any other disability, are capable of learning new adaptive skills throughout their life.
Relation Between Adaptive Behavior and Intellectual Functioning
It is not surprising that the exact relationship between intelligence and adaptive behavior is
misunderstood and erroneously confounded as causal. In fact, earlier definitions of intelligence
incorporated elements in its definition that included terms such as adaptation or “one’s ability to
respond to their environment’s expectations and demands” (see Binet & Simon, 1905; Sternberg et
al., 2000; Thorndike, 1920). Nonetheless, in a study of the relationship between adaptive behavior
and intelligence, Keith and his colleagues (1987) tested three hypotheses of the relationship between
these two constructs: (a) separate but related constructs, (b) completely independent constructs, or
(c) different facets of a unitary construct. Based on their findings, they concluded that adaptive
behavior and intelligence are related but separate constructs. This finding has been supported over
the years by a number of research studies examining the correlational relationship between adaptive
behavior and intelligence that has consistently reported that the correlation between FSIQ and
composite adaptive behavior score is moderate (De Bildt, Kraijer, Systema, & Minderaa, 2005;
Adaptive Behavior 10
Harrison, 1987; Harrison & Oakland, 2003; McGrew, 2012; Papazoglou, Jacobson, McCabe,
Kaufmann, & Zabel, 2014; Sabat, Tassé, & Tenorio, 2019). The correlation between IQ and
adaptive behavior is strongest between the full-scale IQ score and conceptual adaptive skills and to a
lesser extent with social and practical adaptive skills (Carpentieri & Morgan, 1996; Sabat et al., 2019).
There may be concern that the correlation coefficients may be attenuated between these two
constructs on account of range restrictions of scores on the intelligence and adaptive behavior tests.
Alexander (2017) in a large meta-analytic study of 148 samples containing a total of 16,464
participants, after correcting for range restriction and attenuation reported an estimated population
correlation coefficient = 0.51. These results confirmed an overall moderate relationship between
intelligence and adaptive behavior. Alexander also reported that moderator analyses confirmed that
the correlation coefficients between IQ and adaptive behavior were strongest as the IQ score
decreased; Hence, even it is ever more crucial to consider adaptive behavior measures as intellectual
abilities increase.
Meyers, Nihira, and Zetlin (1979) eloquently summarized the differences between these two
related but separate psychological constructs as follows: “(a) adaptive behavior emphasizes everyday
behavior, whereas intelligence emphasizes thought processes; (b) adaptive behavior focuses on common or typical
behavior. whereas intelligence focuses on maximum performance; and (c) adaptive behavior stresses non-abstract, non-
academic aspects of life, whereas intelligence stresses those aspects that are abstract and academic. (pp. 433-434).
Importance of Adaptive Behavior
The importance of adaptive behavior has only grown over the last century of research and
intervention in the field of intellectual disability. A person’s functioning in terms of adaptive
behavior and intellectual skills must be weighed equally and considered jointly when diagnosing
intellectual disability (Tassé, Luckasson, & Schalock, 2016). In fact, both AAIDD and DSM have
moved to place equal, if not more, importance on adaptive behavior than intellectual functioning in
Adaptive Behavior 11
their conceptualization of intellectual disability. For example, the DSM-5 has abandoned the use of
IQ scores in defining the severity of a person’s intellectual disability and has replaced IQ with the
person’s level of adaptive behavior (American Psychiatric Association, 2013). Hence, the
determination of severity of intellectual disability (mild, moderate, severe, profound) is best
determined on the basis of the severity of deficits in adaptive behavior rather than intellectual
functioning, the reason being that deficits in adaptive behavior are a better correlate with intensity of
support needs than deficits in intellectual functioning (American Psychiatric Association, 2013;
Simoes, Santos, Biscaia, & Thompson, 2016), and, equally important, research has shown that higher
levels of adaptive behavior are strongly correlated with improved quality of life (Chou et al. 2013;
Claes et al. 2012; Nota et al. 2007; Simoes, Santos, Biscaia, & Thompson, 2016).
There is a growing consensus on the importance of focusing our interventions and
treatments on increasing the learning and performance of adaptive behavior. This book has, to that
end, several chapters that present different interventions and approaches to teaching adaptive
behavior and functional skills across the lifespan. In this chapter, we will present the important
elements related to the concepts and assessment of adaptive behavior, which are a critical first step
to the identification of strengths and areas of needed intervention. We will present some of the
tools that exist that can aide in assessing the outcomes and effectiveness of an intervention.
Assessment of Adaptive Behavior
Coulter and Morrow (1978) observed that the field’s interest in the assessment of adaptive
behavior falls into two primary purposes. Adaptive behavior assessment continues to be driven
essentially by these two goals: (1) establish a diagnosis/determine eligibility (i.e., does the person
present with significant deficits in adaptive behavior) and (2) identify areas of deficits and relative
strengths that can inform intervention objectives and strategies (i.e., individual education plan,
individual support plan, identify strengths and weaknesses).
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Edgar Doll (1936) was the first recognize the important of adaptive behavior and develop a
standardized measure, called the Vineland Social Maturity Scale. Since the first publication of the
Vineland Social Maturity Scale, more than 200 measures of adaptive behavior and functional skills have
been identified (Reschly, Myers, & Hartel, 2002; Schalock, 1999). Some of these instruments might
consist of a brief inventory, checklist, or questionnaire dealing with a very specific skill area (e.g.,
social skills, communication, motor skills, vocational skills) and most of these 200 assessments are
not comprehensive of adaptive behavior. Some are direct measures, while others are created to
assess the person’s adaptive behavior by getting input from a third-party respondent (e.g., parent,
caregiver, teacher, direct support professional, etc.). Almost all use as rating scales are designed to
allow the respondent to complete the scale on their own by entering their ratings directly onto the
form. A few more rigorous standardized scales, predominantly developed for diagnostic purposes,
rely more heavily on a semi-structured interview procedure between a trained professional and the
respondent (e.g., parent/caregiver, teacher or direct support staff, etc.).
Although there was a time when the validity and psychometric properties of adaptive
behavior scales were viewed with skepticism (see Witt & Martens, 1984; Zigler, Balla, & Hodapp,
1984), this has changed over the last couple of decades. There are currently several existing
standardized adaptive behavior scales that have been robustly developed and have strong
psychometrically properties that rely on comprehensive norm-based evaluations of adaptive
behavior across the lifespan and include well written items that encompass all three critical domains:
conceptual (i.e., communication, functional academics, self-direction, budgeting/paying bills), social
(i.e., interpersonal skills, emotion regulation, social problem solving, wariness, following rules and
laws), and practical (i.e., self-care, domestic skills, money and time concepts, vocational/work skills)
adaptive skills. These are several of these instruments that are considered examples of “gold
standard” measures of adaptive behavior and include: Adaptive Behavior Assessment System, 3rd
Adaptive Behavior 13
edition (Harrison & Oakland, 2015); Adaptive Behavior Diagnostic Scale (Pearson, Patton, &
Mruzek, 2016); Diagnostic Adaptive Behavior Scale (Tassé et al., 2018); and Vineland Adaptive
Behavior Scales (Sparrow, Cicchetti, & Saulnier, 2016). We do not include in this list, the Scales of
Independent Behavior, Revised (SIB-R; Bruininks et al., 1996). Despite being a highly respected,
well-constructed, and psychometrically robust measure of adaptive behavior, the SIB-R has become
somewhat outdated since its last revision and re-norming in 1996 (i.e., almost 25 years
ago). Unlike with tests of intelligence, aging norms on scales of adaptive behavior do not cause a
spurious rise in adaptive behavior scores (i.e., the Flynn effect). It remains, nonetheless, important
to periodically revise item content and refresh normative data on these tests. Item content on
measures of adaptive behavior need to be periodically refreshed to keep up with changing societal
norms and expectations. For example, more current adaptive behavior scales may include more
technology items such as using a cell phone or microwave and should have deleted outdated items
such as using a pay phone or using a telephone book to find a phone number. We will briefly
present these four aforementioned standardized adaptive behavior instruments.
Adaptive Behavior Assessment System 3
nd Edition
The Adaptive Behavior Assessment System 3nd Edition (ABAS-3; (ABAS-3; Harrison &
Oakland, 2015) is in its third edition, having been first published in 2000. The ABAS-3 was the first
comprehensive norm-referenced measure of adaptive behavior to offer standard scores for the three
adaptive behavior domains: conceptual, social, and practical adaptive skills. The ABAS-3 can be
used for multiple purposes, including: (1) making the determination of intellectual disability,
developmental disabilities, learning disability, and behavioral and emotional disorders; (2) identifying
functional limitations of people with autism spectrum disorder, attention deficit/hyperactivity
disorder, and Alzheimer disease; (3) establishing an individual’s eligibility for services and supports
under Individuals with Disabilities Education Act (IDEA), social security administration benefits,
Adaptive Behavior 14
and intensity of need for other types of supports and services; (4) identifying and measuring
intervention goals and progress in adaptive behavior and functional limitations interventions, and (5)
being used as an outcome measure in program evaluations and interventions. It has robust norms
drawn from the general population and it can be used to assess adaptive behavior across the
lifespan, including the ages of 0 to 89 years.
The ABAS-3 consists of five distinct survey forms:
o Parent or Primary Caregiver Form (0 5 years old): appropriate for the assessment of
adaptive behavior in infants and preschoolers in the home. The respondent providing
adaptive behavior information on this form is the child’s parent or other primary caregiver.
o Teacher or Daycare Provider Form (2 5 years old): used for the assessment of adaptive
behavior in toddlers and preschool-aged children in daycare, preschool, and other similar
setting. The respondent for the Teacher or Daycare Provider Form is typically the child’s
daycare or preschool teacher or teacher’s aide, or some other childcare or preschool
personnel.
o Parent Form (5 21 years old): appropriate for the assessment of adaptive behavior in
children and adults and observed having been observed at home and other community
settings. The respondent completing the Parent Form is generally the child’s parent or other
caregiver who lives with the child or adult.
o Teacher Form (5 21 years old): used to assess adaptive behavior in children or adults in
the context of the classroom and school (Kindergarten to 12th grade). The respondent for
this form is generally the student’s teacher, teacher’s aide, and other school personnel.
o Adult Form (16 89 years old): appropriate for the assessment of adaptive behavior in
adolescents and adults in the context of their home and across community settings. The
Adaptive Behavior 15
respondent on the Adult Form is most often a parent/caregiver or other family member but
can also be completed, when the respondent has sufficient knowledge of the person’s
adaptive behavior, a spouse/significant other, co-worker, work supervisor, friend, or other
knowledgeable person who has good familiarity with the individual’s everyday functioning.
The ABAS-3 Adult Form is the only adaptive behavior form that has been developed and
normed for self-report by the individual him or herself. Self-reported adaptive behavior
information is most valuable for the identification and prioritization of teaching and training
goals targeting adaptive skills.
Although the ABAS-3 User’s Manual (Harrison & Oakland, 2015) indicated that the
administration time is approximately 15-20 minutes, a more realistic time of administration is
probably closer to 30 40 minutes to complete the adult form. The ABAS-3 continues to be the
only standardized adaptive behavior scale that provides a self-report administration and norms for
self-reported adaptive behavior using the Adult Form.
The ABAS yields standard scores (Mean = 100; standard deviation = 15) presenting an
overall assessment of adaptive behavior (i.e., General Adaptive Composite[GAC}) and the three
adaptive behavior domains: Conceptual, Social, and Practical skills. The ABAS-3 forms also provide
more discrete standard scores (mean = 10 and standard deviation = 3) across the following 10
subscales: (1) communication, (2) functional academics, (3) self-direction, (4) leisure, (5) social, (6)
community use, (7) home/school living, (8) health & safety, (9) self-care, and (10) work (completed
only when assessed person has a part-time or full-time job). These subscale scores are probably the
most informative sources of measurement when looking to assess adaptive behavior/functional
limitations for the purpose of intervention planning and evaluation.
Adaptive Behavior 16
The ABAS-3 has been in use for more than two decades and has good psychometric
properties (Henington, 2017; Wu, 2017). Harrison and Oakland (2015) reported internal consistency
for the ABAS-3 GAC Cronbach alphas ranging from .96 .99 and from .85 .99 for Conceptual,
Social, and Practical domains. Harrison and Oakland also reported very good score stability for the
ABAS-3 average GAC correlation coefficient of r = .86, average correlation coefficients of r = .76
for the domain standard scores, and an average r = .70 across the ten adaptive skill areas.
Adaptive Behavior Diagnostic Scale
The Adaptive Behavior Diagnostic Scale (ABDS; Pearson, Patton, & Mruzek, 2016) is one
of the newer standardized adaptive behavior scales. Although an entirely new adaptive behavior
scale, the ABDS was developed by Pro-Ed and is a replacement for the Adaptive Behavior Scale:
School Edition (Lambert, Nihira, & Leland, 1993) and Adaptive Behavior Scale: Residential and
Community (Nihira, Lambert, & Leland, 1993).
The ABDS is an interview-based scale that assesses adaptive behavior with robust general
population norms for individuals from 2 to 21 years. This instrument was specifically developed
using the conceptual model of adaptive behavior domains including: Conceptual, Social, and
Practical skills. The ABDS consists of a total of 150 items, with 50 discrete adaptive skill items
across each of the three domains. Administration of this instruments is approximately 15-20
minutes. The results of the ABDS yields standard scores (mean = 100 and standard deviation = 15)
for each of the three domains: Conceptual, Social, and Practical as well as an overall Adaptive
Behavior Index.
Pearson et al. (2016) reported excellent psychometric properties, including internal
consistency coefficients for all domain and overall index standard scores above .90. Pearson et al.
reported sensitivity coefficient of .85 (accuracy of ABDS to correctly identify people with intellectual
Adaptive Behavior 17
disability) and specificity coefficient of 0.99 (accuracy of ABDS to correctly identify people who do
not have intellectual disability).
Diagnostic Adaptive Behavior Scale
The Diagnostic Adaptive Behavior Scale (DABS; Tassé et al., 2017) is the newest of the
comprehensive adaptive behavior scales available. Like the ABDS, the DABS was developed and
refined to accurately measure adaptive behavior according the conceptual model adopted by
AAIDD (Schalock et al., 2010) and the DSM-5 (American Psychiatric Association, 2013). The
DABS construction used item response theory (IRT) to select and include the most precise and
relevant items/skills that inform about a person’s adaptive behavior across the ages of 4 to 21 years
(Tassé et al., 2016; 2017). The DABS’s item pool includes items that are often missing from more
traditional adaptive behavior scales, items measuring concepts of higher order social skills such as
gullibility, vulnerability, and social naiveté.
The DABS consists of the fewest number of total items among all the comprehensive
standardized adaptive behavior scales described in this chapter. It consists of a total of 75 items
across all three adaptive behavior domains: Conceptual, Social, and Practical skills (25 items per
domain). The DABS is administered via a semi-structured interview between a professional (i.e.,
DABS interviewer) and a respondent (e.g., parent, grandparent, caregiver, teacher, etc.). The time
needed to administer the DABS is generally estimated to be approximately 20 minutes. Because the
DABS using IRT to score the responses and yield individualized standard error or measurement, the
scoring of the DABS can only be done via online computerized scoring (see
https://aaidd.org/dabs). This scoring provides standard scores (mean = 100 and standard deviation
= 15) for each of the three domains (Conceptual, Social, and Practical) as well as Overall or
Composite Adaptive Behavior score.
Adaptive Behavior 18
The DABS was standardized on a large national sample of the general US population
between the ages of 4 and 21 years (Tassé et al., 2017). The authors of the DABS (Balboni et al.,
2014; Tassé et al., 2017; Tassé, Schalock, Balboni, Spreat, & Navas, 2016) have published several
studies reporting strong psychometric properties, including robust validity and reliability. Tassé,
Schalock, et al. (2016) reported good to excellent concurrent validity between the DABS and the
Vineland-II ranging from r = .70 to .84. They also reported strong DABS test score stability, as
measured using test-retest reliability coefficients, ranging from r = .78 to .95 and good interrater
concordance as measured by intraclass correlation coefficients that ranged from .61 to .87. Balboni
et al. (2014) reported on the DABS sensitivity and specificity. The DABS sensitivity (correctly
identifying someone who has intellectual disability) ranged from 81% to 98% and specificity
(correctly identifying someone who does not have intellectual disability) ranged from 89% to 91%,
Vineland Adaptive Behavior Scale, 3
rd Edition
The Vineland Adaptive Behavior Scale, 3rd Edition (Vineland-3; Sparrow, Cicchetti, &
Saulnier, 2016) is the oldest and probably best known comprehensive standardized adaptive
behavior scale. The Vineland-3 has its roots in the Vineland Social Maturity Scale (VSMS; Doll,
1936) and has gone through several revisions since its first edition. The Vineland-3 measures
adaptive behavior in individuals from 0 through 90 years old and consists of three forms: (1)
Interview Form (0 through age 90), (2) Parent/Caregiver Form (0 through age 90), and (3) Teacher
Form (3 to 21 years old). All three forms have two versions, depending on the purpose of the
evaluation, including the Domain-level Form and a longer version called the Comprehensive Form.
The Comprehensive Form is used for the purpose of providing more detailed skill information
needed for intervention planning and evaluation. It yields standard scores (mean = 100 and
standard deviation = 15) for: (a) Composite Score and (b) three domain scores (Daily Living Skills,
Communication, Socialization). It also provides standard scores on a scale of mean = 10 and
Adaptive Behavior 19
standard deviation =3 for nine subdomain scores: personal, domestic, community, receptive
communication, expressive communication, written communication, interpersonal relationships,
play and leisure time, and coping skills. The Domain-level Form is shorter and provides standard
scores (mean = 100 and standard deviation = 15) across the three VABS-3 domains: Daily Living
Skills, Communication, and Socialization (as well as the optional domain of Motor Skills) and is
most useful for the purpose of making diagnostic determinations.
The Vineland-3 can be administered via a semi-structured interview using the Interview
Form or be given directly to the parent or caregiver who complete the instrument directly on their
own (i.e., Parent/Caregiver Form). These different forms consist of approximately comparable
number of items but have slightly different item stem wordings. The Comprehensive Form consists
of 502 items and Domain-Level Form consists of 195 items on the interview form and 180 items on
the parent/caregiver form. The Teacher Form is not usually used in isolation, but is instead often
used in conjunction with the Interview Form or the Parent/Caregiver Form. The Teacher Form:
Comprehensive Form consists of 333 items and Teacher Form: Domain-level Form consists of 149
items. Below is a brief description of the different Vineland-3 forms:
o Interview Form (0 to 90 years old): The Interview Form is administered via a semi-
structured interview between a professional and the respondent (parent or caregiver). The
Vineland-3 uses an interview procedure that encourages the interviewer to engage in a
conversation with the respondent about the assessed person’s adaptive behavior and
encourages the interviewer to avoid directly eliciting ratings from the respondent on the
individual item stems but rather instructs the interviewer complete the item ratings at the
end of the interview with the respondent. The Interview Form has two versions:
Comprehensive Form (502 items) or Domain-level Form (195 items). According to the
Vineland-3 User’s Manual, the time of administration is 25 minutes for the Domain-level
Adaptive Behavior 20
Form (195 items) and 40 minutes for the Comprehensive Form (502 items).
o Parent/Caregiver Form (0 to 90 years old): This form is completed directly by the parent or
caregiver much like a rating scale. The respondent rates the assessed person’s performance
on each of the adaptive skill items. The Parent/Caregiver Form has two versions:
Comprehensive Form (502 items; identical items that are included on the Interview Form) or
Domain-level Form (180 items). The Vineland-3 User’s Manual list the time of
administration for the Domain-level Form at 15 minutes and the Comprehensive Form at 40
minutes.
o Teacher Form (3 to 21 years old): Similar to the Parent/Caregiver Form, the Teacher Form
is completed directly by the teacher, teacher’s aide, or a daycare staff member who assesses
the student’s observed performance on each of the adaptive skill items. The Teacher Form
also consists of two forms: (1) Comprehensive Form (333 items) and (2) Domain-level Form
(149 items). The Vineland-3 User’s Manual reports the administration time for the Teacher
Form: Domain-Level version (149 items) at approximately is 10 minutes and the Teacher
Form: Comprehensive version (333 items) necessitating approximately 25 minutes to
complete.
The Vineland-3 domains are slightly different from the other comprehensive standardized
scales (e.g., ABAS-3, ABDS, and DABS) and not consistent with the recommended domains in the
AAIDD (Schalock et al., 2010) and DSM-5 (American Psychiatric Association, 2013).
The Vineland-3 provides its items and standard scores (mean = 100 and standard deviation
= 15) aggregated across the following four domains: Daily Living Skills, Communication,
Socialization, and Motor Skills (optional domain for children under 6 years old). These Vineland-3
domain names are the same domain names used in original Vineland scale and the authors have
Adaptive Behavior 21
chosen to maintain these domain names despite their lack of alignment with the current tripartite
model of adaptive behavior (conceptual, social, and practical) used by the existing diagnostic systems
(e.g., AAIDD, DSM-5).
The Vineland-3 has robust and representative norms of the general population. It has good
to excellent psychometric properties, including internal consistency, score stability as measured by
test-retest reliability, and inter-respondent concordance (Pepperdine & McCrimmon, 2017). Sparrow
et al. (2016) reported excellent internal consistency coefficients across all domains, with Cronbach
alphas ranging from .90 to .98. The test-retest reliability of the Vineland-3 scores ranged from r =
.80 to .92 for the adaptive behavior composite standard score. Inter-respondent concordance was
reported at r = .79 for the adaptive behavior composite and ranging from .70 to .81 for the different
domains.
Other Means and Measures
An important source of information about a person’s skills and functional abilities can be
obtained from direct observations of the person or via semi-structured clinical interviews with
people who have lived with, worked with, or had the opportunity to observe the person on a regular
basis and seen how they function at home, school, work, and/or play. These semi-structured
interviews do not need to be based on a standardized measure and can consist of tailored questions
that focus on the skill areas of interest or at the center of an intervention (e.g., self-care, cooking,
home living skills, money concepts, work skills, social skills, etc.).
There exists also a number of school, medical, or other personal records that might provide
valuable information, either as a primary source or as a supplemental or use to corroborate adaptive
behavior or functional skills information obtained through other means. These records include:
social and family history, medical records, school performance, IEPs, educational, psychological, or
neuropsychological evaluations, work records, social security administration evaluations, etc.
Adaptive Behavior 22
There are a number of other comprehensive standardized measures that are more focused
on specific adaptive skills or functional skills that can provide useful information about a person’s
skill levels. These can also serve well to inform on specific skill or domain areas. Below are a couple
of good examples of such instruments.
Social Skills Improvement System Rating Scales
The Social Skills Improvement System - Rating Scales (SSIS; Gresham & Elliott, 2008) is a revision
of the popular Social Skills Rating System (SSRS; Gresham & Elliott, 1990). The SSIS is a suite of
rating scales that are used to measure the social skills as well as problem behaviors of children and
adolescents between the ages of 3 and 18 years old. The SSIS is particularly focused on social skills
and problem behavior that the authors have identified as especially relevant for school success (Doll
& Jones, 2010).
The SSIS can be completed directly by student on a self-report form or completed by a
third-party respondent (e.g., parent form or teacher form). Students, parents and teachers provide
an individual rating of the frequency and perceived importance of each social skill item. The student
self-report form consists of 46 items, whereas, the parent/teacher forms consist of 46 social skill
items and an additional 33 items identifying problem behaviors for the parent to rate or 30
additional items identifying problem behaviors for the teacher to rate. The administration time of
the SSIS ranges from 10 to 25 minutes.
The SSIS can be scored by hand or using a computerized scoring system. The scoring of the
SSIS yields standard scores (mean = 100, standard deviation = 15) and a criterion-based evaluation
(well-above average, above average, average, below average, well below average) across: social skills,
problem behaviors, and academic competence (teacher ratings only). Perhaps the most practical
Adaptive Behavior 23
information comes in the form of a series of suggested actions and interventions objectives derived
from the results from the SSIS ratings.
In terms of psychometric properties for the SSIS, they are good (Crosby, 2011). The social
skills assessment across all three forms provides practical and psychometrically sound information
(Doll & Jones, 2010) and a useful screening tool to aide teachers in planning interventions targeting
social skills (e.g., the accompanying intervention guide; Crosby, 2011; Lee-Farmer & Meikamp,
2010).
Texas Functional Living Scale
The Texas Functional Living Scale (TFLS; Cullum, Weiner, & Saine, 2009) is a brief
performance-based individually administered screening measure that assesses independent living
skills in the areas of: time, money concepts and calculations, communication, and memory. The
focus of the TFLS items is on the abilities that might be most impacted by age-related cognitive
decline. Although initially developed to assess functional living skills in older adults with dementia,
the FTLS was normed on a larger sample of the general population aged from 16 to 90 years old in
the hopes of expanding its utility to include individuals across the lifespan with other disabilities
(e.g., intellectual disability, traumatic brain injury, and schizophrenia; Lindsay-Glenn, 2010).
The TFLS consists of 24 items that are administered directly to the assessed person and
requires either a verbal or written response. The total administration time requires less than 15
minutes. The TFLS yields t-scores (mean = 50, standard deviation = 10) which are typically more
complicated for most practitioners to use and understand than the more traditional normative scores
with a mean = 100 and a standard deviation = 15. The TFLS has shown some utility in identifying
intervention goals as well as measuring treatment outcomes and effectiveness in the defined
independent living skill areas that it assesses.
Adaptive Behavior 24
The psychometric properties of the TFLS are adequate for a screening instrument (Strang,
2010; Lindsay-Glenn, 2010). The internal consistency reliability ranges from .65 to .81 and
reportedly good test score stability. Its validity evidence was measured using a comparison between
the TFLS and the ABAS, 2nd Edition. These correlation coefficients assessing its concurrent validity
were in the range of .41 to .80. Overall, the range of skills assessed is limited but the TFLS has
shown to be a useful screening tool that can inform on performance across the limited number of
functional skills its measures: time, money and calculations, communication and memory (Lindsay-
Glenn, 2010).
Teaching Adaptive Behavior
A person’s level of adaptive behavior is an indicator of how well an individual typically
functions in everyday life, which is also highly predictive of positive life outcomes and has important
implications for intervention (Farley et al., 2009; Kanne, Gerber, Quirmbach, Sparrow, Cicchetti, &
Saulnier, 2011). Teaching and promoting the acquisition of adaptive behavior should be an essential
goal of any intervention. Gresham and colleagues have described the importance of social skills as
academic enablers and problem behaviors as academic disablers (Gresham, 2015; Gresham &
Elliott, 2008). The outcome of increasing a person’s adaptive behavior will often lead to greater
independence, personal autonomy, likelihood of being in an inclusive setting, self-direction, overall
quality of life as well as a reduced perception among laypeople that the person has a disability. The
DSM-5 (American Psychiatric Association, 2013) embraced using the person’s level of adaptive
functioning as the determinant of severity of intellectual disability, because adaptive behavior is a
better indicator of the person’s overall functioning and intensity of needed supports. With the
proper level of instruction and supports, people with intellectual disability can learn new adaptive
Adaptive Behavior 25
skills throughout their life and as a result, their overall functioning will generally improve (Schalock
et al., 2010).
Henry Leland, a pioneer in the field of intellectual disability, once said that it was a person’s
adaptive behavior deficits that made others in their community take notice of them and identify
them as a person with a disability. Once exited from school, one’s intellectual functioning plays a
lesser role than their adaptive functioning in predicting successful life outcomes. A good illustration
of this is what was once called the “6-hour retarded student.” These were students who, when in
school, were identified as having an intellectual disability and received special education services but
when out of school, they were seen by others in their neighborhood as a regular kid largely because
of their adaptive behavior (President’s Committee on Mental Retardation, 1970).
A fundamental assumption is that with proper instruction and supports, people with
intellectual disability can and will learn new adaptive skills throughout their lifetime and their
functioning will improve (Schalock et al., 2010).
Summary and Conclusions
Adaptive behavior is a separate and independent construct of intellectual functioning and
equally essential in making the determination of intellectual disability. Adaptive behavior is a
complex construct that includes skills in domains such as conceptual, social, and practice skills. It is
an important aspect of human functioning that deficits in adaptive behavior are a core feature of
number of conditions. There are a number of robust and reliable assessment instruments available
to assist clinicians in determining intervention goals geared at increasing adaptive skills. The
presence of adaptive behavior has been shown to be associated with fewer challenging behaviors,
enhanced opportunities across settings and throughout the lifespan as well as being related to
improved overall quality of life. With person-centered interventions and supports, a person will
Adaptive Behavior 26
learn and improve their adaptive skills and ability to meet the expectations and demands. Teaching
and promoting the acquisition of adaptive behavior should be an essential goal of any intervention.
It is important to remember that anyone can learn new adaptive behaviors and functional living
skills, no matter their ability/disability level and these new skills, if selected appropriately, can
contribute to improved functioning, enhanced independence and overall quality of life.
Adaptive Behavior 27
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... • Clinical description, diagnosis, support interventions (Tassé, 2021 ;Tassé & Balboni, 2021) • Role of the environmental factors ...
Presentation
Background. Adaptive Behavior (AB) is an essential component of everyday functioning and constitutes a fundamental dimension of many developmental and neurodevelopmental disorders, both in their clinical description and diagnosis, as well as in support interventions. In preschool children with special educational needs with such disabilities, environmental factors, particularly the family context, exert considerable influence on the development and learning of adaptive skills. This study aims to examine family context as a factor associated with AB. Method. Preliminary analyses were conducted on data from 17 participants aged 42 to 59 months, collected from parents of children in Switzerland for whom a request for special educational measures has been made for their forthcoming school entry. The French version of the Diagnostic Adaptive Behavior Scale (DABS-F, currently under validation) was used to measure the conceptual, social, and practical domains of AB. Additionally, the family context, including dimensions such as the child's position among siblings, the family's social capital, and the parental profile, was explored through socio-demographic questions associated with the administration of the DABS-F. Findings. The results of these analyses reveal associations between family context and AB, especially in the social domain. Indeed, children who are the youngest in their sibling groups exhibit higher social skills scores than the only children in the sample. Similarly, children from families with higher scores in family or friends' social capital demonstrate higher social skills scores. Finally, it appears that children whose parents report having fewer protective behaviors have lower social skills scores. Conclusions. Results of this study provide preliminary evidence of the relationships between the three dimensions of AB and the family context, with particularly interesting results concerning the social domain. Understanding these relationships helps to highlight family and adaptive resources and challenges, facilitating the intervention of the support needed to promote a better home-school transition.
... Adaptive behavior is a relevant construct in determining the development of human functioning level in the disability context. In the literature, the link between adaptive functional behavior and the degree of autonomy and the quality of life of people with disabilities is underlined, with higher levels of adaptive behavior associated with more positive life outcomes and improved quality of life [1]. Defined as a set of skills and behaviors learned to perform and respond to daily requirements, functional adaptive behavior could be associated with how students with disabilities perceive teachers' support regarding their autonomy. ...
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Optimizing adaptive functional behaviors is an essential goal of educational programs for students with support needs. The relevance of social and personal factors such as perceived teacher autonomy support, self-determination, and self-concept are highlighted, these constructs through direct and indirect effects could lead to modification and changes of adaptive functional behaviors and skills. The purpose of the present study is to investigate the patterns of relationships in terms of direct and indirect effects among perceived teacher autonomy support, adaptive functional behaviors, self-determination, and self-concept in the Romanian intellectual disability context. Standardized measuring instruments such as the Learning Climate Questionnaire, Child and Adolescent Social Adaptive Functioning Scale, The AIR Self-Determination Scale student form, and Five-Factor Self-Concept questionnaire were administered to a total number of 275 students with support needs consecutive to intellectual disability conditions (M = 14.47, SD = 1.11). The study’s findings showed that perceived teacher autonomy support, self-determination, and self-concept positively and directly affect adaptive functional behaviors and skills. The mediating roles of self-determination and self-concept on the relationship between perceived autonomy support and adaptive behavior were significant, indicating partial mediations. The study contributes to current Romanian research in this field, and practical educational implications were directed.
... In the case of congenitally disabled, including intellectual and developmental disabilities, adaptive behaviors are evaluated to set goals for education and rehabilitation [16]. Adaptive behavior is an intentionally learned action defined as the level of daily performance of tasks necessary to fulfill normal roles in society, including maintaining independence and meeting the cultural expectations of personal and social responsibility [17]. ...
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The adjustment of stroke survivors is self-directed and multi-dimensional. This study developed an adaptive behavior scale for stroke survivors reflecting these characteristics and performed a psychometric evaluation. The item pool was derived based on conceptual attributes and indicators of adaptive behaviors for stroke survivors. Ten experts assessed the content validity. The scale was refined through pilot testing and interviews with 10 stroke survivors. From December 2021 to May 2022, a self-report questionnaire consisting of a five-point Likert scale was administered to 215 stroke survivors visiting a university hospital in S City, South Korea. Item analysis and confirmatory factor analysis were conducted to assess the construct validity; reliability was confirmed using Cronbach’s α. The final scale comprised three factors and 16 items: taking an optimistic view, restructuring daily activities to suit oneself, and carrying out one’s daily life. The confirmatory factor analysis indicated a good fit for the three-factor model; Cronbach’s α coefficient of the scale was 0.90, indicating a very good internal consistency. This easy-to-use, concise self-report scale applies to stroke survivors from subacute to chronic stages, providing healthcare professionals with the basic data needed to assess their adaptation. It may also facilitate individualized intervention program development to improve stroke survivor adaptation.
... Adaptive skills, even in young children, support individuals to "meet the demands and expectations of their environment" (Tassé, 2021, p. 1). As one gets older, adaptive skills become more complex to meet the challenges of more complex social and emotional responsibilities (Tassé, 2021). ...
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The literature has yet to review the differential effects of Natural Environment Teaching (NET) and Discrete Trial Teaching (DTT) on adaptive skills. A sample of 142 children diagnosed with ASD between the ages of 16 and 35 months received either DTT, NET, or both interventions (NET+ DTT). The Bayley Scales of Infant and Toddler Development (BSID) Adaptive Subscale and the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) Barriers Assessment were used as baseline and posttest measures. Children who received NET and NET+DTT conditions showed significant improvements compared to the DTT condition indicating that the addition of NET leads to increased adaptive skills and decreased barrier behaviors in participants. DTT may also play a necessary foundational role for children with more significant delays. These results provide support for the use of a combination of teaching strategies in community-based early intervention and refine protocols for teaching adaptive skills to toddlers with ASD.
... Intelligence remains relatively stable, but adaptive skills with appropriate personalized support could be learned and developed over time; moreover, people with intellectual disabilities are able to learn new adaptive skills throughout life and improve their conditions [9,10]. In fact, persons with intellectual disabilities may have or develop some talents and skills that make them eligible to be part of the work force. ...
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Background Adaptive behavior is an important characteristic of people with intellectual disabilities, and it has been associated with a person's performance in social and work contexts. Indeed, adaptive behavior denotes what a person does independently, without help, support, reminders, or prompts. In Peru, available measures of adaptive behavior are commercial; thus, there is a need for an open-access tool to assess the adaptive behavior of people with intellectual disabilities. For this reason, the aim of the study was to design and develop a new Adaptive Behavior Test Battery for people from 13 to 60 years old with intellectual disabilities who have an interest in being part of the economically active population. Methods A cross-sectional design was defined, starting with a qualitative approach to designing and constructing the item pool for the test battery. Then, quantitative indexes Aiken's V for content validity and Krippendorff's alpha for inter-observer reliability were estimated, resulting in a first version of the three subscales that comprised the test battery. The initial versions were tested on a sample of 566 persons with intellectual disabilities from two regions of Peru: Lima (Coast) and San Martín (Jungle). The internal structure was analyzed under a factor analysis approach, along with internal consistency measures of reliability. Further analyses of invariance regarding gender, region, and age were carried out. Results Three observer subscales were proposed: Daily living activities (11 items), Instrumental skills (4 items), and Communication (9 items). All subscales showed excellent psychometric properties denoted by the Aiken's V coefficient, Krippendorff's alpha, factor analysis, internal consistency analysis, and invariance analyses. Conclusion The developed a new Adaptive Behavior Test Battery is a useful tool for the measurement of adaptive behavior and the monitoring of social and labor inclusion programs for people with intellectual disabilities.
... Beyond cognitive abilities, social and practical domains play a crucial role. The social domain covers empathy, interpersonal skills, and the ability to form friendships, while the practical domain involves selfmanagement in education, work, and leisure [36]. People with the same diagnosis can exhibit a high degree of variability in characteristics, influenced by differences in cognitive skills like language, memory, attention, and visual-perceptual abilities [40]. ...
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This paper presents a framework for integrating scaffolding in co-design sessions with people with cognitive and learning disabilities. While scaffolding has been recognized for enhancing participant engagement in co-design, its application lacks standardization. Our study pursues three primary objectives: (1) Present two case studies involving an Augmented Reality application and the ACCESS+ museum application, highlighting specific user needs; (2) Adapt the concept of scaffolding to support the informal learning needed to interact with technology while having an active role in co-design (3) Discuss how to revisit collaborative design to become more accessible and inclusive as to empower people with cognitive and learning disabilities. Through a methodical approach of task subdivision, prompt initiation , assessment of understanding, support through prompting and fading, and repetition if needed, our framework demonstrates how tailored scaffolding can effectively engage participants, emphasizing the importance of integrating diverse perspectives in technology development.
... The number and complexity of adaptive behaviors needed to meet these demands increases with age. It can be concluded that higher levels of adaptive behavior are associated with more positive life outcomes and better quality of life (Tassé, 2021). ...
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Objectives of the research: The goal of the research was to identify the type and extent of activities that special education facilities engage in to teach and promote independence in people with profound disorders of intellectual development. Research methods: Empirical material was collected using the author’s original online questionnaire, which consisted of 30 questions measuring the extent to which students’ needs for developing independent living skills are met. The survey was conducted among special education teachers (N=642) from seven European countries (Portugal, Spain, Belgium, Poland, Bulgaria, Romania, and Turkey). A short description of the context of the issue: Independent living is widely seen as an immanent attribute of adulthood. Children and adolescents are prepared for independent living through the process of upbringing and socialization; people with disabilities are additionally prepared through rehabilitation. For people with a profound disorder of intellectual development, independent living is challenging but possible with the right support. Research findings: The results indicate that in the course of developing independent living skills in people with profound disorders of intellectual development, efforts are mainly made to improve their self-management skills and democratic management methods in both team work and individual work. Conclusions and recommendations: In the surveyed countries, there is a tendency to limit work for developing independent living skills to a single type of intervention. Rarely are two or three methods – not to mention four – simultaneously used to stimulate the development of independent living skills. It is therefore necessary to call for increased efforts to promote independent living among people with profound disorders of intellectual development and to focus this support on autonomy, self-determination, achieving quality of life goals, and, above all, the ability to make decisions – since this is what determines true independence in life.
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The term severe disability is primarily used in reference to people with severe to profound cognitive and adaptive functioning impairments associated with intellectual disability, autism spectrum disorder, and/or cerebral palsy. However, the term severe disability could also be applied to some individuals with traumatic brain injury and various neurodegenerative conditions, such as Alzheimer’s, amyotrophic lateral sclerosis, and other motor neuron diseases. This chapter describes a range of conditions associated with severe disability. The cognitive and adaptive functioning limitations of people with severe disabilities, and associated learning and behavioral characteristics, are also reviewed.
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Introduction Studies of cognitive functioning in patients with attention‐deficit/hyperactivity disorder (ADHD) have often used healthy comparison groups. The present study examines cognitive profiles, including general intellectual and executive functions, in a young adult psychiatric outpatient clientele with ADHD and evaluates whether their cognitive profiles can help differentiate them from patients with non‐ADHD‐associated psychiatric disorders. Methods The study group comprised 141 young adult psychiatric patients (age range 18–25 years) of whom 78 had ADHD. Comprehensive neuropsychological assessment included the Wechsler Adult Intelligence Scale, 4th version and subtests from Delis–Kaplan Executive Function System. Clinical psychiatric assessments and diagnostic evaluation were performed. Results The ADHD group (including all subtypes) had significantly lower verbal comprehension and full‐scale intelligence quotient than the non‐ADHD group. Tests measuring working memory or executive function did not separate those with and without ADHD. Conclusion The results of our study suggest that, except for the need to establish overall cognitive performance level, the clinical implication of testing is small if the purpose is to “rule out” an ADHD diagnosis.
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Background Adaptive behaviour is an important characteristic of people with intellectual disabilities, and it has been associated with the individual’s requirements to performance adequately in the social context. Indeed, measuring adaptive behaviour indicates what an individual does independently, without help, support, reminders, or prompts. Peru has a particular society and there is not an accessible scale to evaluate the adaptive behaviour in people with intellectual disabilities. We proposed to create and obtain evidence of validity and reliability of a new Adaptive Behaviour Test for people over 15 years old with intellectual disabilities with interest in being part of the economically active population. Methods We used a qualitative approach to construct the test, the Aiken V coefficient to assess content validity, and Krippendorff's alpha for inter-observer reliability. We performed an exploratory and confirmatory factor analysis to assess the internal structure and consistency to check the homogeneity between the proposed items. We performed convergent validity to analyze the relationship of the test with other variables. Results We obtained a 25-item test with three dimensions: a) activities of daily living; b) instrumental skills and c) communication. Aiken's V coefficient, Krippendorff's alpha, factor analysis and internal consistency allowed us to identify the most important items and confirm the factors. convergent validity with quality of life was demonstrated. Conclusion The developed scale is a useful screening test for the measurement of adaptive behavior and the monitoring of social and labor inclusion programs, the results show that the items and factors contribute to the measurement of the construct.
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Definition of Intellectual Disability and Assumptions Regarding Its Application (Schalock, Luckasson, & Tassé, 2021) Intellectual disability (ID) is characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates during the developmental period, which is defined operationally as before the individual attains age 22. The following five assumptions are essential to the application of this definition: 1. Limitations in present functioning must be considered within the context of community environments typical of the individual’s age peers and culture. 2. Valid assessment considers cultural and linguistic diversity as well as differences in communication, sensory, motor, and behavioral factors. 3. Within an individual, limitations often coexist with strengths. 4. An important purpose of describing limitations is to develop a profile of needed supports. 5. With appropriate personalized supports over a sustained period, the life functioning of the person with ID generally will improve. Source: Schalock, R. L., Luckasson, R.., & Tassé, M. J. (2021). Intellectual disability: Definition, diagnosis, classification, and systems of supports (12th edition). American Association on Intellectual and Developmental Disabilities. https://www.aaidd.org/intellectual-disability/definition
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Studies have shown that executive function abilities are related and have predictive power over adaptive behaviour in both typical and atypical populations. This study examined the relationship between executive functioning and adaptive behaviour in adolescents with Down syndrome, as it has not been studied before in this population. We propose and test a model of how each core EF (i.e., working memory, inhibition, and flexibility) contributes to each domain of AB (i.e., conceptual, social, and practical). We found that parent reported Conceptual skills were related to working memory, while teacher reported Conceptual and Practical skills were related to inhibition and flexibility. We hypothesise that these findings are related to the different requirements and expectations of the home and school environments: the more predictable home environment requires the adolescent to rely on working memory for his everyday activities, while the changing and challenging school environment requires the inhibition common behaviours and to flexibly change actions to be successful.
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Down syndrome (DS) is characterized by difficulties in both intellectual functioning and adaptive behavior. These sets of abilities are considered as separate but related domains with small to moderate correlations. The main objective of this study was to explore the relationship of intellectual functioning and adaptive behavior in adolescents with DS because previous studies have shown different relationship patterns between these constructs across other syndromes. Fifty-three adolescents with DS were assessed regarding their intellectual functioning whereas adaptive behavior was reported by parents and teachers. Participants showed a better performance on verbal than nonverbal tasks when assessing intellectual functioning, contrary to previous findings. Regarding adaptive behavior, higher social skills were reported than conceptual and practical skills. Intellectual functioning and adaptive behavior showed a medium correlation, consistent with observations in typical population. These results support the exploration of the variability across the DS phenotype.
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This study examined the role of parent expectations and adaptive behavior in predicting outcomes for youth with intellectual disability. A sample of students with intellectual disability were drawn from the National Longitudinal Transition Study-2 for inclusion in this study. Four latent variables were created: demographic factors, adaptive behavior, parent expectations, and post-school outcomes. Structural equation modeling was used to test relationships between these constructs. Results indicated that adaptive behavior was more important than parent expectations in predicting post-school outcomes. Results supported the conclusion that adaptive behavior plays a critical role in post-school success for individuals with intellectual disability and that parent expectations alone were insufficient to ensure positive outcomes for youth with poor adaptive skills. Implications are discussed.
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Increased emphasis has been placed on including an evaluation of adaptive behavior in the assessment of children considered mildly mentally retarded. Reasons for this increased emphasis are reviewed, including general trends in societal views concerning treatment of the mentally retarded. Following a discussion of the various definitions of adaptive behavior, the present article discusses the relationship between measures of adaptive behavior and intellectual ability and the issue of declassification. Particular emphasis is placed upon the educational relevance of adaptive behavior in efforts toward nonbiased assessment and classification of the mildly retarded.
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Intelligence tests and adaptive behavior scales measure vital aspects of human functioning. Assessment of each is a required component in the diagnosis or identification of intellectual disability. The present study investigated the population correlation between intelligence and adaptive behavior using psychometric meta-analysis. The main analysis included 148 samples with 16,468 participants. Following correction for sampling error, measurement error, and range departure, analysis resulted in a population correlation of ρ = .51. The most pertinent moderator analysis indicated that the relation between intelligence and adaptive behavior tended to decrease as IQ increased. The theoretical prevalence of intellectual disability is affected not only by IQ and adaptive behavior cut scores but also by the correlation between the two; thus, these findings inform practice and policy related to eligibility criteria and prevalence of intellectual disability.
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Adaptive behavior is a critical metric for measuring outcomes in those with autism spectrum disorder (ASD). Executive function skills predict adaptive behavior in youth with ASD with average or higher IQ; however, no study has examined this relationship in ASD with lower IQ (IQ ≤ 75). The current study evaluated whether executive function predicted adaptive behavior in school-age youth with ASD with lower IQ, above and beyond nonverbal IQ. We examined adaptive behavior and executive function through informant report on 100 youth with ASD with lower IQ. Executive function skills explained variance in adaptive social and communication domains, beyond nonverbal IQ; monitoring skills played a significant role. This research suggests that malleable skills like executive function may contribute to functional outcomes in this population.