Adaptive Behavior and Skills Professional Standards Assessment and

Adaptive Behavior and Skills: Professional Standards, Assessment, and Uses

Conceptual Foundations of Adaptive Skills Assessment

Adaptive skills assessment has been important in a data-based, decision-making model of psychological, educational, social, and rehabilitative services. A data-based, decisionmaking model is applicable for: • assessing daily functional adaptive skills • identifying deficits or problems in adaptive skills • designing and implementing interventions for increasing adaptive skills • monitoring the effectiveness of adaptive skill interventions

An emphasis on adaptive skills, not merely the more general concept of adaptive behavior, is needed to better promote functional development.

Adaptive skills comprise everyday competence. Adaptive skills are defined as practical, everyday skills needed to function and meet the demands of one's environment, including the skills necessary to effectively and independently take care of oneself and to interact with other people.

Professional Standards Governing Adaptive Assessment

Adaptive skills have been closely tied to mental retardation. Deficits in adaptive skills, in addition to subaverage intelligence, have been included as part of definitions of mental retardation by the AAMR, DSM–IV, and IDEA.

The 1992 definition of mental retardation from the AAMR placed greater emphasis on adaptive skills than previous AAMR definitions: “Mental retardation refers to substantial limitations in present functioning. It is characterized by significantly subaverage intellectual functioning, existing concurrently with related limitations in two or more of the following applicable adaptive skill areas: communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure, and work. Mental retardation manifests before age 18” (AAMR, 1992, p. 5).

Mental retardation is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills. This disability originates before age 18.

Implications of AAMR’s 2002 definition of mental retardation

Limitations in present functioning must be considered within the context of community environments, including schools and homes, typical of the individual’s age peers and culture.

Within an individual, limitations often coexist with strengths (i. e. , studies that examine a person’s pattern of scores is likely to reveal a person’s relative strengths).

A person’s personal life functioning generally will improve with appropriate personalized education and support provided over a sustained time period.

Adaptive Behavior is important to Current Neuropsychological Approaches • lesion guessing game is over due to neuroimaging methods • new focus: the impact of cerebral dysfunction on executive and adaptive skills

Although adaptive skills traditionally have been associated with mental retardation, adaptive skills are important for all individuals, including individuals with disabilities or with other mental, physical, and social difficulties.

Adaptive skills should be assessed routinely for individuals who have difficulties that could interfere with daily functioning.

For example, individuals with the following difficulties may have problems with daily functioning. Adaptive skills assessment may provide important information for diagnosis and in planning treatment or other interventions: • • developmental delays social-emotional disorders attention disorders behavior disorders brain disorders and injuries sensory or motor impairment learning disorders and disabilities

Adaptive Behavior Assessment

Adaptive skill measures should assess a comprehensive range of skills. AAMR identifies 10 adaptive skill areas. The ABASII assesses these 10 plus motor development.

Communication Speech, language, and listening skills needed for communication with other people, including vocabulary, responding to questions, conversation skills, etc.

Community Use Skills needed for functioning in the community, including use of community resources, shopping skills, getting around in the community, etc.

Functional Academics Basic reading, writing, mathematics, and other academic skills needed for daily, independent functioning, including telling time, measurement, writing notes and letters, etc.

Home Living Skills needed for basic care of a home or living setting, including cleaning, straightening, property maintenance and repairs, food preparation, performing chores, etc.

Health and Safety Skills needed for protection of health and to respond to illness and injury, including following safety rules, using medicines, showing caution, etc.

Leisure Skills needed for engaging in and planning leisure and recreational activities, including playing with others, engaging in recreation at home, following rules in games, etc.

Self-Care Skills needed for personal care including eating, dressing, bathing, toileting, grooming, hygiene, etc.

Self-Direction Skills needed for independence, responsibility, and self-control, including starting and completing tasks, keeping a schedule, following time limits, following directions, making choices, etc.

Social Skills needed to interact socially and get along with other people, including having friends, showing and recognizing emotions, assisting others, and using manners.

Work Skills needed for successful functioning and holding a part-time or full-time job in a work setting, including completing work tasks, working with supervisors, and following a work schedule.

Motor Skills Fine and Gross Motor Development is included in the ABAS–II for children ages 0– 5

The Conceptual skill domain includes: Communication Functional Academics Self-Direction The Social skill domain includes: Social Skills Leisure The Practical skill domain includes: Self-care Home/School Living Community Use Health and Safety Work

Motor skill scores contribute to the General Adaptive Composite but not to the adaptive domains.

Thus, one can utilize data from each of the 10 adaptive skill areas, three adaptive skill domains (i. e. , Conceptual, Social, and Practical skills ) and the General Adaptive Composite (GAC).

Assessment within a databased, decision-making model

Assessment within a data-based, decision-making model attempts to link assessment with interventions and other needed services. The use of assessment to diagnose is not sufficient.

Traditional and current trends in assessment Assumptions about behavior: • Traditional: Behavior is stable. • Current: Behavior is dynamic. Assumptions about focus of assessment: • Traditional: Past and present • Current: Present and future

Assumptions about the assessment process TRADITIONAL • Use paper/pencil • Test simulated outcomes • Judge attainment in light of behavioral objectives • Emphasize summative evaluation CURRENT • Use multi-sources, methods, and traits displayed in multiple settings • Test authentic outcomes • Judge attainment in light of developmental outcomes • Emphasize formative evaluation

Comprehensive assessment within a data-based, decision-making model includes: · Multiple domains · Multiple environments · Across time · Multiple methods · Multiple sources of information

The use of rating scales is just one method of assessment within a data-based, decision-making model.

Rating Scale Advantages • allow for a comprehensive assessment of a large number of adaptive skills • involve important informants in the assessment process. • obtain information from multiple perspectives and multiple sources of information. • focus on adaptive skills occurring in naturalistic settings. • provide information about what a client actually does and how often he or she does it when needed at home, school, community, and work settings • considered to be one of the most valid, practical, and efficient techniques for assessing adaptive skills.

Rating Scale Limitations • Ratings for individual items reflect a summary of the relative frequency, rather than exact frequency, of the client’s skills. • Ratings reflect respondent’s standards for skills that may differ from respondent to respondent and setting to setting. • Thus, use of multiple respondents assists in providing information from different perspectives. • Respondent’s ratings may be influenced by characteristics of the client (e. g. , appearance, ability, background) other than the trait being assessed. • Ratings reflect the respondent’s perceptions and honesty in communicating these perceptions.

Selection of Adaptive Behavior Scales • There a number of adaptive behavior scales with good psychometric and clinical properties. • For each individual client, professionals should select the instrument(s) in light of a client’s characteristics and purposes of assessment.

Overview of the Adaptive Behavior Assessment System –II (ABAS–II)

ABAS–II is based on three sources of information: • A conception of adaptive skills promoted for many years by the American Association on Mental Retardation (1992, 2002) • Legal and professional standards applicable to a number of special education and disability classification systems, such as state special education regulations, IDEA (Department of Education, 1997), and DSM–IV–TR (2000); • Research investigating diagnosis and intervention for people with various disabilities. The three sources of information are uniform in their conclusion that every person requires a repertoire of skills in order to meet the daily demands and expectations of his or her environment.

General Description • Assesses the 10 areas of adaptive skills specified by AAMR (1992, 2002). • Measures adaptive skills in the multiple environments in which individuals of various ages may participate, including home, school, community, and work settings. • Multi-informant—Provides separate forms for parents, teachers, and adults. Users of the instrument may elect to use one or some combination of the three rating forms, depending on their needs of assessment.

• Norms for ages 0– 89 were established using large standardization samples stratified according to 1999 and 2000 census data. • Each form is designed in a checklist format that can be completed by a teacher/daycare worker, parent, or adult. • The ABAS–II can be completed in about 15– 20 minutes and scored in about 5 minutes. • Separate scores are provided for each of the 10 areas of adaptive skills and three domains, facilitating analysis of strength and weakness across these areas. • A General Adaptive Composite also is provided.

Applications • To provide a comprehensive, norm-referenced assessment of adaptive skills for diagnosis, classification, and planning programs. • To assist in the assessment of individuals with known or suspected difficulties in daily adaptive skills needed to function effectively in their environment, especially individuals with mental retardation. • To assist in the assessment of individuals with known or suspected disabilities in other areas, including learning, behavior, medical, psychological, and neuropsychological disorders. • To assist in program planning. • To assist in research, program monitoring, and evaluation.

Parent/Primary Caregiver Form (Ages 0– 5) The infant-preschool version of the parent form may be completed by parents or other primary-care providers of children ages birth to 5 years. This form is available in Spanish.

Parent Form (Ages 5– 21) The school-age version of the parent form may be completed by parents or other primary-care providers of children in grades kindergarten (K)– 12 or ages 5– 21 years. This form is available in Spanish.

Teacher/Day Care Provider Form (Ages 2– 5) The infant-preschool version of the teacher form may be completed by teachers, teacher’s aides, daycare instructors, and other daycare or child-care providers of children ages 2 – 5 years.

Teacher Form (Ages 5– 21) The school-age version of the teacher form may be completed by teachers or teacher’s aides of students in grades K– 12 or ages 5– 21 years.

Adult Form (Ages 16– 89) There is one rating form for adults ages 16– 89 years. It can be completed by self or others

The Parent, Teacher, and Adult forms are completed independently by respondents. Items may be read to the respondent if he or she does not have the reading skills to complete the rating scale independently.

A respondent typically completes the ABAS-II by reading the instructions and responding to each item.

Some adaptive skills are more important or observable in some settings and by some respondents more than others. Thus, the five forms are designed to assess the adaptive skills most relevant for the specific setting and type of respondent.

The ABAS-II allows you to use one or more informants, depending on the needs for an adaptive skills assessment. For a school-age child, both the Parent and Teacher Forms may be completed to obtain ratings from two types of important informants, parents and teachers, about the child’s daily adaptive skills. • For a 30 -year-old client, the Adult Form may be completed by three different informants: the client himself or herself, a family member, and a work supervisor or caregiver.

Select respondents using the following guidelines. • The Parent Form should be completed by parents and other primary care-providers. Care-providers should be living with the child and familiar with the daily activities. • The Teacher/Day Care Form should be completed by teachers and other school personnel. The respondent should be familiar with the child’s adaptive skills in a structured classroom and school setting. • The Adult Form should be completed by informants for adults. Informants may include family members, supervisors, careproviders, and others familiar with the daily activities of the client. For higher functioning clients, the respondent may be the client himself or herself.

Respondents generally should have the following qualifications: • frequent contact with the client, for example, almost everyday • contacts of long duration, for example, several hours for each contact • recent contact, for example, over the past 1– 2 months • opportunities to observe the variety of skills measured by the ABAS–II.

ABAS-II Reliability

Internal Consistency Reliability coefficients for the GAC are in the high. 90 s for all age groups, ranging from. 98 to. 99. Average reliability coefficients of the adaptive skill areas across age groups are typically in the. 90 s, ranging from. 86 to. 97.

Test-Retest Reliability Test-retest reliability coefficients of the GAC are all in. 90 s. The mean GAC scores of the two testing (in a 1 - to 2 -week period) are also very consistent, with the mean retest scores slightly higher. As expected, the test-retest reliability coefficients of 10 adaptive skill areas are slightly lower, mainly in. 80 s to. 90 s.

Inter-Rater Reliability : Teacher Form-Ratings by Two Teachers Inter-rater reliability coefficients on the GAC scores are. 91 for students between ages 5 and 9, . 87 for students between ages 10 and 21, and. 89 for students from all ages. The inter-rater reliability coefficients for the adaptive skill areas generally were in the. 60 to. 70 s.

Inter-Rater Reliability: Parent Form-Ratings by Both Parents The inter-rater reliability coefficients on the GAC scores are. 83 to. 85 for both age groups (ages 5– 11 and 12– 21) and the overall sample. The inter-rater reliability coefficients for the adaptive skill areas generally are in the. 60 s to. 70 s.

Inter-Rater Reliability: Adult Form-Ratings by Two Adult Informants The inter-rater reliability coefficients on the GAC scores are. 90 without the Work Scale and. 93 with the Work Scale. The inter-rater reliability coefficients for the adaptive skill areas generally are in the. 80 s. (Correlations corrected for variability in sample).

Cross-Form Consistency: Parent and Teacher Forms The correlation between the teacher and parent rating is. 70 for GAC. The average scores differ by about 1 point. The correlation coefficients for the adaptive skill areas generally are in the. 60 s to. 70 s. Mean scores differ by less than 1 scaled score.

Cross-Form Consistency: Adult Form with Self-Ratings and Ratings by Other Respondents The correlation between self-ratings and ratings by others is. 94 for the GAC (without Work Scale) and. 88 for the GAC (with Work Scale). The average scores differ by about 1 point. The correlation coefficients for the adaptive skill areas generally are in the. 80 s. Mean scores differ by less than 1 scaled score.

ABAS–II Validity

Age Group Differences All ABAS–II items display age differences (i. e. , persons who are older tend to display the behavior more frequently than those who are younger).

Intercorrelations among the adaptive skill areas Intercorrelations among the 10 adaptive skill areas for the total sample generally are in the. 60 s.

Summary of Clinical Findings • The ABAS-II can assist in validly assessing individuals with various disabilities and disorders. • Further research is needed with larger samples. • Assessment of adaptive skills can provide important information to a comprehensive assessment. • Information on strengths and weaknesses in adaptive skills may provide useful information for program planning and monitoring.

Summary of Clinical Findings The ABAS-II has good clinical sensitivity in distinguishing (1) some clinical from non-clinical groups and (2) individuals with mild and moderate levels of mental retardation. The mean GACs are significantly lower for clinical groups than matched control groups. Most clinical cases obtained GACs < 71. Most clinical cases obtained adaptive skill scaled cores <5.

Summary The ABAS–II provides: • current norms • norms reflect the racial/ethnic US population • consistency with current AAMR recommendations re: diagnosis and treatment • consistency with DSM–IV–TR criteria for mental retardation • comprehensive yet rapid assessment of adaptive skills • does not require a parent or teacher interview

Summary The ABAS–II provides: • a guessing score • greater coverage of infants, children, and youth • a computer scoring system that allows score profiles to be obtained quickly • parent and teacher forms in Spanish • evidence of relationships with the WISC–III, WISC–IV and WPPSI–III

ABAS’s Evaluation (Journal of Psychoeducational Assessment, 21, 4, 390 -396) • The ABAS provides a truly comprehensive assessment of adaptive skills as defined by the AAMR and DSM/IV diagnostic criteria. • The ABAS is psychometrically and theoretically sound and can be used with individuals with from ages 5 -89. • The standardization sample matches the most recent 1999 census data but is limited to Englishspeaking US citizens.

Evaluation: continued • Although factor analysis and reliability data suggest the GAC score is the best representation of an individual’s adaptive skills, information gleaned from the scores in the 10 adaptive skill areas can also be used to target specific areas in which the individual may need intervention. • The content, divergent, and convergent validity of the ABAS strongly support its use.

16 th MM Yearbook • Developed from a sound theory and empirical methodology • Validity data are impressive • Authors should be commended for exploring the usefulness of the data for intervention planning and progress monitoring • ABAS-II data could strengthen most comprehensive assessments