The Value of Adaptive Behavior in Promoting Wellness and Beyond

The Value of Adaptive Behavior in Promoting Wellness and Beyond

Dr. Thomas Oakland

University of Florida

University of Hong Kong

Promoting Wellness and Beyond

• My primary emphasis will be on intervention issues—how best to promote development and how an emphasis on adaptive behavior promotes children’s happiness and thus well-being

• My secondary emphases are on

– diagnosis

– common patterns of adaptive behaviorsdisplayed by special needs children

Promoting Wellness and Beyond

• Some changes that are occurring as we transition from the ABAS-II to the ABAS-III

• The U.S. Justice Department’s emphasis on placing persons with ID in meaningful jobs

• And to solicit comments about your use of the ABAS-II

Let’s Begin By Talking About You

Think about those behaviors you display most every day that enable you to meet your personal needs and the natural and social demands and expectations in your life consistent with your age, social class, and culture.

Let’s Talk About You

• You are likely to have – Used your car or other forms of transportation– Maintained your composure and feelings– Took care of your health (e.g. liquids, vitamins, food)– Cared for your personal needs (toileting and bathing)– Talked with others– Used your reading skills and possibly math skills– Engaged with others socially– Engaged in leisure time activities

Let’s Talk About You

• In summary, you displayed suitable adaptive behavior in light of standards established for your age, social class, and culture.

• Today we will focus on – What adaptive behavior is– How to assess it– How to use this information, and – Common patterns of adaptive behavior of children

and youth who display various special needs

Human Growth and Development

• Most people develop normally• Some develop more slowly at first

– And then catch up later

– Some remain delayed for years, perhaps for their lives

– Delays may be in• One behavior

• Two or more—and for some, many behaviors

All children require support and assistance– 10% to 15% require extra support and assistance

Children who display the following disabilities/disorders generally need more support and assistance

• Attention disorders • Autism• Behavior disorders• Brain disorders and injuries• Developmental delays• Learning disorders and disabilities• Social-emotional disorders• Sensory or motor impairment• Visual and auditory disorders• others

What Parents of Special Needs Children Want For Them

• Parents generally want their children to be happy. – Some attempt to purchase happiness– However, happiness is earned, not purchased

• Happiness occurs when children achieve behaviors they personally value– And the behaviors become habitual

• These behaviors include important adaptive skills and behaviors.

How to promote happiness in children

• Happiness is a brain-based and regulated emotional state characterized by positive or pleasant emotions.

• The purpose of emotions is to influence the scope of our brain functioning and thus either to draw fully on our capabilities or to limit our activities.


• Happiness has a strong biological base, one that is highly dependent on various brain-related qualities.

• Among them are the left cortex, prefrontal cortex, the amygdala, serotonin levels, dopamine, and others. Keep in mind that emotions are biologically based.

• Thus, interventions must be sufficiently powerful to influence and modify the brain.


• The brain is wired to assist us in displaying routine behaviors somewhat automatically.

• 95% of brain-behavior relationships are habitual. • Habits are acquired over time and not easily

changeable. This has important implications for our behavior-centered work with children, especially those with special needs, including efforts to promote adaptive behavior.

• Do not expect habit regulated behaviors to occur over night

Stress: a culprit to happiness• Stress generally alerts us to immediate

problems.

• When stressed, the brain favors pre-wired and thus easily activated and quickly achieved solutions to immediate problems.

• Thus, when stressed, we tend to behavior habitually.

Stress: a culprit to happiness• Happy people see their problems as

temporary, impersonal, and solvable and thus feel less stress.

• Prolonged stress decreases our ability to be happy.

• Stress triggers both brain and physiological reactions that intensify our anxiety and thus restricts our knowledge of options.

Stress: a culprit to happiness• Stress produces anxiety

• Together they lead to a restricted range of emotions and thus behaviors, often either withdraw or aggression

• When stressed, we are inclined to engage in behaviors we believe will comfort us (e.g. drink, drugs, food) yet rarely do.

Stress: a culprit to happiness• Persons on the autism spectrum experiences

stress and anxiety due to limitations in their amygdala and fusiform gyrus.

• This results in low levels of social intuition—qualities that limit both their display and understanding of suitable social behaviors and promote social anxiety.

Two Strong and One Weak Influences

• 50% from genetics

• 40% from personal experiences and activities

• 10% from the stuff we purchase to make life easier and more attractive

Implications from this information

• How to use the 40% of variance that contributes to happiness over which we have control– Engage children in activities

• They personally value• That offer enduring contributions• From which they learn about themselves and

others

• Children must be personally engaged: others cannot give happiness to them

Children’s personal engagement

• on their own or with family, friends, and other favorite people

• reading, watching movies, or in other stimulating experiences

• involvement in their community: schools, sports, hobbies, and other forms of recreation

• taking trips

• becoming independent and self-directed

Children’s personal engagement

• In short, to promote children’s adaptive behavior, we need to strive to– identify their personal goals and values – create conditions that enable them to acquire

personal competence to attain them to the point they become habitual—accessed easily and used successfully

• Again, habits, by definition, are not changed easily. We will talk more about this later.

Remember, happiness is derived

• from how much children enjoy and value their ability to do what they believe to be important,

• From children’s own actions

• From harmony in what children think, say, feel, and do

• Happiness cannot be purchased or given by others.

Six Brain-based emotional styles contribute importantly to happiness

• The Most Important Two

• Resilience: our ability to recover from adverse events—to develop habits that favor recovery

• Expectations: our ability to view life positively


• Four Other Important Qualities

• Social intuition: our ability to attend to, grasp, and understand social cues—often expressed nonverbally by others

• Self-awareness: our ability to be sensitive to signals from our brain and physiological system that inform us how we are doing


• Four Other Important Qualities

• Sensitivity to context: our ability to moderate our behaviors and emotional responses in light of the persons, places, and events we encounter

• Attention: our ability to form and remain focused

Thus, attempts to promote happinessand thus a fuller range of brain-behaviors include attention to

• Promoting resilience

• Understanding personal expectations

• Engaging students in activities that contribute to their current and future success

• Reducing stress in order to utilize brain-behavior abilities more fully

What parents also desire for their special needs children

• Parents want their children to– Be less dependent on them and more independent– Function effectively at

• Home• School• Work• Community

– In short, to function as effectively as possible in their natural and social environments with limited support, leading to self-confidence and thus happiness.

10 Specific Behaviors Parents Want For Them

• 5 Practical skills: To personally– Care for their personal needs – Care for their home – Use community resources– Care for their health and safety– Find and sustain work

10 Specific Behaviors Parents Want For Them

• 3 Cognitive skills: To personally – Communication with others– Acquire and use functional academic skills– Be self-directed and to evaluate their behaviors

• 2 Social skills: To personally– Get along well with others– Use their free (leisure) time well

What is Adaptive Behavior?

• Adaptive behavior refers to ways an individual meets his or her personal needs as well as deals with natural and social demands and expectations in their environment consistent with their age, social class, and culture.

• Abilities and skills that enable a person to function effectively and independently daily at home, school, work, and the community.

Why do we use measures of adaptive behavior?

• What is the major purpose of using any test?

• To accurately describe behavior

Other reasons to use measures of adaptive behavior

• estimate future behaviors

• assist guidance and counseling services

• identify service needs

• establish intervention methods

• monitor intervention effectiveness

• evaluate progress

Other reasons to use measures of adaptive behavior

• diagnose disabling disorders

• help place persons in jobs or programs

• assist in determining whether persons should be credentialed, admitted/employed, retained, or promoted

• research

• administrative and planning purposes

The First Assessment of ID/MR

• The ancient Greek civilization thought a person was mentally retarded if his or her daily living skills were substantially lower than others their age or family members.

• Measures of intelligence began to be used in the early 1900s to assess ID/MR

• Now measures of intelligence and adaptive behavior are used to assess ID/MR

• Measures of adaptive behavior also should be used with persons with other disorders and disabilities

Three Authoritative Sources That Define MR/ID

• American Association on Mental Retardation (now called the American Association on Intellectual and Developmental Disabilities)– AAMR/AAIDD

• Diagnostic and Statistical Manual of Mental Disorders– DSM-4 and DSM-5

• International Classification of Diseases-10

Authoritative Sources

• The AAMR/AAIDD, the DSM-4 and -5, and ICD-10 are relied on internationally to guide our understanding of disorders and disabilities by

• Defining them• Describing standards for their

– Diagnosis– Assessment

1992 AAMR and DSM-4 Definition of MR/ID

• 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.

• The DSM-4 also used this definition for MR

1992 AAMR and DSM-4 Definition of MR/ID

• Thus, this definition identified 9 important

skill areas to assess in children– communication self-care, – home living social skills, – community use self-direction,– health and safety functional academics, – leisure (work for adults, not children)

Communication

• Looks at others’ faces when they are talking

• Starts conversations on topics of interest to others.

• Uses up to date information to discuss current events

Community Use

• Recognizes own home in his/her immediate neighborhood

• Carries enough money to make small purchases.

• Calls a doctor or hospital when ill or hurt

Functional Academics

• Points to pictures in books when asked (e.g.

points to a horse or cow)

• Writes his/her first and last names

• Reads and follows instruction to assemble new

purchases

Home Living

• Removes cookies, chips, or other food from a box or bag

• Folds clean clothes

• Performs minor household repairs (e.g. a clogged drain or leaky faucet)

Health and Safety

• Cries or whimpers when he/she does not feel well or is injured

• Cares for his/her minor injuries (e.g. paper cuts, knee scrapes, nosebleeds

• Buys over the counter medications when needed for illness

Leisure

• Plays with a single toy or game for at least one minute

• Follows rules in games

• Reserves tickets in advance for activities (e.g. concerts or sports events)

Self-Care

• Swallows liquids with no difficulty

• Washes his/her own hair

• Cuts or files his/her own fingernails and toenails

Self-Direction

• Entertains self in crib or bed for at least one minute after waking

• Chooses own clothing almost every day

• Plans ahead to allow enough time to complete big projects

Social

• Smiles when he/she sees parents

• Personally makes or buys gifts for family members on major holidays

• Listens to friends or family members who need to talk about problems

Work (for ages > 15)• Shows a positive attitude toward the work

• Returns tools and other work related items to their proper location after their use

• Checks his or her work to determine it improvements are needed

1992 AAMR/DSM-4 Definition of MR/ID

• Information on these 10 skill areas is

important for two reasons

1. The evaluation of adaptive skills confirms that a person has functional limitations and, more importantly,

2. The identification of functional, adaptive skill limitations can be linked to a person's needs for interventions and services.

• Thus, the inclusion of adaptive behavior addresses two issues:– Diagnosis– Intervention

2002 AAMR/DSM-5 Definition of MR/ID

• 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. • The DSM-5 uses this definition yet is vague

about the age 18 cutoff.–We will review some DSM-5 changes shortly

Current Definition of ID

– Thus, attention is drawn to three adaptive skill domains• Conceptual

• Social

• Practical

– The three domains include the 10 skill areas

Current Definition of ID

The Conceptual skill domain includes:CommunicationFunctional AcademicsSelf-Direction

The Social skill domain includes: Social Skills Leisure

The Practical skill domain includes: Self-care Home and School Living

Community UseHealth and SafetyWork

Some general DSM-5 changes

• Discontinuation of multiple axes (all now are I)

• Places some disorders on a spectrum, thus changing from nominal to ordinal descriptions

• Reclassified and recombined some disorders

• Added disorders

• Recognition of neurocognitive disorders that may predispose one to display a diagnosis

• Greater emphasis on both clinical and utility

• More reliance on professional (clinical) judgment

DSM-5 and ID: An introduction

• Named Intellectual Developmental Disorder

• Specifies four levels: mild, moderate, severe, profound

• Does not specify an IQ cut off

• Greater reliance on adaptive functioning and less reliance on intelligence

• Is more functionally focused (e.g. base diagnosis and intervention on needed levels of supports)

DSM-5 and ID: An introduction

• Supports may include the need for … help

– Intermittent: now and then with one skill (eating meat)

– Limited: only with one skill (e.g. eating most foods)

– Extensive: regular help in many areas (e.g. dressing, bathing, eating)

– Pervasive: assisting in maintaining all areas of life

Intellectual developmental disorder

• A neurodevelopmental disorder (yet remains a mental disorder)

• Characterized by deficits in intellectual functioning that lead to deficits in adaptive behavior– Deficits in intellectual functioning (no longer an IQ

~70) as seen in • An individually administered standardized measure

of intelligence• A clinical assessment and judgment

Intellectual developmental disorder

• Deficits in adaptive functioning compared to age, gender, and socially/culturally matched peers in one or more of the following three domains (no score level is specified)

• Conceptual abilities• Social abilities• Practical abilities

• Includes an emphasis on personal independence together with a new quality: social responsibility

• Its onset occurs during the developmental period (no longer stated as < age 19 yet this is assumed)

Intellectual developmental disorder: more on adaptive behavior

• ID severity is determined from adaptive behavior – A standardized assessment of adaptive behavior– And a clinical assessment

• This information is used to clinically judge the degree a person needs support in reference to the four levels: mild, moderate, severe, profound

• We do not have and cannot develop standardized measures that assess qualities associated with these four levels.

• Treatment monitoring may be used to assess severity level• The goal is to normalize life as much as possible

Thus, when assessing ID,

• Place more reliance on adaptive functioning and less reliance on intelligence

• Place more reliance on professional/clinical judgment and less reliance on specific scores

• The assessment will be more comprehensive and likely to utilize behavioral ‘need for support’ data to determine the degree of disability

• 30% to 50% of those with ID display another mental disorder, including a psychiatric disorder

GAC & 3 Conceptual Areas (teacher report)

50

60

70

80

90

100

GAC Conceptual Social Practical

Behavior Domain

SS

1 DiagnosisN=56

2 DiagnosesN=42

3 DiagnosesN=38

4 DiagnosesN=21

GAC & 3 Conceptual Areas (parent report)

50

60

70

80

90

100

GAC Conceptual Social Practical

Behavior Domain

SS

1 DiagnosisN=41

2 DiagnosesN=26

3 DiagnosesN=25

4 DiagnosesN=20

How the ABAS-II and the DSM-5 overlap

• The ABAS-II– Emphasizes the importance of assessing adaptive

behavior with current standardized tests – Can be used as a clinical interview– Is the only measure of adaptive behavior that assesses

the three DSM-5 domains; conceptual, social, and practical skills

– Provides an assessment of persons from birth through age 89 and thus includes the DSM-5 ages

How the ABAS-II and the DSM-5 overlap

• The ABAS-II– Emphasizes the importance of examining behaviors in

light of environmental needs and requirement and thus contributes to an understanding of ‘need for support’.

– ABAS-2 research confirms that children who display more diagnoses generally display more adaptive behavior deficits.

2002 AAIDD Definition of ID

• The ABAS-II has a hierarchical model

(e.g. like a pyramid)

– 1 General Adaptive Composite (GAC)

– 3 domains: conceptual, social, and practical

– 10 skill areas: communication, self-care, home living, social/interpersonal skills, use of community resources, self-direction, functional academics, leisure, health and safety, and work (for older adolescents and adults)

Some Implications from the Definitions

– 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.

– Let’s discuss this important point: see next slide


– Limitations exist when the needs and requirements found in a person’s environment exceed the person’s adaptive skills

– Thus, we need to know what the person’s environment requires of the person in order to judge if there is a limitation

– Low scores in themselves do not indicate a limitation

– A change in environments may result in a change in needed requirements.


– A person’s personal life functioning generally will improve

• With appropriate personalized education and support • When interventions are

– valued by the person– important to his/her caretakers/teachers – important in success in his/her environment– sustained over weeks and months, and– used daily—development them to become habits

Keep in mind some prior comments

• Behavior have a strong biological base• Behaviors typically are habitual and thus slow to change

(95% of brain behaviors are habitual)• Their change requires the involvement of key persons

– Children/students– Their parents/guardians– Their teachers and other educators

• All are likely to be more knowledgeable than us as to what a student needs and desires

Keep in mind some prior comments

• Intervention planning requires knowledge of– needed and desired behaviors– availability of needed resources, including time, to

support their implementation– willingness to use needed resources– best environments in which to train the new behaviors– a commitment to sustain the intervention over time – recognition that change may be slow

Introduce the ABAS to the Respondent

• Our initial work always is intended to

develop other’s trust

• Discuss the following topics with respondents:

–Purpose of the overall assessment

–Reason for administering the ABAS and from whom the ABAS information will be acquired

–Explain the instructions

• Designed to acquire an accurate understanding of the child’s typical performance, not their very best behavior

Acquire an accurate understanding of the child’s typical performance, not their best performance

Be wary of attemptsto mischaracterize the person

•Mary, the mother of Jane

– Husband died, is single and has little money

– Wants her daughter to be normal and happy

– Moved recently from New York to Florida

– Enrolled Jane in her neighborhood school

Acquire an accurate understanding of the child’s typical performance, not their very best behavior

• Jane

– 9 years old female

– Displays cerebral palsy and diminished development in other areas

– Is in a special education program for young children with multiple disorders

– Is not sufficiently strong to sit upright and thus is strapped into a special wheel chair and has a special table

ABAS Scores Differ: Evidence of Promoting a Cloak of Competence

mother teacher

General Adaptive Functioning 90 55

Domains

conceptual 89 45

social 93 52

practical 90 58

How to resolve these differences? Who is correct?

ABAS Scores Differ

• I met with mother and Jane at their home

• (Describe what occurred)

• Mother trusted me and, after my work, called me for understanding, support, and encouragement

• Thus, not all scores may be correct.

– Some respondents may not know how to complete the ABAS and thus do it incorrectly

– Others lie about the child’s behaviors

– Some differences may exist between home and school

Be Wary of Attempts to (Mis)Characterize Self or Others as Performing Low

• Possible benefits from mischaracterization– Financial support from the state and federal

governments– Provision of special education support– Under Atkins v Virginia, an ID diagnosis (that

requires diminished adaptive behavior) prevents executions

The ID diagnose will depend on yourdiagnostic standards. One follows.

1. Determine the standard for diagnosing ID

1. Consider the level of the GAC (< 70?)

2. Two or more skill area score < 4

3. One of more of the three domains < 70

2. Interview the student, parents, teachers, and other relevant person.

3. Review the person’s history, other assessments, and records—a search for consistency in the data

Using the ABAS scores to diagnose ID

4. Review the intelligence data to determine their consistency with the ABAS data.

5. A diagnosis of ID is a high stakes decision, one likely to be life changing.

6. Make this diagnosis only after a careful review of all relevant information and in consultation with others—especially family members.

Estimate future behaviors

• Development during ages 0-18 – Is continuous– Shows a similar developmental trajectory for

children who are average and below average– Yet, for those with special needs, is slower and

plateaus earlier– Is most rapid during infancy—thus, early

interventions are important– Development decelerates with age

Estimate future behaviors

• Four levels of ID– Mild – Moderate– Severe– Profound

• Improvements in adaptive functioning – May occur in all four levels– Will be most apparent in those with mild levels– Least in those with severe and profound levels

ABAS–II Information to Plan and Implement Interventions

Basic considerations:

• Analyze environmental needs:• current environment

• target environment

• Strive to match skills and environmental needs/demands

• Identify support needs

• Assumption: adaptive skills interventions are more effective than those on adaptive behavior.

• Analyze the client’s adaptive skills at the item level

Components of Planning and Implementing Interventions: A summary

1. Identify skill levels needed in one’s current environment or the environment into which the person is moving. Note the need for various levels of support:

– Intermittent: now and then with one skill (eating meat)

– Limited: only with one skill (e.g. eating most foods)

– Extensive: regular help in many areas (e.g. dressing, bathing, eating)

– Pervasive: assisting in maintaining all areas of life

2. Identify current areas of strengths and weaknesses relative to environmental needs/demands.

3. Identify and prioritize intervention objectives based on discrepancies between environmental needs and personal attainment.

4. Identify behaviors others desire.

5. Implement interventions to achieve objectives

6. Monitor the implementation and effectiveness of the interventions

Using the ABAS scores to plan and monitor intervention programs

1. Understand the nature and needs of the person’s environments.

① To what extent does the person possess needed qualities. (Is there a skill deficit?) = a score of 0 on ABAS items

② To what extent does the person display needed qualities. (Is there a performance deficit?) = a score of 1 on ABAS items

③ What resources are needed to help develop or display needed behaviors? See next frame.


What resources are needed to help develop or display needed behaviors?

– Intermittent help– Limited help– Extensive help– Pervasive help

• For how long will this help be needed?


• Does the person’s environments

– have the resources to provide needed support?

– display a desire to provide it?

• What changes in these environments are need to provide needed assistance?

– E.G. assistance in organizing work

help preparing to eat

making suitable purchases


The possibility of change—the issue of prognosis.

With mild levels of delay: good. Many children with mild levels of ID can assume a somewhat normal adult life—with support

With moderate levels of delay: less good. Prognosis is better if they are educated, live, and work in normal environments

With severe to profound levels of delay: generally not good. They are likely to need life-long assistance to meet their basic needs of food, clothing, shelter, and toileting.


Where is change most likely to occur?

On specific behaviors (that is, at the item level)

Less likely: skill area

Unlikely: domains and GAC levels


– Identify three or four relevant ABAS items that are either… to work on initially

0 = the person is unable to display the desired behavior

1 = the person is able yet does not display the desired behavior

2 = the person displays the desired behavior sometimes when needed

– Then identify the ways in which these behaviors can be both developed and sustained. Become an educator.

Consider using the ABAS Intervention Planner for suggestions.

Using the ABAS scores to plan and monitor intervention programs: importance of the child/student

• The success of interventions is higher when the child or student

– participates in selecting the interventions

– values the behaviors

– wants to acquire them

– thus, is motivated to both develop, use, and thus sustain the behavior

Using the ABAS scores to plan and monitor intervention programs: importance of the parentsand teachers

• Success increases when they also– participate in the selection of the interventions– value the behaviors– want them acquired– thus are motivated to both help

• develop the behavior and • sustain an environment in which these behaviors can be

displayed and rewarded regularly

Using the ABAS scores to plan and monitor intervention programs: importance of the parentsand teachers

• The success of these interventions is higher when– they have the resources to implement and sustain

the behavior program– the interventions are within the zone of proximal

development– training occurs in environments in which the

desired behaviors eventually will be displayed.


– Remember: change most likely will occur in reference to specific behaviors, that is, at the item level

– Thus, program monitoring may require the re-administration of ABAS items, perhaps after three months, to determine if desired changes occurred.

– .


– If desired changes are not apparent,

• Examine the degree the desired interventions were implemented with integrity and at least daily

• Discuss with others why the interventions were not successful

• Plan and implement Plan B


– If desired changes are apparent, identify other desired behaviors using the previously discussed strategies

– Determine their importance to the person who is acquiring the behaviors and to caretakers and others who are implementing the change.

– Also determine that the desired behaviors are within the person’s zone of proximal development, have the opportunity to be displayed and rewarded daily, and are trained in the environments in which the desired behaviors are to occur.

ABAS is used with children and youth who display various disorders

• ID

• ADHD

• Behavior/Emotional Disorders

• Hearing Impairment

• LD

• Neuropsychological Disorders

ABAS is used with younger children and youth who display various disorders

• Developmental Delays• Pervasive Developmental Disorders• Motor Disorder• Mild and Moderate ID• Language Disorder• Autism Spectrum Disorder

Validity Studies with Clinical Samples

Results for Samples with ID

Sample GAC GAC <70 2+ skill areasMean % 4 or below

Down’s (T, n=22) 55 (100) 82 (5) 100 (23)

MRMI (T, n=66) 73 (97) 50 (14) 76 (32)

MRMO (T, n=41) 59 (98) 70 (4) 100 (30)

MR-UN (T, n=84) 62 (101) 70 (7) 98 (20)

MR-UN (P, n=41) 64 (99) 71 (0) 83 (5)

MR-UN (A, n=30) 62 (92) 87 (17) 87 (17)

Note: Data for matched control group appears in parentheses.

ID

0

1

2

3

4

5

6

7

COM CU FA SL HS LEI SC SD SOC

C1C2C3C4C5C6

Adaptive Skill Area

SS

Mean Performance across Adaptive Skill Area

ADD/ADHDSample Mean GAC 70 2 or More Skill 4

GAC % %

Ages 5–9 (T, n=30) 77 (101) 43 (7) 66 (20)

Ages 6–21 (P, n=49) 91 (100) 14 (2) 27 (12)

3

4

5

6

7

8

9

10


T 5-9P 6-21

Adaptive Skill Area

SS


Behavior Disorder & Emotional Disturbance

Mean GAC 70 2 or More Skill 4 Sample GAC % %

Ages 6–21 (T, n=56) 77 (92) 39 (16) 73 (36)

Ages 5–18 (T, n=73) 78 (99) 37 (10) 70 (25)

3

4

5

6

7

8


C1C2

Adaptive Skill Area

SS


Hearing Impairment Mean GAC 70 2 or More Skill 4

Sample GAC % %

Ages 5–19 (T, n=19) 93 (99) 16 (5) 26 (21)

5

6

7

8

9

10


Hear

Adaptive Skill Area

SS


Learning Disability Mean GAC 70 2 or More Skill 4

Sample GAC % %

Ages 5–9 (T, n=72) 91 (102) 11 (3) 42 (17)

Ages 10–12 (T, n=62) 84 (99) 29 (8) 61 (27)

Ages 13–21 (T, n=114) 87 (94) 24 (11) 48 (36)

Ages 7–21 (P, n=26) 88 (103) 15 (8) 42 (15)

5

6

7

8

9

10


C1C2C3C4

Adaptive Skill Area

SS


Neuropsychological Disorder Mean GAC 70 2 or More Skill 4 Sample GAC % %

C1, Ages 18–85 (AS, n=18) 82 (100) 28 (0) 50 (6)

C2, Ages 25–85 (AO, n=20) 67 (101) 75 (5) 75 (10)

3

4

5

6

7

8

9


C1C2

Adaptive Skill Area

SS


Developmentally Delayed

Mean Performance acrossAdaptive Skill Area

Teacher Parent(n=48) (n=78)

Age Range 2–5 0–5

MeanConceptual 84 (99) 81 (102)Social 86 (97) 84 (100)Practical 86 (97) 86 (101) GAC 84 (97) 82 (101)

% ≤ 70Conceptual 26 (4) 28 (1)Social 17 (2) 20 (8)Practical 20 (9) 19 (5)GAC 22 (4) 25 (4)

% of 2 or More Skill ≤ 435 (8) 70 (9)

Note. Numbers in parenthesis represent non-clinical sample cases.

3

4

5

6

7

8

9

CU COM FA HS LEI MO HL SC SD SOC

T 2-5 P 0-5

Adaptive Skill Area

Pervasive Develop’l Disorder






% of 2 or More Skill ≤ 474 (11) 56 (0)


3

4

5

6

7

8

9


T 3-5 P 3-5

Adaptive Skill Area

At Risk






% of 2 or More Skill ≤ 427 (0) 26 (3)


3

4

5

6

7

8

9


T 2-5 P 0-5

Adaptive Skill Area

Motor Impairment






% of 2 or More Skill ≤ 453 (9) 36 (4)


3

4

5

6

7

8

9


T 2-5 P 0-5

Adaptive Skill Area

Mild ID






% of 2 or More Skill ≤ 468 (0) 70 (0)


3

4

5

6

7

8

9


T 2-5 P 2-5

Adaptive Skill Area

Moderate ID






% of 2 or More Skill ≤ 468 (5) 77 (9)


2

3

4

5

6

7


T 2-5 P 2-5

Adaptive Skill Area

Language Disorder






% of 2 or More Skill ≤ 429 (17) 23 (2)


3

4

5

6

7

8

9


T 2-5 P 2-5

Adaptive Skill Area

Autism Spectrum Disorder Mean GAC 70 2 or More Skill 4

Sample GAC % %

Ages 5–18 (T, n=32) 54 (101) 84 (3) 92 (16)

Adaptive Skill Area

SS


Autism Spectrum Disorder







% of 2 or More Skill ≤ 477 (0) 71 (9)

Adaptive Skill Area

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 and Domain scores < 71.

– adaptive skill scaled scores < 5.

Some Changes in the ABAS-III

• Revisions were guided by focus group meetings held last year at the NASP and other conventions

• Updating norms to reflect demographic changes• Changes to about 10% of the items

– Our environments have changed considerably in the last 10 years (e.g. we no longer use pay phones)

• Inclusion of more items that assess gullibility– A quality often displayed by those with ID

Some Changes in the ABAS-III

• All items for one skill area appear on one page• Simplify the transfer of data from one page to

another• Includes an option to access the ABAS-III

through the Internet• Adds to and improve our Intervention Planner• The manual and forms with have a new WPS

look– This is the first ABAS revision made by WPS

Justice Department Settles RI Case on Jobs for those with ID

• Long-standing practice of placing special needs persons in segregated shelter workshops– Removed from competitive employment

– Performs routine and dull work

– Did not acquire skills that generalized to other settings

– Were not paid minimum wage

– Clients often remained in these workshops until their retirement

Justice Department Settles RI Case on Jobs for those with ID: The Remedy

• Prepare high school students for competitive jobs in the community that promote inclusion by utilizing – Internships– Mentoring programs

Justice Department Settles RI Case on Jobs for those with ID: The Remedy

• Help persons obtain typical jobs in the community that– pay at least minimum wages– allow employed hours typical of the industry

• Provide support for non-work activities in normal environments– Community centers

– Libraries

– Recreational facilities

– Educational facilities

A Further Look At ASD

Let’s review some information about children with Autism SpectrumDisorder

• Impaired social interactions

• Impaired interpersonal communication

• Restricted repertoire of activities and interests

• Current CDC estimates suggest an incidence of 1:65 to 85

Let’s review some information about children with ASD

• There are no consistent biological markers for ASD.

• Thus, we need to rely on behavioral measures for diagnosis, intervention, and follow-up evaluation.

National Autism Center’s National Standards Project

• Its review of 775 studies identifying intervention programs that were – Established = demonstrably effective– Emerging– Unestablished– Ineffective/harmful

Information from the National Standards Project

• Established Treatments emphasized– Applied behavioral analysis– Behavioral psychology– Positive behavior supports– Functional alternative behaviors– Interventions in naturalistic settings– Promotion of independent behaviors

An emphasis on behaviors

= A person’s activities in response to external and internal stimuli

= Qualities that can be objectively observed and measured

• In contrast, in UK, emphasis is placed on decreasing stress and thus anxiety, leading to a fuller utilization of brain-related behaviors

An emphasis on behavioral assessment

Observations, interviews, tests, and other methods that sample personal qualities displayed in a situational context.

The results of such measures often lead to interventions.

As emphasis on functional behaviors that• help ensure survival• are foundational to other behaviors• have a direct bearing on daily living skills• ABAS and other measures of adaptive behavior are

critical when working with children who display ASD– Diagnosis– Program planning/intervention– Program evaluation

Questions and Comments

• Including your use of the ABAS-II

Thanks for attending

• Best wishes for a successful conference

The Value of Adaptive Behavior in Promoting Wellness and Beyond

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Transcript of The Value of Adaptive Behavior in Promoting Wellness and Beyond