Additional measures of social cognition or social skills and issues relevant to social skills assessment of people with mental retardation have been discussed further (Bell-Dolan & Allan, 1998; Blacher, 1982; Blake & Andrasik, 1986; Jackson et al., 1981; Matson et al., 1983; Meyer et al., 1990; Monti, 1983; Smith & Greenberg, 1979; Van Hasselt et al., 1981). In this format, the professional has the opportunity to ask questions that are at the appropriate level of sophistication and also appropriate to the cultural group of the respondent. Regarding the ability to adjust one's social strategies to fit the needs of a particular social situation, children with mild mental retardation often fail to use information from the specific social cues present in the social situation to guide their search for appropriate strategies (Leffert et al., 2000). In other instances, scales may be constructed such that they are relevant to only certain age groups (e.g., the motor scale in the Vineland ABS), or different versions of the same scale may be used in different settings (e.g., school versus residential and community settings). Assessment of adaptive behavior should include social competence, play and leisure skills, and self-help/independent living skills. Unlike the area of social perception, there is no single instrument for assessing strategy generation in individuals with mental retardation. These areas include social-cognitive and social skill assessmentwith a specific focus on social cognitive processes of social perception, strategy generation, and consequential thinkingand vocational and work-related skills assessment with prognostic value. There are vast differences in how the third-party respondent reports on the adaptive behaviors of a client, particularly in the structure for the interview. Breadth of Domains. It is clear that different scales place different levels of emphasis on different adaptive behavior domains. This framework, reiterated in 1983, described adaptive behavior limitations consisting of significant limitations in an individual's effectiveness in meeting the standards of maturation, learning, personal independence, or social maturity that are expected for his or her age level and cultural group, as determined by clinical assessment and, usually, standardized scales (Grossman, 1983, p. 11). Jane obtained a GAC score of 72. Nine behavior domains measure personal independence and personal responsibility in daily living, including prevocational/vocational activity. Readers are referred to the test manuals and to Reschly (1990), Harrison and Robinson (1995), Thompson et al. At first glance, current definitions seem to be quite similar; however, there are subtle differences in the conceptualization of adaptive behavior that may affect the outcomes of diagnostic decisions for individuals with mental retardation, particularly those in the mild range. . In this definition, the order of the constructs can be switched without affecting the validity of the definition. Generally, adaptive behavior assessment involves obtaining information from parents, legal primary caregivers, or even teachers about a child with a learning disability to determine their strengths and weaknesses and how well they can perform independently at home, school, and in the community. For the Scales of Independent Behavior-R (Bruininks et al., 1996), the norming sample included 2,182 people ages 3 years 11 months to 90 years, with a sampling frame based on the general population of the United States stratified for gender, race, Hispanic origin, occupational status, occupational level, geographic region, and community size. Nonetheless, there is a rich literature documenting differential outcomes for quality of life, autonomy, and clinical decision making for adaptive behavioral development as measured by existing assessment instruments (Jacobson & Mulick, 1996). The 1961 manual (Heber, 1961) discussed adaptive behavior with respect to maturation, learning, and social adjustment. Scores from the instrument that are useful in diagnostic decisions must be provided and, in turn, interpretations need to be guided by the structure and organization of the adaptive behavior inventory. The purpose of doing a behavioral assessment is to understand and to explain how behavior can affect a child or an individual depending on the environment. For most people, the use of currently available adaptive behavior instruments along with other information on adaptive functioning will improve decisions about mental retardation classification. Checklists completed by teachers, parents, or other caregivers are often used to rate individuals' behavior for a broad variety of suspected conditions (e.g., mental retardation, autism, other pervasive developmental disorders, attention deficit disorder). There are at least 200 published adaptive behavior instruments that have been used for diagnosis, research, program evaluation, administration, and individualized programming. There is a much larger number of scales that do not have extensive norms but may nonetheless be suitable as a means of gathering and summarizing information that can be assessed on a clinical basis. The skills or abilities items may be readily assessed through direct measures of the individual with behavioral tasks, while performance or does-do features can be assessed only through extensive behavioral observations that often are impractical given the breadth of the adaptive behavior construct and the number of relevant settings. Social Skills Dimension of Social Competence. Reprinted with permission. Factor analyses of existing measures finds consistent domains of functioning. However, a maladaptive behavior is quite different from adaptive behavior. For example, a percentile rank of 41 indicates that the examinee scored higher than (or the same as) 41% of the age-matched norm sample. In their review of child assessment practices of psychologists, Kamphaus et al. It should also be noted, however, that there is no gold standard against which cutoff scores could be appraised, or research from which a true proportion of people with observed IQs in the range of approximately 65-75 who manifest adaptive limitations consistent with mental retardation may be directly projected. Adaptive Functioning Adaptive functioning is affected by three basic skill sets: Conceptual This includes reading, numbers, money, time, and communication skills. For the Adaptive Behavior Assessment System (Harrison & Oakland, 2000a), the norming groups for 5- to 21-year-olds included 1,670 (parent form) to 1,690 (teacher form) children; for 16- to 89-year-olds, the norming groups included 920 (rated by others) to 990 (self-report) adults without disabilities throughout the United States. The issue of sociocultural bias also arises in the context of the adaptive behavior interview. Lowe and his colleagues (2007) categorized problem behavior into four broad groupings including self-injurious behavior, aggression toward persons, destruction of objects, and disruptive behavior. ADHD Testing. Regardless of the assessment type . Inventories or checklists that attempt to assess vocational interests, emotional status, and personality traits nearly always are typical performance measures. The definition also views adaptive behavior as a multidimensional construct, in that the definition is expanded to include two or more factor scores below two or more standard deviations. Social cognition encompasses such constructs as social problem solving (Spivack & Shure, 1974), decision making (Hickson & Khemka, 1999), and social and emotional learning (Elias et al., 1997). Although schools may be the service settings in which adaptive behavior measures are most likely to be used, the information derived from these assessments may not be considered meaningful for the purposes of classification by decision makers. For example, assessments are used during classroom instruction to measure students' learning related to the academic content, and different assessments are used to measure students' overall cognitive, physical, or social . This has generalized to adaptive behavior measures. Correspondence Between SSI Classification Domains and Domains or Subdomains in Prominent Adaptive Behavior Measures. The standardization sample was proportional in demographic characteristics to the 1980 census data. Behavior . Various measures differ on the degree to which they attempt to assess the can-do and does-do characteristics of adaptive functioning (Adams, 2000; Sparrow et al., 1984a). Food handling 7. The value of such instruments will depend on careful decisions about instrument choice, score interpretation, and consideration of other information that bears on adaptive status. However, available data are sufficient to raise concerns that such issues should be studied further (Bryant et al., 1999; Craig & Tasse, 1999). At the workplace, for example, overdependence on the strategy of appealing to a supervisor, regardless of the nature of the problem, can be a problem in creating tension with peers or in creating a perception that the person cannot function autonomously in a work setting. The typical adaptive behavior inventory inquires about both the individuals' skills or abilities (what they can do) and about what they usually do in various circumstances (performance of skills or typical performance). One concern that emerged over time was that it was developed and normed for use with children and youth. Infants and toddlers may more appropriately be assessed with more specialized measures in most cases. If it is assumed that maladaptive behavior ratings should not contribute to diagnostic decisions about adaptive functioning, then problems in their measurement need not affect this process. For older adolescents, ages 18 to 21, the difficulty level of items often permits identification of either delayed or typical skills. The inability to adjust to a situations or different situations is known as maladaptive behavior. However, children who do meet intellectual and functional criteria for mental retardation also are classified as having disabilities other than mental retardation in some schools and in some cases, and not necessarily consistently so (McCullough & Rutenberg, 1988). Because adaptive behavior scales are typically completed through interview of informants or direct responses (marking of a protocol by the informant), the reliability and the validity of informant responses have been particular concerns. The determination of whether adaptive deficits are marked in character requires clinical interpretation informed in part by the data provided by the scoring of adaptive behavior measures. Individuals with mental retardation often demonstrate difficulties at the most basic level of recognizing specific types of social cues (e.g., recognizing a person's emotional state on the basis of his or her facial expression) (Adams & Markham, 1991; Gumpel & Wilson, 1996; Harris, 1977; Hobson et al., 1989). During the 1920s, Doll, Kuhlmann, and Porteus sought to develop assessment practices consistent with a definition of mental retardation that emphasized adaptive behavior and social competence. The disadvantage is that each clinician imposes his or her own subjective criteria, a process that threatens both the reliability and the validity of the assessment. One must consider not only general competencies across relevant domains but also the level, quality, and fluency of those behaviors. However, the simplicity and lack of reliability or validity of many such procedures render them less useful than more complex measures administered professionally. Areas assessed, and information that may be revealed, include areas of communication, daily living skills, community functioning, socialization, self-reliance skills, and motor skills. Although the assessment of intellectual functioning has a longer history (e.g., first standardized test was developed in 1905) than the measurement of adaptive behavior, standardized tests of adaptive behavior have progressed significantly since the first such scale was published (Vineland Social Maturity Scale, Doll, 1936).The first version of the Vineland instrument consisted of items . One of the key themes throughout the DSM-IV definition is the cultural aspect of adaptive behavior. The subscales are similar to general adaptive behavior scales, but there is a greater emphasis on skills required to function in community settings than on basic adaptive skills. The ABS-S:2 is used to identify students who are significantly below their peers in adaptive functioning for diagnostic purposes. Assessments work best when they document: (a) quantitative level of performance, (b) fluency of performance (e.g., qualitative criterion performance), (c) the extent to which the individual has failed to acquire skills or failed to perform skills already learned, and (d) the inability of the individual to perform skills through lack of opportunity. Grooming 2. Among these four definitions, there is little variation in the intelligence construct for individuals with mental retardation. The person is then asked, What will happen after the protagonist carries out this strategy? Full details on standardization and reliabilities are provided in the manuals associated with the major adaptive behavior scales (Adams, 2000; Bruininks et al., 1996; Harrison & Oakland, 2000b; Lambert et al., 1993b; Sparrow et al., 1984b; see also Harrington, 1985). (1999) reviewed studies that reported factor analyses of adaptive behavior measures. Both legislative action and judicial decisions at the federal level have focused on concerns that parents may misinform clinicians regarding their children's skills in order to obtain SSI benefits. There is considerable overlap in adaptive behavior attainment among children with mild mental retardation and matched peers. This use may result from concerns among clinicians about the robustness of adaptive behavior measures. The definition speaks to the presence of significant limitations in intellectual functioning and significant limitations in adaptive behavior, which exist concurrently. Is adaptive behavior a set of abilities and skills useful in coping with environmental demands that are mastered by the individual? On one instrument, the items are shown to the respondent and the respondent is given responses from which to choose (e.g., Bruininks et al., 1996), while in another the interviewer is required to assess adaptive competencies through a general conversation with prompts such as Tell me about Thomasina's language skills (Sparrow et al., 1984a). In addition to the usual considerations attendant on any measure of individuals, special considerations always exist with typical performance measures (Cronbach, 1990). For the Vineland Adaptive Behavior Scales (Sparrow et al., 1984a) the standardization sample was representative of the U.S. population. In recent years, existing operational definitions of adaptive behavior and techniques for measuring adaptive behavior have been criticized as being inadequate for determining the presence of significant limitations in individuals with mild mental retardation. Specifically, a comprehensive adaptive behavior assessment should include information obtained from: 1. This is the key difference between these two forms of behavior. (1999), Jacobson and Mulick (1996), Spector (1999), Hill (1999), Test Critiques, test reviews in the Journal of Psychoeducational Assessment, and the Mental Measurements Yearbooks for more detailed psychometric information about these and other measures. Connect with AAIDD on Social Media Some of these scales were developed to serve only one of these purposes; however, several have attempted to include both the breadth required for diagnosis and the depth required for clinical use. For example, the SIB-R has four factors (Motor Skills, Social Interaction and Communication Skills, Personal Living Skills, and Community Living Skills) that are combined to yield a Broad Independence score. This is usually a parent or teacher. Traditional measures of achievement and intellectual functioning are examples of maximum performance tests. The Comprehensive Test of Adaptive Behavior (CTABAdams & Hartleben, 1984) has been described as fairly efficient and inexpensive, with excellent reliability, solid validity, and adequate norms (Reschly, 1990). Technical manuals present analyses of data gathered in the process of test development that addresses content validity (in terms of representativeness and inferences from age norms), substantive validity (in that they present either a theoretical or empirically derived model of adaptive behavior to which the scale conforms), generalization validity (with respect to differing age or disability groups), external validity (in terms of concurrence with previous or contemporary adaptive behavior measures and intellectual measures), and consequential validity (in terms of evidence of bias or procedures utilized to reduce bias). Chapter 4, The Role of Adaptive Behavior Assessment. All of the measures above have demonstrated concordance with psychiatric diagnosis. At the turn of the century, intelligence assessment placed primary emphasis on moral behavior (which largely comports with the current construct of social competence) and on the pragmatics of basic academics. For the Social Skills and Vocational Success, Chadsey-Rusch (1992) described three measurement approaches to operationalize a definition of social skills, including (1) the perception of others in the workplace, especially employers, (2) the goals and perceptions of the target individual, and (3) performance of social behaviors in natural contexts. Reviews of the ILS have been generally negative, and it may not be suitable for disability determination purposes. Interestingly, individuals with mild mental retardation often face their most significant obstacles to competitive employment and job retention arising not from task-related skills, but rather from limitations in their social functioning (Bullis & Foss, 1986; Butterworth & Strauch, 1994; Chadsey-Rusch, 1992; Foss & Bostwick, 1981; Greenspan & Shoultz, 1981; Salzberg et al., 1988; Salzberg, Likins et al., 1986). The most cited definition in the field is that of the American Association on Mental Retardation (AAMR). The available instruments include indirect assessments, such as rating scales that assess an individual's typical performance of social behaviors based on information from informants, including teachers, parents, and job coaches, as well as instruments that permit direct assessment of the processes that, according to theoretical models of successful social adaptation, underlie the ability to perform situationally appropriate behavior. Most adaptive behavior scales contain factors addressing interpersonal relationships or social skills, but they do not address overall social competence. Deficits in adaptive behavior are defined as non-existent in an individual's effectiveness in meeting the standards of maturation, learning, personal independence, social responsibility and school performance. The standardization sample consisted mostly (80 percent) of adults living in residential facilities, and the overall functioning level of the sample may be lower than if other community-dwelling adults had been included (Harrison, 1998). A consequence of this, according to Thompson et al., is the inability to develop precise measures of adaptive behavior that would objectively differentiate individuals by disability. Useful score scales and appropriate norms are vital features of adaptive behavior instruments used in diagnostic decisions. In addition to rating skill performance, raters also specify whether each skill is critical to success in the environment in which the child is observed, i.e., school or classroom. Interpretation should focus on the composite score or, perhaps, implement the AAMR classification criterion of deficits in two or more adaptive skills areas. It is, however, performance or typical performance that most adaptive measures address. No mention is made of the degree of severity of adaptive deficits for each of these levels, nor of the number or types of impaired adaptive behavior domains at each level. The Social Skills Rating System, described below, is a behavior rating scale that was developed to provide this information for students. Question Guide for the Assessment of Social-Cognitive Processes. Thus, characteristics of the factor structure of a measure of adaptive behavior have important implications for diagnosis. The Adaptive Behavior: Street Survival Skills Questionnaire (SSSQLinkenhoker & McCarron, 1983) was designed to assess adaptive behavior in youth from age 9 years and adults with mild to moderate mental retardation. However, depending on the age range of adult participants without disabilities sampled during norming studies, the ceiling (i.e., the highest level of behavioral performance assessed) may differ across scales and may affect the characterization of the degree of delay manifested. Their repertoires often exclude certain types of socially adaptive strategies. Avoiding danger 6. The following areas by age should be adopted by SSA: Current science also suggests that several measures of adaptive behavior tap into these domains. A record of maladaptive behavior may permit an individual to be qualified for SSI by virtue of concurrent IQ in the range of 2 to 2.66 SD and presence of another mental (or behavioral) disorder (Jacobson, 1990; Jacobson & Janicki, 1983). The Independent Living Scales (ILSLoeb, 1996) were designed to assess the degree to which older adults are capable of caring for themselves (i.e., functional competence). Adams (2000), in contrast, uses a mixture of typical performance with third-party respondents and maximum performance operations. For example, an item may tap skills associated only with childhood (e.g., performing a specific activity or completing a task with adult assistance in an age-typical manner) or with adulthood (e.g., menstrual care for an adult or adolescent woman). In using the term accompanied, the definition suggests that adaptive behavior is a supplementary variable to intelligence, although both criteria must be present. Federal review of the SSI program has indicated that such deception is an uncommon occurrence. A number of factors and descriptive categories of behavioral development must be represented adequately in order to ensure comprehensiveness and documentation of both strengths and limitations for clinical and diagnostic purposes. Adaptive Behavior Below is a listing of some of the adaptive behaviors measured by commonly used scales and checklists based on models of the construct of adaptive behavior. Limitations in present functioning must be considered within the context of community environments typical of the individual's age, peers, and culture. The Batelle Developmental Inventory (BDINewborg et al., 1984) is a developmental scale, rather than an adaptive behavior scale, and is appropriate for children from birth to age 8 (Spector, 1999). What are examples of adaptive behaviors? However, depending on the functional domain and the measure, many people with a diagnosis of mild mental retardation do not have adaptive delays or limitations to this degree. Aggressive could mean that she hits, bites, yells, or displays other forms of aggression. 2. Generally, these instruments do not have well-established norms but rather have been assessed for their sensitivity with diagnosed cases (e.g., Reiss & Valenti-Hein, 1994), and some scales are more suitable for youth than for children: the Assessment of Dual Diagnosis (Matson & Bamburg, 1998); the Psychopathology Instrument for Mentally Retarded Adults (Balboni et al., 2000; Linaker, 1991; Sturmey & Ley, 1990; Watson et al., 1988); and the Reiss Screen for Maladaptive Behavior (Havercamp & Reiss, 1997; Prout, 1993; Sturmey & Bertman, 1994) For practitioners skilled in clinical interviewing, a field-tested adaptation of a structured clinical interview is available. Edger Doll produced form board speeded performance tests, which were analogues to everyday vocational tasks. Since the adaptive behaviors that need to be assessed are those found in the context of a broad range of everyday living situations displayed across a wide variety of settings, an assessment of adaptive functioning by direct observation is usually not practical. (Chapter 3 provides details on the development of intelligence assessment.). Some of the more common and relevant response sets are (a) social desirability, involving responses consistent with positive or desirable connotations of the items or behaviors, (b) acquiescence, involving the tendency to say yes, true, or, in cases in which knowledge is lacking or uncertain, sometimes, and (c) halo effects, involving reporting higher adaptive behavior among persons who are more liked by the respondent.

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