1. Dr. Thomas Oakland University of Florida University of Hong Kong
Adaptive Behavior as measured by the Adaptive Behavior Assessment System-II (ABAS-II)
Dr. Thomas Oakland University of Florida University of Hong Kong

2. With Appreciation to… The Australian Council for Educational Research
Blair Heading
Brendan Pye

3. Purposes of this presentation
Today we will learn more about adaptive behavior:
What is adaptive behavior
How the DSM-5 characterizes Intellectual Developmental Disorder (ID)
How the ABAS-II and the DSM-5 overlap
Advantages to using the ABAS-II
How to use these data beyond making a diagnosis

4. 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 environments 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 in the community.

5. Human Growth and Development
Most people develop normally
Some develop more slowly at first
Some then catch up later and others do not
Delays may be in
One behavior
Two or more—and for some, many behaviors
May require extra support and assistance
Tends to increase to early 20s and then plateaus
Tends to decline when in ones 70s

6. Children who display the following disabilities are likely to display adaptive behavior deficits
Attention disorders
Autism
Behavior disorders
Brain disorders and injuries
Developmental delays
Learning disorders and disabilities
Mental retardation/ID
Social-emotional disorders
Sensory or motor impairment
Visual and auditory disorders

7. Adults who display the following disabilities are likely to display adaptive behavior deficits
All of those listed on the prior slide with the exception of early developmental delays
Alcohol and drug abuse
Alzheimer’s disease
Depression
Neurobehavioral disorders
Neurocognitive disorders
Neurodevelopmental disorders
Psychosis

8. Current concepts of adaptive behavior
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 and School Living Community Use Health and Safety Work

9. 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 (1) clinical (2) utility
More reliance on professional (clinical) judgment
Let’s review some changes to the DSM-5 before looking at the overlap between the DSM-5 and the ABAS-II

10. 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 supports)

11. 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

12. 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)

13. Intellectual developmental disorder: more on adaptive behavior
ID severity is determined from adaptive behavior
A standardized assessment of adaptive behavior
Its 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 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

14. 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

15. How the ABAS-II and the DSM-5 overlap
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

16. How the ABAS-II and the DSM-5 overlap
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 with more diagnoses generally display more adaptive behavior deficits.

17. Advantages to using the ABAS-II
Standardized on > 7000 persons from birth
through age 89
Assesses the 10 skill areas, three domains, the provides a general adaptive composite
Clinicians select from five forms
Parent/Primary Care Giver for ages
0-5
5-21
Teacher/Day Care Provider for ages
2-5
An adult scale for ages 16-89

18. Advantages to using the ABAS-II
All forms are completed by knowledgeable
respondents
Administration time ~ 20 minutes
The number of guessed item averages < 3 among it ~ 250 items
Strong psychometric features: E.G. General Adaptive Composite reliability
Internal consistency is .98 to .99
Test-retest reliability is .90.
Ratings from two teachers is .91.

19. 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

20. Some Implications from the Definitions
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 to clinically 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.

21. Some Implications from the Definitions
A person’s personal life functioning generally will improve
With appropriate personalized education and support
When interventions are
sustained over time
used daily
valued by the person, and
important to his/her caretakers and
important in his/her environment.

22. Some Implications from the Definitions
The success of these interventions is higher when the person
participates in selecting the interventions
values the behaviors
wants to acquire them
thus is motivated to both develop the behaviors and sustain their display

23. Some Implications from the Definitions
The success of these interventions is higher when important caregivers also
participate in the selection of the interventions
value the behaviors
want them acquired
thus are motivated to both
help develop the behavior and
help sustain an environment in which these behaviors can be displayed and rewarded regularly

24. Some Implications from the Definitions
The success of these interventions is higher when
the caregiver has the resources to implement and sustain the behavior program
the interventions are within the zone of proximal development
training occurs in the environment in which the desired behaviors eventually will be displayed.

25. ABAS–II Information to Plan and Implement Interventions
Basic considerations:
Analyze the client’s adaptive skills at the item level
Analyze environmental needs:
current environment
target environment
Match between skills and environmental demands
Identify support needs
Assumption: adaptive skills interventions are more effective than those on adaptive behavior.

26. Using the ABAS scores to plan and monitor intervention programs
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?

27. Using the ABAS scores to plan and monitor intervention programs
Does the person’s environments
have the resources to provide needed support?
display a desire to provide support?
What changes in these environments are need to provide needed assistance?

28. Using the ABAS scores to plan and monitor intervention programs
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.

29. Using the ABAS scores to plan and monitor intervention programs
Where is change most likely to occur?
On specific behaviors (that is, at the item level)
Less likely: skill area
Least likely: domains and GAC levels

30. Validity Studies with Clinical Samples

31. Mean Performance across Adaptive Skill Area
Developmentally Delayed
Mean Performance across Adaptive Skill Area
Teacher
Parent
(n=48)
(n=78)
Age Range
2–5
0–5
Mean
Conceptual
84 (99)
81 (102)
Social
86 (97)
84 (100)
Practical
86 (101)
GAC
84 (97)
82 (101)
% ≤ 70
26 (4)
28 (1)
17 (2)
20 (8)
20 (9)
19 (5)
22 (4)
25 (4)
% of 2 or More Skill ≤ 4
35 (8)
70 (9)
Note. Numbers in parenthesis represent non-clinical sample cases.
Adaptive Skill Area

32. Mean Performance across Adaptive Skill Area
Motor Impairment
Mean Performance across Adaptive Skill Area
Teacher
Parent
(n=32)
(n=50)
Age Range
2–5
0–5
Mean
Conceptual
84 (98)
86 (98)
Social
87 (99)
Practical
71 (96)
79 (97)
GAC
76 (97)
79 (98)
% ≤ 70
30 (13)
18 (4)
29 (6)
16 (0)
58 (13)
24 (2)
40 (10)
33 (0)
% of 2 or More Skill ≤ 4
53 (9)
36 (4)
Note. Numbers in parenthesis represent non-clinical sample cases.
Adaptive Skill Area

33. Mean Performance across Adaptive Skill Area
Mild Mental Retardation
Mean Performance across Adaptive Skill Area
Teacher
Parent
(n=31)
(n=27)
Age Range
2–5
Mean
Conceptual
67 (101)
68 (100)
Social
71 (104)
71 (101)
Practical
71 (99)
GAC
66 (100)
% ≤ 70
65 (0)
70 (0)
58 (0)
52 (4)
52 (3)
43 (0)
% of 2 or More Skill ≤ 4
68 (0)
Note. Numbers in parenthesis represent non-clinical sample cases.
Adaptive Skill Area

34. Mean Performance across Adaptive Skill Area
Autism/Asperger’s
Mean Performance across Adaptive Skill Area
Teacher
Parent
(n=30)
(n=49)
Age Range
3–5
Mean
Conceptual
73 (102)
72 (98)
Social
67 (101)
65 (99)
Practical
66 (101)
65 (98)
GAC
67 (102)
64 (98)
% ≤ 70
62 (0)
56 (0)
74 (0)
65 (6)
71 (0)
71 (6)
% of 2 or More Skill ≤ 4
77 (0)
71 (9)
Adaptive Skill Area
Note. Numbers in parenthesis represent non-clinical sample cases.

35. 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.

36. 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.

37. Questions and Comments