Adaptive Behavior
Adaptive behavior includes behaviors and skills required for an individual to function effectively in everydaylifeatanage-appropriatelevelofindependence. The American Association on Mental Retardation (AAMR) distinguishes three major categories of adaptive functioning.
Conceptual skills include language, functional academics, and self-direction. Social skills include establishing friendships, social interaction, and social comprehension. Practical skills include basic self-care skills and navigation of home, school, and community tasks and environments. In later adolescence, vocational functioning is also assessed as part of the practical domain.3.6
Measures of Achievement
| INSTRUMENT (REF.) | DESCRIPTION | COMMENTS |
| Kaufman Test of Educational Achievement-II (KTEA-II) (99) | Reading (decoding and comprehension), math (computation and applications), and written language composites (spelling and composition), as well as additional subtests measuring reading- related skills and oral language. Ages 4.6-25. | Age- and grade-based norms provided; norms broken down by fall, winter, spring; reading- related subtests help identify specific deficits in phonological awareness or rapid naming. |
| Wechsler Individual Achievement Test-II (WIAT-II) (100) | Subtests measure pseudoword decoding, word reading, comprehension, numerical operations, math reasoning, written expression, spelling, oral language, and listening comprehension. Ages 4-85. | Age- and grade-based norms provided; norms broken down by fall, winter, spring; co-normed with the Wechsler Intelligence Scale for Children-IV to promote statistically sound comparisons between IQ and achievement scores. |
| Woodcock Johnson III Tests of Achievement (WJ-III) (101) | Scales assess reading, oral language, mathematics, written language, and knowledge. Separate scales assess basic skills, applications, and fluency for reading, math, and written language. Multiple additional scales of highly specified skills are included. Ages 2-90+. | Age- and grade-based norms provided; scoring provided through use of computer software only; lack of hand-scoring option limits clinician in interpretation in some cases; specific fluency scores useful in populations with processing speed deficits; written expression subtest relatively simplistic. |
| Wide Range Achievement Test-IV (WRAT-IV) (102) | Subtests include sentence comprehension, word reading, spelling, and math computation Ages 5-94. | Brief measure that does not assess some critical aspects of academic functioning. |
| Peabody Individual Achievement Test-Revised (PIAT-R) (103) | Includes subtests for general information, reading recognition, reading comprehension, mathematics, spelling, and written expression. Ages 5-18. | Uses a recognition format that accommodates individuals with language and motor impairments; measures relatively limited set of skills compared to other tests |
Deficits in adaptive behavior are one of the core criteria in determining a diagnosis of mental retardation, along with significantly impaired intellectual functioning. Adaptive functioning is assessed primarily through structured interviews and rating scales completed by persons familiar with the child in natural settings, such as parents and teachers. These scales are open to the response bias inherent in this type of assessment, but are also directly linked to programming assistance. There is great utility in using responses to adaptive skills to identify target skills for rehabilitation. Several issues are especially noteworthy in using these assessments with rehabilitation populations. First, adaptive scores may be disparate with intellectual testing scores in a traumatic brain injury population, because they represent more procedural learning and are often less affected directly after the injury.
The failure to gain subsequent abilities can be a source of substantial disability as time goes on, due to impairments in sensory or cognitive abilities. Second, in contrast to individuals with developmental mental retardation, who may be expected to show a general pattern of mastery of easier skills and nonmastery of more difficult skills on each scale, the rehabilitation population is more likely to show uneven peaks and valleys across skills even within the same domain. For example, a person with motoric impairment may struggle with some “easier” self-care skills, but have the cognitive and adaptive ability to handle more “difficult” skills in the same domain. In these individuals, standardized scores may not provide a meaningful picture, but analysis of specific items can provide direction for rehabilitation programming.The Vineland Adaptive Behavior Scales-II (106) is a widely used set of scales that has four forms: Survey Interview, Parent/Caregiver Rating, Expanded Interview, and Teacher Rating. Each assesses four broad domains. The communication domain assesses expressive, receptive, and written communication. The daily living skills domain assesses personal, community, and domestic skills. The socialization domain assesses interpersonal relationships, play and leisure time, and coping skills, The motor skills domain assesses fine and gross motor skills for young children. The domain scores are combined to yield a composite index. A maladaptive behavior domain surveys inappropriate social or behavioral displays. The survey interview and rating scales take 20-60 minutes to complete, while the expanded interview is lengthier. The second edition includes updated content and increased coverage of early childhood adaptive behavior for use down to early infancy.
The Adaptive Behavior Assessment System-2 (ABAS-2) (87) includes five forms, each taking 15-20 minutes to complete: Parent/Primary Caregiver form for birth to 5 years, Teacher/Daycare Provider Form for children ages 2-5 years, the Teacher Form for ages 5-21 years, the Parent form for ages 5-21 years, and the Adult form for ages 16-89. In the second edition of the system, the domains are closely aligned with the AAMR definition of adaptive behavior. The conceptual domain assesses communication, functional academics (or pre-academics), and self-direction. The social domain assesses leisure and social skills. The practical domain assesses self-care, home/school living, community use, health and safety, and, for older adolescents and adults, work skills. The scales are well validated. Table 3.7 provides a complete listing of these tests.