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Profiles of Adaptive Functioning: Autism Spectrum Disorders, Mental Retardation, and Beyond .

Profiles of Adaptive Functioning: Autism Spectrum Disorders, Mental Retardation, and Beyond . California Association of School Psychologists February 17, 2005 8:30-10:15 Sara S. Sparrow, PhD Yale Child Study Center. How I Discovered Adaptive Behavior. Speech Pathology Psychology

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Profiles of Adaptive Functioning: Autism Spectrum Disorders, Mental Retardation, and Beyond .

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  1. Profiles of Adaptive Functioning: Autism Spectrum Disorders, Mental Retardation, and Beyond. California Association of School PsychologistsFebruary 17, 2005 8:30-10:15 Sara S. Sparrow, PhD Yale Child Study Center

  2. How I Discovered Adaptive Behavior Speech Pathology Psychology Doman-Delacato Measurement Dilemmas

  3. 4 AREAS FOR TODAY • NEW FEATURE OF THE VINELAND II • CHANGES IN THE PURPOSES OF ADAPTIVE BEHAVIOR ASSESSMENTS • RECENT RESEARCH ON EFFECTS OF INTERVENTION WITH PERSONS WTH HIGH FUNCTIONING ASD • CLINICAL APPLICATIONS AND ADAPTIVE PROFILES

  4. Adaptive Behavior Assessment Working our way back: 30 years since Pl 94-142 (1975) 16 years earlier AAMD (1959) 24 years earlier Edgar Doll published The Vineland Social Maturity Scale (1935)

  5. Purpose Diagnosis of Mental Retardation

  6. Things Have Changed More and more assessing adaptive behavior has had broader applications One reason is that different research has demonstrated that there appear to be different profiles for various diagnostic groups

  7. USES OF ADAPTIVE BEHAVIOR ASSESSMENTS • Confirming or establishing diagnosis • Special services qualification • Program planning • Progress reporting/tracking • Identifying changes over time

  8. USES, conintued • Mental Retardation • Early Childhood Special Education • Autism Spectrum Disorders • Traumatic Brain Injury • Adult Mental Problems • As a measure to support the diagnosis ofother disabilities • Death Penalty Cases and • Many others

  9. A word about Death penalty cases: Atkins versus Virginia. Psychologists will be increasingly asked to provide testimony in these cases, mainly regarding adaptive functioning A Virginia court just ruled that Atkins did not meet criteria for a diagnosis of mental retardation

  10. 2005 Supreme Court rules that individuals with (chronological) age under 18 years cannot be executed. What about mental age?

  11. THUS • Implications for the development of the Vineland II

  12. Introducing the Vineland-II

  13. VINELAND-II Overview • Because clinicians have different needs when it comes to assessing adaptive behavior, we now offer four forms: --Survey Interview Form • NEW Parent/Caregiver Rating Form • Teacher Rating Form • Expanded Interview Form

  14. MAJOR NEW FEATURES • Ages: Birth to 90 years of age • New Norms • Increase Item density at floor and ceiling • Extensive investigation and elimination of item bias • Increase items relevant to ASD and young children • Eliminate outdated items • Increase Items reflecting our society’s technological advances • Subdomain standard scores • New Maladaptive

  15. Other New Features • Parent Caregiver Forms • Teacher report Form – • Daily Living Skills • Personal Subdomain • Academic Subdomain • School-Community Subdomain

  16. Validity Evidence: 11 Clinical Groups • Attention Deficit/Hyperactivity Disorder • Autism – nonverbal • Autism – verbal • Learning Disability • Mental Retardation – Mild (child) • Mental Retardation – Moderate (child) • Mental Retardation – Mild (adult) • Mental Retardation – Moderate (adult) • Emotional Disturbance • Visual Impairment • Hearing Impairment

  17. Validity Evidence: Criterion • Vineland Adaptive Behavior Scales • Adaptive Behavior Assessment System (ABAS) • WISC III • WAIS-III • BASC-2

  18. SUBDOMAIN V-SCALED SCORES Mean = 15 SD = 3

  19. Yale University VINELAND II NEW MALADAPTIVE DOMAIN

  20. STILL BOTH MINOR AND MAJOR MALADAPTIVE

  21. FACTOR ANALYTIC STUDIES REVEALED THREE FACTORS

  22. Internalizing Items • Is overly dependent  • Avoids others and prefers to be alone  • Has eating difficulties  • Has sleep difficulties  • Refuses to go to work or school because of fear, feelings of rejection, or isolation  • Is overly anxious or nervous  • Cries or laughs too easily  • Has poor eye contact  • Is sad for no clear reason  • Avoids social interaction  • Lacks energy or interest in life 

  23. Externalizing Items • Is impulsive • Has temper tantrums • Intentionally disobeys or defies those in authority • Taunts, teases, or bullies • Is inconsiderate or insensitive of others • Lies, cheats, or steals • Is physically aggressive • Is stubborn or sullen • Says embarrassing things or asks embarrassing questions in public • Behaves inappropriately at the urging of others

  24. Group Maladaptive Differences

  25. Maladaptive Behavior by Age for Individuals with MR School-aged children with MR (all levels) had maladaptive means significantly higher than age matched clinical groups but < 1SD difference. Adults (19-90) with MR (all levels) had maladaptive means significantly higher than age matched clinical groups AND school aged groups with MR

  26. Maladaptive Behaviors by Age for Individuals with MR Differences were greatest in the adult severe-profound group Only Internalizing behaviors fell into the “elevated range” (the highest level) for this group

  27. Adaptive Functioning of Mental Retardation Groups For all levels and ages, mean levels of all domains and the adaptive behavior composite were at least 2SD below the mean

  28. Severe Moderate Mild

  29. Mean Subdomain Scores

  30. Mean Subdomain Scores

  31. Validity Evidence: Mental Retardation Ages >18 Ages 6-18 Mean scores by age group and level Mild, Moderate, Severe to Profound

  32. Validity Evidence: Autism, ADHD, EBD, LD Mean scores by age group and disability

  33. Validity Evidence: Visual Impairments, Hearing Impairments Mean scores by age group and disability

  34. Clinical Group Summary Vineland-II differentiates clinical groups from nonclinical groups. • Documented significant deficits for MR groups (at least 2 SDs below mean) • Demonstrated expected mean score changes for mild, moderate, and severe to profound levels of mental retardation • Differentiated between Verbal and Nonverbal Autism groups • Demonstrated distinctive profile patterns

  35. Validity Evidence: Criterion • Vineland Adaptive Behavior Scales • Adaptive Behavior Assessment System (ABAS) • WISC III • WAIS-III • BASC-2

  36. Vineland-II and Vineland ABS High degree of consistency between forms Correlations corrected for restriction of range

  37. IMPORTANT THERE APPEARS TO BE NO FLYNN EFFECT

  38. Vineland-II and WISC-III and WAIS-III Documents the distinct difference between IQ and Adaptive Behavior. Confirms the need to assess both when making diagnostic decisions. Correlations corrected for restriction of range

  39. Ages 6-11 Vineland-II and Behavior Assessment System for Children, 2nd Edition (BASC-2) Correlations corrected for restriction of range

  40. Conclusions • Much is the same but much is better! Manual Criteria Case studies Summer 2006 • Teacher checklist Winter 2006 • Expanded Form

  41. Adaptive Profiles from Research Studies Since 1984 over 1400 studies have been published investigating adaptive functioning in the following groups: Mental retardation Autism Spectrum Closed Head Injury Hearing Impaired Homeless HIV Learning disability Gifted Emotionally Disturbed Spina Bifida Tourette Syndrome Conduct Disorder Cocain Exposed Low Birthweight Children exposed to Violence ETC.!

  42. Groups with Mental Retardation Non Specific MR All levels of MR Genetic Forms of MR Fragile X Down Syndrome Praeder Willi William Syndrome Special Olympics

  43. Groups on the Autism Spectrum PDD NOS Asperger Syndrome High functioning Autism Low functioning Autism Multiplex Nonverbal Learning Disability (?)

  44. Atypical and Normally DevelopingChildren Sparrow, S.S. Rescorla, L.A., Provence, S., Condon, S.O., Goudreau, D., Cicchetti, D.V., (1986). Follow-up of “atypical” children Journal of American Academy of Child Psychiatry. 25, 2:181-185.

  45. Atypical and NormallyDevelopingChildren

  46. PDDnos (Atypical) and Non (Atypical) PDDnos

  47. Social Deficits In Autism Volkmar, F.R., Sparrow, S.S., Goudreau, D., Cicchetti, D.V., Paul, R., Cohen, D.J., (1987) Social deficits in autism: An operational approach using the Vineland Adaptive Behavior Scales. Journal of the American Academy of Child and Adolescent Psychiatry. 26, 2:156-161.

  48. AUTISM • Carter,A. S., Volkmar,F. R., Sparrow,S. S., Wang,J. J., Lord,C., Dawson,G., Fombonne,E., Loveland,K., Mesibov,G., Schopler,E., (1998),The Vineland Adaptive Behavior Scales - Supplementary Norms for Individuals with Autism, Journal of Autism & Developmental Disorders, 28:4, pp. 287-302.

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