The Development of the Diagnostic Adaptive Behavior Scale

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The Development of the Diagnostic Adaptive
Behavior Scale

• A New Measure of Adaptive Behavior

• Presented At
• International Association for the Scientific
  Study of Intellectual Disability (IASSID).
• Cape Town South Africa,
• August 26, 2008

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Authors This paper represnets the work of a
team.

• H Bersani Jr., Western Oregon University (USA),
• M J Tassé, University of South Florida (USA
  co-chairman),
• R L Schalock, Hastings College (USA
  co-chairman),
• G Balboni, University of Valle d'Aosta (IT),
• S A Duffy, University of California at Riverside
  (USA),
• J Scherba de Valenzuela, University of New Mexico
  (USA),
• S Spreat, Woodland Center for Challenging
  Behaviors (USA),
• D M Thissen, University of North Carolina at
  Chapel Hill (USA),
• K F Widaman, University of California at Davis
  (USA), and
• D Zhang, Texas AM University (USA)

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Adaptive Behavior Definition

• The definition of adaptive behavior can be
  summarized as
• the individuals everyday behavior that he/she
  emits to respond to the demands of his/her
  cultural, social, and physical environment.

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Why Is AB Measured in the Field of Intellectual
Disability

• AB is measured to diagnose/rule-out ID
• Significant limitations in adaptive behavior is
  one of the three criteria for a diagnosis of
  intellectual disability.
• Adaptive behavior is also measured for other
  purposes
• planning rehabilitation (ISP)
• planning education interventions (IEP)
• evaluating the effectiveness of an intervention
  program
• indentifying adaptive behavior patterns specific
  to genetic syndromes

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My own theory

• The tool designed to perform many tasks does
  tone of them well

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What Are Important Factors to Consider When
Assessing Adaptive Behavior

• Adaptive behavior is multidimensional and
  consists conceptual, social, and practical
  skills.

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What Are Important Factors to Consider When
Assessing Adaptive Behavior

• Adaptive behavior is age-specific and increases
  in complexity with age and development and then
  plateaus.

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What Are Important Factors to Consider When
Assessing Adaptive Behavior

• Adaptive behavior is context specific and is
  dependent upon the individuals cultural group
  and the demands of particular situations and
  environments.

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What Are Important Factors to Consider When
Assessing Adaptive Behavior

• Adaptive behavior reflects the individuals
  present typical performance during daily
  routines.

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For our purposes

• The measurement of adaptive behavior is most
  critical for the group of people with tested
  general intellectual functioning of about 70 on a
  standardized intelligence test

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Current Instruments

• Based on these four factors of adaptive behavior
  gt scales of adaptive behavior generally consist
  of the following
• interview a respondent who knows the individual
  very well, generally parent/caregiver
• evaluation of the persons level of present
  typical performance in conceptual, social, and
  practical skills gt based on adapting to the
  environmental demands dependent upon age and
  cultural/ethnic group and in community setting

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Current Instruments

• Based on these four factors of adaptive behavior
  gt scales of adaptive behavior generally consist
  of the following
• inference of the developmental level of adaptive
  behavior transforming the raw scores obtained in
  the adaptive behavior scale into normative scores
  that have been obtained from general population
• use of clinical judgment for taking into account
  the role of several factors that may have
  influenced the individuals opportunity to learn
  or express adaptive behavior skills such as
  setting / environmental demands, cultural/ethnic
  group, physical limitations unrelated to the
  presence of ID

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Available AB Instruments

• The exist approximately 200 adaptive behavior
  scales (Schalock, 1999).
• There are really only FIVE Adaptive Behavior
  scales according to Luckasson et al. (2002) and
  Schalock et al. (2008) that have strong
  reliability, established validity, and that are
  normed on the general population (with and
  without disabilities).

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Available AB Instruments

• Vineland Adaptive Behavior Scales-II
• (Sparrow, Balla, Cicchetti, 2005).
• Adaptive Behavior Assessment System-II
• (Harrison Oakland, 2003).
• AAMR Adaptive Behavior ScaleSchool Edition
  (Lambert, Nihira, Leland, 1993).
• Scales of Independent Behavior-Revised
• (Bruininks, Woodcock, Weatherman, Hill, 1996).
• Comprehensive Test of Adaptive Behavior- Revised
• (Adams, 2000).

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Factors in Developing a Valid AB Scale to
Diagnose ID

• Use items that discriminate clearly at the upper
  end of the IQ/AB criteria.
• Do not use the same scale for multiple purposes
  (e.g., diagnoses and planning intervention).
• Measure social vulnerability.
• Include repertories of cultural/ethnic practice
  and environment demands.
• Use multiple respondents

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Purpose

• To develop DABS, a third-party standardized AB
  scale to use for the diagnoses of ID with 4 to 21
  years old individuals
• DABS must
• contains items that maximally differentiate
  between AB of individuals with and without ID
• measures all the AB aspects based on current AB
  factor analytic investigations (e.g., Thompson,
  McGrew, Bruininks, 1999 Widaman McGrew,
  1996) and theoretical reviews (e.g., Schalock,
  1999)
• and allows the interviewer to scoring taking
  into account factors like presence of physical
  impairments, environment demands, or repertories
  of cultural practice, that may influence the
  opportunity of expression of individuals
  behaviors (e.g., Luckasson et al., 2002)

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Defining Features of the DABS

• Exclusively diagnostic focus on cut-off
• Short-precise assessment instrument
• Tailored to the AAIDD tri-partite definition of
  adaptive behavior gt

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Diagnostic Adaptive Behavior Scale

• Social skills
• interpersonal skills, responsibility,
  self-esteem, wariness/naïveté, follow rules,
  etiquette, social problem solving.
• Practical skills
• activities of daily living, occupational skills,
  safety, healthcare, travel.
• Conceptual skills
• language, functional academics, self-direction,
  money management, time concepts.

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Item Selection

• Listing items from existing AB scales and
  literature N items 2,871
• Classification of items (using N-Vivo) and
  reduction, deletion or addition of new items to
  allow the measurement of all AB areas (included
  social vulnerability, problem solving, and
  technology-based skills, that are not currently
  measured by published AB scales) N 1,180
• Investigation of content validity of items asking
  to
• international experts of AB and ID (N 20) to
  assign items to their respective AB domains
  conceptual, social, and practical skills.
  Preservation of the items that were specific just
  to one AB domain.
• experts of AB and ID of four different United
  States minority groups African American (N 4),
  Asian American (N 4), Hispanic American (N
  2), and Native American (N 5) to judge if
  items are culturally/ethnically sensitive/biased
  with respect to individuals living in the United
  States. Preservation of items that were no
  biased.
• Selection of items typically for 4 to 21 years
  old individual. Rewriting items in clear, concise
  and easy to observe ways.

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Diagnostic Adaptive Behavior Scale

• Age 4 21 years old
• Administration
• Semi-structured interview
• Face-to-face Interviewer ? Respondent

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DABS Sample Items

• CONCEPTUAL SKILLS
• (communication)
• Follows verbal directions.
• Communicates ideas through oral, sign, or written
  language (includes assistive technology).
• (money concepts)
• Plans how his/her money will be spent.
• (time)
• Uses clock or other timepiece to determine when
  it is time to do something (e.g., go to
  school/work, eat, or be home).

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DABS Sample Items

• SOCIAL SKILLS
• (inter-personal)
• Stays on the topic in group conversations.
• Introduces self to others.
• (gullibility)
• Questions others when he/she is told something
  that may not be true.
• Recognizes signs that someone is trying to
  exploit him/ her.

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DABS Sample Items

• PRACTICAL SKILLS
• (activities of daily living)
• Uses the restroom.
• Dresses appropriately depending on the occasion.
• (occupational skills)
• Completes work assignments.
• (maintains safe environment/safety)
• Properly stores dangerous household cleaning
  products.
• Shows safety awareness when crossing streets
  (e.g., checks for traffic before crossing
  streets).

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Standardization of DABS

• Norms - 4 to 21 years old typically developing
• US Census
• Race/ethnicity
• Education levels
• Geographic representation

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• Interview multiple respondents that know the
  individual being evaluated very well and that
  have had the opportunity to observe her/his
  typical behavior in different settings
• Based on respondents, evaluate the persons level
  of present typical performance in adapting to the
  environmental demands typical for the
  individuals age cultural/ethnic group

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• Pilot administration of DABS with 15 individuals
  with ID for the
• 1. identification of items that are missing,
  potentially problematic or need to be rewording
• 2. investigation of the clarity/adequacy of the
  DABS administration instructions and rating
  system
• ? Arrangement of DABS standardization form

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• Standardization with approximately 1,300
  individuals with typical development and 500
  individuals with ID, with 4 to 21 years old, and
  representative of the general United States
  population
• Assess DABS psychometric qualities
• Arrangement a Computerized Adaptive Test (CAT
  e.g., Thissen Wainer, 2001) DABS format based
  on Item Response Theory

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• Contains item that maximally differentiate
  between AB of individuals with and without ID
• Measures all the AB aspects that are not
  currently measured social vulnerability, social
  processes, and technology-based skills
• Uses multiple respondents and is based on
  interviewers clinical judgment for the scoring
  taking into account factors that may influence
  the opportunity to express individuals
  behaviors presence of physical impairments,
  environment demands or repertories of cultural
  practice
• Uses Item Response Theory to reliably measure
  individual levels of performance around the
  cutoff point for determining significant
  limitations in AB

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So where are we now?

• And Would you like to participate?

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Diagnostic Adaptive Behavior ScaleClosing Remarks

• Consistent with AAIDD Diagnostic Manual
• Diagnosis
• Brief but precise
• Recent norms based on general population
• Standardized measure of adaptive behavior (4 to
  21 years old)
• Based on most current research and psychometric
  science
• Reduce the number of culturally/geographically-bia
  sed items.

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References

• Luckasson, R., et al. (2002). Mental retardation
  Definition, classification, and systems of
  supports (10th ed.). Washington, DC AAMR.
• Schalock, R.L. (1999). The merging of adaptive
  behavior and intelligence Implications for the
  field of mental retardation. In R. L. Schalock
  (Ed.), Adaptive behavior and its measurement (pp.
  43-59). Washington, DC American Association on
  Mental Retardation.
• Thissen, D. Wainer, H. (2001). Test scoring.
  Mahwah (NJ) Lawrence Erlbaum a
• Thompson, J. R., McGrew, K. S., Bruininks, R.
  H. (1999). Adaptive and maladaptive behavior
  Functional and structural characteristics. In R.
  L. Schalock (Ed.), Adaptive behavior and its
  measurement (pp. 15-42). Washington, DC AAMR.
• Widaman, K. F. McGrew, K. S. (1996). The
  structure of adaptive behavior. In J. W. Jacobson
  J. A. Mulick (Eds.), Manual of diagnosis and
  professional practice in mental retardation (pp.
  97-110). Washington, DC APA.

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Contact Information

• Hank Bersani Jr., Professor of Special
  EducationWestern Oregon University345 N.
  Monmouth AveMonmouth OR 97361503-838-8687bersan
  h_at_wou.eduwww.wou.edu/bersanh