Adaptive Behavior as measured by
the Adaptive Behavior Assessment
System-II (ABAS-II)
Dr. Thomas Oakland
University of Florida
University of Hong Kong
With Appreciation to…
• The Australian Council for Educational
Research
– Blair Heading
– Brendan Pye
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
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.
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
Children who display the following
disabilities are likely to display adaptive
behavior deficits
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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
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
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
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
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)
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
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)
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
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
How the ABAS-II and the
DSM-5 overlap
• The ABAS-II
– 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
How the ABAS-II and the
DSM-5 overlap
• The ABAS-II
– 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.
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
• 5-21
– An adult scale for ages 16-89
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.
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
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.
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.
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
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
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.
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.
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?
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?
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.
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
Validity Studies with
Clinical Samples
Developmentally Delayed
Age Range
Teacher
(n=48)
Parent
(n=78)
2–5
0–5
Mean Performance across
Adaptive Skill Area
9
Mean
Conceptual
Social
Practical
GAC
84 (99)
86 (97)
86 (97)
84 (97)
81 (102)
84 (100)
86 (101)
82 (101)
8
7
6
5
% ≤ 70
Conceptual
Social
Practical
GAC
26 (4)
17 (2)
20 (9)
22 (4)
28 (1)
20 (8)
19 (5)
25 (4)
% of 2 or More Skill ≤ 4
35 (8)
70 (9)
4
3
CU
COM
FA
HS
LEI
MO
HL
SC
SOC
Adaptive Skill Area
T 2-5
Note. Numbers in parenthesis represent non-clinical sample cases.
SD
P 0-5
Motor Impairment
Age Range
Teacher
(n=32)
Parent
(n=50)
2–5
0–5
Mean Performance across
Adaptive Skill Area
9
Mean
Conceptual
Social
Practical
GAC
84 (98)
84 (98)
71 (96)
76 (97)
86 (98)
87 (99)
79 (97)
79 (98)
8
7
6
5
% ≤ 70
Conceptual
Social
Practical
GAC
30 (13)
29 (6)
58 (13)
40 (10)
% of 2 or More Skill ≤ 4
53 (9)
18 (4)
16 (0)
24 (2)
33 (0)
4
3
CU
COM
FA
HS
LEI
MO
HL
SC
SD
SOC
Adaptive Skill Area
36 (4)
T 2-5
Note. Numbers in parenthesis represent non-clinical sample cases.
P 0-5
Mild Mental Retardation
Age Range
Teacher
(n=31)
Parent
(n=27)
2–5
2–5
Mean Performance across
Adaptive Skill Area
9
Mean
Conceptual
Social
Practical
GAC
67 (101)
71 (104)
71 (99)
67 (101)
68 (100)
71 (101)
71 (99)
66 (100)
8
7
6
5
% ≤ 70
Conceptual
Social
Practical
GAC
65 (0)
58 (0)
52 (3)
58 (0)
70 (0)
52 (4)
43 (0)
70 (0)
% of 2 or More Skill ≤ 4
68 (0)
70 (0)
4
3
CU
COM
FA
HS
LEI
MO
HL
SC
SOC
Adaptive Skill Area
T 2-5
Note. Numbers in parenthesis represent non-clinical sample cases.
SD
P 2-5
Autism/Asperger’s
Teacher
(n=30)
Parent
(n=49)
Age Range
3–5
3–5
Mean
Conceptual
Social
Practical
GAC
73 (102)
67 (101)
66 (101)
67 (102)
72 (98)
65 (99)
65 (98)
64 (98)
% ≤ 70
Conceptual
Social
Practical
GAC
62 (0)
74 (0)
74 (0)
71 (0)
56 (0)
65 (6)
65 (6)
71 (6)
% of 2 or More Skill ≤ 4
77 (0)
71 (9)
Note. Numbers in parenthesis represent non-clinical sample cases.
Mean Performance across
Adaptive Skill Area
Adaptive Skill Area
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.
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.
Questions and Comments