The Value of Adaptive Behavior in Promoting Wellness and Beyond

1
The Value of Adaptive Behavior in Promoting
Wellness and Beyond

• Dr. Thomas Oakland
• University of Florida
• University of Hong Kong

2
Promoting Wellness and Beyond

• My primary emphasis will be on intervention
  issueshow best to promote development and how an
  emphasis on adaptive behavior promotes childrens
  happiness and thus well-being
• My secondary emphases are on
• diagnosis
• common patterns of adaptive behaviors displayed
  by special needs children

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Promoting Wellness and Beyond

• Some changes that are occurring as we transition
  from the ABAS-II to the ABAS-III
• The U.S. Justice Departments emphasis on placing
  persons with ID in meaningful jobs
• And to solicit comments about your use of the
  ABAS-II

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Lets Begin By Talking About You

• Think about those behaviors you display most
  every day that enable you to meet your personal
  needs and the natural and social demands and
  expectations in your life consistent with your
  age, social class, and culture.

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Lets Talk About You

• You are likely to have
• Used your car or other forms of transportation
• Maintained your composure and feelings
• Took care of your health (e.g. liquids, vitamins,
  food)
• Cared for your personal needs (toileting and
  bathing)
• Talked with others
• Used your reading skills and possibly math skills
• Engaged with others socially
• Engaged in leisure time activities

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Lets Talk About You

• In summary, you displayed suitable adaptive
  behavior in light of standards established for
  your age, social class, and culture.
• Today we will focus on
• What adaptive behavior is
• How to assess it
• How to use this information, and
• Common patterns of adaptive behavior of children
  and youth who display various special needs

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Human Growth and Development

• Most people develop normally
• Some develop more slowly at first
• And then catch up later
• Some remain delayed for years, perhaps for their
  lives
• Delays may be in
• One behavior
• Two or moreand for some, many behaviors
• All children require support and assistance
• 10 to 15 require extra support and assistance

8
Children who display the following
disabilities/disorders generally need more
support and assistance

• Attention disorders
• Autism
• Behavior disorders
• Brain disorders and injuries
• Developmental delays
• Learning disorders and disabilities
• Social-emotional disorders
• Sensory or motor impairment
• Visual and auditory disorders
• others

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What Parents of Special Needs Children Want For
Them

• Parents generally want their children to be
  happy.
• Some attempt to purchase happiness
• However, happiness is earned, not purchased
• Happiness occurs when children achieve behaviors
  they personally value
• And the behaviors become habitual
• These behaviors include important adaptive skills
  and behaviors.

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How to promote happiness in children

• Happiness is a brain-based and regulated
  emotional state characterized by positive or
  pleasant emotions.
• The purpose of emotions is to influence the scope
  of our brain functioning and thus either to draw
  fully on our capabilities or to limit our
  activities.

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How to promote happiness in children

• Happiness has a strong biological base, one that
  is highly dependent on various brain-related
  qualities.
• Among them are the left cortex, prefrontal
  cortex, the amygdala, serotonin levels, dopamine,
  and others. Keep in mind that emotions are
  biologically based.
• Thus, interventions must be sufficiently powerful
  to influence and modify the brain.

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How to promote happiness in children

• The brain is wired to assist us in displaying
  routine behaviors somewhat automatically.
• 95 of brain-behavior relationships are habitual.
  
• Habits are acquired over time and not easily
  changeable. This has important implications for
  our behavior-centered work with children,
  especially those with special needs, including
  efforts to promote adaptive behavior.
• Do not expect habit regulated behaviors to occur
  over night

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Stress a culprit to happiness

• Stress generally alerts us to immediate problems.
  
• When stressed, the brain favors pre-wired and
  thus easily activated and quickly achieved
  solutions to immediate problems.
• Thus, when stressed, we tend to behavior
  habitually.

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Stress a culprit to happiness

• Happy people see their problems as temporary,
  impersonal, and solvable and thus feel less
  stress.
• Prolonged stress decreases our ability to be
  happy.
• Stress triggers both brain and physiological
  reactions that intensify our anxiety and thus
  restricts our knowledge of options.

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Stress a culprit to happiness

• Stress produces anxiety
• Together they lead to a restricted range of
  emotions and thus behaviors, often either
  withdraw or aggression
• When stressed, we are inclined to engage in
  behaviors we believe will comfort us (e.g. drink,
  drugs, food) yet rarely do.

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Stress a culprit to happiness

• Persons on the autism spectrum experiences stress
  and anxiety due to limitations in their amygdala
  and fusiform gyrus.
• This results in low levels of social
  intuitionqualities that limit both their display
  and understanding of suitable social behaviors
  and promote social anxiety.

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Two Strong and One Weak Influences

• 50 from genetics
• 40 from personal experiences and activities
• 10 from the stuff we purchase to make life
  easier and more attractive

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Implications from this information

• How to use the 40 of variance that contributes
  to happiness over which we have control
• Engage children in activities
• They personally value
• That offer enduring contributions
• From which they learn about themselves and
  others
• Children must be personally engaged others
  cannot give happiness to them

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Childrens personal engagement

• on their own or with family, friends, and other
  favorite people
• reading, watching movies, or in other stimulating
  experiences
• involvement in their community schools, sports,
  hobbies, and other forms of recreation
• taking trips
• becoming independent and self-directed

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Childrens personal engagement

• In short, to promote childrens adaptive
  behavior, we need to strive to
• identify their personal goals and values
• create conditions that enable them to acquire
  personal competence to attain them to the point
  they become habitualaccessed easily and used
  successfully
• Again, habits, by definition, are not changed
  easily. We will talk more about this later.

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Remember, happiness is derived

• from how much children enjoy and value their
  ability to do what they believe to be important,
• From childrens own actions
• From harmony in what children think, say, feel,
  and do
• Happiness cannot be purchased or given by others.

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Six Brain-based emotional styles contribute
importantly to happiness

• The Most Important Two
• Resilience our ability to recover from adverse
  eventsto develop habits that favor recovery
• Expectations our ability to view life positively

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Six Brain-based emotional styles contribute
importantly to happiness

• Four Other Important Qualities
• Social intuition our ability to attend to,
  grasp, and understand social cuesoften expressed
  nonverbally by others
• Self-awareness our ability to be sensitive to
  signals from our brain and physiological system
  that inform us how we are doing

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Six Brain-based emotional styles contribute
importantly to happiness

• Four Other Important Qualities
• Sensitivity to context our ability to moderate
  our behaviors and emotional responses in light of
  the persons, places, and events we encounter
• Attention our ability to form and remain focused

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Thus, attempts to promote happiness and thus a
fuller range of brain-behaviors include attention
to

• Promoting resilience
• Understanding personal expectations
• Engaging students in activities that contribute
  to their current and future success
• Reducing stress in order to utilize
  brain-behavior abilities more fully

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What parents also desire for their special needs
children

• Parents want their children to
• Be less dependent on them and more independent
• Function effectively at
• Home
• School
• Work
• Community
• In short, to function as effectively as possible
  in their natural and social environments with
  limited support, leading to self-confidence and
  thus happiness.

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10 Specific Behaviors Parents Want For Them

• 5 Practical skills To personally
• Care for their personal needs
• Care for their home
• Use community resources
• Care for their health and safety
• Find and sustain work

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10 Specific Behaviors Parents Want For Them

• 3 Cognitive skills To personally
• Communication with others
• Acquire and use functional academic skills
• Be self-directed and to evaluate their behaviors
• 2 Social skills To personally
• Get along well with others
• Use their free (leisure) time well

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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 environment 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 the community.

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Why do we use measures of adaptive behavior?

• What is the major purpose of using any test?
• To accurately describe behavior

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Other reasons to use measures of adaptive
behavior

• estimate future behaviors
• assist guidance and counseling services
• identify service needs
• establish intervention methods
• monitor intervention effectiveness
• evaluate progress

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Other reasons to use measures of adaptive
behavior

• diagnose disabling disorders
• help place persons in jobs or programs
• assist in determining whether persons should be
  credentialed, admitted/employed, retained, or
  promoted
• research
• administrative and planning purposes

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The First Assessment of ID/MR

• The ancient Greek civilization thought a person
  was mentally retarded if his or her daily living
  skills were substantially lower than others their
  age or family members.
• Measures of intelligence began to be used in the
  early 1900s to assess ID/MR
• Now measures of intelligence and adaptive
  behavior are used to assess ID/MR
• Measures of adaptive behavior also should be used
  with persons with other disorders and disabilities

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Three Authoritative Sources That Define MR/ID

• American Association on Mental Retardation (now
  called the American Association on Intellectual
  and Developmental Disabilities)
• AAMR/AAIDD
• Diagnostic and Statistical Manual of Mental
  Disorders
• DSM-4 and DSM-5
• International Classification of Diseases-10

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Authoritative Sources

• The AAMR/AAIDD, the DSM-4 and -5, and ICD-10 are
  relied on internationally to guide our
  understanding of disorders and disabilities by
• Defining them
• Describing standards for their
• Diagnosis
• Assessment

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1992 AAMR and DSM-4 Definition of MR/ID

• Mental retardation refers to substantial
  limitations in present functioning. It is
  characterized by significantly subaverage
  intellectual functioning, existing concurrently
  with related limitations in two or more of the
  following applicable adaptive skill areas
  communication, self-care, home living, social
  skills, community use, self-direction, health and
  safety, functional academics, leisure, and work.
  Mental retardation manifests before age 18.
• The DSM-4 also used this definition for MR

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1992 AAMR and DSM-4 Definition of MR/ID

• Thus, this definition identified 9 important
• skill areas to assess in children
• communication self-care,
• home living social skills,
• community use self-direction,
• health and safety functional academics,
• leisure (work for adults, not children)

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Communication

• Looks at others faces when they are talking
• Starts conversations on topics of interest to
  others.
• Uses up to date information to discuss current
  events

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Community Use

• Recognizes own home in his/her immediate
  neighborhood
• Carries enough money to make small purchases.
• Calls a doctor or hospital when ill or hurt

40
Functional Academics

• Points to pictures in books when asked (e.g.
  points to a horse or cow)
• Writes his/her first and last names
• Reads and follows instruction to assemble new
  purchases

41
Home Living

• Removes cookies, chips, or other food from a box
  or bag
• Folds clean clothes
• Performs minor household repairs (e.g. a clogged
  drain or leaky faucet)

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Health and Safety

• Cries or whimpers when he/she does not feel well
  or is injured
• Cares for his/her minor injuries (e.g. paper
  cuts, knee scrapes, nosebleeds
• Buys over the counter medications when needed for
  illness

43
Leisure

• Plays with a single toy or game for at least one
  minute
• Follows rules in games
• Reserves tickets in advance for activities (e.g.
  concerts or sports events)

44
Self-Care

• Swallows liquids with no difficulty
• Washes his/her own hair
• Cuts or files his/her own fingernails and
  toenails

45
Self-Direction

• Entertains self in crib or bed for at least one
  minute after waking
• Chooses own clothing almost every day
• Plans ahead to allow enough time to complete big
  projects

46
Social

• Smiles when he/she sees parents
• Personally makes or buys gifts for family members
  on major holidays
• Listens to friends or family members who need to
  talk about problems

47
Work (for ages gt 15)

• Shows a positive attitude toward the work
• Returns tools and other work related items to
  their proper location after their use
• Checks his or her work to determine it
  improvements are needed

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1992 AAMR/DSM-4 Definition of MR/ID

• Information on these 10 skill areas is
• important for two reasons
• The evaluation of adaptive skills confirms that a
  person has functional limitations and, more
  importantly,
• The identification of functional, adaptive skill
  limitations can be linked to a person's needs for
  interventions and services.
• Thus, the inclusion of adaptive behavior
  addresses two issues
• Diagnosis
• Intervention

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2002 AAMR/DSM-5 Definition of MR/ID

• Mental retardation is a disability
• characterized by significant limitations both in
  intellectual functioning and in adaptive
  behavior as expressed in conceptual, social, and
  practical adaptive skills.
• This disability originates before age 18.
• The DSM-5 uses this definition yet is vague about
  the age 18 cutoff.
• We will review some DSM-5 changes shortly

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Current Definition of ID

• Thus, attention is drawn to three adaptive skill
  domains
• Conceptual
• Social
• Practical
• The three domains include the 10 skill areas

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Current Definition of ID

• The Conceptual skill domain includes Communicat
  ion 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

52
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 both clinical and utility
• More reliance on professional (clinical) judgment

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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 levels of supports)

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DSM-5 and ID An introduction

• Supports may include the need for help
• Intermittent now and then with one skill (eating
  meat)
• Limited only with one skill (e.g. eating most
  foods)
• Extensive regular help in many areas (e.g.
  dressing, bathing, eating)
• Pervasive assisting in maintaining all areas of
  life

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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

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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 lt age 19 yet this is
  assumed)

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Intellectual developmental disorder more on
adaptive behavior

• ID severity is determined from adaptive behavior
• A standardized assessment of adaptive behavior
• And a 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 and cannot develop 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

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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

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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

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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 who
  display more diagnoses generally display more
  adaptive behavior deficits.

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2002 AAIDD Definition of ID

• The ABAS-II has a hierarchical model
• (e.g. like a pyramid)
• 1 General Adaptive Composite (GAC)
• 3 domains conceptual, social, and practical
• 10 skill areas communication, self-care, home
  living, social/interpersonal skills, use of
  community resources, self-direction, functional
  academics, leisure, health and safety, and work
  (for older adolescents and adults)

64
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 individuals age peers and
  culture.
• Lets discuss this important point see next slide

65
Some Implications from the Definitions

• Limitations exist when the needs and requirements
  found in a persons environment exceed the
  persons adaptive skills
• Thus, we need to know what the persons
  environment requires of the person in order to
  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.

66
Some Implications from the Definitions

• A persons personal life functioning generally
  will improve
• With appropriate personalized education and
  support
• When interventions are
• valued by the person
• important to his/her caretakers/teachers
• important in success in his/her environment
• sustained over weeks and months, and
• used dailydevelopment them to become habits

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Keep in mind some prior comments

• Behavior have a strong biological base
• Behaviors typically are habitual and thus slow to
  change (95 of brain behaviors are habitual)
• Their change requires the involvement of key
  persons
• Children/students
• Their parents/guardians
• Their teachers and other educators
• All are likely to be more knowledgeable than us
  as to what a student needs and desires

68
Keep in mind some prior comments

• Intervention planning requires knowledge of
• needed and desired behaviors
• availability of needed resources, including time,
  to support their implementation
• willingness to use needed resources
• best environments in which to train the new
  behaviors
• a commitment to sustain the intervention over
  time
• recognition that change may be slow

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Introduce the ABAS to the Respondent

• Our initial work always is intended to
• develop others trust
• Discuss the following topics with respondents
• Purpose of the overall assessment
• Reason for administering the ABAS and from whom
  the ABAS information will be acquired
• Explain the instructions
• Designed to acquire an accurate understanding of
  the childs typical performance, not their very
  best behavior

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Acquire an accurate understanding of the
childs typical performance, not their best
performance

• Be wary of attemptsto mischaracterize the
  person
• Mary, the mother of Jane
• Husband died, is single and has little money
• Wants her daughter to be normal and happy
• Moved recently from New York to Florida
• Enrolled Jane in her neighborhood school

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Acquire an accurate understanding of the childs
typical performance, not their very best behavior

• Jane
• 9 years old female
• Displays cerebral palsy and diminished
  development in other areas
• Is in a special education program for young
  children with multiple disorders
• Is not sufficiently strong to sit upright and
  thus is strapped into a special wheel chair and
  has a special table

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ABAS Scores Differ Evidence of Promoting a
Cloak of Competence

• mother teacher
• General Adaptive Functioning 90 55
• Domains
• conceptual 89 45
• social 93 52
• practical 90 58
• How to resolve these differences? Who is correct?

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ABAS Scores Differ

• I met with mother and Jane at their home
• (Describe what occurred)
• Mother trusted me and, after my work, called me
  for understanding, support, and encouragement
• Thus, not all scores may be correct.
• Some respondents may not know how to complete the
  ABAS and thus do it incorrectly
• Others lie about the childs behaviors
• Some differences may exist between home and school

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Be Wary of Attempts to (Mis)Characterize Self or
Others as Performing Low

• Possible benefits from mischaracterization
• Financial support from the state and federal
  governments
• Provision of special education support
• Under Atkins v Virginia, an ID diagnosis (that
  requires diminished adaptive behavior) prevents
  executions

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The ID diagnose will depend on yourdiagnostic
standards. One follows.

• Determine the standard for diagnosing ID
• Consider the level of the GAC (lt 70?)
• Two or more skill area score lt 4
• One of more of the three domains lt 70
• 2. Interview the student, parents, teachers, and
  other relevant person.
• 3. Review the persons history, other
  assessments, and recordsa search for consistency
  in the data

76
Using the ABAS scores to diagnose ID

• 4. Review the intelligence data to determine
  their consistency with the ABAS data.
• 5. A diagnosis of ID is a high stakes decision,
  one likely to be life changing.
• 6. Make this diagnosis only after a careful
  review of all relevant information and in
  consultation with othersespecially family
  members.

77
Estimate future behaviors

• Development during ages 0-18
• Is continuous
• Shows a similar developmental trajectory for
  children who are average and below average
• Yet, for those with special needs, is slower and
  plateaus earlier
• Is most rapid during infancythus, early
  interventions are important
• Development decelerates with age

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Estimate future behaviors

• Four levels of ID
• Mild
• Moderate
• Severe
• Profound
• Improvements in adaptive functioning
• May occur in all four levels
• Will be most apparent in those with mild levels
• Least in those with severe and profound levels

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ABASII Information to Plan and Implement
Interventions

• Basic considerations
• Analyze environmental needs
• current environment
• target environment
• Strive to match skills and environmental
  needs/demands
• Identify support needs
• Assumption adaptive skills interventions are
  more effective than those on adaptive behavior.
• Analyze the clients adaptive skills at the item
  level

80
Components of Planning and Implementing
Interventions A summary

• 1. Identify skill levels needed in ones current
  environment or the environment into which the
  person is moving. Note the need for various
  levels of support
• Intermittent now and then with one skill (eating
  meat)
• Limited only with one skill (e.g. eating most
  foods)
• Extensive regular help in many areas (e.g.
  dressing, bathing, eating)
• Pervasive assisting in maintaining all areas of
  life

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• Identify current areas of strengths and
  weaknesses relative to environmental
  needs/demands.
• Identify and prioritize intervention objectives
  based on discrepancies between environmental
  needs and personal attainment.
• Identify behaviors others desire.
• Implement interventions to achieve objectives
• Monitor the implementation and effectiveness of
  the interventions

82
Using the ABAS scores to plan and monitor
intervention programs

• Understand the nature and needs of the persons
  environments.
• To what extent does the person possess needed
  qualities. (Is there a skill deficit?) a score
  of 0 on ABAS items
• To what extent does the person display needed
  qualities. (Is there a performance deficit?) a
  score of 1 on ABAS items
• What resources are needed to help develop or
  display needed behaviors? See next frame.

83
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?

84
Using the ABAS scores to plan and monitor
intervention programs

• Does the persons environments
• have the resources to provide needed support?
• display a desire to provide it?
• What changes in these environments are need to
  provide needed assistance?
• E.G. assistance in organizing work
• help preparing to eat
• making suitable purchases

85
Using the ABAS scores to plan and monitor
intervention programs

• The possibility of changethe issue of prognosis.
• With mild levels of delay good. Many children
  with mild levels of ID can assume a somewhat
  normal adult lifewith 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.

86
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
• Unlikely domains and GAC levels

87
Using the ABAS scores to plan and monitor
intervention programs

• Identify three or four relevant ABAS items that
  are either to work on initially
• 0 the person is unable to display the desired
  behavior
• 1 the person is able yet does not display the
  desired behavior
• 2 the person displays the desired behavior
  sometimes when needed
• Then identify the ways in which these behaviors
  can be both developed and sustained. Become an
  educator.
• Consider using the ABAS Intervention Planner for
  suggestions.

88
Using the ABAS scores to plan and monitor
intervention programs importance of the
child/student

• The success of interventions is higher when the
  child or student
• participates in selecting the interventions
• values the behaviors
• wants to acquire them
• thus, is motivated to both develop, use, and thus
  sustain the behavior

89
Using the ABAS scores to plan and monitor
intervention programs importance of the
parentsand teachers

• Success increases when they also
• participate in the selection of the interventions
• value the behaviors
• want them acquired
• thus are motivated to both help
• develop the behavior and
• sustain an environment in which these behaviors
  can be displayed and rewarded regularly

90
Using the ABAS scores to plan and monitor
intervention programs importance of the
parentsand teachers

• The success of these interventions is higher when
• they have the resources to implement and sustain
  the behavior program
• the interventions are within the zone of proximal
  development
• training occurs in environments in which the
  desired behaviors eventually will be displayed.

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Using the ABAS scores to plan and monitor
intervention programs

• Remember change most likely will occur in
  reference to specific behaviors, that is, at the
  item level
• Thus, program monitoring may require the
  re-administration of ABAS items, perhaps after
  three months, to determine if desired changes
  occurred.
• .

92
Using the ABAS scores to plan and monitor
intervention programs

• If desired changes are not apparent,
• Examine the degree the desired interventions were
  implemented with integrity and at least daily
• Discuss with others why the interventions were
  not successful
• Plan and implement Plan B

93
Using the ABAS scores to plan and monitor
intervention programs

• If desired changes are apparent, identify other
  desired behaviors using the previously discussed
  strategies
• Determine their importance to the person who is
  acquiring the behaviors and to caretakers and
  others who are implementing the change.
• Also determine that the desired behaviors are
  within the persons zone of proximal development,
  have the opportunity to be displayed and rewarded
  daily, and are trained in the environments in
  which the desired behaviors are to occur.

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ABAS is used with children and youth who display
various disorders

• ID
• ADHD
• Behavior/Emotional Disorders
• Hearing Impairment
• LD
• Neuropsychological Disorders

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ABAS is used with younger children and youth
who display various disorders

• Developmental Delays
• Pervasive Developmental Disorders
• Motor Disorder
• Mild and Moderate ID
• Language Disorder
• Autism Spectrum Disorder

96
Validity Studies with Clinical Samples
97
Results for Samples with ID

• Sample GAC GAC lt70 2 skill areas Mean
  4 or below
• Downs (T, n22) 55 (100) 82 (5)
  100 (23)
• MRMI (T, n66) 73 (97) 50
  (14) 76 (32)
• MRMO (T, n41) 59 (98) 70
  (4) 100 (30)
• MR-UN (T, n84) 62 (101) 70
  (7) 98 (20)
• MR-UN (P, n41) 64 (99) 71
  (0) 83 (5)
• MR-UN (A, n30) 62 (92) 87
  (17) 87 (17)
• Note Data for matched control group appears in
  parentheses.

98
ID
99
ADD/ADHD
Sample Mean GAC ? 70
2 or More Skill ? 4 GAC

Ages 59 (T, n30) 77 (101)
43 (7) 66 (20) Ages 621 (P,
n49) 91 (100) 14 (2)
27 (12)
Mean Performance across Adaptive Skill Area
SS
Adaptive Skill Area
100
Behavior Disorder Emotional Disturbance
Mean
GAC ? 70 2 or More Skill ? 4
Sample GAC
Ages
621 (T, n56) 77 (92)
39 (16) 73 (36) Ages 518
(T, n73) 78 (99) 37
(10) 70 (25)
Mean Performance across Adaptive Skill Area
SS
Adaptive Skill Area
101
Hearing Impairment
Mean
GAC ? 70 2 or More Skill ? 4
Sample GAC
Ages
519 (T, n19) 93 (99)
16 (5) 26 (21)
Mean Performance across Adaptive Skill Area
SS
Adaptive Skill Area
102
Learning Disability
Mean
GAC ? 70 2 or More Skill ? 4
Sample GAC
Ages
59 (T, n72) 91 (102)
11 (3) 42 (17) Ages 1012 (T,
n62) 84 (99) 29 (8)
61 (27) Ages 1321 (T, n114)
87 (94) 24 (11) 48
(36) Ages 721 (P, n26) 88 (103)
15 (8) 42 (15)
Mean Performance across Adaptive Skill Area
SS
Adaptive Skill Area
103
Neuropsychological Disorder

Mean GAC ? 70 2 or More Skill ?
4 Sample GAC

C1, Ages 1885 (AS, n18) 82 (100)
28 (0) 50 (6) C2,
Ages 2585 (AO, n20) 67 (101)
75 (5) 75 (10)
Mean Performance across Adaptive Skill Area
SS
Adaptive Skill Area
104
Developmentally Delayed
105
Pervasive Developl Disorder
106
At Risk
107
Motor Impairment
108
Mild ID
109
Moderate ID
110
Language Disorder
111
Autism Spectrum Disorder
Mean
GAC ? 70 2 or More Skill ? 4
Sample GAC
Ages
518 (T, n32) 54 (101)
84 (3) 92 (16)
Mean Performance across Adaptive Skill Area
SS
Adaptive Skill Area
112
Autism Spectrum Disorder
Note. Numbers in parenthesis represent
non-clinical sample cases.
113
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.

114
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 and Domain scores lt 71.
• adaptive skill scaled scores lt 5.

115
Some Changes in the ABAS-III

• Revisions were guided by focus group meetings
  held last year at the NASP and other conventions
• Updating norms to reflect demographic changes
• Changes to about 10 of the items
• Our environments have changed considerably in the
  last 10 years (e.g. we no longer use pay phones)
• Inclusion of more items that assess gullibility
• A quality often displayed by those with ID

116
Some Changes in the ABAS-III

• All items for one skill area appear on one page
• Simplify the transfer of data from one page to
  another
• Includes an option to access the ABAS-III through
  the Internet
• Adds to and improve our Intervention Planner
• The manual and forms with have a new WPS look
• This is the first ABAS revision made by WPS

117
Justice Department Settles RI Case on Jobs for
those with ID

• Long-standing practice of placing special needs
  persons in segregated shelter workshops
• Removed from competitive employment
• Performs routine and dull work
• Did not acquire skills that generalized to other
  settings
• Were not paid minimum wage
• Clients often remained in these workshops until
  their retirement

118
Justice Department Settles RI Case on Jobs for
those with ID The Remedy

• Prepare high school students for competitive jobs
  in the community that promote inclusion by
  utilizing
• Internships
• Mentoring programs

119
Justice Department Settles RI Case on Jobs for
those with ID The Remedy

• Help persons obtain typical jobs in the community
  that
• pay at least minimum wages
• allow employed hours typical of the industry
• Provide support for non-work activities in normal
  environments
• Community centers
• Libraries
• Recreational facilities
• Educational facilities

120
A Further Look At ASD
121
Lets review some information about children
with Autism SpectrumDisorder

• Impaired social interactions
• Impaired interpersonal communication
• Restricted repertoire of activities and interests
• Current CDC estimates suggest an incidence of
  165 to 85

122
Lets review some information about children
with ASD

• There are no consistent biological markers for
  ASD.
• Thus, we need to rely on behavioral measures for
  diagnosis, intervention, and follow-up
  evaluation.

123
National Autism Centers National Standards
Project

• Its review of 775 studies ? identifying
  intervention programs that were
• Established demonstrably effective
• Emerging
• Unestablished
• Ineffective/harmful

124
Information from the National Standards Project

• Established Treatments emphasized
• Applied behavioral analysis
• Behavioral psychology
• Positive behavior supports
• Functional alternative behaviors
• Interventions in naturalistic settings
• Promotion of independent behaviors

125
An emphasis on behaviors

• A persons activities in response to external
  and internal stimuli
• Qualities that can be objectively observed and
  measured
• In contrast, in UK, emphasis is placed on
  decreasing stress and thus anxiety, leading to a
  fuller utilization of brain-related behaviors

126
An emphasis on behavioral assessment

• Observations, interviews, tests, and other
  methods that sample personal qualities displayed
  in a situational context.
• The results of such measures often lead to
  interventions.

127
As emphasis on functional behaviors that

• help ensure survival
• are foundational to other behaviors
• have a direct bearing on daily living skills
• ABAS and other measures of adaptive behavior are
  critical when working with children who display
  ASD
• Diagnosis
• Program planning/intervention
• Program evaluation

128
Questions and Comments

• Including your use of the ABAS-II

129
Thanks for attending

• Best wishes for a successful conference