Adaptive Behavior as measured by the Adaptive Behavior Assessment System-II (ABAS-II)

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

• 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:CommunicationFunctional AcademicsSelf-Direction

The Social skill domain includes: Social Skills Leisure

The Practical skill domain includes: Self-care Home and School Living

Community UseHealth and SafetyWork

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


– 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.


– 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.


– 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


– 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


– 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?


• 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?


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.


– 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

Mean Performance acrossAdaptive Skill Area

Teacher Parent(n=48) (n=78)

Age Range 2–5 0–5

MeanConceptual 84 (99) 81 (102)Social 86 (97) 84 (100)Practical 86 (97) 86 (101) GAC 84 (97) 82 (101)

% ≤ 70Conceptual 26 (4) 28 (1)Social 17 (2) 20 (8)Practical 20 (9) 19 (5)GAC 22 (4) 25 (4)

% of 2 or More Skill ≤ 435 (8) 70 (9)

Note. Numbers in parenthesis represent non-clinical sample cases.

3

4

5

6

7

8

9

CU COM FA HS LEI MO HL SC SD SOC

T 2-5 P 0-5

Adaptive Skill Area

Motor Impairment






% of 2 or More Skill ≤ 453 (9) 36 (4)


3

4

5

6

7

8

9


T 2-5 P 0-5

Adaptive Skill Area

Mild Mental Retardation






% of 2 or More Skill ≤ 468 (0) 70 (0)


3

4

5

6

7

8

9


T 2-5 P 2-5

Adaptive Skill Area

Autism/Asperger’s







% of 2 or More Skill ≤ 477 (0) 71 (9)

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.

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Adaptive Behavior as measured by the Adaptive Behavior Assessment System-II (ABAS-II)

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