Adaptive behavior scales for infants and early childhood

Definition

Adaptive behavior scales are standardized tests used to describe and evaluate the behavior of infants, toddlers, and preschoolers, especially those at risk for communication delays and behavior impairments.

Purpose

Adaptive behaviors are learned. They involve the ability to adapt to and manage one's surroundings to effectively function and meet social or community expectations. Infants learn to walk, to talk, and to eat with a spoon. Older children learn to cross the street, to go to the store, and to follow a great variety of rules while interacting with people, such as when to say please and thank you. Good adaptive behavior promotes independence at home, at school, and in the community. Undesirable or socially unacceptable behaviors that interfere with the acquisition of desired skills and with the performance of everyday activities are classified as maladaptive behaviors, or more commonly, behavior problems. Maladaptive behavior interferes with child's achievement of independence because the child requires more supervision and assistance in order to learn how to behave appropriately.

Problems in developing adaptive skills can occur in children of any age. For example, difficulties can develop in mastering basic functional skills (such as talking, walking, or toileting), in learning academic skills and concepts, or in making social and vocational adjustments. Adaptive behavior scales are evaluation tools designed to help care providers improve their assessments of the abilities and needs of infants and children who have disabilities or are at risk for developmental delays.

Description

Many different adaptive behavior scales are used in the United States for assessment purposes. The most widely used are the Developmental Profile II (DPII), the Early Coping Inventory (ECI), the Bayley Scales of Infant Development (BSID), the Scales of Independent Behavior—Revised (SIB-R), the Vineland Adaptive Behavior Scales (VABS), and the Adaptive Behavior Scales (ABS).

Developmental Profile II (DPII)

The DP-II behavior scale is used to screen for developmental delays and compare a child's development to that of other children who are in the same age group. This scale is a check-off list of 186 skills. A parent or therapist who knows the child well simply indicates whether the child has mastered the skill in question. The DPII, which can be administered from infancy to age nine, assesses development in the following areas:

• Physical development: Large and small muscle coordination, strength, stamina, flexibility, and sequential motor skills.
• Self-help development: Ability to cope independently with the environment, for example, to eat, dress, and take care of self and others.
• Social development: Interpersonal abilities, emotional needs, and how the child relates to friends, relatives, and other adults.
• Academic development: Intellectual abilities and skills required for academic achievement; IQ (intellectual quotient) score.
• Communication development: Expressive and receptive communication skills , including written, spoken, and body language.

Early Coping Inventory (ECI)

The ECI measures adaptive behavior. It is based on observation and is used to assess the coping-related behaviors that are used by infants and toddlers in everyday living. Analysis of a child's scores provides information about level of effectiveness, coping style, and specific coping strengths and weaknesses. The findings can then be used to plan educational and therapeutic interventions. The ECI can also be used to involve parents in its use as a means of increasing knowledge of the child. The ECI, which can be administered to infants aged four to 36 months or to children with disabilities, has 48 test items that are divided into three broad coping clusters:

• Sensorimotor organization: According to the famous developmental psychologist, Jean Piaget, infants learn, from birth to approximately age two, to coordinate all their sensory experiences (sights, sounds, etc.) with their motor behaviors. At this stage of development, children start to explore and understand the world around them by doing things like sucking, grasping, and crawling . This part of the ECI tests the child's level of sensorimotor skills: visual attention, reaction to touch, self-regulation of basic body functions, tolerance for various body positions, and activity level depending on various situations.
• Reactive behavior: This behavior includes a child's capacity to accept emotional warmth and support from other people and to react to the feelings and moods of others. The ECI can assess reactive behavior, including tolerance of frustration, ability to "bounce back" after stressful events, and capacity to adapt to changes in the environment.
• Self-initiated behavior: This part of the ECI tests the ability of a child to initiate action in order to communicate needs, to try new behaviors, to achieve a goal, as well as problem-solving abilities and level of persistence during activities.

Bayley Scales of Infant Development (BSID)

The BSID are used extensively to assess the development of infants from one to three years of age. The test is given on an individual basis and takes from 45 to 60 minutes to complete. It is administered by examiners who are experienced clinicians specifically trained in BSID test procedures. The examiner presents a series of test materials to the child and observes the child's responses and behaviors. The test also contains items designed to identify young children at risk for developmental delay . BSID evaluates three scales:

• Mental scale: This part of the evaluation assesses several types of abilities: sensory/perceptual acuities, discriminations, and response; memory-learning and problem-solving; vocalization and range of verbal communication; basis of abstract thinking; development of habits.
• Motor scale: This part of the BSID assesses the degree of body control, large muscle coordination, finer manipulatory skills of the hands and fingers, dynamic movement, postural imitation, and the ability to recognize objects by sense of touch (stereognosis).
• Behavior rating scale: This scale provides information that can be used to supplement information gained from the mental and motor scales. This 30-item scale rates the child's relevant behaviors and measures attention/arousal, orientation/engagement, emotional regulation, and motor quality.

Scales of Independent Behavior—Revised (SIB-R)

Children with developmental disabilities or who become handicapped through accident or illness often need special assistance at home and at school. The SIBR assesses adaptive and maladaptive behavior to determine the type and amount of special assistance that children with disabilities may need. The SIB-R is widely used in preschool and special education programs for diagnosis, for intervention planning, and for assessing outcomes. The SIB-R evaluation can be completed by a teacher, psychologist, or social worker directly or with the help of special interview materials that involve parents. The SIB-R contents provide opportunity for team discussion, often eliciting information and opinions that parents might not otherwise bring up on their own.

The SIB-R adaptive behavior items include 14 subscales grouped into four clusters: motor skills, social interaction and communication skills, personal living skills, and community living skills. Each SIB-R adaptive behavior item is a statement of a task. (For example, "Child washes, rinses, and dries hair.") The examiner rates the child being assessed regarding each task, using a scale from zero to three:

• 0—never or rarely performs the task (even if asked)
• 1—does the task but not well or about 25 percent of the time (may need to be asked)
• 2—does the task fairly well or about 75 percent of the time (may need to be asked)
• 3—does the task very well always or almost always (without being asked)

The Vineland Adaptive Behavior Scales (VABS)

The VABS are designed to assess the personal and social self-sufficiency of individuals from birth to early adulthood. The scales are equally applicable to handicapped and non-handicapped children. The VABS assessment provides the information required for the diagnosis or evaluation of a wide range of disabilities, including mental retardation , developmental delays, functional skills impairment, and speech/language impairment. Vineland has also been proven to be an accurate resource for predicting autism and Asperger syndrome, among other diagnoses. The Vineland measures adaptive behavior in four domains:

KEY TERMS

Adaptive behavior —The ability to do things on one's own without getting into trouble and to adapt to and manage one's surroundings.

Asperger syndrome —A developmental disorder of childhood characterized by autistic behavior but without the same difficulties acquiring language that children with autism have.

Autism —A developmental disability that appears early in life, in which normal brain development is disrupted and social and communication skills are retarded, sometimes severely.

Behavior —A stereotyped motor response to an internal or external stimulus.

Body language —Communication without words, also sometimes referred to as "non-verbal communication"; conscious or unconscious bodily movements and gestures that communicate to others a person's attitudes and feelings.

Fine motor skill —The abilities required to control the smaller muscles of the body for writing, playing an instrument, artistic expression and craft work. The muscles required to perform fine motor skills are generally found in the hands, feet and head.

Gross motor skills —The abilities required to control the large muscles of the body for walking, running, sitting, crawling, and other activities. The muscles required to perform gross motor skills are generally found in the arms, legs, back, abdomen and torso.

Maladaptive behavior —Undesirable and socially unacceptable behavior that interferes with the acquisition of desired skills or knowledge and with the performance of everyday activities.

Motor skills —Controlled movements of muscle groups. Fine motor skills involve tasks that require dexterity of small muscles, such as buttoning a shirt. Tasks such as walking or throwing a ball involve the use of gross motor skills.

Sensorimotor —Relating to the combination of sensory and motor coordination.

Sensory —Refers to network of nerves that transmit information from the senses to the brain.

Sequential motor skill —Ability to coordinate different motor skills in sequence, such as running followed by a jump.

Socialization —The process by which new members of a social group are integrated in the group.

Stereognosis —The ability to recognize objects by sense of touch.

• Communication: Vineland evaluates expressive and written communication skills, as well as the ability to listen.
• Daily living skills: These skills are assessed on a personal basis, in the family setting and in the wider community.
• Socialization: VABS evaluate interpersonal relationships, play and leisure time activities, and interpersonal coping skills.
• Motor skills: The test also evaluates both gross and fine motor skills.

The Adaptive Behavior Scales—School (ABS-S)

The ABS-S scale was developed to assess the personal independence of school-age children. Like other scales, it evaluates the personal and social skills used for everyday living. It is most frequently used to assess the current functioning of children being evaluated for evidence of mental retardation, for evaluating adaptive characteristics in autistic children, and for distinguishing behavior-disordered children who require special education assistance from those who can be educated in a regular school setting. The ABS-S is divided into two parts:

• ABS Part One: This part focuses on personal independence and is designed to evaluate coping skills considered important for developing personal independence and responsibility in daily living. The skills within Part One are grouped into nine behavior domains: independent functioning, physical development, economic activity, language development , numbers and time, prevocational/vocational activity, self-direction, responsibility, and socialization.
• ABS Part Two: This part evaluates social maladaptation. The behaviors assessed are assigned to seven domains that are measures of those adaptive behaviors that may lead to personality and behavior disorders: social behavior, conformity, trustworthiness, stereotyped and hyperactive behavior, self-abusive behavior, social engagement, and disturbing interpersonal behavior.

Precautions

Since behavior is socially defined, a child's performance must be considered within the context of the cultural environments and social expectations that affect his or her functioning.

Preparation

Before performing an adaptive behavior test, the examiner explains to the parents the purpose of the test. If the parents are required to provide the answers, they are reminded that accuracy is the best way to achieve a result that may help the child. If the test is given directly to the child, the examiner describes what will happen during the test procedure and the parents are asked not to talk to the child during the test to avoid skewing results.

Risks

There are no risks associated with adaptive behavior tests.

Parental concerns

Parental involvement in the developmental assessment of their children is very important. First, because parents are more familiar with their child's behavior, their assessment may indeed be more indicative of the child's developmental status than an assessment that is based on limited observation in an unfamiliar clinical setting. The involvement of parents in their child's development testing also improves their knowledge of child development issues and their subsequent participation in required intervention programs, if any.

See also Autism; Bayley Scales of Infant Development; Emotional development; Personality development; Personality disorders.

Resources

BOOKS

Frieman, Jerome L. Learning and Adaptive Behavior. Florence, KY: Wadsworth Publishing, 2002.

Porter, Louise. Young Children's Behavior: Practical Approaches for Caregivers and Teachers, 2nd ed. Baltimore, MD: Paul H. Brookes Publishing Co., 2003.

Sattker, Jerome M. Assessment of Children: Behavioral and Clinical Applications, 4th ed. Lutz, FL: Psychological Assessment Resources Inc., 2001.

Wetherby, Amy, et al. Communication and Symbolic Behavior Scales: Developmental Profile. Baltimore, MD: Paul H. Brookes Publishing Co., 2002.

PERIODICALS

Fenton, G., et al. "Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay." Autism 7, no. 3 (September 2003): 269–87.

Hall, J. R., et al. "Criterion-related validity of the three-factor model of psychopathy: personality, behavior, and adaptive functioning." Assessment 11, no. 1 (March 2004): 4–16.

Ladd, G. W. "Probing the adaptive significance of children's behavior and relationships in the school context: a child by environment perspective." Advances in Child Development Behavior 31 (2003): 43–104.

Matson, J. L., et al. "A system of assessment for adaptive behavior, social skills, behavioral function, medication side-effects, and psychiatric disorders." Research in Developmental Disabilities 24, no. 1 (January-February 2003): 75–81.

ORGANIZATIONS

American Academy of Child & Adolescent Psychiatry (AACAP). 3615 Wisconsin Ave., NW, Washington, DC 20016–3007. Web site: <www.aacap.org>.

American Academy of Pediatrics (AAP). 141 Northwest Point Boulevard, Elk Grove Village, IL 60007–1098. Web site: <www.aap.org>.

American Psychological Association (APA). 750 First Street, NE, Washington, DC 20002–4242. Web site: <www.apa.org>.

Child Development Institute (CDI). 3528 E Ridgeway Road, Orange, CA 92867. Web site: <www.childdevelopmentinfo.com>.

WEB SITES

"Early Child Assessment Measures." New Assessments: Early Childhood Resource. Available online at <www.newassessment.org> (accessed November 8, 2004).

SIB-R User's Group Home Page. Available online at <www.cpinternet.com/~bhill/sibr/> (accessed November 8, 2004).

Monique Laberge, Ph.D.