Adaptive Skills and Behavior

This article presents an overview of the development and teaching of adaptive skills or behavior to special education students in the U.S. An adaptive skill is a skill used by an individual on a daily basis in order to live, work, and participate in leisure activities in a community. Using mental retardation as a framework, the paper presents definitions, historical perspectives, measurements of adaptive skills, adaptive skills through the lifespan, and teaching methods. An outline of how mental retardation is defined is also provided.

Keywords Activities of Daily Living; Adaptive Behaviors; Adaptive Skills; Intelligence Tests; Mental Retardation; Special Education; Task Analysis

Overview

In the literature, the use of the term adaptive skills is synonymous with adaptive behaviors. For the purposes of this paper, the term adaptive skills will be used to refer to both terms. According to the Centers for Disease Control and Prevention (CDC) 1996 report on mental disabilities, mental retardation (MD) affects 1.5 million people aged 6-64 and the overall rate of MR was 7.6 cases per 1000 population in the U.S. alone. To facilitate the understanding of adaptive skills, this paper will use the disability of mental retardation for explanation of the concepts. However, this in no way implies that adaptive skills are only used in defining mental retardation. Individuals use adaptive skills with many other types of disabilities (i.e., autism, blind, hearing impaired, cerebral palsy) to live, work and pursue leisure activities on a daily basis.

Definitions

An adaptive skill is a skill used by an individual on a daily basis in order to live, work, and participate in leisure activities in a community. The American Association of Intellectual and Developmental Disabilities (AAIDD) defines adaptive skills as conceptual, social, and practical daily living skills which allow the individual to reside in his/her community.

Conceptual skills include communication, money concepts, and reading and writing, social skills include interpersonal skills, responsibility, and self-esteem; and activities of daily living which include self-care, housekeeping, and transportation (AAIDD, 2007).

When using the definitions above, the age of the individual should be kept in mind as the skills are defined by what is acceptable in the community of the individual, and that performance of a skill should be typical (Sparrow, Balla, & Cicchettti, 1985). For instance, as an infant it is important to learn to eat, whereas later in life it is important to be able to prepare meals. Throughout the lifespan, an individual's performance is considered typical when the skills needed are executed appropriately.

Mental Retardation as a Framework

In the 1900's, the determination that an individual was mentally retarded was based solely on intelligence test scores. Adaptive skills were first included as part of the definition of mental retardation in the American Association of Mental Deficiency's (AAMD) first published manual (Sparrow, Balla, & Cicchettti, 1985). The AAMD is currently known as the AAIDD and provides the most used definition of mental retardation. Over the years, revisions of the definition have been necessary due to new research. The current definition of mental retardation provided by the AAIDD is:

"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 the age of 18. A complete and accurate understanding of mental retardation involves realizing that mental retardation refers to a particular state of functioning that begins in childhood, has many dimensions, and is affected positively by individualized supports. As a model of functioning, it includes the contexts and environment within which the person functions and interacts and requires a multidimensional and ecological approach that reflects the interaction of the individual with the environment, and the outcomes of that interaction with regards to independence, relationships, societal contributions, participation in school and community, and personal well being" (AAIDD, 2007).

The AAIDD definition is commonly used as it compares standardized intelligence test scores to age-matched peers, provides levels of independence in relation to individual's age and culture, and states that mental retardation must be determined in the first 18 years of life. With each revision, a key component of the definition is the continued emphasis on adaptive skills in comparison to intelligence levels (Kirk & Gallagher, 1986; Sparrow, Balla, & Cicchettti, 1985; Williamson, McLeskey, Hoppey, & Rentz, 2006).

An individual is considered mentally retarded if his or her standardized test scores are two or more standard deviations below the average age group as well as having low adaptive skills. On a well-standardized test of intelligence two standard deviations below the mean is below the second percentile. In the normal population fewer than two percent (2%) of the population will score below the second standard deviation (Paul, 2007). The rationale for the use of both scores is that many individuals may have a low intelligence scores but have learned to adapt behaviors in relation to his or her cultural or societal expectations.

For instance, many individuals can perform well within the home, community, and within their social group. As such, these individuals may be considered normal within his or her community or cultural environment but may score low on an intelligence test (Heward & Orlansky, 1992; Kirk & Gallagher, 1986). However, the same individual may be seen as delayed in the academic setting. Thus, there is not a consistent disability so this child may not be mentally retarded. Whereas, the same child may be considered mentally retarded if within the community or cultural environment and the academic setting the child is not seen as normal. In other words, low intelligence scores combined with low social adaptations is considered to be a hallmark feature of mental retardation.

Individuals who are mentally retarded are classified as being either mild, moderate, or severe/profound. Mild retardation is defined as an individual who has an intelligence quotient of 50 to 70, has academic difficulties and low social skills. Yet, with special education services or supports this individual can learn in the educational environment and use adaptive skills in activities of daily living outside of school. In general, these individuals can hold jobs and live independently within the community.

An individual is moderately mentally retarded when his or her intelligence quotient is 35 to 55. These individuals require special education support with academics and need assistance to learn activities of daily living. Adaptive skills can be learned for employment in a supported work environment or sheltered workshop as well as living in supervised settings.

The individual with severe/profound mental retardation has intelligence quotients below 35 and requires training in basic survival skills (feeding, dressing, toileting). These individuals may be employed in a highly structured sheltered workshop or often live in a extremely supervised group home or institution. Typically, these individuals do not gain independence in providing for their own care.

Historical Perspective

Special education services in the United States have undergone radical changes in the last twenty years. In 1975 the Education for All Handicapped Act, commonly referred to as P.L. 94-142, was passed and provided all children with a free appropriate education. The passage of P.L. 94-142 further substantiated the importance of adaptive skills in determining a disability. Currently, P.L. 94-142 is referred to as the Individuals with Disabilities Education Act of 2004 (IDEA 2004). This federal law continues to mandate special education and related services to individuals with disabilities age birth to 21 years. It is important to note that the IDEA definition of mental retardation is similar to the AAIDD definition. The main difference between the two definitions is that the IDEA extends the assessment of adaptive skills beyond the diagnosis of mental retardation to include all children with disabilities. To understand the need for the continued focus on adaptive skills one must examine how treating the disordered progressed from a historical standpoint.

The understanding of adaptive skills must acknowledge the evolution of the treatment of individuals with disabilities. Beck (2002) proposed that as early as the first humans began on earth we have been involved in the care and treatment of individuals with disabilities.

Kolstoe (1976) described the late 1700's and early 1800's work of French doctor Jean Marc Gaspard Itard with Victor the "Wild Boy of Averyon" as the beginning of educational programs for individuals with disabilities. Itard provided the first and most widely recognized documented account of the idea of special education services. He believed that by providing stimulation to Victor, a boy believed to be raised by animals, he could effectively change an individual's learning potential (Cook, Klein, Tessier, & Daley, 2004). Itard's thoughts and teaching methods can be found in his book "The Wild Boy of Aveyron" published in 1962.

Kirk and Gallagher (1986) stated that Itard failed in his attempts to educate Victor. However, Itard's student, Edward Seguin, continued to refine and develop Itard's methods and became an early leader in educating individuals with mental retardation (Kirk & Gallagher, 1986). Seguin moved to the United States in the mid-1800s and influenced the movement to educate individuals with disabilities, specifically the mentally retarded.

Measurements of Adaptive Skills

AAMD Adaptive Behavior Scales

The American Association on Mental Deficiency Adaptive Behavior Scales (AAMD), developed by Nihira, Foster, Shellhaas, and Leland in 1975, was one of the first used objective measures to describe an individual's adaptive skills (Shea & Bauer, 1985). The goal of the AAMD was to assess how the individual reacts or responds to the demands of everyday living.

The AAMD was divided into two sections to assess independence in activities of daily living and social skills. The first section assessed skills such as

• Motor development;

• Self-help;

• Number, time, and money concepts;

• Housekeeping skills;

• Job skills; and

• Socialization.

The second section, the Adaptive Behavior Scale, assessed behaviors by identifying

• Areas of need for programming;

• Changes in behavior over time;

• Comparison of behaviors in different environments;

• Comparison of perceptions of different caregivers (parents, teachers, employees); and, collaboration among different caregiver groups (shea & bauer, 1985).

Assessment of behaviors included the maladaptive behaviors such as:

• Self-abuse;

• Destructive or violent tendencies;

• Odd mannerisms; and,

• Other socially unacceptable behaviors.

ABS-S:2

According to Harrington and Stinnett, the AAMR Adaptive Behavior Scale--School, Second Edition (ABS-S:2) was revised in 1993 by Lambert, Nihira, and Leland. The ABS-S:2 is divided into two parts. The first part examines an individual's level of independence, and social skills are assessed in the second part of the scale (Harrington and Stinnett, 1981-1993). The individual's classroom teacher or a person familiar with the child typically completes scoring.

ABIC/SOMPA

Adaptive Behavior Inventory for Children (ABIC) is another tool for assessing adaptive skills. The ABIC is a subsection of System of Multicultural Pluralistic Assessment (SOMPA) by Mercer & Lewis (1978). Six areas of adaptive skills are assessed: family, community, peer relations, nonacademic school roles, earner/consumer skills, and self-maintenance.

Vineland Adaptive Behavior Scales

Edgar Doll originally developed the Vineland Adaptive Behavior Scales to objectively assess adaptive skills (Sparrow, Balla, & Cicchetti, 1985; Sparrow, Cicchetti & Balla, 2005). It is believed that Doll's greatest contribution in developing the Vineland Adaptive Behavior Scales was the thought that adaptive skills are developmental in nature. Interestingly, his work was not used until the 1960's and 1970's (Sparrow, Balla, & Cicchetti, 1985; Sparrow, Cicchetti & Balla, 2005).

The Vineland Adaptive Behavior Scales have been revised and are widely used internationally for their psychometric properties in determining adaptive skills in individuals with mental retardation (Bildt, Kraijer, & Sytema, 2005). The scales are now known as the Vineland Adaptive Behavior Scales-II (Sparrow, Cicchetti & Balla, 2005). The scales do not require the individual to participate but does allow for information to be obtained from people familiar with the daily life of the individual in the home and community environment. There are five domains with two to three subdomains for each skill assessed. The adaptive skill domains assessed by the Vineland are:

• Communication,

• Daily living skills,

• Socialization,

• Motor skills and

• Maladaptive behavior index, which is optional.

Each subdomain assesses a variety of aspects associated the domain. For example, in the communication domain receptive (i.e., what the child understands) and expressive (the child's speaking, reading, writing) skills are separately assessed.

The primary differences between the ABS-S: 2, ABIC, and Vineland are related to where the assessment takes place. The ABS-S: 2 focus is on behaviors in the school setting; the ABIC focus is behavior outside of school; and, the Vineland focus is on both the home and community. Regardless of the assessment instrument, assessment of the individual is conducted through observations and interviewing individuals who can provide information about an individual's behavior over a period of time in the environment within and outside of the school (Mercer & Lewis, 1978; Kirk & Gallagher, 1986; Paul, 2007; Sparrow, Cicchetti & Balla, 2005).

Regardless of the test instrument used, assessment of adaptive skills should include performance of skills in the individual's daily environment. The importance of assessing skills in the daily environment is to prevent the misdiagnosis of an individual with a disability. For example, an individual who performed poorly on a standardized test for cognitive functioning may have adaptive skills that compensate for the limits. Thus, the individual may be considered normal in his or her daily environment.

Adaptive Skills Through the Lifespan

Adaptive skills through the lifespan include general stages of human aging: infancy and early childhood, childhood and early adolescence, and late adolescence and adulthood. The stages to be discussed are based on the AAIDD use of age groups. Due to the nature of individual differences in individuals with disabilities it should be stated that stages are not defined based on chronological age but on developmental ages. For example, an individual may be cognitively impaired and have a chronological age of 30 but his or her skills are similar to those associated with an infant.

Infancy & Early Childhood

This stage can be defined as encompassing birth to approximately six years of age developmentally. In these children, sensorimotor, communication, self-help, and socialization are of primary importance and constitute much of the child's primary learning (Peterson, 1987; Paul, 2007). Sensorimotor skills include learning to pick things up, walk, or respond to the environment. Communication skills typically emerging in this stage include first words, understanding what is said, or telling someone of a need. Self-help skills consist of eating, grooming, dressing, or toileting.

The lack of development in these areas will have a great amount of influence on the developmental outcomes and adaptive skills. For example, if the self-help skill of learning to drink from a cup, a skill developed around 12 to 18 months of age, does not replace bottle-feeding during this time then bottle-feeding may be prolonged. When a child does not transition to cup drinking until four to five years of age, then his or her development would be considered delayed in terms of adaptive skills in most communities in the United States.

Childhood & Early Adolescence

The ages typically associated with this stage are from 6 to 18 years of age developmentally. Children in this stage are learning skills which are a combination of academics and application of appropriate reasoning and judgments in learning to master the environment (Peterson, 1987). Social skill learning is focused on group participation and using interpersonal skills. For instance, a child who is not able to establish a peer group due to limited communication skills or social skills would be considered delayed.

Late Adolescence & Adulthood

An individual older than 18 years of age developmentally could be included in this group of learners. Typically, the adaptive skills becoming refined in this stage include vocational and social responsibility (Peterson, 1987). An individual who could not seek employment independently would be considered delayed.

Teaching Adaptive Skills

The teaching methods presented are a broad overview and represent the most basic information on how to teach adaptive skills.

One way to teach adaptive skills is through the use of task analysis. Task analysis is a process by which a skill or activity is broken down into small teachable sequences. Therefore, each skill builds the sequence and the skill is learned.

An example can be demonstrated in learning to tie a shoe. The general sequence of steps is:

• Put the shoe on the correct foot.

• Grab each shoelace with the hands.

• Pull the shoelaces up.

• Cross the right shoelace over the left shoelace.

• Pull the shoelaces down.

• Form a loop with the right thumb and forefinger.

• Cross the left shoelace over the loop.

• Push the left shoelace through the loop.

• Pull down.

It should be noted that there are many different ways and methods of learning to tie a shoe. Each of the steps above could be eliminated, changed or further broken down depending on the individual's needs.

An individual who needs to gain independence in a vocational or learning situation may need to develop functional communication skills (Cascella & McNamara, 2005; Paul, 2007). The goal of this teaching method is to identify and target communication skills an individual would need to be successful in communicating his or her wants and needs (Sigafoos, Drasgow, Reichle, O'Reilly, Green, & Tait, 2004). Ideally, this adaptive skill would be taught before the individual leaves the educational setting.

In teaching functional communication skills, the continued need to develop literacy skills cannot be overlooked. An innovation in this area has been discussed by Basil and Reyes (2003), and Hetzroni and Schanin (2002) discuss the use of computer-assisted learning. Computer-assisted learning is often used in teaching literacy skills.

Conclusions

Most special education personnel would agree that assessing and teaching adaptive skills is exciting, dynamic and frustrating. In spite of the growing consensus on the importance of adaptive skills, work has just begun to determine the most effective teaching methods.

The challenges demand that special education personnel keep in mind that individuals with special needs must be viewed within the school and community environment. If education exists to ready all citizens for the workforce and to be members of society, then special education must ensure high-quality services that will benefit the individual in the school and community settings. Appropriate educational programming will not occur without special education and regular education teachers who have an understanding of adaptive skills and who can plan and implement instructional strategies that meet the individual needs of all students.

Terms & Concepts

Activities of Daily Living Skills: Activities of daily living skills (ADLs) are skills that are considered essential for self care. ADLs include but are not limited to: mobility, communication, toileting, grooming, and leisure skills.

Group Home: A group home is a home where individuals with disabilities live in the community or in a residential facility. Often times the home has been adapted to accommodate the various needs of its residents.

Individuals with Disabilities of Education Act 2004 (IDEA 2004): IDEA 2004 is a federal law that continues to mandate special education and related services to individuals with disabilities age birth to 21 years.

Intelligence Quotient (IQ): Intelligence quotient is a score from a standardized test that assesses intelligence.

Interpersonal Skills: Interpersonal skills are communication skills that are used during social interactions or communications. The skills rely somewhat on cognitive abilities to assess the verbal and nonverbal aspects of communication within a context.

Sheltered Workshops: Sheltered workshops are part of the vocational process which evaluates the ability of the individual to work in terms of ability and work tolerance.

Standard Deviations: In very basic terms, a standard deviation is defined as the average difference of scores from the mean.

Standardized Intelligence Test: A standardized intelligence test consists of a structured test that measures intelligence.

Supported Work Environment: A supported work environment is a place where people with disabilities can work and learn skills necessary for employment in the community.

Task Analysis: Task analysis is a teaching method used with individuals to break a routine activity in small sequenced learning steps.

Bibliography

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Dessemontet, R., Bless, G. G., & Morin, D. D. (2012). Effects of inclusion on the academic achievement and adaptive behaviour of children with intellectual disabilities. Journal of Intellectual Disability Research, 56, 579-587. Retrieved December 15, 2013, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=75051688&site=ehost-live

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Harrington, R. & Stinnett, T. (1981-1993). AAMR Adaptive Behavior Scale--School, Second Edition (ABS-S:2). Retrieved June 26, 2007 from EBSC Online Database Mental Measurements Yearbook. http://search.ebscohost.com/login.aspx?direct=true&db=loh&AN=13191391&site=ehost-live

Hetzroni, O. & Schanin, M. (2002). Emergent literacy in children with severe disabilities using interactive multimedia stories. Journal of Developmental and Physical Disabilities, 14, 173-190.

Heward, W. & Orlansky, M. (1992). Exceptional children: An introductory survey of special education (4th ed) New York: Maxwell Macmillian Inc.

Peterson, N. (1987). Early intervention for handicapped and at-risk children: An introduction to early childhood special education. Denver: Love Publishing, Company.

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Metsiou, K., Papadopoulos, K., & Agaliotis, I. (2011). Adaptive behavior of primary school students with visual impairments: The impact of educational settings. Research in Developmental Disabilities, 32, 2340-2345. Retrieved December 15, 2013, from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=66402959&site=ehost-live

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Paul, R. (2007). Language disorders from infancy through adolescence: Assessment and intervention. (2nd ed). St. Louis, MO: Mosby Elsevier.

Shea, T. & Bauer, A. (1985). Parents and teachers of exceptional students. Boston: Allyn and Bacon.

Sigafoos, J., Drasgow, E., Reichle, J., O'Reilly, M., Green, V., & Tait, K. (2004). Tutorial: Teaching communicative rejecting to children with severe disabilities. American Journal of Speech-Language Pathology, 13, 31-42.

Sparrow, S., Balla, D., & Cicchettti, D. (1985). Vineland Adaptive Behavior Scales Circle Pines, MN: American Guidance Service.

Sparrow, S., Cicchetti, D., & Balla, D. (2005). Vineland Adaptive Behavior Scales-II. Upper Saddle River, NJ: Pearson Assessments.

Suggested Reading

Hetzroni, O. & Schanin, M. (2002). Emergent literacy in children with severe disabilities using interactive multimedia stories. Journal of Developmental and Physical Disabilities, 14, 173-190.

Itard, J. M. (1962). The wild boy of aveyron. New York: Appleton-Century Crofts.

Sigafoos, J., Drasgow, E., Reichle, J., O'Reilly, M., Green, V., & Tait, K. (2004). Tutorial: Teaching communicative rejecting to children with severe disabilities. American Journal of Speech-Language Pathology, 13 , 31-42.

Winzer, M. (1993). The history of special education: From isolation to integration. Washington, DC: Gallaudet University Press.