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Profiles of Adaptive Functioning: Autism Spectrum Disorders, Mental Retardation, and Beyond. California Association of Profiles of Adaptive Functioning: Autism Spectrum Disorders, Mental Retardation, and Beyond. California Association of School Psychologists February 17, 2005 8: 30 -10: 15 Sara S. Sparrow, Ph. D Yale Child Study Center

How I Discovered Adaptive Behavior Speech Pathology Psychology Doman-Delacato Measurement Dilemmas How I Discovered Adaptive Behavior Speech Pathology Psychology Doman-Delacato Measurement Dilemmas

4 AREAS FOR TODAY • NEW FEATURE OF THE VINELAND II • CHANGES IN 4 AREAS FOR TODAY • NEW FEATURE OF THE VINELAND II • CHANGES IN THE PURPOSES OF ADAPTIVE BEHAVIOR ASSESSMENTS • RECENT RESEARCH ON EFFECTS OF INTERVENTION WITH PERSONS WTH HIGH FUNCTIONING ASD • CLINICAL APPLICATIONS AND ADAPTIVE PROFILES

Adaptive Behavior Assessment Working our way back: 30 years since Pl 94 -142 (1975) Adaptive Behavior Assessment Working our way back: 30 years since Pl 94 -142 (1975) 16 years earlier AAMD (1959) 24 years earlier Edgar Doll published The Vineland Social Maturity Scale (1935)

Purpose Diagnosis of Mental Retardation Purpose Diagnosis of Mental Retardation

Things Have Changed More and more assessing adaptive behavior has had broader applications One Things Have Changed More and more assessing adaptive behavior has had broader applications One reason is that different research has demonstrated that there appear to be different profiles for various diagnostic groups

USES OF ADAPTIVE BEHAVIOR ASSESSMENTS – Confirming or establishing diagnosis – Special services qualification USES OF ADAPTIVE BEHAVIOR ASSESSMENTS – Confirming or establishing diagnosis – Special services qualification – Program planning – Progress reporting/tracking – Identifying changes over time

USES, conintued – – – Mental Retardation Early Childhood Special Education Autism Spectrum Disorders USES, conintued – – – Mental Retardation Early Childhood Special Education Autism Spectrum Disorders Traumatic Brain Injury Adult Mental Problems As a measure to support the diagnosis of other disabilities – Death Penalty Cases and – Many others

A word about Death penalty cases: Atkins versus Virginia. Psychologists will be increasingly asked A word about Death penalty cases: Atkins versus Virginia. Psychologists will be increasingly asked to provide testimony in these cases, mainly regarding adaptive functioning A Virginia court just ruled that Atkins did not meet criteria for a diagnosis of mental retardation

2005 Supreme Court rules that individuals with (chronological) age under 18 years cannot be 2005 Supreme Court rules that individuals with (chronological) age under 18 years cannot be executed. What about mental age?

THUS • Implications for the development of the Vineland II THUS • Implications for the development of the Vineland II

Introducing the Vineland. II Introducing the Vineland. II

VINELAND-II Overview • Because clinicians have different needs when it comes to assessing adaptive VINELAND-II Overview • Because clinicians have different needs when it comes to assessing adaptive behavior, we now offer four forms: --Survey Interview Form – NEW Parent/Caregiver Rating Form – Teacher Rating Form – Expanded Interview Form

MAJOR NEW FEATURES • • • Ages: Birth to 90 years of age New MAJOR NEW FEATURES • • • Ages: Birth to 90 years of age New Norms Increase Item density at floor and ceiling Extensive investigation and elimination of item bias Increase items relevant to ASD and young children Eliminate outdated items Increase Items reflecting our society’s technological advances Subdomain standard scores New Maladaptive

Other New Features • Parent Caregiver Forms • Teacher report Form – – Daily Other New Features • Parent Caregiver Forms • Teacher report Form – – Daily Living Skills • Personal Subdomain • Academic Subdomain • School-Community Subdomain

Validity Evidence: 11 Clinical Groups • Attention Deficit/Hyperactivity Disorder • Autism – nonverbal • Validity Evidence: 11 Clinical Groups • Attention Deficit/Hyperactivity Disorder • Autism – nonverbal • Autism – verbal • Learning Disability • Mental Retardation – Mild (child) • Mental Retardation – Moderate (child) • Mental Retardation – Mild (adult) • Mental Retardation – Moderate (adult) • Emotional Disturbance • Visual Impairment • Hearing Impairment

Validity Evidence: Criterion • Vineland Adaptive Behavior Scales • Adaptive Behavior Assessment System (ABAS) Validity Evidence: Criterion • Vineland Adaptive Behavior Scales • Adaptive Behavior Assessment System (ABAS) • WISC III • WAIS-III • BASC-2

SUBDOMAIN V-SCALED SCORES Mean = 15 SD = 3 SUBDOMAIN V-SCALED SCORES Mean = 15 SD = 3

VINELAND II NEW MALADAPTIVE DOMAIN VINELAND II NEW MALADAPTIVE DOMAIN

STILL BOTH MINOR AND MAJOR MALADAPTIVE STILL BOTH MINOR AND MAJOR MALADAPTIVE

FACTOR ANALYTIC STUDIES REVEALED THREE FACTORS FACTOR ANALYTIC STUDIES REVEALED THREE FACTORS

Internalizing Items • • • Is overly dependent Avoids others and prefers to be Internalizing Items • • • Is overly dependent Avoids others and prefers to be alone Has eating difficulties Has sleep difficulties Refuses to go to work or school because of fear, feelings of rejection, or isolation Is overly anxious or nervous Cries or laughs too easily Has poor eye contact Is sad for no clear reason Avoids social interaction Lacks energy or interest in life

Externalizing Items • Is impulsive • Has temper tantrums • Intentionally disobeys or defies Externalizing Items • Is impulsive • Has temper tantrums • Intentionally disobeys or defies those in authority • Taunts, teases, or bullies • Is inconsiderate or insensitive of others • Lies, cheats, or steals • Is physically aggressive • Is stubborn or sullen • Says embarrassing things or asks embarrassing questions in public • Behaves inappropriately at the urging of others

Group Maladaptive Differences Mean All 21. 4 Int 6. 4 EX 8. 6 Other Group Maladaptive Differences Mean All 21. 4 Int 6. 4 EX 8. 6 Other 6. 4 V Imp Mean 6. 1 2. 4 1. 7 1. 9 HI Imp Mean 5. 6 1. 4 2. 2 1. 9 ADHD Mean 14. 6 3. 4 5. 8 5. 4 Autism. Nonverbal Mean 21. 3 8. 9 4. 8 7. 7 Autism-Verbal Mean 14. 9 5. 5 4. 3 5. 1 EBD

Maladaptive Behavior by Age for Individuals with MR School-aged children with MR (all levels) Maladaptive Behavior by Age for Individuals with MR School-aged children with MR (all levels) had maladaptive means significantly higher than age matched clinical groups but < 1 SD difference. Adults (19 -90) with MR (all levels) had maladaptive means significantly higher than age matched clinical groups AND school aged groups with MR

Maladaptive Behaviors by Age for Individuals with MR Differences were greatest in the adult Maladaptive Behaviors by Age for Individuals with MR Differences were greatest in the adult severe-profound group Only Internalizing behaviors fell into the “elevated range” (the highest level) for this group

Adaptive Functioning of Mental Retardation Groups For all levels and ages, mean levels of Adaptive Functioning of Mental Retardation Groups For all levels and ages, mean levels of all domains and the adaptive behavior composite were at least 2 SD below the mean

Severe Moderate Mild Severe Moderate Mild

Mean Subdomain Scores Mean Subdomain Scores

Mean Subdomain Scores Mean Subdomain Scores

Validity Evidence: Mental Retardation Ages >18 Ages 6 -18 MR: Mild 6 -18 N-45 Validity Evidence: Mental Retardation Ages >18 Ages 6 -18 MR: Mild 6 -18 N-45 MR: Mod 6 -17 N=31 MR: S/P 6 -18 N=36 MR: Mild 19 -69 N-34 MR: Mod 19 -50 N=33 MR: S/P 26 -86 N=20 Adaptive Behavior Composite 66. 3 61. 1 41. 5 49. 9 33. 6 20. 4 Communication 68. 5 60. 9 41. 4 27. 7 21. 2 Daily Living Skills 66. 6 61. 9 41. 5 56. 8 40. 1 23. 4 68. 5 64. 3 45. 0 56. 4 40. 7 20. 0 Vineland-II Socialization Mean scores by age group and level Mild, Moderate, Severe to Profound

Validity Evidence: Autism, ADHD, EBD, LD Vineland-II Autism Verbal 3 -16 N=46 Adaptive Behavior Validity Evidence: Autism, ADHD, EBD, LD Vineland-II Autism Verbal 3 -16 N=46 Adaptive Behavior Composite 65. 7 50. 7 94. 1 85. 7 95. 3 68. 4 47. 0 92. 4 87. 2 91. 2 67. 8 52. 5 99. 5 92. 2 98. 4 64. 4 51. 0 94. 2 82. 4 98. 3 81. 2 67. 4 Communication Daily Living Skills Socializatio n Motor (Ages 3 -6 only) Autism Nonverbal 3 -16 N=31 ADHD 6 -18 N=55 EBD 8 -17 N=34 LD 7 -17 N=56 Mean scores by age group and disability

Validity Evidence: Visual Impairments, Hearing Impairments Vineland-II Adaptive Behavior Composite Communication Daily Living Skills Validity Evidence: Visual Impairments, Hearing Impairments Vineland-II Adaptive Behavior Composite Communication Daily Living Skills Socialization Visual Impairments 6 -18 N=36 Hearing Impairments 6 -18 N=58 86. 8 90. 1 95. 6 89. 2 82. 6 89. 7 87. 4 95. 8 Mean scores by age group and disability

Clinical Group Summary Vineland-II differentiates clinical groups from nonclinical groups. • Documented significant deficits Clinical Group Summary Vineland-II differentiates clinical groups from nonclinical groups. • Documented significant deficits for MR groups (at least 2 SDs below mean) • Demonstrated expected mean score changes for mild, moderate, and severe to profound levels of mental retardation • Differentiated between Verbal and Nonverbal Autism groups • Demonstrated distinctive profile patterns

Validity Evidence: Criterion • Vineland Adaptive Behavior Scales • Adaptive Behavior Assessment System (ABAS) Validity Evidence: Criterion • Vineland Adaptive Behavior Scales • Adaptive Behavior Assessment System (ABAS) • WISC III • WAIS-III • BASC-2

Vineland-II and Vineland ABS High degree of consistency between forms Ages s 0 -2 Vineland-II and Vineland ABS High degree of consistency between forms Ages s 0 -2 3 -6 7 -18 N=25 Adaptive Behavior Composite Communication Daily Living Skills Socialization Motor N=29 N=70 . 87. 69. 76 . 94. 89. 96 . 89. 91 . 89 . 95 . 71 . 93 . 90 Correlations corrected for restriction of range

IMPORTANT THERE APPEARS TO BE NO FLYNN EFFECT IMPORTANT THERE APPEARS TO BE NO FLYNN EFFECT

Vineland-II and WISC-III and WAIS-III Documents the distinct difference between IQ and Adaptive Behavior. Vineland-II and WISC-III and WAIS-III Documents the distinct difference between IQ and Adaptive Behavior. Confirms the need to assess both when making diagnostic decisions. WISC-III WAIS-III FSIQ 6 -16 17 -68 N=28 N=83 Adaptive Behavior Composite . 12 . 20 Communication . 36. 25 . 30. 06 -. 39 . 27 Daily Living Skills Socialization Correlations corrected for restriction of range

Vineland-II and Behavior Assessment System for Children, 2 nd Edition (BASC-2) Ages 6 -11 Vineland-II and Behavior Assessment System for Children, 2 nd Edition (BASC-2) Ages 6 -11 Correlations corrected for restriction of range

Conclusions • Much is the same but much is better! Manual Criteria Case studies Conclusions • Much is the same but much is better! Manual Criteria Case studies Summer 2006 • Teacher checklist Winter 2006 • Expanded Form

Adaptive Profiles from Research Studies Since 1984 over 1400 studies have been published investigating Adaptive Profiles from Research Studies Since 1984 over 1400 studies have been published investigating adaptive functioning in the following groups: Mental retardation Autism Spectrum Closed Head Injury Hearing Impaired Homeless HIV Learning disability Gifted Emotionally Disturbed Spina Bifida Tourette Syndrome Conduct Disorder Cocain Exposed Low Birthweight Children exposed to Violence ETC. !

Groups with Mental Retardation Non Specific MR All levels of MR Genetic Forms of Groups with Mental Retardation Non Specific MR All levels of MR Genetic Forms of MR Fragile X Down Syndrome Praeder William Syndrome Special Olympics

Groups on the Autism Spectrum PDD NOS Asperger Syndrome High functioning Autism Low functioning Groups on the Autism Spectrum PDD NOS Asperger Syndrome High functioning Autism Low functioning Autism Multiplex Nonverbal Learning Disability (? )

Atypical and Normally Developing Children Sparrow, S. S. Rescorla, L. A. , Provence, S. Atypical and Normally Developing Children Sparrow, S. S. Rescorla, L. A. , Provence, S. , Condon, S. O. , Goudreau, D. , Cicchetti, D. V. , (1986). Follow-up of “atypical” children Journal of American Academy of Child Psychiatry. 25, 2: 181 -185.

Atypical and Normally Developing Children Group AGE FIQ VIQ PIQ Atypical Development 10. 1 Atypical and Normally Developing Children Group AGE FIQ VIQ PIQ Atypical Development 10. 1 110 111 108 Normally Developing 112 111 112 10. 4

PDDnos (Atypical) and Non (Atypical) PDDnos DOMAIN Communication PDDnos Standard Score 87 Non. PDDnos PDDnos (Atypical) and Non (Atypical) PDDnos DOMAIN Communication PDDnos Standard Score 87 Non. PDDnos Standard Score 102* Daily Living 80 89* Socialization *significant 74 98*

Social Deficits In Autism Volkmar, F. R. , Sparrow, S. S. , Goudreau, D. Social Deficits In Autism Volkmar, F. R. , Sparrow, S. S. , Goudreau, D. , Cicchetti, D. V. , Paul, R. , Cohen, D. J. , (1987) Social deficits in autism: An operational approach using the Vineland Adaptive Behavior Scales. Journal of the American Academy of Child and Adolescent Psychiatry. 26, 2: 156 -161.

AUTISM • Carter, A. S. , Volkmar, F. R. , Sparrow, S. S. , AUTISM • Carter, A. S. , Volkmar, F. R. , Sparrow, S. S. , Wang, J. J. , Lord, C. , Dawson, G. , Fombonne, E. , Loveland, K. , Mesibov, G. , Schopler, E. , (1998), The Vineland Adaptive Behavior Scales - Supplementary Norms for Individuals with Autism, Journal of Autism & Developmental Disorders, 28: 4, pp. 287 -302.

AUTISM AND ASPERGER Dissanayake, Cheryl, Macintosh, Kathleen, (2003), Mind reading and social functioning in AUTISM AND ASPERGER Dissanayake, Cheryl, Macintosh, Kathleen, (2003), Mind reading and social functioning in children with autistic disorder and Asperger's disorder. Pp 213 -239 Individual differences in theory of mind: Implications for typical and atypical development. Repacholi, Betty, Slaughter, Virginia (Editors), Macquarie Monographs in Cognitive Science, Psychology Press, New York, NY.

Subject Characteristics Age and IQ matched children with mental retardation without and with autism Subject Characteristics Age and IQ matched children with mental retardation without and with autism Mean age 11. 8 Mean IQ 54 Vineland scores were so low we had to use age equivalents/mental age ratios Thus, if Adaptive Behavior was consistent with MA, Score should be near 100.

SOCIAL DEFICITS IN AUTISM DOMAIN AUTISTIC NONAUTISTIC ABDomain/MA Communication 66 81* Daily Living 97 SOCIAL DEFICITS IN AUTISM DOMAIN AUTISTIC NONAUTISTIC ABDomain/MA Communication 66 81* Daily Living 97 95 Socialization *significant 39 70*

SOCIAL DEFICITS IN AUTISM Communication SUBDOMAIN Receptive AUTISTIC Age Equivalent 3. 2 NONAUTISTIC Age SOCIAL DEFICITS IN AUTISM Communication SUBDOMAIN Receptive AUTISTIC Age Equivalent 3. 2 NONAUTISTIC Age Equivalent 3. 5* Expressive 2. 9 4. 4* Written *significant 4. 4 5. 1

SOCIAL DEFICITS IN AUTISM Socialization SUBDOMAIN Interpersonal AUTISTIC Age Equivalent 1. 6 NONAUTISTIC Age SOCIAL DEFICITS IN AUTISM Socialization SUBDOMAIN Interpersonal AUTISTIC Age Equivalent 1. 6 NONAUTISTIC Age Equivalent 3. 5* Play and Leisure 2. 5 3. 6* Coping *significant 2. 7 4. 4*

Other Populations Precocious readers (not hyperlexic) IQs: 121 to 122 Ages: 3 -2 to Other Populations Precocious readers (not hyperlexic) IQs: 121 to 122 Ages: 3 -2 to 4 -9 Asperger and high functioning autism

Special Thanks • Ami Klin • Fred R. Volkmar • Celine Saulnier • Kathy Special Thanks • Ami Klin • Fred R. Volkmar • Celine Saulnier • Kathy Lord • Domenic V. Cicchetti • All the participating families from the Yale Child Study Center and the Autism and Communication Disorders Center at the University of Michigan • NICHD grant 5 -PO 1 -HD 03008

Recent Research in ASD • Autism symptoms have a severe impact on a person’s Recent Research in ASD • Autism symptoms have a severe impact on a person’s ability to meet the demands of everyday life • Extreme variability in symptomatology and cognitive ability affects daily functioning • “Higher-functioning” individuals, despite potential, fail to translate their skills to real-life adaptation

Outcome in ASD • Increasing focus on early diagnosis & intensive intervention = progress Outcome in ASD • Increasing focus on early diagnosis & intensive intervention = progress • Still enormous variability in outcome – 12% achieving “very good outcome” – 60% with “poor” or “very poor outcome” (Howlin, Goode, Hutton, & Rutter, 2004) • Cognitive & language measures • Does higher cognitive ability = greater outcome in adulthood? ? ? • Translating potential into real-life skills becomes critical – Adaptive Behavior

Adaptive Functioning in Autism • “Real-life” Skills • Vineland Adaptive Behavior Scales (Sparrow, Balla, Adaptive Functioning in Autism • “Real-life” Skills • Vineland Adaptive Behavior Scales (Sparrow, Balla, & Cicchetti, 1984) – Communication Daily Living Skills – Socialization Motor • Communication & Socialization skills = central & defining features • Deficits in adaptive skills fall below cognitive ability across the spectrum – Significant deficits in socialization – Intermediate deficits in communication (Bolte & Pustka, 2002; Carter et al. , 1998)

Adaptive Communication Adaptive Communication

Adaptive Social Skills Adaptive Social Skills

Relationship between IQ and Adaptive Functioning • Consistent findings: – Adaptive impairments exist beyond Relationship between IQ and Adaptive Functioning • Consistent findings: – Adaptive impairments exist beyond MR – No entitlement for services without MR • Inconsistent findings: (Freeman, Del’Homme, Guthrie, & Zhang, 1999; Liss et al. , 2001; Schatz & Hamden-Allen, 1995; Szatmari, Bryson, Boyle, Streiner, & Duku, 2003) – Positive relationship • e. g. , Vineland Communication & VIQ • Early language and nonverbal IQ predicting outcome for both comm. & socialization skills – Negative relationship

Relationship between Age and Adaptive Functioning • Equally unclear relationship: – Stable relationship (e. Relationship between Age and Adaptive Functioning • Equally unclear relationship: – Stable relationship (e. g. , Schatz & Hamden-Allen, 1995) – Increase in AF w/ age (e. g. Freeman et al. , 1999) – Decrease in AF w/ age (e. g. Szatmari et al. , 2003)

Autism Symptomatology • Varying measures to assess severity of autism symptoms –Autism Behavior Checklist Autism Symptomatology • Varying measures to assess severity of autism symptoms –Autism Behavior Checklist –Childhood Autism Rating Scale –Autism Diagnostic Observation Schedule • Other factors (e. g. , adaptive behavior and language) appear to be stronger predictors of outcome than severity of symptoms • Very little research on relationship between symptomatology and adaptive behavior

Many Unanswered Questions • Cognitive potential may or may not play a role in Many Unanswered Questions • Cognitive potential may or may not play a role in positive outcomes • Severity of autism symptoms may or may not play a role in positive outcomes • Early detection and intensive intervention are beneficial to some, but not all, individuals on the spectrum • “Real-life” skills are important for outcome – adaptive communication & social skills

Present Study • Examines relationship between adaptive behavior (ability) and severity of symptoms (disability) Present Study • Examines relationship between adaptive behavior (ability) and severity of symptoms (disability) – Vineland Adaptive Behavior Scales – Autism Diagnostic Observation Schedule • Investigates nature of ability & disability in relation to: – Age – IQ – Diagnostic Classification

Participants Total Sample • 187 males with a diagnosis of an ASD • Diagnosis Participants Total Sample • 187 males with a diagnosis of an ASD • Diagnosis based on ADI, ADOS, & clinical judgment of 2 licensed clinicians • Verbal IQ > 70 • Age range from 7 to 18 years Yale Site • N = 84 – Autism=32; Asperger’s=35; PDD-NOS=17 Michigan Site • N = 103 – Autism=31; Asperger’s=1; PDD-NOS=66

Measures • Autism Diagnostic Observation Schedule (Lord, Rutter, Di. Lavore, & Risi, 1999) • Measures • Autism Diagnostic Observation Schedule (Lord, Rutter, Di. Lavore, & Risi, 1999) • Vineland Adaptive Behavior Scales (Sparrow, Balla, & Cicchetti, 1984) • Intelligence Scales – Yale: Wechsler scales: WISC-III, WAIS- R (The Psychological Corporation) – Michigan: Mix of Wechsler scales, Differential Ability Scales, & Stanford-Binet

Characterization by Site Yale(n=84) Mean (SD) Michigan(n=103)Mean (SD) 12. 4 (2. 9) 10. 0 Characterization by Site Yale(n=84) Mean (SD) Michigan(n=103)Mean (SD) 12. 4 (2. 9) 10. 0 (2. 4) 99. 8 (20. 6) 104. 7 (21. 3) 94. 5 (19. 7) 99. 0 (17. 1) 101. 2 (18. 3) 98. 5 (18. 9) Communication Socialization 72. 2 (17. 1) 52. 0 (11. 5) 83. 5 (20. 0) 67. 0 (15. 4) ADOS** Communication Social 4. 0 (1. 5) 9. 5 (2. 6) 3. 2 (1. 7) 6. 5 (3. 0) Age IQ Full Scale Verbal Performance Vineland* Note. ADOS Commun. scores range 0 -8 & Social scores 0 -14 *For Vineland scores, higher numbers indicate greater ability **For ADOS scores, higher numbers indicate greater disability

Real-life (adaptive functioning) in higher functioning individuals with autism and PDDs • N=187 • Real-life (adaptive functioning) in higher functioning individuals with autism and PDDs • N=187 • Autism, AS, and PDD-NOS • Socialization (Vineland): Mean 52 Yale (SD 12. 6) • Interpersonal Age Equivalent: Yale Mean 3. 6 years (SD 1. 7 years) From Klin, Saulnier, Sparrow, Cicchetti, Lord & Volkmar (submitted)

Real-life (adaptive functioning) in higher functioning individuals with autism and PDDs • Social ability Real-life (adaptive functioning) in higher functioning individuals with autism and PDDs • Social ability and disability: two relatively dissociated domains (correlation)!!!!!!! • Social disability is not correlated with age (stable) • Social ability is negatively correlated with age (decline relative to peers, relative to increasing demands of the environment) • Most programs emphasize reduction of symptoms • Conclusion: all programs should prioritize adaptive functioning (REAL-LIFE SKILLS) From Klin, Saulnier, Sparrow, Cicchetti, & Volkmar (submitted)

High Functioning ASD High Functioning ASD

Prototypical Comparative Profiles Based on our work and those of many others These are Prototypical Comparative Profiles Based on our work and those of many others These are group data and some affected individuals may not demonstrate the prototypical profiles

ASPERGER AND AUTISM • Szatmari, Peter; Archer, Lynda; Fisman, Sandra; Streiner, David L. (1995), ASPERGER AND AUTISM • Szatmari, Peter; Archer, Lynda; Fisman, Sandra; Streiner, David L. (1995), Asperger's syndrome and autism: Differences in behavior, cognition, and adaptive functioning. Journal of the American Academy of Child & Adolescent Psychiatry, Dec. 34: 12, pp. 1662 -1671.

ASPERGER AND AUTISM Klin, A. , Volkmar, F. R. , Sparrow, S. S. , ASPERGER AND AUTISM Klin, A. , Volkmar, F. R. , Sparrow, S. S. , Cicchetti, D. V. , and Rourke, B. P. (1995). Validity and Neuropsychological Characterization of Asperger Syndrome. Journal of Child Psychology and Psychiatry. 36: 1127 -1140.

High Functioning Autism and Asperger DIAGNOSIS: DOMAIN: HIGH FUNCTIONING AUTISM ASPERGER FIQ VCI PRI High Functioning Autism and Asperger DIAGNOSIS: DOMAIN: HIGH FUNCTIONING AUTISM ASPERGER FIQ VCI PRI Communication Same Lower Higher Lower Same Higher Lower Higher Daily Living Socialization Motor Similar Higher Similar Lower

ADHD Roizen, N. J. , Blondis, T. A. , Irwin, M. , Stein, M. ADHD Roizen, N. J. , Blondis, T. A. , Irwin, M. , Stein, M. (1994) Adaptive functioning in children with attention-deficit hyperactivity disorder, Archives of Pediatrics & Adolescent Medicine Nov, 148: 11, pp 1137 -1142.

ADHD, ADD • Stein, Mark A. , Szumowski, Emily, Blondis, Thomas A. (1995) Adaptive ADHD, ADD • Stein, Mark A. , Szumowski, Emily, Blondis, Thomas A. (1995) Adaptive skills dysfunction in ADD and ADHD children, The Journal of Child Psychology and Psychiatry and Allied Disciplines, May, pp. 36, 663 -670.

Cognitive and Adaptive Profiles of Normally developing children and ADHD DOMAIN I. Q. DIAGNOSIS Cognitive and Adaptive Profiles of Normally developing children and ADHD DOMAIN I. Q. DIAGNOSIS NORMAL Same ADHD Same Communication Higher Lower Daily Living Higher Lower Socialization Higher Lower Motor Similar

DOWN-SYNDROME Dykens, E. M. , Hodapp, R. M. , Evans, D. W. (1994) Profiles DOWN-SYNDROME Dykens, E. M. , Hodapp, R. M. , Evans, D. W. (1994) Profiles and Development of Adaptive Behavior in Children with Down-Syndrome, American Journal of Mental Retardation, March, 98: 5, pp. 580 - 587

Cognitive and Adaptive Profiles of Nonspecific MR and Down syndrome DOMAIN I. Q. Communication Cognitive and Adaptive Profiles of Nonspecific MR and Down syndrome DOMAIN I. Q. Communication Daily Living Socialization Motor DIAGNOSIS NON DOWN SPECIFIC SYNDROME MR Same Higher Lower Similar Lower Higher Lower

DOWN-SYNDROME Burack, J. A. ; Shulman, C. ; Katzir, E. ; Schaap, T. ; DOWN-SYNDROME Burack, J. A. ; Shulman, C. ; Katzir, E. ; Schaap, T. ; Brennan, J. M. ; Iarocci, G. ; Wilansky, P. ; Amir, N. (1999) Cognitive and behavioural development of Israeli males with fragile X and Down Syndrome International Journal of Behavioral Development, JUNE, 23: 2, pp. 519 -531

• Cicchetti, Domenic V. , Sparrow, Sara S. (1990)Assessment of adaptive behavior in • Cicchetti, Domenic V. , Sparrow, Sara S. (1990)Assessment of adaptive behavior in young children, pp 173 -196, Johnson, James H. , Goldman, Jacquelin, Developmental assessment in clinical child psychology: A handbook. Pergamon general psychology series, 163 Pergamon Press, Inc, Elmsford, NY.

Cognitive and Adaptive Profiles of Normal Development and Hearing Impaired DOMAIN DIAGNOSIS NORMAL HEARING Cognitive and Adaptive Profiles of Normal Development and Hearing Impaired DOMAIN DIAGNOSIS NORMAL HEARING IMPAIRED I. Q. Same Communication Higher Lower Daily Living Similar Socialization Higher Lower Motor Similar

Cognitive and Adaptive Profiles of Prototypical Autism and Mental Retardation DOMAIN: DIAGNOSIS: AUTISM Cognitive and Adaptive Profiles of Prototypical Autism and Mental Retardation DOMAIN: DIAGNOSIS: AUTISM MENTAL RETARDATION I. Q. Same Communication Lower Higher Daily Living Similar Socialization Lower Higher Motor Higher Lower

Conclusions Assessment of Adaptive functioning is important for individuals within any diagnostic category Determining Conclusions Assessment of Adaptive functioning is important for individuals within any diagnostic category Determining how everyday life (adaptive functioning) is affected by nature or nurture (or both) should be our goal Research and clinical work has shown us how different profiles are found in different groups Aside: (Program planning and assessment of change after intervention are other goals of adaptive behavior assessment)