Adaptive behavior and its importance of assessment in clinical practice
Authors:
Hapčová Margaréta 1; Malík Barbora 1; Demkaninová Diana 1; Celušáková Hana 1; Belica Ivan 2,3
Authors‘ workplace:
Katedra psychológie, Filozofická fakulta, Univerzita Komenského, Bratislava, Slovensko
1; Akademické centrum výskumu autizmu, Fyziologický ústav, Lekárska fakulta, Univerzita Komenského, Bratislava, Slovensko
2; Výskumný ústav detskej psychológie a patopsychológie, Bratislava, Slovensko
3
Published in:
Čes. a slov. Psychiat., 121, 2025, No. 1, pp. 7-14.
Category:
Review
doi:
https://doi.org/10.48095/cccsp202501
Overview
The aim of this paper is to introduce the importance of assessing adaptive behavior in the context of the changes in the new International Classification of Diseases, 11th Revision. Adaptive behavior is a collection of conceptual, social, and practical skills that individuals learn and use in their daily lives, enabling them to function independently within society. It constitutes age-appropriate conduct, delineated by the expectations of the individual‘s environment, and is amenable to modification throughout life. The ICD-11 has included adaptive behavior among core criteria for diagnosing intellectual disability, as in DSM-5. The assessment of adaptive behavior, conducted through standardized methods, carries equivalent weight to intelligence test results, reflecting a contemporary approach in assessment and intervention planning. Its evaluation is also integral to assessing other neurodevelopmental disorders such as autism spectrum disorders or ADHD, aiding in determining the level of functionality. It also holds significance in neurodegenerative and genetic disorders affecting CNS function. However, the practical challenge remains in assessing it due to the lack of standardized methods for our population for objective evaluation. ICD-11 offers behavioral indicators characteristic of various degrees of intellectual disability across different age groups.
Keywords:
adaptive behavior – autism spectrum disorders – ICD-11– intellectual disabilities –neurodevelopmental disorders
Sources
1. WHO. ICD-11 – International Classification of Diseases 11th Revision. [online]. Available from: https: //icd.who.int/en/. Published 2019.
2. Freeman BJ, Cronin P. Standardized assessment of social skills in autism spectrum disorder. In: Handbook of social skills and autism spectrum disorder. Autism and Child Psychopathology Series. Springer, Cham. 2017.
3. Oakland T, Harrison PL. Adaptive behaviors and skills: an introduction. In: Oakland T, Harrison PL (eds). Adaptive Behavior Assessment System-II.
Practical resources for the mental health professional. Academic Press 2008: 1–20.
4. Saulnier CA, Klaiman C. Essentials of adaptive behavior assessment of neurodevelopmental disorders. John Wiley & Sons 2018: 208.
5. Price JA, Morris ZA, Costello S. The Application of adaptive behaviour models: a systematic review. Behav Sci (Basel) 2018; 8 (1): 11. doi: 10.3390/bs8010011.
6. Schalock RL, Luckasson RA, Shogren KA et al. The renaming of mental retardation: understanding the change to the term intellectual disability. Intellect Dev Disabil 2007; 45 (2): 116–124. doi: 10.1352/1934-9556 (2007) 45[116: TROMRU]2.0.CO; 2.
7. Sparrow SS, Cicchetti DV, Saulnier CA. Vineland adaptive behavior scales, third edition (Vineland-3). Pearson 2016.
8. Saulnier CA, Klaiman C, McQueen E. Adaptive Behavior profiles in autism spectrum disorder. Curr Psychiatry Rep 2022; 24 (12): 749–756. doi: 10.1007/s11920-022-01381-w.
9. Tassé M. Adaptive behavior and functional life skills across the lifespan: conceptual and measurement issues. In: Adaptive behavior strategies for individuals with intellectual and developmental disabilities 2021: 1–20.
10. World Health Organization. How to use the ICF: a practical manual for using the International Classification of Functioning, Disability and Health (ICF). Exposure draft for comment. WHO 2013.
11. AAIDD. Intellectual Disability: Definitions, Classifications, and Systems of Supports (11th ed.). American Association on Intellectual and Developmental Disorders 2010.
12. APA. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed., text rev.). Published 2022.
13. Dočkal V. Mentálne postihnutie v MKCH-11. Psychológia a patopsychológia dieťaťa 2023; 57 (2): 112–142.
14. Grieco J, Pulsifer M, Seligsohn K et al. Down syndrome: cognitive and behavioral functioning across the lifespan. Am J Med Genet C Semin Med Genet 2015; 169 (2): 135–149. doi: 10.1002/ajmg.c.31439.
15. Mohr P, Bravermanová A, Melicher T et al. Funkční schopnosti a spokojenost s léčbou pacientů se schizofrenií v České republice: průřezová studie. Čes a slov Psychiat 2012; 108 (6): 279–285.
16. Ivančík V, Hajdúk M. Súčasné trendy a možnosti hodnotenia funkčnosti u ľudí so schizofréniou. Čes a slov Psychiat 2023; 119 (6): 238–247.
17. Scahill L, McDougle CJ, Aman MG et al. Effects of risperidone and parent training on adaptive functioning in children with pervasive developmental disorders and serious behavioral problems. J Am Acad Child Adolesc Psychiatry 2012; 51 (2): 136–146.
18. Novell R, Esteba-Castillo S, Rodriguez E. Efficacy and safety of a GABAergic drug (Gamalate® B6): effects on behavior and cognition in young adults with borderline-to-mild intellectual developmental disabilities and ADHD. Drugs Context 2020; 9: 212601.
19. Nishimura T, Kato T, Okumura A et al. Trajectories of Adaptive behaviors during childhood in females and males in the general population. Fronti Psychiatry 2022; 13: 817383. doi: 10.3389/fpsyt.2022.
817383.
20. Bornstein MH, Giusti Z, Leach DB et al. Maternal reports of adaptive behaviours in young children: urban-rural and gender comparisons in Italy and United States. Infant and Child Development 2005; 14 (4): 403–424. doi: 10.1002/icd.414.
21. Harrison PL, Oakland T. Adaptive Behavior Assessment System (ABAS-3): Manual. Pearson Clinical Assessment 2015.
22. Hapčová M, Celušáková H, Turoňová D et al. Adaptive behavior in Slovak children with intellectual disability in institutional care. Children (Basel) 2022; 9 (12): 1911.
23. Alexander RM, Reynolds MR. Intelligence and adaptive behavior: a meta-analysis. School Psychology Review 2020; 49 (2): 85–110.
24. Demkaninová D, Hapčová M, Turoňová D. Vzťah exekutívnych funkcií a (mal) adaptívneho správania u detí. Sociálne procesy a osobnosť 2023: 92–99.
25. Will EA, Schworer EK, Esbensen AJ. The role of distinct executive functions on adaptive behavior in children and adolescents with Down syndrome. Child Neuropsychol 2021; 27 (8): 1054–1072. doi: 10.1080/09297049.2021.1917531.
26. Pugliese CE, Anthony L, Strang JF et al. Increasing adaptive behavior skill deficits from childhood to adolescence in autism spectrum disorder: role of executive function. J Autism Dev Disord 2015; 45 (6): 1579–1587. doi: 10.1007/s10803-014-2309-1.
27. Piccolo L da R, Arteche AX, Fonseca RP et al. Influence of family socioeconomic status on IQ, language, memory and executive functions of Brazilian children. Psicol Reflex Crit 2016; 29.
28. Viezel K, Lowell A, Davis A et al. Differential profiles of adaptive behavior of maltreated children. Psychological Trauma: Theory, Research, Practice, and Policy 2014; 6 (5): 574–579. doi: 10.1037/a0036718.
29. Kožený J. Vinelandská škála sociální zralosti: příručka. 1st ed. Psychodiagnostické a didaktické testy 1974.
30. Knobloch H. Manual of developmental diagnosis : the administration and interpretation of the revised Gesell and Amatruda developmental and neurologic examination. Harper & Row 1980.
31. Chadimová L, Jelínek J, Seifert M. Škála měření adaptivních schopností u dětí: první pilotní studie. In: Psychologické Dny 2016: „Možnosti a Hranice Psychologie“: Sborník z Konference. Univerzita Palackého v Olomouci; 2017: 75–88.
32. Szapuova ZJ, Argalasova L, Vondrova D et al. Association between environmental tobacco smoke exposure and adaptive behavior in individuals with autism spectrum disorder. Toxics 2022; 10 (4): 189. doi: 10.3390/toxics10040189.
33. Balboni G, Tassé MJ, Schalock RL, et al. The Diagnostic Adaptive Behavior Scale: evaluating its diagnostic sensitivity and specificity. Res Dev Disabil 2014; 35 (11): 2884–2893. doi: 10.1016/j.ridd.2014.07.032.
34. Lemay KR, Kogan CS, Rebello TJ et al. An international field study of the ICD-11 behavioural indicators for disorders of intellectual development. J Intellect Disabil Res 2022; 66 (4): 376–391. doi: 10.1111/jir.
12924.
35. World Health Organisation. ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines. World Health Organisation 1992.
36. Spreat S. Is adaptive behaviour too normal to be normally distributed? Disability, CBR & Inclusive Development 2017; 28 (3): 71–79. doi: 10.5463/dcid.v28i3.652.
37. Salvador-Carulla L, García-Gutiérrez JC, Ruiz Gutiérrez-Colosía M et al. Borderline intellectual functioning: consensus and good practice guidelines. Rev Psiquiatr Salud Ment 2013; 6 (3): 109–120. doi: 10.1016/j.rpsm.2012.12.001
38. Endrikat EG. Adaptive behavior and posttraumatic symptomatology of physically neglected children. Dissertation. Fairleigh Dickinson University 2017.
39. Dočkal V. Meranie inteligencie. Psychológia a patopsychológia dieťaťa 2014; 48 (suppl 3): 6–28.
40. de Bildt A, Sytema S, Kraijer D et al. Adaptive functioning and behaviour problems in relation to level of education in children and adolescents with intellectual disability. J Intellect Disabil Res 2005; 49 (Pt 9): 672–681. doi: 10.1111/j.1365-2788.2005.00711.x.
41. Hahn LJ, Brady NC, Warren SF et al. Do children with fragile X syndrome show declines or plateaus in adaptive behavior? Am J Intellect Dev Disabil 2015; 120 (5): 412–432. doi: 10.1352/1944-7558-120.5.
412.
42. Pathak M, Bennett A, Shui AM. Correlates of adaptive behavior profiles in a large cohort of children with autism: the autism speaks Autism Treatment Network registry data. Autism 2019; 23 (1): 87–99. doi: 10.1177/1362361317733113.
43. Howlin P, Goode S, Hutton J et al. Adult outcome for children with autism. J Child Psychol Psychiatry 2004; 45 (2): 212–229. doi: 10.1111/j.1469-7610.2004.00215.x.
44. Posar A, Visconti P. Long-term outcome of autism spectrum disorder. Turk Pediatri Ars 2019; 54 (4): 207–212. doi: 10.14744/TurkPediatri Ars.2019.16768.
45. Yang S, Paynter JM, Gilmore L. Vineland adaptive behavior scales: ii profile of young children with autism spectrum disorder. J Autism Dev Disord 2016; 46 (1): 64–73. doi: 10.1007/s10803-015-2543-1.
46. Mayo J, Chlebowski C, Fein DA et al. Age of first words predicts cognitive ability and adaptive skills in children with ASD. J Autism Dev Disord 2013; 43 (2): 253–264. doi: 10.1007/s10803-012-1558-0.
47. Demetriou EA, Lampit A, Quintana DS et al. Autism spectrum disorders: a meta-analysis of executive function. Mol Psychiatry 2018; 23 (5): 1198–1204. doi: 10.1038/mp.2017.75.
48. Bertollo JR, Strang JF, Anthony LG et al. Adaptive behavior in youth with autism spectrum disorder: the role of flexibility. J Autism Dev Disord 2020; 50 (1): 42-50. doi: 10.1007/s10803-019-04220-9.
49. Bertollo JR, Yerys BE. More than IQ: executive function explains adaptive behavior above and beyond nonverbal IQ in youth with autism and lower IQ. Am J Intellect Dev Disabil 2019; 124 (3): 191–205. doi: 10.1352/1944-7558-124.3.191.
50. Balboni G, Incognito O, Belacchi C et al. Vineland-II adaptive behavior profile of children with attention-deficit/hyperactivity disorder or specific learning disorders. Res Dev Disabil 2017; 61: 55–65. doi: 10.1016/j.ridd.2016.12.003.
Mgr. Margaréta Hapčová, PhD.
Katedra psychológie
Filozofická fakulta
Univerzita Komenského
Gondova ulica 2
811 02 Bratislava
Slovensko
e-mail: margareta.hapcova@uniba.sk
Labels
Addictology Paediatric psychiatry PsychiatryArticle was published in
Czech and Slovak Psychiatry

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