Abstract
Purpose of Review
The goal of this paper is to provide an overview of profiles of adaptive behavior in autism spectrum disorder and highlight the importance of these everyday skills in optimizing self-sufficiency throughout life.
Recent Findings
Research has clearly confirmed that adaptive deficits exist in ASD, particularly in social skills. These impairments are highly associated with co-occurring conditions such as executive functioning impairments, psychiatric conditions, and even psychosis. There tends to be a discrepancy between intellectual capacity and adaptive functioning, particularly in autistic individuals without cognitive and language delays, with this gap widening between childhood and adulthood.
Summary
Although cognition and language skills are associated with good outcome in ASD, they are insufficient in the absence of intact adaptive behavior. There is a critical need to emphasize the importance of adaptive functioning in diagnostic evaluations and treatment/intervention programs to ensure that every autistic individual has the potential for success.
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References
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Sparrow SS, Cicchetti DV, Saulnier CA. Vineland Adaptive Behavior Scales, Third Edition (Vineland-3). 3rd ed. Bloomington, MN: NCS Pearson; 2016.
Volkmar FR, Sparrow SS, Goudreau D, Cicchetti DV, Paul R, Cohen DJ. Social deficits in autism: an operational approach using the Vineland Adaptive Behavior Scales. J Am Acad Child Adolesc Psychiatry. 1987;26(2):156–61.
Carter A, Volkmar FR, Sparrow SS, Wang JJ, Lord C, Dawson G, et al. The Vineland Adaptive Behavior Scales: supplementary norms for individuals with autism. J Autism Dev Disord. 1998;28(4):287–302.
Volkmar FR, Cohen DJ. Current concepts: infantile autism and the pervasive developmental disorders. J Dev Behav Pediatr. 1986;7(5):324–9.
Maenner MJ, Shaw KA, Bakian AV, Bilder DA, Durkin MS, Esler A, et al. Prevalence and Characteristics of autism spectrum disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 Sites, United States, 2018. MMWR Surveill Summ. 2021;70(11):1–16.
Szatmari P, Bryson SE, Boyle MH, Streiner DL, Duku E. Predictors of outcome among high functioning children with autism and Asperger syndrome. J Child Psychol Psychiatry. 2003;44(4):520–8.
•• Alvares GA, Bebbington K, Cleary D, Evans K, Glasson EJ, Maybery MT, et al. The misnomer of “high functioning autism”: Intelligence is an imprecise predictor of functional abilities at diagnosis. Autism. 2020;24(1):221–32. This study investigated the relationship between adaptive behavior, cognitive estimates, and age at diagnosis in ASD and helped further hone our understanding of the nuance of adaptive behavior in autistic individuals.
Howlin P, Moss P, Savage S, Rutter M. Social outcomes in mid- to later adulthood among individuals diagnosed with autism and average nonverbal IQ as children. J Am Acad Child Adolesc Psychiatry. 2013;52(6):572-81.e1.
American Psychiatric Association. The diagnostic and statistical manual of mental disorders, fifth edition: DSM-5. Arlington: American Psychiatric Association; 2013.
Meyers CE, Nihira K, Zetlin A. The measurement of adaptive behavior. Hillsdale, NJ: Lawrence Erlbaum Associates; 1979.
World Health Organization. The ICD-10 classification of mental and behavioral disorders. Geneva: Author; 1992.
•• Tassé MJ, Balboni G, Navas P, Luckasson R, Nygren MA, Belacchi C, et al. Developing behavioural indicators for intellectual functioning and adaptive behaviour for ICD-11 disorders of intellectual development. J Intellect Disabil Res. 2019;63(5):386–407. This study helps pave the way for ensuring adaptive behavior skills are a part of comprehensive intervention planning for individuals with autism and other developmental disabilities.
Kanne SM, Gerber AJ, Quirmbach LM, Sparrow SS, Cicchetti DV, Saulnier CA. The role of adaptive behavior in autism spectrum disorders: implications for functional outcome. J Autism Dev Disord. 2011;41(8):1007–18.
Meyer AT, Powell PS, Butera N, Klinger MR, Klinger LG. Brief report: developmental trajectories of adaptive behavior in children and adolescents with ASD. J Autism Dev Disord. 2018;48(8):2870–8.
Doll EA. Idiot, imbecile, and moron. J Appl Psychol. 1936;20(4):427–37.
Doll EA. The measurement of social competence: a manual for the Vineland Social Maturity Scale. Minneapolis, MN: Educational Test Bureau, Educational Publishers, Inc.; 1953.
Sparrow SS, Balla D, Cicchetti DV. Vineland Adaptive Behavior Scales. Expanded. Circle Pines, MN: American Guidance Service; 1984.
Chatham CH, Taylor KI, Charman T, Liogier D’ardhuy X, Eule E, Fedele A, et al. Adaptive behavior in autism: minimal clinically important differences on the Vineland-II. Autism Res. 2018;11(2):270–83.
Scahill L, Bearss K, Lecavalier L, Smith T, Swiezy N, Aman MG, et al. Effect of parent training on adaptive behavior in children with autism spectrum disorder and disruptive behavior: results of a randomized trial. J Am Acad Child Adolesc Psychiatry. 2016;55(7):602-9.e3.
Bradshaw J, Bearss K, McCracken C, Smith T, Johnson C, Lecavalier L, et al. Parent education for young children with autism and disruptive behavior: response to active control treatment. J Clin Child Adolesc Psychol. 2018;47(sup1):S445–55.
Reichow B, Hume K, Barton EE, Boyd BA. Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2018;5(5):Cd009260.
Fuller EA, Oliver K, Vejnoska SF, Rogers SJ. The effects of the early start denver model for children with autism spectrum disorder: a meta-analysis. Brain Sci. 2020;10(6).
Georgia Department of Community Health Medicaid. Policies and Procedures for autism spectrum disorder services. 2022.
Sundberg ML. Verbal behavior milestones assessment and placement program: the VB-MAPP. Concord, CA: AVB Press; 2008.
Partington JW. The Assessment of Basic Language and Learning Skills: ABLLS-R Protocol: Behavior Analysts Incorporated; 2008.
Klin A, Saulnier CA, Sparrow SS, Cicchetti DV, Volkmar FR, Lord C. Social and communication abilities and disabilities in higher functioning individuals with autism spectrum disorders: the Vineland and the ADOS. J Autism Dev Disord. 2007;37(4):748–59.
Ray-Subramanian CE, Huai N, Ellis WS. Brief report: adaptive behavior and cognitive skills for toddlers on the autism spectrum. J Autism Dev Disord. 2011;41(5):679–84.
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.
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.
• Hodge MA, Boulton KA, Sutherland R, Barnett D, Bennett B, Chan E, et al. Predictors of adaptive functioning in preschool aged children with autism spectrum disorder. Autism Res. 2021;14(7):1444–55. This study exmained contributing factors to variability in adaptive behavior in preschool children with autism and further highlights that autism symptom severity is not a predictor of varaibility in adaptive behavior.
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.
Di Rezze B, Duku E, Szatmari P, Volden J, Georgiades S, Zwaigenbaum L, et al. Examining trajectories of daily living skills over the preschool years for children with autism spectrum disorder. J Autism Dev Disord. 2019;49(11):4390–9.
Ventola P, Saulnier CA, Steinberg E, Chawarska K, Klin A. Early-emerging social adaptive skills in toddlers with autism spectrum disorders: an item analysis. Journal of autism and developmental disorders. 2011.
Farmer C, Swineford L, Swedo SE, Thurm A. Classifying and characterizing the development of adaptive behavior in a naturalistic longitudinal study of young children with autism. J Neurodev Disord. 2018;10(1):1.
Miller LE, Dai YG, Fein DA, Robins DL. Characteristics of toddlers with early versus later diagnosis of autism spectrum disorder. Autism. 2021;25(2):416–28.
Kraper CK, Kenworthy L, Popal H, Martin A, Wallace GL. The gap between adaptive behavior and intelligence in autism persists into young adulthood and is linked to psychiatric co-morbidities. Journal of autism and developmental disorders. 2017.
Kojovic N, Ben Hadid L, Franchini M, Schaer M. Sensory Processing issues and their association with social difficulties in children with autism spectrum disorders. J Clin Med. 2019;8(10).
Zukerman G, Yahav G, Ben-Itzchak E. The gap between cognition and adaptive behavior in students with autism spectrum disorder: implications for social anxiety and the moderating effect of autism traits. J Autism Dev Disord. 2021;51(5):1466–78.
Voulgarakis HM, Saulnier CA, Bendell-Estroff D, Bush JP, Field TM. Deficits in socialization and daily living skills associated with gastrointestinal symptoms in children with autism spectrum disorder. Child Health Care. 2021;50(4):398–412.
Tillmann J, San José Cáceres A, Chatham CH, Crawley D, Holt R, Oakley B, et al. Investigating the factors underlying adaptive functioning in autism in the EU-AIMS Longitudinal European Autism Project. Autism Research. 2019;12(4):645–57.
Dijkhuis R, de Sonneville L, Ziermans T, Staal W, Swaab H. Autism symptoms, executive functioning and academic progress in higher education students. J Autism Dev Disord. 2020;50(4):1353–63.
Demetriou EA, Lampit A, Quintana DS, Naismith SL, Song YJC, Pye JE, et al. Autism spectrum disorders: a meta-analysis of executive function. Mol Psychiatry. 2018;23(5):1198–204.
Tschida JE, Yerys BE. Real-world executive functioning for autistic children in school and home settings. Autism. 2022;26(5):1095–107.
Wallace GL, Kenworthy L, Pugliese CE, Popal HS, White EI, Brodsky E, et al. Real-world executive functions in adults with autism spectrum disorder: profiles of impairment and associations with adaptive functioning and co-morbid anxiety and depression. J Autism Dev Disord. 2016;46(3):1071–83.
Gilotty L, Kenworthy L, Sirian L, Black DO, Wagner AE. Adaptive skills and executive function in autism spectrum disorders. Child Neuropsychol. 2002;8(4):241–8.
Peterson RK, Noggle CA, Thompson J, Davis JJ, editors. Everyday executive functioning influences adaptive skills in autism spectrum disorders. 2015.
Pugliese CE, Anthony L, Strang JF, Dudley K, Wallace GL, Kenworthy L. Increasing adaptive behavior skill deficits from childhood to adolescence in autism spectrum disorder: role of executive function. J Autism Dev Disord. 2015;45(6):1579–87.
Pugliese CE, Anthony LG, Strang JF, Dudley K, Wallace GL, Naiman DQ, et al. Longitudinal examination of adaptive behavior in autism spectrum disorders: influence of executive function. J Autism Dev Disord. 2016;46(2):467–77.
Craig F, Margari F, Legrottaglie AR, Palumbi R, de Giambattista C, Margari L. A review of executive function deficits in autism spectrum disorder and attention-deficit/hyperactivity disorder. Neuropsychiatr Dis Treat. 2016;12:1191–202.
Yerys BE, Bertollo JR, Pandey J, Guy L, Schultz RT. Attention-deficit/hyperactivity disorder symptoms are associated with lower adaptive behavior skills in children with autism. J Am Acad Child Adolesc Psychiatry. 2019;58(5):525-33.e3.
Matson JL, Rivet TT, Fodstad JC, Dempsey T, Boisjoli JA. Examination of adaptive behavior differences in adults with autism spectrum disorders and intellectual disability. Res Dev Disabil. 2009;30(6):1317–25.
Matthews NL, Pollard E, Ober-Reynolds S, Kirwan J, Malligo A, Smith CJ. Revisiting cognitive and adaptive functioning in children and adolescents with autism spectrum disorder. J Autism Dev Disord. 2015;45(1):138–56.
Kirby AV, Baranek GT, Fox L. Longitudinal predictors of outcomes for adults with autism spectrum disorder: systematic review. OTJR: Occupation, Participation and Health. 2016;36(2):55–64.
Landmark LJ, Zhang D. Compliance and practices in transition planning. Remedial and Special Education. 2013;34(2):113–25.
Clarke EB, McCauley JB, Lord C. Post-high school daily living skills in autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2021;60(8):978–85.
Buescher AV, Cidav Z, Knapp M, Mandell DS. Costs of autism spectrum disorders in the United Kingdom and the United States of America. JAMA Pediatrics. 2014.
Partington JW, Mueller MM. The assessment of functional living skills guide. Matawan, NJ: Behavior Analysts Inc; 2012.
Killion WK. Functional Independence Skills Handbook (FISH) Assessment and curriculum for individuals with developmental disabilities kit. Austin, TX: Pro Ed; 2003.
Harrison P, Oakland T. Adaptive Behavior Assessment System, Third Edition (ABAS-3). Torrance, CA: Western Psychological Services; 2015.
Tasse MJ, Schalock RL, Balboni G, Bersani H, Borthwick-Duffy SA, Spreat S, et al. Diagnostic adaptive behavior scale: user’s manual. Washington, DC: American Association on Intellectual and Developmental Disabilities; 2017.
McCarney SB, House SN. Adaptive Behavior Evaluation Scale. 3rd ed. Columbia, MO: Hawthorne Educational Services, Inc.; 2017.
Bayley N, Aylward GP. Bayley Scales of Infant and Toddler Development, Fourth Edition. San Antonio, TX. 2019.
Acknowledgements
The authors would like to acknowledge the contributions of Drs. Edgar Doll, Sara Sparrow, and Domenic Cicchetti to our understanding of adaptive behavior profiles in neurodevelopmental disorders.
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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).
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Celine A. Saulnier receives royalties from Pearson Assessments for her authorship on the Vineland-3. Cheryl Klaiman and Emma McQueen have no conflicts of interest to disclose.
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Saulnier, C.A., Klaiman, C. & McQueen, E. Adaptive Behavior Profiles in Autism Spectrum Disorder. Curr Psychiatry Rep 24, 749–756 (2022). https://doi.org/10.1007/s11920-022-01381-w
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DOI: https://doi.org/10.1007/s11920-022-01381-w