Adaptive Behavior Comparisons for Children with Intellectual Disabilities and Dual Diagnoses Autism Spectrum/ Intellectual Disabilities Laura Murphy, Ed.D., Sacha Bliss, Ph.D., Lauren Gardner, Ph.D., Colby Reed, Ph.D., Kerrie Murphy, Ph.D., Nichol Pritchard, Ph.D., and Fred Palmer, M.D.
Background & Introduction Children with Intellectual Disabilities (ID) and those with dual diagnoses Autism Spectrum Disorders and Intellectual Disabilities (ASD/ID) demonstrate social deficits (APA, 2000). Social adaptive functioning, an aspect of social behavior, uniquely measures the daily activities required for personal and social sufficiency (Sparrow, Cicchetti, and Balla, 2005). To more fully explore the core social behaviors of children with ASD, it is important that research comparisons of children with ASD/ID be made to those with ID within the same chronological age range and with commensurate intellectual functioning. Further, because African American children may be diagnosed with ASD at later stages, (Mandell, Ittenbach, Levy, & Pinto-Martin, 2002) comparable representation of African American within the ID and ASD/ID group is also desirable. This study compared the social adaptive functioning of children diagnosed with ID to those with ASD/ID. Ethnicity within the ID and ASD/ID group was comparable as was chronological age and intellectual functioning. It was hypothesized that adaptive scores in communication, daily living, and socialization would be significantly higher for ID than ASD/ID. No differences were hypothesized for adaptive motor skills.
Study Description
Participants: 133 children ages 21 months to 71 months (M=50.00 , SD =12.82). There were 52 children with ID and 81 children with ASD/ID.
Table 1.
Diagnostic Determination: An interdisciplinary or psychology team determined the diagnosis of ID or ASD/ID. Disagreements were resolved by consensus.
Diagnostic Reliability: Subset of 30 children were independently rated for ID or ASD/ID by a psychologist and developmental pediatrician. Ratings yielded high inter-rater reliability (.93)
IQ Measures: Stanford Binet 5 (Roid, 2003) Hypotheses:
ID group will score significantly higher than ASD/ID group for Communication, Daily Living, Socialization, and Vineland-II Composite Partial support for Hypotheses was found
Participant Age Table 1.
No difference Between Groups
Ethnicity of ID & ASD/ID groups did not significantly differ.
Chronological age did not significantly differ by group.
Mental age did not significantly differ by group.
The Composite, Communication, Daily Living, Socialization, & Motor were compared for all groups.
Group
Communication Daily Living Socialization Motor Skills
Mean (SD)
ID, n=52
63.63 (12.59)
ASD/ID, n= 81
60.69 (14.27)
ID, n= 44
64.32 (11.95)
ASD/ID, n= 76
60.84(11.81)
ID, n=44
69.45(15.39)
ASD/ID, n=75
66.93(14.53)
ID, n= 44
71.16(12.24)
ASD/ID, n= 75
64.03(12.05)
ID, n= 41
71.88(17.60)
ASD/ID, n= 75
71.87(17.90)
72
68
66
62
60
Participant Age Chronological Age Mental Age
Months (SD) 50.00 (12.80) 26.11(7.50)
Ethnic Composition n (%) African American 83 (62%) White 43 (32%) Other 7 (5%) Table 2. Child Intellectual Functioning (n = 133) Stanford Binet 5 Edition Full Scale IQ
Mean (SD) 53.89(10.62)
Analysis: •
Vineland-II Domain Composite
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Adaptive Behavior Measure: Social adaptive functi0oning was rated on the Vineland Adaptive Behavior Scales-II: Interview Edition (Vineland-II; Sparrow, Cicchetti, and Balla, 2005) by the child’s caregiver.
Table 3. Vineland Domain Means (SD)
In general the ASD group tended to have slightly lower domain mean scores than the ID group on the Vineland-II; however, differences between the groups were not significant except for the Socialization Domain. Lower socialization has previously been documented (Volkmar, et al, 1987). Mean scores in the Motor Skill domain were very similar for the ID and ASD groups (e.g., 71.88 and 71.87 respectively). These findings suggest that when using the Vineland-II to assist in differentiating young children with ID from those with ASD/ID, the most sensitive adaptive skill is socialization. As adaptive skills are modifiable (Sparrow, et al, 2005), implications for intervention with each diagnostic group will be discussed.
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This study compared social adaptive functioning of children diagnosed with ID to those with ASD/ID. For this sample of young children, the ID group scored significantly higher on Vineland-II Interview Edition Socialization Domain than the ASD/ID group.
Methods
Discussion
Results
Nonverbal IQ
59.33(12.73)
58
56
54 Com
Table 4. VABS-II Domain Composite Communication Daily Living Socialization
Verbal IQ
54.38(10.65)
Motor
DaLiv
Soc
Motr
Comp
References Sparrow, Sara S., Cicchetti, Domenic, V., and Balla, David A.. (2005). Vineland Adaptive Behavior Scales-II. : Interview Edition. Circle Pines, MN: American Guidance Service.
M Comparisons ID, n=52 ASD/ID, n= 81 ID, n= 44 ASD/ID, n= 76 ID, n=44 ASD/ID, n=75 ID, n= 44 ASD/ID, n= 75 ID, n= 41 ASD/ID, n= 75
t 1.24
p= .227
1.547 .125 .894
.373
3.099 .002 .003
.997
Mandell, D.S., Ittenbach, R.F., Levy, S.E., & Pinto-Martin, J.A. (2007). Disparities in diagnosis received prior to a diagnosis of autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(9), 1795-1802. Roid, Gale H. Stanford Binet Intelligence Scales: Fifth Edition. (2005). Rolling Meadows, Il. : Riverside Publishing. Volkmar, F.R., Sparrow, S.S., Goudreau, D., Cicchetti, D/V/, Paul, R., Cohen, D.J. (1987). Journal of the American Academy of Child and Adolescent Psychiatry, 26, 2, 156-161.
Acknowledgements: We would like to thank the children and caregivers who participated in this study. We would also like to thank the psychology staff who assisted with data collection: Leah Adams, Haley Hawkins, Sarah McMurtry, Preeti Rao, Brittany Reyes, Colby Taylor, and Rachel Tillery.