Adaptive Behavior as an Alternative Outcome to Intelligence Quotient in Studies of Children at Risk: A Study of Preschool-Aged Children in Flint, MI, USA.

Shuting Zheng,Somer Bishop,Tiffany Ceja,Mona Hanna-Attisha,Kaja LeWinn,Lauren O'Connell

doi:10.3389/fpsyg.2021.692330

Abstract

Intelligence quotient (IQ) is commonly measured in child development studies, while adaptive behavior is less frequently considered. Given its associations with functional outcomes in children with neurodevelopmental disabilities, adaptive behavior may be a useful outcome in general population samples, as well. This study aimed to compare social and environmental correlates of adaptive behavior vs. IQ in a sample of preschoolers exposed to the Flint water crisis (N = 184). Mother–child dyads were recruited from the community and administered a comprehensive battery to obtain information about child neurodevelopmental functioning, including direct assessment of IQ via the Wechsler Preschool and Primary Scale of Intelligence and assessment of parent-reported adaptive functioning via the Vineland Adaptive Behavior Scales. Multiple social environmental factors were explored as potential correlates of child outcomes (i.e., IQ and adaptive behavior), and robust correlates were identified using a data-driven approach [i.e., least absolute shrinkage and selection operator (LASSO) regression]. We then examined associations between the LASSO-selected predictors and IQ and adaptive behavior while controlling for child age, child sex, and maternal age. Children in this sample showed relative strength in adaptive behaviors, with scores in the adequate range, while average IQs fell in the low-average range. Adaptive behavior was significantly associated with maternal nurturance practices, while IQ was associated with the maternal education level. Implications for the use of adaptive behavior as an outcome measure in studies of children at an increased risk for neurodevelopmental problems are discussed.

Highlights

Adaptive behavior is defined as the conceptual, social, and practical skills that are needed to function within his/her environment of an individual in everyday life (Schalock et al, 2021)
The Center for Epidemiological Studies-Depression Scale (CES-D) consists of 20 self-report items assessing for depression
The CAGE–AID is used to screen the respondent for problems associated with drug abuse

Summary

Introduction

Adaptive behavior is defined as the conceptual, social, and practical skills that are needed to function within his/her environment of an individual in everyday life (Schalock et al, 2021). While evidence of a low intelligence quotient (IQ) is still required for a diagnosis of intellectual disability (ID; previously called mental retardation), DSM-5 currently stipulates that the level of ID (i.e., mild, moderate, severe, and profound) should be based on adaptive functioning rather than IQ (American Psychiatry Association, 2013) This reflects the understanding that cognitive and adaptive functioning is correlated, the capacity to acquire a given skill may be different than the likelihood of executing that skill in everyday life (Sparrow and Cicchetti, 1985; Keith et al, 1987; Oakland and Harrison, 2008; Alexander and Reynolds, 2020). Information about the relationship between IQ and adaptive behavior in typically developing populations is more limited and comes mainly from validation studies of adaptive behavior measures showing that, as intended, IQ and adaptive behavior are only moderately correlated (Sparrow et al, 2005, 2016; Harrison and Oakland, 2015)

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