Adaptive Functioning In Adults Research Articles

49 Examining Associations Between Intelligence and Adaptive Functioning in Adults with Down Syndrome at Risk for Alzheimer's Disease

Objective:Individuals with Down syndrome (DS) experience intellectual disability, such that measures of cognitive and adaptive functioning are near the normative floor upon evaluation. Individuals with DS are also at increased risk for Alzheimer's disease (AD) beginning around age 40; and test performances and adaptive ratings at the normative floor make it difficult to detect change in cognition and functioning. This study first assessed the range of raw intelligence scores and raw adaptive functioning of individuals with DS at the normative floor. Next, we assessed whether those raw intelligence scores were predictive of raw adaptive functioning scores, and by association, whether they may be meaningful when assessing change in individuals with a lower baseline of cognitive functioning.Participants and Methods:Participants were selected from a cohort of 117 adults with DS in a longitudinal study examining AD risk. Participants (n=96; M=40.9 years-old, SD=10.67; 57.3% female) were selected if they had both a completed measure of IQ (Kaufmann Brief Intelligence Test; KBIT2) and informant ratings of adaptive functioning (Vineland Adaptive Behavior Scales; VABS-II). Multiple regression was conducted predicting VABS-II total raw score using K-BIT2 total raw score, while controlling for age.Results:A slight majority (57.3%) of the sample had a standardized IQ score of 40 with the majority (95.7%) having a standardized score at or below 60. Additionally, 85.3% of the sample had a standard VABS-II score at or below 60. Within the normative floor for the KBIT2 (IQ=40), there was a normal distribution and substantial range of both KBIT2 raw scores (M = 31.19, SD = 13.19, range: 2 to 41) and VABS-II raw scores (M = 406.33, SD = 84.91, range: 198 to 569). Using the full sample, age significantly predicted raw VABS-II scores (ß = -.283, p = .008). When KBIT2 raw scores were included in the model, age was no longer an independently significant predictor. KBIT2 raw scores significantly predicted raw VABS-II scores (ß = .689, p < .001). Age alone accounted for 8.0% of variance in VABS-II raw scores and KBIT2 raw scores accounted for 43.8% additional variance in VABS-II raw scores. This relationship was maintained when the sample was reduced to individuals at the normative floor (n = 51) where KBIT2 raw scores accounted for 23.7% of the variance in raw VABS-II scores (ß = .549, p < .001).Conclusions:The results indicate that meaningful variability exists among raw intelligence test performances that may be masked by scores at the normative floor. Further, the variability in raw intelligence scores is associated with variability in adaptive functioning, such that lower intelligence scores are associated with lower ratings of adaptive functioning. Considering this relationship would be masked by a reduction of range due to norming, these findings indicate that raw test performances and adaptive functioning ratings may have value when monitoring change in adults with DS at risk for AD.

Functioning assessment short test (FAST): validity and reliability in adults with Autism Spectrum Disorder

BackgroundThe assessment of functional impairment is crucial both for the diagnosis and the therapeutic approach to autism spectrum disorder (ASD). The purpose of the present study was to evaluate whether the FAST is a reliable and valid tool to assess functional impairment in adults with Level 1 ASD and to study the differences in psychosocial functioning between younger and older adults with ASD.MethodsA case–control study was carried out in a sample of 150 participants, 71 adults with Level 1 ASD, and 79 adults without psychiatric history records.ResultsResults showed good psychometric properties in terms of validity and reliability. Cronbach’s alpha for the total scale was .91 and the area under the curve was .98. The study also showed that adults with ASD present different profiles of functional impairment depending on their age: while younger patients present greater impairment in autonomy, older patients show more difficulties in interpersonal relationships.ConclusionsOur results support the use of the FAST in the evaluation of adaptive functioning in adults with Level 1 ASD.

Initial Responsiveness to Reward Attainment and Psychopathology in Children and Adults: An RDoC Study

The Research Domain Criteria (RDoC) initiative of the National Institute of Mental Health (NIMH) established a dimensional framework for understanding psychiatric constructs. Initial Responsiveness to Reward Attainment (IRRA) was identified as a dimensional construct relevant to several psychiatric disorders. The current study aimed to (1) examine IRRA as a predictor of psychopathology and impairment in children and their parents, and (2) examine the potential effects of sex and ancestry on the relationship between IRRA and psychopathology. Participants included 1127 children ages 6 to 12, and 1018 of their parents. Parents and children completed self-report measures of IRRA. Psychopathology and impairment were measured using self-report for adults, and parent-report and semi-structured interview for children. In adults, IRRA was significantly, but modestly, related to adaptive functioning. In children, IRRA was significantly, but modestly, related to overall, school, spare time, home, and peer functioning. Findings suggest IRRA may be a helpful construct for understanding adaptive functioning in adults and children, however it may be less helpful for understanding specific dimensions of psychopathology. Additionally, ancestry should be taken into consideration when examining how IRRA relates to psychopathology and functioning.

C-29Executive and Adaptive Functioning in Adults with Congenital Heart Disease

C-29Executive and Adaptive Functioning in Adults with Congenital Heart Disease

Adaptive Functioning in Williams Syndrome: A Systematic Review

Literature on the level of adaptive functioning and relative strengths and weaknesses in functioning of individuals with Williams syndrome (WS) was reviewed. The electronic databases PsycINFO, PubMed, Expanded Academic, Web of Science, Scopus and ProQuest were searched electronically for relevant articles and dissertations using the search terms ‘Williams syndrome’ or ‘Williams-Beuren syndrome’ combined with ‘adaptive function*’, ‘adaptive behavio*’, ‘independ*’ and ‘autonomy’. Selection criteria included English language articles, theses and book chapters, participants with a diagnosis of Williams syndrome and inclusion of a standardised assessment of adaptive functioning. Twenty-two published articles and two PhD. dissertations (one subsequently published as a poster presentation) met the selection criteria for inclusion in the review. Fifteen investigated adaptive functioning in children and adolescents aged up to 19 years of age, five investigated adaptive functioning in adults and four included participants across a wider age range and included both children and adults. Along with identifying methodological issues, the review addressed the following areas: overall level of adaptive functioning in WS, domain strengths and weaknesses, evidence of heterogeneity, relationship to intellectual ability, changes with chronological age, relationship with maladaptive behaviour, gender differences and the potential influence of environmental factors which may be related to adaptive functioning in WS.

Relationship between psychiatric disorders and adaptive functioning in adults with intellectual disabilities

Purpose – Though the very high prevalence of psychiatric disorders (PD) in people with intellectual disability (PwID), the impact of these disorders on adaptive functioning has been minimally investigated. The few contributions present in the literature focussed on children, adolescents, and individual with autism spectrum disorders (ASD). There are no studies concerning the evaluation of any kind of impact on individual skills. Comparison studies between PD and organic disorders, including neurological disorders (ND), was also underexplored. The purpose of this paper is to assess the impact of the presence of a PD on the adaptive functioning of adults with intellectual disability (ID). Design/methodology/approach – In total, 107 adults with ID living in residential facilities or attending day care centers in Tuscany were consecutively assessed with the Psychiatric Instrument for the Intellectually Disabled Adult (SPAID-G), the Diagnostic Manual-Intellectual Disability (DM-ID) criteria, and the Vineland Adaptive Behavior Scales (VABS). The scores were statistically compared and results were controlled for level of ID and other background variables. Findings – The presence of a PD resulted to have a significant negative impact on individual adaptive skills. Participants with PD scored significantly lower than those without PD in communication and socialization areas of VABS. Participants with ND scored significantly lower than people without ND in daily living and motor skills. The average scores of participants with only PD and those of participants with PD and ND showed no significant differences. Significant differences were found between participants with only ND and participants with ND and PD in the interpersonal relationship subscale. Originality/value – As far as the best knowledge, this is the first study on the evaluation of the impact of any kind of PD on the abilities of PwID. This paper suggests that the presence of a PD seems to have a relevant negative impact on functioning of PwID higher than that of ND, particularly in communication and socialization skills.

Promoting Positive Adaptation in Adult Survivors of Natural Disasters

This article integrates the guidelines of American Red Cross and the Psychological First Aid: Field Operations Guide (Brymer et al., 2006) with adult development theories to demonstrate the promotion of adaptive functioning in adults after a disaster. Case examples and recommendations for counselors working in disaster situations are included. ********** Disasters, natural and human-made, strike with and without warning. Lifetime prevalence for a significant traumatic life event involving posttraumatic stress disorder (PTSD) is estimated at 60.7% for men and 51.2% for women (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995). Lifetime prevalence for exposure to a natural disaster is approximately 20% (Briere & Elliott, 2000; Kessler et al., 1995). Norris, Friedman, Watson, Byrne, et al. (2002) in a study of 60,000 disaster survivors found that between 18% and 21% of the participants indicated severe to very severe impairment. Survivors' rates of PTSD in technological and human-made disasters range from 29% to 54% (McMillen, North, & Smith, 2000), whereas survivors' rates of PTSD in natural disasters are lower, between 4% and 8% (Norris, Friedman, Watson, Byrne, et al., 2002). Study results also indicate that impairment from experiencing a disaster can endure for years (Briere & Elliott, 2000; Grace, Green, Lindy, & Leonard, 1993). Some researchers have called into question the low rates of PTSD because of the stringent criteria for PTSD and given the higher rates of other psychiatric disorders among those with PTSD (Yehuda & McFarlane, 1995). McMillen et al. (2000) proposed that the low rates of PTSD may reflect the stringency of PTSD symptom Criterion C, avoidance and numbing. In a study of Hurricane Hugo survivors 1 to 2 months postdisaster (Norris, Friedman, Watson, Byrne, et al., 2002), 83% met Criterion B (reexperiencing) and 42% met Criterion D (arousal), but only 6% met Criterion C. This criterion is more difficult to meet given that one must exhibit three symptoms in this category; however, the outpouring of community support that often occurs after a disaster may minimize social withdrawal and numbing symptoms (McMillen et al., 2000). McMillen et al. (2000) tested this hypothesis with 130 Northridge, California, earthquake survivors. Of the primarily female sample, 13% met the full criteria for PTSD, whereas 48% met both the reexperiencing and the arousal symptoms Criteria B and D, respectively. As noted earlier, much attention has focused on the psychological effects experienced by survivors in the aftermath of a disaster. Psychologists, licensed professional counselors, social workers, and marriage and family counselors assist survivors of disasters by serving on state and local disaster teams associated with the Disaster Response Network of the American Psychological Association (APA) or by volunteering with the American Counseling Association or the American Red Cross as a disaster mental health volunteer (DMHV). In this article, we integrate adult development theories, the guidelines of the American Red Cross (2005) disaster mental health training workbook, and the principles in the Psychological First Aid: Field Operations Guide (PFA; Brymer et al., 2006) developed by the National Child Traumatic Stress Network in the presentation of case examples of adult disaster survivors who received services from American Red Cross DMHVs. PROBLEMATIC RESPONSES Research on the mental health and psychosocial supports that are most effective during and immediately following a disaster is scarce (Inter-Agency Standing Committee [IASC], 2007). Most empirical studies are conducted in the months and years after a disaster. It is well known that specific subgroups of the population are considered to be at increased risk during a natural disaster. Women, children, older adults, individuals who are poor, and young men who become targets of violence are among the most vulnerable (Cronkite & Moos, 1984; Kessler et al. …

Cognitive, Linguistic and Adaptive Functioning in Williams Syndrome: Trajectories from Early to Middle Adulthood

Background Little is known about trajectories of cognitive functioning as individuals with Williams syndrome (WS) move though adulthood.Method The present study investigated cognitive, linguistic and adaptive functioning in adults with WS aged 19–55 years, using both cross‐sectional and longitudinal approaches.Results Data from the cross‐sectional study (n = 92; mean age = 32 years) indicated that IQ was comparable across age groups (Full‐Scale IQ mean = 56–57) with Verbal IQ being slightly higher than Performance IQ. Daily Living Skills (as measured by the Vineland Adaptive Behavior Scales) were significantly higher in older individuals. Language abilities showed no consistent age‐related differences. On formal tests of language, comprehension scores were higher than expressive language scores for almost all individuals, although this pattern was not replicated on the Vineland. In the longitudinal study, a follow‐up of 47 individuals (mean age = 37 years) first assessed 12 years previously, similar trajectories were found. IQ remained very stable (FSIQ = 61–62 at both time points); there were significant improvements on the Social and Daily Living domains of the Vineland and significant decreases in Maladaptive scores. There were no improvements in language over time.Conclusions The data indicate that adults with WS (at least up to the age of 50 years) show no evidence of deterioration in cognitive skills. Adaptive abilities continue to develop although language shows relatively little improvement with time.

Health and social outcomes in adults with Williams syndrome: Findings from cross-sectional and longitudinal cohorts

Previous studies have investigated trajectories of cognitive, language and adaptive functioning in Williams syndrome (WS) but little is known about how other aspects of the Williams syndrome behavioural phenotype change across the life-span. Therefore, the present study examined age associated changes in a number of different domains of functioning in adults with WS. Semi-structured interviews and standardized assessments of physical health, educational and occupational levels, self-care and independence, social interactions, and behavioural difficulties were conducted with adults with WS and their parents/carers. Ninety-two individuals with genetic confirmation of WS (50 males, 42 females) participated in a cross-sectional study (age range 19–55 years; mean 32 years) and 43 individuals (21 males, 22 females) were involved in a longitudinal study as they had taken part in a previous study of adults with WS. Not all individuals in the longitudinal cohort had genetically confirmed WS. Cross-sectional analyses revealed no age related differences in the areas of functioning investigated. However, in the longitudinal sample, significant improvements were reported in physical health, self-care and occupational skills. Social skills and adaptive behaviours had generally improved while behavioural difficulties had declined. In both cross-sectional and longitudinal cohorts there were significant correlations between adaptive functioning and IQ. These findings are consistent in indicating no age related decline in social or adaptive functioning in adults with WS, at least up to the age of 50–55 years.

The effect of Autism Spectrum Disorders on adaptive independent living skills in adults with severe intellectual disability

Autism Spectrum Disorders are a class of conditions categorized by communication problems, ritualistic behaviors, and deficits in social behaviors. While evidence supporting a genetic component of Autism Spectrum Disorders (ASDs) is strong, no specific genetic marker has been identified. Thus, professionals have had to utilize intelligence tests and measures of adaptive functioning to aid in the diagnosis of individuals with ASD. The present study aimed to isolate specific differences in adaptive functioning in adults with ASD. Two hundred and thirty-four adults with ASD (Autism Spectrum Disorder) or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) and intellectual disabilities (IDs) were evaluated with respect to the nature and extent of their independent living skill functioning. The implications of these data for more fully describing and diagnosing autism and PDD-NOS in adults are discussed.

The utility of self-report measures and the continuous performance test in the diagnosis of ADHD in adults.

Attention-deficit/hyperactivity disorder (ADHD) occurs in as many as 4 percent of adults yet it is often not recognized in clinical settings because the presenting symptoms may resemble those seen in other disorders or because symptoms may be masked by commonly comorbid conditions such as anxiety and depression. The purpose of this study was to examine the diagnostic utility of instruments commonly used in the assessment of adults presenting with symptoms of ADHD. We reviewed several widely used self-report and laboratory measures and empirically examined the utility of the Brown Attention-Deficit Disorder Scale for Adults (Brown ADD Scale) and the Conners Continuous Performance Test (CPT) in differentially identifying adults with ADHD and those with other Axis I disorders. Ninety-three adults who self-referred to the ADHD program for adults at a university medical center participated in the study. Of these, 44 had ADHD combined subtype (ADHD-CB), and 26 had ADHD, predominantly inattentive subtype (ADHD-IA). Thirty-three non-ADHD adults diagnosed with Axis I mood or anxiety disorders comprised an "Other Psychiatric" group. Rates of comorbid disorders, including substance abuse, in the ADHD groups were typical of those reported in the adult ADHD literature. Data on the Brown ADD Scale and on the CPT were available for subsets of 61 and 46 participants, respectively. Analyses showed that the ADHD-CB, ADHD-IA, and Other Psychiatric groups all received mean scores in the clinical range on the Brown ADD Scale, with a trend toward even higher elevations in the two ADHD groups. Among 12 CPT variables assessed for the three groups, the mean scores on only two variables for the ADHD-IA group were clinically elevated. Neither the Brown ADD Scale nor CPT scores evinced sufficient sensitivity and specificity to qualify them to assist in differential diagnosis of ADHD vis-a-vis other, predominantly internalizing, psychiatric disorders. The results indicate a need for closer examination of executive and adaptive functioning in adults with ADHD compared with those with internalizing disorders in order to identify features that could assist in differential diagnosis.

Integration of Information Between the Cerebral Hemispheres

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Right hemisphere dysfunction in nonverbal learning disabilities: Social, academic, and adaptive functioning in adults and children.

This review addresses recent research on social and nonverbal learning disabilities. Involvement of right hemispheric dysfunction in these disabilities has been hypothesized, as studies with adults have suggested that documented right hemisphere damage may lead to deficits in social skills, prosody, spatial orientation, problem solving, and recognition of nonverbal cues. Studies of children purported to evidence nonverbal learning disabilities are reviewed and compared with the results from studies of adults with right hemisphere damage. Specific subtypes of nonverbal learning disabilities are reviewed, including the nonverbal perceptual-organization-output subtype, Asperger's Syndrome, Developmental Gerstmann Syndrome, left hemisyndrome, right hemisphere syndrome, and right parietal lobe syndrome. Finally, implications and future research needs are addressed. The need for a diagnostic nosology and improved and validated intervention techniques is stressed as is early identification of these types of specific nonverbal learning disabilities.

Right hemisphere dysfunction in nonverbal learning disabilities: Social, academic, and adaptive functioning in adults and children.

Right hemisphere dysfunction in nonverbal learning disabilities: Social, academic, and adaptive functioning in adults and children.