Diagnostic Assessment For The Severely Handicapped-II Research Articles

Convergent validity of the Autism Spectrum Disorders-Diagnostic Adult (ASD-DA) with the Pervasive Developmental Disorder/Autism subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II)

The Autism Spectrum Disorders-Diagnosis for Adults (ASD-DA) is a standardized assessment used to measure autistic symptomatology in adults with intellectual disabilities (ID). In order to further establish the validity of this measure, convergent validity of the ASD-DA was established by comparing ASD-DA total and subscales scores with the Pervasive Developmental Disorder/Autism (PDD/Autism) subscale score on the Diagnostic Assessment for the Severely Handicapped-II (DASH-II). Data was collected from 278 adults residing in two large supports and services centers in the southeastern region of the United States. The ASD-DA total scores and all subscale scores correlated with the PDD/Autism subscale score at the p<.001 level, further supporting the validity of the ASD-DA as a valid measure of autistic symptoms in adults with ID. The implications of these findings are discussed.

Symptoms of psychopathology in adults with intellectual disability and seizures

Seizures are more common in individuals with intellectual disabilities than in the general population. As a result, differences in functioning for individuals with intellectual disability with and without seizures have been evaluated. Research on differences in psychopathology for individuals with intellectual disability with and without seizures has been mixed. The purpose of this study was to examine differences in subscale scores on the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) between individuals with intellectual disability with and without seizures. In this study, 321 individuals from two large developmental centers in the southeastern United States were administered the DASH-II. Researchers found that the seizure group endorsed significantly more symptoms on the mood subscale than the group without seizures. No other group differences were found to be significant. Implications of these results are discussed.

The effects of gender and age on repetitive and/or restricted behaviors and interests in adults with autism spectrum disorders and intellectual disability

Frequency of repetitive and/or restricted behaviors and interests (RRBIs) was assessed in 140 adults with autism spectrum disorders (ASDs) and severe or profound intellectual disability (ID). The associations of gender and age range were analyzed with RRBI frequency which was obtained using the Stereotypies subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II). A significant main effect of gender was found. Male participants had higher frequency of RRBIs than females regardless of age range. There was not a significant main effect of age range or a significant interaction between gender and age range. Results and implications are discussed.

The Interrelationships of Psychopathology Symptoms on Social Skills in Adults with Autism or PDD-NOS and Intellectual Disability

Autism Spectrum Disorders (ASD) are debilitating, life long conditions which are known to co-occur with intellectual disability (ID) and comorbid psychopathology. All of these are risk factors, yet little has been done to explore the degree that these variables alone and in combination impact the well being of such persons. Three-hundred and two adults with severe or profound ID were studied. From the total sample, 137 evinced ASD (either autism or PDD-NOS). The Diagnostic Assessment for the Severely Handicapped-II (DASH-II) was used to assess psychopathology symptoms. Social behaviors were assessed using the Matson Evaluation of Social Skills for Individuals with sEvere Retardation (MESSIER). For participants with ASD, psychopathology symptoms, particularly impulse and mania, were associated with negative social behaviors (i.e., nonverbal, verbal, and general) as well as positive verbal and nonverbal social skills. For participants with ID only, impulse symptoms, as well as symptoms of mania, PDD/autism, anxiety, organic, and stereotypy were associated with negative social behaviors, but not positive social skills as was found for participants with ASD.

The validity of the autism spectrum disorders-diagnosis for intellectually disabled adults (ASD-DA)

Psychologists interviewed direct-care staff using a battery of assessment measures including the autism spectrum disorders-diagnosis for intellectually disabled adults (ASD-DA), the Diagnostic Assessment for the Severely Handicapped-II (DASH-II), the Matson Evaluation of Social Skills for Individuals with Severe Retardation (MESSIER), the Socialization domain of the Vineland Adaptive Behavior Scales (VABS), and a checklist containing criteria for autism and PDD-NOS from the DSM-IV-TR and ICD-10. Three hundred and seven intellectually disabled (ID) adolescents and adults ranging in age from 16 to 88 were assessed. Participants were diagnosed with either ID and ASD (autism or PDD-NOS; n = 156) or ID and no Axis I diagnosis ( n = 151). A modification of the multitrait–multimethod approach was used to establish the convergent and discriminant validity of the ASD-DA. The scale proved to have robust convergent validity when correlated with the DSM-IV-TR/ICD-10 checklist, MESSIER, and Socialization domain of the VABS. Additionally, discriminant validity was demonstrated by comparing the ASD-DA to items from the DASH-II (measure of general psychopathology). The implications of these data are discussed.

Patterns of emotional and behavioural disturbance associated with autistic traits in young people with severe intellectual disabilities and challenging behaviours

Emotional and behavioural disturbance was assessed in 82 individuals with severe intellectual disabilities and challenging behaviour using the Diagnostic Assessment for the Severely Handicapped-II (DASH-II). Levels of disturbance were compared firstly in individuals with and without features of autism as assessed by the DASH-II, and secondly in individuals with varying severities of autism. In both cases levels of ability and overall severity of behaviour disorder were comparable across groups. Individuals with autistic features were found to have significantly higher scores than nonautistic individuals on the DASH-II organic disorder, anxiety, mania, PDD/autism and stereotypies subscales. When participants with autistic features were separated into groups of severe and moderate autism and compared with nonautistic participants, significant effects of group were found for scores on the anxiety, mood, mania, PDD/autism, schizophrenia and stereotypies subscales. Scheffé tests were conducted to further evaluate between-group differences. Item analysis showed seven DASH-II items to have a 30% or more difference between levels of endorsement in autistic and nonautistic individuals, with six further items showing a 20% or greater difference in levels of endorsement. Findings are compared to those from previous research and implications for the conceptualisation of emotional and behavioural disorders in individuals with autism are discussed.

Correlates of restraint use in an institutional population: a replication

Reducing inappropriate restraint is an important mission of services for people with intellectual disabilities (IDs). In this study, 52 clients who had been restrained were compared with 52 other clients, individually matched on age, gender and level of IDs. Participants were mostly adults with severe and profound IDs in an institutional setting. The two groups differed on six Diagnostic Assessment for the Severely Handicapped-II (DASH-II) and three Aberrant Behaviour Checklist (ABC) scales. However, discriminant functional analysis demonstrated that only DASH-II Impulse control disorder and ABC Irritability and Elimination disorder scores predicted group membership but only moderately. Individual differences in maladaptive behaviours were only moderately predictive of restraint use.

Validity of the sleep subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II)

Currently there are no available sleep disorder measures for individuals with severe and profound intellectual disability. We, therefore, attempted to establish the external validity of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) sleep subscale by comparing daily observational sleep data with the responses of direct care staff to the sleep subscale of the DASH-II. Participants included 25 individuals with severe intellectual disability and 25 individuals with profound intellectual disability who reside in a large developmental center in central Louisiana. Four of the five items of the DASH-II were shown to have external validity. Implications of these findings for future research and practice are discussed.

Assessment of Schizophrenia in Persons with Severe and Profound Mental Retardation Using the Diagnostic Assessment for the Severely Handicapped-II (DASH-II)

The identification and diagnosis of schizophrenia in persons with severe and profound mental retardation has been a controversial issue. Although it has been established that schizophrenia occurs in this clinical population, persons with odd behaviors characteristic of mental retardation or severe behavior disturbances are often diagnosed with schizophrenia and treated with traditional or atypical antipsychotic medications. The present study assessed schizophrenia in a sample of persons with severe and profound mental retardation using the Diagnositic Assessment for the Severly Handicapped-II (DASH-II), a rating scale which contains purely behavioral criteria that are essential features of various DSM-IV disorders. Three groups of participants were compared; (a) those with an independent psychiatric diagnosis of schizophrenia and a significant elevation on the schizophrenia subscale of the DASH-II; (b) those with a significant elevation on this subscale, but no formal diagnosis of schizophrenia; and (c) controls without any elevation of the DASH-II subscales. Results indicated that the three groups were empirically distinguished across the frequency, duration, and severity dimensions of the DASH-II schizophrenia subscale. Item analyses demonstrated that individuals with a diagnosis of schizophrenia and an elevation of the subscale had higher scores on items containing verbal symptoms of the disorder. Implications of these findings are discussed with respect to the diagnosis of schizophrenia in persons with severe and profound mental retardation, with particular emphasis on the efficacy of the DASH-II for assessing the disorder.

Characteristics of depression as assessed by the diagnostic assessment for the severely handicapped-II (DASH-II)

Fifty-seven individuals with severe and profound mental retardation (18 with a DSM-IV diagnosis of depression, 19 with a Diagnostic Statistical Manual, 4th edition diagnosis of autism, and 20 who meet no criteria for an emotional disorder) were studied. The validity of the Diagnostic Assessment for the Severely Handicapped II depression subscale was evaluated to determine its value in categorizing individuals in these two groups. Suggestions were made for diagnosing depression in persons with severe and profound mental retardation. In a second study the above individuals were compared on symptomology to assess comorbidity with related symptoms. These “core,” peripheral, or associated features of depression were identified. Implications of the findings for describing and defining depression in these persons are discussed.

The effect of stereotypies on adaptive skills as assessed with the DASH-II and Vineland Adaptive Behavior Scales

The relationship of the Stereotypy subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) to adaptive functioning was investigated. Differences in adaptive skills measured with the Vineland Adaptive Behavior Scales (VABS) for individuals scoring at or above the cutoff of the Stereotypy scale and below the cutoff of the scale were analyzed. Individuals with high stereotypy scores had significantly lower VABS scores. Implications of these findings for assessment and treatment are discussed.

A comparison of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) and the Aberrant Behavior Checklist (ABC)

A comparison of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) and the Aberrant Behavior Checklist (ABC)

Validity of the mania subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II)

We attempted to establish the internal consistency and validity of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) to screen for the presence of mania (bipolar disorder) in severely and profoundly mentally retarded adults. Subjects included 22 individuals residing in a large developmental center in Central Louisiana. The Mania subscale of the DASH-II was internally consistent. Additionally, the DASH-II could be used to accurately classify manic and control individuals. Specific items on the subscale were examined to identify those items most associated with a diagnosis of mania.

Characteristics of autism as assessed by the diagnostic assessment for the severely handicapped—II (DASH-II)

The present study involved 1245 individuals with severe and profound mental retardation. Individuals with and without autistic features as assessed by the DASH-II were compared on demographic variables and symptomatology. The core and associated features of autism in severely and profoundly mentally retarded population were identified. Characteristics of persons with autistic disorders are reviewed, and the implications of the results are discussed.