Higher Adaptive Functioning Research Articles

Occurrence and Predictors of Challenging Behavior in Youth with Intellectual Disability with or without Autism

ABSTRACT Introduction : Challenging behaviors are common in individuals with developmental disabilities and pose significant challenges to their well-being and that of their families and communities. Method : We explored the occurrence and predictors of self-injurious behavior and aggressive/destructive behavior in 372 Canadian youths (aged 4–20 years) with a moderate to severe intellectual disability (ID), with or without autism. Data were collected through the Great Outcomes for Kids Impacted by Severe Developmental Disabilities (GO4KIDDS) basic survey. Results : Parent-report survey data indicated that 56% of the sample had displayed aggressive/destructive behavior and 39% self-injurious behavior over the past 2 months. Both behaviors were significantly more common in youths with ID plus autism compared to ID alone. There was an interaction between diagnosis and adaptive behavior in relation to aggressive/destructive behavior. For those with ID alone, lower adaptive functioning was predictive of aggressive/destructive behavior, whereas for those with ID plus autism, higher adaptive functioning was predictive. Conclusion : Overall, a large proportion of children in the sample were reported to engage in at least one challenging behavior. These findings highlight the importance of differential diagnosis, and an assessment of adaptive function to ascertain the prognosis of challenging behavior. Study limitations and avenues for future research are discussed.

Socio-economic and demographic factors associated with adaptive behaviour among children diagnosed with autism spectrum disorder in Egypt

BackgroundAdaptive behaviour among children diagnosed with autism spectrum disorder determines wide range of self-independent and autonomous activities. Adaptive behaviour is a clearly defined measurable variable that can be used as an outcome, hence impacts intervention and training programs. The current study aims to determine the socio-economic and demographic factors that are associated with adaptive behaviour among children diagnosed with autism spectrum disorder in Egypt. In this observational cross sectional study, caregivers’ reports on their children with a confirmed diagnosis of autism spectrum were obtained. Vineland Adaptive Behaviour Scale was used to assess adaptive behaviour among children aged 3–6 years and admitting at the outpatient clinic. Socioeconomic Status Scale was used to assess family socioeconomic status.ResultsParticipants in the current study scored low in domains of adaptive behaviour. Older children scored low in adaptive behaviour compared to younger children. There was significant positive correlation between daily living activities subdomain of adaptive behaviour and education, occupation, family possessions, and home sanitation and health care domains of socioeconomic status scale. There were significant positive correlations between socialization subdomain of adaptive behaviour and education, occupation, family, and family possessions and home sanitation domains of the socioeconomic status scale. The motor functioning subdomain of adaptive behaviour correlates significantly with the following SES domains: education (r = .268), occupation (r = .274), family possessions (r = .232), economic (r = .195) and health care (r = .291). Results of the current study revealed that high socioeconomic status correlates with higher adaptive functioning in daily living skills, socialisation and motor skills domains of adaptive behaviour.ConclusionThe correlations detected in the current study between adaptive behaviour and some social determinants of health can influence stakeholders’ decisions in planning and implementation of autism specific interventions.

Integrating the Early Start Denver Model into Israeli community autism spectrum disorder preschools: Effectiveness and treatment response predictors.

Early intensive intervention has been shown to significantly affect the development of children with autism spectrum disorder. However, the costly implementation of such interventions limits their wide dissemination in the community. This study examined an integration of the Early Start Denver Model into community preschool programs for children with autism spectrum disorder in Israel. Four community preschools implemented the preschool-based Early Start Denver Model and four implemented a multidisciplinary developmental intervention which is widely applied in Israeli community autism spectrum disorder preschools. Fifty-one children (aged 33–57 months) participated in the study. Twenty-six attended the preschool-based Early Start Denver Model preschools and twenty-five attended the multidisciplinary developmental intervention settings. Groups were comparable on age, developmental functioning, and socio-economic status. Compared to the multidisciplinary developmental intervention group, children in the preschool-based Early Start Denver Model treatment made greater gains on blinded measures of overall cognitive development, receptive and expressive language skills, as well as on parent- and teacher-reported adaptive communication and socialization abilities. In the preschool-based Early Start Denver Model group, children with lower symptom severity, higher adaptive functioning, and receptive language abilities at pre-treatment showed greater improvement. This study documents the successful integration of an Early Start Denver Model intervention into pre-existing community preschools, underlining the importance of disseminating evidence-based early intervention in community settings.Lay Early intensive intervention has been shown to significantly affect the development of children with Autism. However, the costly implementation of such interventions limits their wide dissemination in the community. This study examined an integration of a research-supported early intensive intervention model called the Early Start Denver Model into community preschool programs for children with Autism in Israel. Four community preschools implemented the preschool-based Early Start Denver Model and four implemented the existing multidisciplinary developmental intervention which is widely applied in Israeli community preschools for children with autism. Fifty-one children (aged 33–57 months) participated in the study. Twenty-six attended the preschool-based Early Start Denver Model preschools and twenty-five attended the multidisciplinary developmental intervention preschools. Before the intervention began, groups were comparable on children’s age and developmental functioning and on families’ socio-economic status. Results showed that, compared to the multidisciplinary developmental intervention group, children in the preschool-based Early Start Denver Model treatment group made greater gains on measures of overall cognitive development, language skills, as well as on parent- and teacher-reported adaptive communication and socialization abilities. Children who had lower autism symptom severity, higher adaptive functioning and better language understanding abilities before taking part in the preschool-based Early Start Denver Model program showed greater improvements following it. This study documents the successful implementation of an intensive early intervention program in pre-existing community preschools, underlining the importance of the integration of research-supported intervention programs into community settings.

Abstract WP383: Neuropsychological Outcomes Following Pediatric Cerebral Sinovenous Thrombosis

Introduction: Few research studies have investigated neuropsychological domains beyond IQ in pediatric cerebral sinovenous thrombosis (CSVT). Additionally, prior studies have contained small sample sizes making generalization of results difficult. This study investigates a broad set of neuropsychological domains in pediatric CSVT and identifies predictors of poor outcomes. Hypothesis: Children with CSVT were predicted to have worse cognitive outcomes compared to the normative sample. Earlier age at CSVT and the presence of acute symptoms associated with CNS dysfunction (e.g., altered mental status, aphasia, ataxia, seizure, and hemiparesis) were also hypothesized to predict worse long-term outcomes. Methods: 20 children (mean age = 15.6 years) who suffered a CSVT during childhood (range = 3.6 to 18.0 years) participated in this study. Children completed a comprehensive neuropsychological battery and parents completed several standardized behavioral questionnaires. Testing was completed at least 6 months post-CSVT. Data were analyzed using one-sample t -tests and ANOVA. Results: Children with CSVT had significantly greater problems on measures of mood, behavior, visual-motor integration, and processing speed compared to the normative sample (all p -values < 0.05). There were also trends for children with CSVT to have poorer performance on measures of confrontation naming ( p = 0.051), sentence repetition ( p = 0.064), and metacognition ( p = 0.057). Age at the time of CSVT was a significant predictor, such that older age at CSVT was associated with poorer single word reading and poorer visual-motor integration, but higher adaptive functioning. In these preliminary findings, acute symptoms associated with CNS dysfunction did not significantly predict outcomes. Conclusions: To our knowledge, these findings represent the largest study to date investigating a broad set of neuropsychological domains following pediatric CSVT. This population demonstrated weaknesses in visual-motor integration and processing speed compared to the normative sample. Additionally, these children exhibited more mood and behavior symptoms, supporting the need for careful psychological follow-up in this vulnerable population.

Effects of Age, Adaptive Behavior, and Cognitive Abilities on Competence-Related Abilities in Children and Adolescents

Consideration of competence to waive Miranda rights (CWM) and competence to stand trial (CST) has become commonplace in the juvenile justice system. Past research has shown age and intelligence are important risk factors for incompetence, but investigations of particular aspects of cognition and more practical aspects of functioning are limited. The present study investigated the direct and indirect effects of age, adaptive functioning, and three specific cognitive abilities (working memory, attention, and processing speed) on both types of competence for 92 children and adolescents ages 8–16. While age was strongly related to all aspects of both types of competence, mixed results were found for the cognitive abilities, and adaptive functioning was only related to some aspects of CWM. Contrary to expectations, it was found that, for the most part, the effect cognitive abilities had on competence did not vary depending on the age of the child or adolescent, and that higher adaptive functioning did not serve as a protective factor for competence when cognitive functioning was low.

Effectiveness of large-scale community-based Intensive Behavioral Intervention: A waitlist comparison study exploring outcomes and predictors

File review data were used to explore the impact of a large-scale publicly funded Intensive Behavioral Intervention (IBI) program for young children with autism. Outcomes were compared for 61 children who received IBI and 61 individually matched children from a waitlist comparison group. In addition, predictors of better cognitive outcomes were explored (n=142). Although random assignment did not take place, a standardized waitlist management system was used that did not include any prioritization other than time of referral. Groups did not differ significantly on available measures at intake. The treatment period tended to be longer than the waitlist period and this difference was controlled in analyses. At exit, the IBI group had better outcomes in all measured areas, with milder autism severity, higher adaptive functioning, and higher cognitive skills. Younger initial age predicted better cognitive outcomes in the IBI group but not the Waitlist group. Higher initial adaptive skills predicted better outcomes similarly in the two groups. Results support the effectiveness of community-based IBI and suggest that earlier age at treatment onset may increase the likelihood of better outcomes relative to comparison conditions.

Mothers of young adults with intellectual disability: multiple roles, ethnicity and well‐being

Two opposing perspectives--role strain and role enhancement--were considered as predictive of women's psychological and physical health. The authors examined the relation between multiple role occupancy (parenting, employment, marriage) and well-being (depression and health) among mothers of young adults with intellectual disability (ID). Participants were 226 mothers aged 35-70 years old caring for a young adult aged 16-26 years old with moderate to severe/profound ID. Mothers were of either Latino ethnicity (n=117) or Anglo (n=109). Mothers' ethnicity and degree of acculturation and young adults' adaptive behaviour and behaviour problems were examined as potential moderators. Mothers who were employed, married, or both reported better well-being than mothers who were both unemployed and unmarried, especially when their offspring had relatively higher adaptive functioning. This relationship between role occupancy and well-being was fully mediated by socio-economic status (SES) factors. Results did not suggest a role enhancement effect, but instead indicated a role shortage effect; unemployed, unmarried mothers experienced markedly poor well-being, while all other mothers experienced comparable well-being. Well-being scores were higher for Anglo than for Latino mothers; this relationship was entirely accounted for by SES. In Latina mothers, the relation between role occupancy and well-being was moderated by degree of acculturation. Findings suggest that multiple roles benefit mothers of young adults with ID primarily through their impact on socio-economic resources. For more acculturated Latina mothers, occupying more roles predicted better well-being even after controlling for SES. Latina mothers who were unemployed and unmarried had lower SES, and this group emerged as at particular risk. The latter group may benefit most from respite assistance and other interventions aimed at addressing their physical and mental health.

Criterion-related validity of the three-factor model of psychopathy: personality, behavior, and adaptive functioning.

The Psychopathy Checklist-Revised (PCL-R) has been conceptualized as indexing two distinct but correlated factors. Previous research has established that these factors demonstrate distinct patterns of relations with external criteria. However, more recent findings suggest that the PCL-R psychopathy construct may encompass three distinguishable factors, reflecting affective, interpersonal, and behavioral symptoms. Here, we evaluated the validity of this newer three-factor model of the PCL-R factors with reference to external criteria from the domains of personality, antisocial behavior; and adaptive functioning in a sample of 310 incarcerated offenders. The interpersonal factor was related to social dominance, low stress reactivity, and higher adaptive functioning; the affective factor was correlated with low social closeness and violent offending; and the behavioral factor was associated with negative emotionality, disinhibition, reactive aggression, and poor adaptive functioning. These findings provide support for the convergent and discriminant validity of these psychopathy facets.

Self-help and help-seeking behavior patterns in healthy elders.

The challenges and losses that accompany aging may alter task performance and self-care ability. However, resourceful elders maintain independence in daily tasks despite adverse situations. Resourcefulness consists of self-help strategies for coping with adversity. Elders may also seek help from others when faced by challenges or losses. This study examines self-help and help-seeking behaviors in relation to depressive cognitions, adaptive functioning, and life satisfaction among 120 healthy elders. Self-help was significantly correlated with the absence of depressive cognitions and with higher adaptive functioning, but help-seeking was not. Both self-help and help-seeking were significantly correlated with greater life satisfaction. However, self-help and help-seeking were not associated. The findings suggest that healthy elders may benefit from interventions that facilitate self-help and those that teach them to seek outside help. Future research should examine self-help and help-seeking strategies in elders whose physical or psychological health is compromised.

Protective Aspects of Adaptive Behavior in Children With Sickle Cell Syndromes

Examining 61 youths diagnosed with sickle cell syndromes, this study focused on both protective and risk factors of adaptive behavioral functioning in these children. Demographic characteristics (age, sex, intelligence, and socioeconomic status), severity of disease (number of days hospitalized, emergency room visits, hemoglobin, and school days missed), behavioral adjustment, and family functioning were examined to determine their relation to adaptive behavioral competencies. Age, sex, and intellectual functioning were found to be efficient predictors of the majority of adaptive behavioral domains, with higher adaptive functioning being associated with younger children, girls, and greater intellectual functioning. Adjustment difficulties characterized by internalizing symptoms were found to predict communication and global adaptive functioning. Within the context of a risk-resistance adaptation model, the present data were interpreted to support the use of secondary prevention efforts for children with s...