Using adaptive behavior scores to convey level of functioning in children with autism spectrum disorder: Evidence from the Study to Explore Early Development

Abstract

Autistic people are often described as "low-" or "high-functioning" based on their scores on cognitive tests. These terms are common in publications and in everyday communication. However, recent research and feedback from the autistic community suggests that relying on cognitive ability alone to describe functioning may miss meaningful differences in the abilities of autistic children and adults and in the kinds of support they may need. Additional methods are needed to describe "functioning" in autistic children. We examined whether scores from a test measuring adaptive behaviors would provide information on the functional abilities of children with autism that is different from cognitive ability and autism symptom severity. Adaptive behaviors include age-appropriate skills that allow people to function in their everyday lives and social interactions. We found that a large amount of the variation in adaptive behavior scores was not explained by cognitive development, autism symptom severity, and behavioral and emotional problems. In addition, there was a wide range of adaptive ability levels in children with autism in our study, including in those with low, average, or high cognitive scores. Our results suggest that adaptive behavior scores could provide useful information about the strengths and support needs of autistic children above and beyond measures of cognitive ability and autism symptom severity. Adaptive behavior scores provide important information on the needs of autistic people.

Keywords: adaptive behavior; adaptive functioning; autism spectrum disorders; cognitive development; epidemiology; intelligence quotient.

Discrepant (I, IV) and concordant (II, III) categorizations of functioning based on cognitive development as measured by the Mullen Scales of Early Learning Composite and/or adaptive behavior scores as measured by the Vineland Adaptive Behavior Scales, Second Edition Composite in children with autism spectrum disorder, Study to Explore Early Development phases one (birth years 2003–2006) and two (birth years 2008–2011). Dashed lines indicate two standard deviations below the mean on the VABS-II (horizontal line) and MSEL (vertical line), the cutoff typically used to indicate significant impairment or delay. Note: VABSII: Vineland Adaptive Behavior Scales, Second Edition; ABC: Adaptive Behavior Composite; MSEL: Mullen Scales of Early Learning; ELC: Early Learning Composite.

Discrepancies of one or more SD between cognitive development as measured by the Mullen Scales of Early Learning (MSEL) Composite (ELC) and Vineland Adaptive Behavior Scales, Second Edition Composite (ABC), Communication (COM), Daily Living Skills (DLS), Socialization (SOC), and Motor Skills (MOT) scores among children with autism spectrum disorder and MSEL ELC >70, Study to Explore Early Development phases one (birth years 2003–2006) and two (birth years 2008–2011) Note: VABS: Vineland Adaptive Behavior Scales, Second Edition; MSEL: Mullen Scales of Early Learning; ELC: Early Learning Composite; SD: standard deviation; ABC: Adaptive Behavior Composite; COM: Communication; DLS: Daily Living Skills; SOC: Socialization; MOT: Motor Skills.

Discrepancies of one or more SD between cognitive development as measured by the Mullen Scales of Early Learning (MSEL) Composite (ELC) and Vineland Adaptive Behavior Scales, Second Edition Composite (ABC), Communication (COM), Daily Living Skills (DLS), Socialization (SOC), and Motor Skills (MOT) scores among children with autism spectrum disorder and MSEL ELC ≤70, Study to Explore Early Development phases one (birth years 2003–2006) and two (birth years 2008–2011) Note: VABS: Vineland Adaptive Behavior Scales, Second Edition; MSEL: Mullen Scales of Early Learning; ELC: Early Learning Composite; SD: standard deviation; ABC: Adaptive Behavior Composite; COM: Communication; DLS: Daily Living Skills; SOC: Socialization; MOT: Motor Skills.