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Adaptive behavior in autism: Minimal clinically important differences on the Vineland-II
C H Chatham1, K I Taylor1, T Charman2
1F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland.
Summary
Establishing minimal clinically important differences (MCIDs) for the Vineland Adaptive Behavior Scales (Vineland-II) in Autism Spectrum Disorder (ASD) is crucial. This study determined that a 2-3.75 point change on the Vineland-II Composite score signifies a clinically meaningful difference for individuals with ASD.
Area of Science:
- Neurodevelopmental Disorders
- Psychometrics
- Clinical Psychology
Background:
- Autism Spectrum Disorder (ASD) is characterized by persistent impairments in adaptive functioning across social, personal, and communicative domains.
- The Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) is the standard measure for quantifying these adaptive deficits.
- Minimal clinically important differences (MCIDs) for Vineland-II scores in ASD populations have not been previously established.
Purpose of the Study:
- To rigorously establish the minimal clinically important differences (MCIDs) for the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) in individuals with Autism Spectrum Disorder (ASD).
- To provide clinicians and researchers with reliable benchmarks for interpreting changes in adaptive behavior scores in ASD.
Main Methods:
- Pooled data from over 9,000 individuals with ASD across multiple international consortia and clinical studies.
- Employed both distribution-based methods (e.g., standard error of measurement, standard deviation fractions) and anchor-based methods (e.g., regression slopes, clinical impression differentiation, equipercentile equating) to estimate MCIDs.
- Analyzed Vineland-II Adaptive Behavior Composite standardized scores.
Main Results:
- Distribution-based MCID estimates ranged from 2.01 to 3.2.
- Sample-size-weighted anchor-based MCID estimates ranged from 2.42 to 3.75.
- Lower MCID estimates were observed in younger individuals and those with greater cognitive impairment.
Conclusions:
- The established MCID range of 2.01-3.75 points on the Vineland-II Composite score provides a critical threshold for assessing the clinical significance of observed changes in individuals with ASD.
- These findings will enhance the evaluation of treatment efficacy and guide clinical decision-making for interventions aimed at improving adaptive behaviors in ASD.
- The study highlights the importance of considering age and cognitive status when interpreting Vineland-II score changes.
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