A Critical Appraisal of the Measurement of Adaptive Social Communication Behaviors in the Behavioral Intervention...

Despite encouraging evidence for the efficacy of comprehensive and intensive behavioral intervention (CIBI) programs, the majority of studies have focused on relatively narrow, deficit-focused outcomes. More specifically, although adaptive social communication and interaction (SCI) are essential for facilitative functioning, the majority of studies have utilized instruments that capture only the severity of SCI symptoms. Thus, given the importance of the comprehensive and appropriate characterization of distinct SCI adaptive skills in CIBI, in this review, based on PubMed search strategies to identify relevant published articles, we provide a critical appraisal of two of the most commonly used adaptive functioning measures-the Vineland Adaptive Behavior Scales-Third Edition (Vineland-3) and the Adaptive Behavior Assessment System-Third Edition (ABAS-3), for characterizing SCI in the behavioral intervention context. The review focused on periodic outcome and treatment planning assessment in people with autism spectrum disorder receiving CIBI programs. Instrument technical manuals were reviewed and a PubMed search was used to identify published manuscripts, with relevance to Vineland-3 and ABAS-3 development, psychometric properties, or measure interpretation. Instrument analysis begins by introducing the roles of periodic outcome assessment for CIBI programs. Next, the Vineland-3 and ABAS-3 are evaluated in terms of their development processes, psychometric characteristics, and the practical aspects of their implementation. Examination of psychometric evidence for each measure demonstrated that the evidence for several key psychometric characteristics is either unavailable or suggests less-than-desirable properties. Evaluation of practical considerations for implementation revealed weaknesses in ongoing intervention monitoring and clinical decision support. The Vineland-3 and ABAS-3 have significant strengths for cross-sectional outpatient mental health assessment, particularly as related to the identification of intellectual disability, but also substantial weaknesses relevant to their application in CIBI outcome assessment. Alternative approaches are offered, including adopting measures specifically developed for the CIBI context.