Tools for Assessing Autism Symptoms and Relevant Features

AUTISM SYMPTOM CHECKLISTS - (EDUCATOR OR PARENT REPORT)

 

Infant-Toddler Checklist (ITC)
Description:  The Infant-Toddler Checklist (ITC; Wetherby & Prizant, 2002) is a 25-item checklist that was developed out of the SCERTS model and is very well attuned to the communicative aspects of ASD in young children.  Designed and validated in a large community sample of children between 6 and 24 months, there is evidence for its effectiveness in screening children for overall developmental delay, as well as differentiating ASD from developmental delay (without autism).  It is a highly sensitive tool (i.e., won't miss many children), but may over-identify ASD in some cases. 

Who it’s best for:  Children up to 2 years old, possibly up to 3 years, if the child has a known developmental delay.  If you apply the ITC to a child older than 2 years, his/her chronological age won't allow for the norms to be useful, so you will need to compute the child's score based on his/her developmental age.  For children out of the recommended age range, but who have significant developmental disabilities, the ITC may be most useful for helping to identify current concerns, more than in providing a particular score or estimate of risk of having ASD.

How it is administered:  The ITC is a brief parent checklist that can be completed by the parent independently, or can serve as the basis for a brief interview.  We are not aware of its use with teachers or interventionists as the informant, or whether its use can be reliably extended to preschoolers; but this particular group of researchers is focused on real-life applications, so I expect work will be pursued in those arenas as well.  It could be useful to ask a teacher or interventionist who knows the child well to complete the measure in addition to the parent and use the data to help make a list of concerning symptoms/behaviors.

How long it takes:  20 minutes for parents to complete, 10 minutes to score

How it’s scored:  The best algorithm for identifying children with ASD is described as:  obtaining a score in the lowest tenth percentile on the Total Score, accompanied by a Social Composite score in the lowest fifth percentile.  Children who meet the Total Score criteria, but not the Social Composite criteria, likely have a developmental delay without autism.

How much training it requires:  None, though the website of Florida State (FSU.edu) has a lot of supporting information for public use, including fabulous videos and links to useful resources.  

How to get it:  www.fsu.edu  search FSU website for "Wetherby" and "autism"

To learn more:
Wetherby, A.M., Brosnan-Maddox, S., Peace, V., & Newton, L. (2008). Validation of the infant-toddler checklist as a broadbrand screener for autism spectrum disorders from 9 to 24 months of age. Autism,12(5), 487-511.

Wetherby, A., & Prizant, B. (2002). Communication and Symbolic Behavior Scales Developmental Profile–First Normed Edition. Baltimore: Paul H. Brookes.Wetherby & Prizant, 2002

Modified Checklist for Autism in Toddlers (M-CHAT)
Description:  The M-CHAT (Robins et al, 2001) is a 23-item checklist designed for caregivers to complete and then discuss with the examiner.  The goal of the tool is to try to differentiate between autism and general developmental delays in young children.

Who it’s best for:  Best for children under the age of 3 years, the M-CHAT may also be helpful in screening children with known developmental disabilities as old as 10 years. 

How it is administered:  The M-CHAT can be administered over the telephone, in a brief in-person meeting, or as a self-report measure with the screener asking follow-up questions, as needed. The American Academy of Pediatrics recommends that the M-CHAT be administered in well-child visits by pediatricians (see AAP.org).  It is also recommended that if the parent completes the checklist independently, it is best for someone to call the parent and ask a few follow-up or clarifying questions. 

How long it takes:  about 10 minutes for parents to complete the form, 20 minutes to ask follow-up questions and score

How it is scored:  Scoring instructions are available in the websites listed below.  The M-CHAT provides a total score (ranging from 0 to 23), and scores above a certain score indicate that the child is “at risk” for ASD and is referred for further evaluation.  There is also a set of items designated as “critical,” meaning that if a parent or caregiver endorses 3 or more of these 7 items, then the child is also deemed “at risk” for ASD and is referred for further testing.

How much training it requires:  None, just some time to get familiar with the questions/behaviors of interest, and identify the critical items.

How to get it:  The M-CHAT is available for free responsible use at:  www.firstsigns.org or www.gsu.edu/~wwwpsy/faculty/robins.htm. Colleagues at JFK Partners worked with the M-CHAT developer and created an iPhone app for parents or clinicians to use.  For more information, contact:  deb.efird@ucdenver.edu

To learn more:
Robins, D. L., & Dumont-Mathieu, T. M. (2006). Early screening for autism spectrum disorders: Update on the Modified Checklist for Autism in Toddlers and other measures. Journal of Developmental and Behavioral Pediatrics, 27(Supplement 2), S111–S119.

Robins, D. L., Fein, D., Barton, M. L., Greene, J. A. (2001). The Modified Checklist for Autism              in Toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Develop- mental Disorders, 31, 131–144.

www.firstsigns.org

www.aap.org

 

Social Communication Questionnaire (SCQ)
Description:  The SCQ (Berument et al, 1999; Rutter, Bailey & Lord, 2003) is a 41-item yes/no parent/caregiver checklist that has very strong scientific support as a screening tool for school-aged children.  The SCQ was derived from a well-respected interview  -- the Autism Diagnostic Interview- Revised; Lord et al, 1999).   Although the ADI-R is thought to be part of a “gold standard” clinical/research evaluation for ASD, it is not thought to be an efficient tool for use in community settings.  The SCQ doesn’t provide as comprehensive a view of the child’s developmental history or current functioning as the ADI-R; however, the SCQ requires about 1/8th the time to administer (20 minutes vs 2 hours) and does not require special training.  Parents can complete it independently; however, follow-up discussion of items endorsed is recommended to be sure that the intent of the items was understood by the respondent.

Who it is best for:  The SCQ is best for children 4 years and older; works best if the child has a developmental age of 2 years or older.  May “miss” children who are very bright intellectually and have more subtle features; may also over-identify a child with significant developmental delays (and not autism).  There is some evidence it isn't as good a tool for assessing girls as boys.  Available in Spanish and English; however, the Spanish version has been criticized for its lack of cultural competence.  It is designed specifically for parents to complete, and although school staff can complete most items and provide qualitative information on the tool, it has not been validated for teacher report. 

How it is administered:  One or more parents/caregivers is asked to complete an SCQ.  The examiner reviews the pattern of scores and tabulates the 1's and 0s. It can also be administered as a brief interview, which may be helpful in building rapport with the family and beginning the dialogue about the child's profile.

How long it takes: 10-20 minutes to complete the checklist; can be done in an interview format in 15-30 minutes; requires 5 minutes to score.

How it’s scored:  The SCQ provides a total score (ranging from 0 to 41), with a score of 15 or higher indicating “risk” for ASD in children 5 and older and a score of 11 or above for use with 4-year olds.  A quick review of the items allows you to develop a list of symptoms that are and are not present, which may be more useful than the actual numerical score. 

How much training it requires:  None, although a background in how symptoms change across development is helpful, since the tool is designed for children up to age 18, you will need to apply your developmental insights to the interpretation of the symptoms and patterns you observe.

How to get it: www.wpspublish.com. Copyrighted/fee required.

To learn more: 
Allen, C.W., Silove, N.,Williams, K., & Hutchins, P. (2007) Validity of the Social Communication Questionnaire in assessing risk of autism in preschool children with developmental problems. Journal of Autism and Developmental Disorders, 37, 1272–1278.

 

Berument, S.K., Rutter, M., Lord, C., Pickles, A., & Bailey, A. (1999). Autism Screening         Questionnaire: Diagnostic validity. British Journal of Psychiatry,175, 444–451.

Rutter, M.,Bailey, A., & Lord, C. (2003). Social Communication Questionnaire. Los Angeles, CA: Western

Psychological Services.

Social Responsiveness Scale (SRS)
Description:  The SRS (Constantino et al, 2007) is a 65-item checklist that can be completed by parents or teachers of children 3 years and older.  Often used in genetics studies, the SRS was designed to try to tell the difference between autism and another psychiatric conditions.  The SRS frames questions that provide insight into how the child usually functions in natural settings.  It has been used in many genetic studies because it picks up on the "broader phenotype" - or characteristics of family members who don't present with full ASD, but have bits and pieces of the condition.  The SRS provides norm-based scores that help you to evaluate the person's risk for actually having an ASD and also allows for development of symptom lists.  There are separate tools for males and females.

Who it’s best for:  The SRS is a good choice for a screening tool if the team is trying to differentiate autism from an emotional/behavioral disability.  Psychometrics are strongest in children 4-14 years and in samples of intellectually competent children.  It is also one of the only tools that uses different norms for boys and girls, making it potentially more sensitive and specific in evaluating females.

How it is administered:  Parents or someone who knows the child well completes a gender-specific checklist, which is then scored by computer or by hand.  Not suggested to be done as an interview, although asking clarifying questions is always fine to do.

How long it takes: 20-30 minutes for parents to complete, 15 minutes to review/score.

How it’s scored:  The SRS provides a total score that is compared to normative data collected on children of the same gender and of similar ages.  This standardized “cut-off score” indicates whether or not a child is at risk for ASD.  The SRS also provides subscale total scores that provide information on a child’s functioning in specific aspects of social relating, communication and flexibility, relative to age- and gender-matched peers.  These subscales are:  Social Awareness, Social Cognition, Social Communication, Social Motivation, and Autistic Mannerisms. 

How much training it requires:  None, although a background in how symptoms change across development is helpful, since the tool is designed for children up to age 18, you will need to apply your developmental insights to the interpretation of the symptom pattern you observe (yup, same as the SCQ).

How to get it: www.wpspublish.com. Copyrighted/fee required for protocols and manual.  Computerized scoring program also available, and recommended, as it saves considerable time and creates a printable report that can be very useful.

To learn more:
Constantino, J.N.,& Gruber, C. P. (2005). The Social Responsiveness Scale Manual. Los Angeles: Western Psychological Services.

Constantino, J.N., LaVesser, P.D., Zhang,Y., Abbacchi, A., Gray,T., & Todd, R.D. (2007). Rapid quantitative assessment of autistic social impairment by classroom teachers. Journal of the American Academy of Child and Adolescent Psychiatry, 46 , 1668–1676.

Constantino, J.N., Przybeck,T., Friesen, D., & Todd, R.D. (2000) Reciprocal social behavior in children with and without pervasive developmental disorders. Developmental and Behavioral Pediatrics, 21, 2–11.

Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L.,Metzger, L.M., Shoushtari, C.S., Splinter, R., & Reich, W. (2003). Validation of a brief quantitative measure of autistic traits: Comparison of the social responsiveness scale with the autism diagnostic interview-revised. Journal of Autism and Developmental Disorders, 33(4), 427-433.

DIRECT ASSESSMENT OF AUTISM SYMPTOMS

Screening Tool for Autism in Two-Year Olds (STAT)
Description:  The STAT (Stone et al, 2000; 2004) is a brief interactive screening measure for use by early identification professionals.  Comprised of a few play-based activities for screener to do with the child, accompanied by a very brief parent interview, the STAT has very strong psychometric characteristics.  Its been shown to be useful differentiating children at risk for ASD from those who are typically-developing, as well as those who are developmentally delayed or have language disorders.  Training and certification are necessary for responsible use.  The STAT has been successfully adopted in statewide Part C efforts in several states.

Who it’s best for: Toddlers, ages 12-23 months, with some recent data supporting its use in children up to 4 years of age, particularly if there are known developmental delays.  I find it useful across preschool years - even for kindergarten (particularly if the child is known to be developing slowly

How it’s administered:  An interventionist/educator from any discipline plays briefly with the child, with the parent present.  The activities include easy-to-remember scripts to elicit pointing, imitation and symbolic play.  Good for assessors that like playing with children and have good observational skills.  The assessor gets the chance to both interact directly with the child and talk to the parent.  In my opinion, the STAT provides an opportunity to collaborate with the child's parent and begin a dialogue that will make it easier to share your concerns than if you do something more open-ended and less structured.  Designed for one person to simultaneously administer and score, the STAT can also be administered by a team, as long as one person takes the lead in the child interaction part.

How long it takes:  approximately 30-45 minutes for testing, 30-45 minutes for interpreting results (2 hours total).  Results can be interpreted immediately after testing.  Results are described as characterizing risk, not giving a diagnosis, which can allow for intervention to get started while waiting for fuller evaluation, if needed.  If sufficient evidence is obtained from the STAT, further evaluation may not be necessary for an educational identification, particularly if you explicitly plan to re-assess in one year (after some time in intervention/school).

How it’s scored:  Each play activity is scored for from a range of 0 to 4.  Item scores are then summed and averaged.  Scores 2 or greater indicate risk for ASD.  A similar scoring scheme is applied to the parent interview portion.

How much training it requires:  Training is required, but is relatively minimal and available online through Vanderbilt/triad website.  I would estimate a 4-10 hour investment to get up to speed and then practicing and refining your style to fit each child.  I believe that training still includes sending tapes of yourself administering, which may require some additional time/money, but also really helps a team to learn the tool effectively.

How to get it: http://kc.vanderbilt.edu/triad/training/page.aspx?id=821

To learn more:
Stone, W.L., Coonrod, E.E. & Ousley, O.Y. (2000).  ‘Brief Report: Screening Tool for Autism in Two-Year-Olds (STAT): Development and Preliminary Data’, Journal of Autism and Developmental Disorders 30 (6): 607–12.

Stone, W.L., Coonrod, E.E., Turner, L.M., & Pozdol, S.L. (2004). Psychometric properties of the STAT for Early Autism Screening. Journal of Autism and Developmental Disorders, 34(6), 691-701.

Autism Diagnostic Observation Schedule (ADOS) (Lord, Rutter, DiLavore, & Risi, 2002) is thought to be the “gold standard” tool for direct observation of autism symptoms.  Designed for research and now integrated into clinical practice, the ADOS is comprised of 4 modules, arranged by language level.  Administrators must complete training in administration and scoring before using.  Revised algorithms now include a severity score, in addition to suscale scores, organized by symptom cluster (e.g., social-communication, repetitive activities).  a standardized, semi-structured direct play/interview with the person suspected of having

The reliability and validity of the ADOS are very strong, particularly when the person being evaluated has a  nonverbal problem-solving developmental level of 12 months or higher.  (At lower levels, the ADOS is less specific in differentiating autism from intellectual impairment without autism.)

Gotham, K. et al. (2007).  The Autism Diagnostic Observational Schedule: Revised algorithms for improved diagnostic validity.  Journal of Autism and Developmental Disorders, 37, 613-627.

Lord, C., Rutter, M., DiLavore, P.C., & Risi, S. (2002). Autism Diagnostic Observation Schedule. Los Angeles: Western Psychological Services.

PARENT/CAREGIVER INTERVIEWS

Autism Diagnostic Interview-Revised (ADI-R; Rutter et al. 2003)
The ADI-R is a semi-structured parent interview that operationalizes DSM-IV and ICD-10 criteria for autism.  Trained interviewers assess domains of social interaction, communication, and restricted, repetitive behaviors/interests.  Onset status can be categorized well.  The interview consists of over 100 questions.   An algorithm has been established that differentiates autism from other developmental disorders at high levels of sensitivity and specificity (over .90 for both) for subjects with mental ages (MA) of 18 months and older.  The ADI-R was developed as the parent interview companion measure to the ADOS.  The ADI-R is used in research more than in clinical practice, due to the amount of time it requires to administer (as well as the amount of time required for clinicians to achieve certification). 

 

Rutter, M., Le Couteur, A., & Lord, C. (2003). Autism diagnostic interview-revised. Los Angeles: Western Psychological Services.

Tools for Learning about a Student’s Pragmatic Skills

MacArthur-Bates Communicative Development Inventories:  Words & Gestures (CGI-WG)
Description: The MacArthur CDI (Fenson et al, 1993; 2003) is a 4-page inventory of specific words and nonverbal acts that are important in the development of communication in young children.  The parent or educator/interventionist who knows the child indicate which of the words/behaviors on this rather long list the child is currently expressing, as well as those the child appears to understand.  The result is a developmentally informed snapshot of the child's current communicative profile (including both nonverbal and verbal acts of sending and receiving messages).  The MacArthur CGI has been shown to be sensitive to treatment effects - it could be used as part of an IEP objective to measure a child's nonverbal communication before and after a year in school, for example. 

Who it’s best for:  Developed and normed on children who are between 8 and 16 months old, the CGI can provide helpful qualitative information for students who are not yet effective communicators - either verbally or nonverbally, at just about any age.  Because the tool is geared to early childhood, if you want to use it for a student who is older than 3 years old, I would recommend asking the parent questions in order to fill out the form instead of giving it directly to them, as you will want to skip some sections that are not developmentally appropriate for an older, nonverbal student. 

Fenson et al. (1993; 2003).  MacArthur Communicative Development Inventories.  San Diego:  Singular Thompson Learning. 

Children’s Communication Checklist-2 (CCC-2;  Bishop, 2003). 
Description:  The CCC-2 is a 70-item checklist used to measure pragmatics (i.e., social-communication) that is completed by an adult who knows the child well (e.g., parent, therapist, teacher).  It’s been used in studies of autism, language impairment, and intellectual/developmental disabilities.  The CCC provides at total Scaled score and ten normed subscales:  “A-Speech (i.e., intelligibility); B-Semantics (i.e., word finding/vocabulary access); C-Syntax (i.e, grammar); D-Coherence (e.g.,  making sense in conversation through the proper referencing and sequencing of events); E-Inappropriate Initiation* (e.g.,  indiscriminate, talks too much, doesn’t initiate topics about reciprocal interests, repetitive initiating); F-Stereotyped Language* (e.g.,  overuse of “learned chunks” in conversations;  being “precise” in communications); G-Use of Context* (e.g.,  use and understanding of the social rules governing communication, including politeness, sarcasm, and humor;  ability to correctly interpret others, including abstract language concepts); H-Nonverbal Communication* (e.g.,  understanding and using nonverbal conversational cues including both gestures and affect); I-Social Relations (i.e.,  regard for and relationships with peers); and J-Interests (i.e.,  restricted and/or repetitive interests and flexibility).” (Bishop, 2003).   A summary variable, The Social Interaction Deviance Composite (SIDC), may be derived from the Scaled Scores to consider whether or not a child is evidencing primarily structural or pragmatic language difficulties.

Tools for Assessing Associated Features

Behavior Rating Inventory of Executive Functions (BRIEF): Preschool Version:  Gioia, Espy, & Isquith, 2003; School-Age Version & Preschool Version:  Gioia, Isquith, Guy, & Kenworthy, 2000). 
Description: 
The BRIEF is an assessment system designed to gather information about how a person’s executive function skills impact functioning at home, in school and in the community.  Two different versions (Preschool and School-Age) allow for developmentally sensitive items across relevant areas of attention and self-regulation.  Norms are provided for each of 9 subscales, as well as for a set of developmentally relevant factors that are thought to reflect global functioning.  For preschoolers, the BRIEF provides subscale scores for Inhibit, Shift, Emotional Control, Working Memory, Plan/Organize and composite scores for Global Executive Composite, Inhibitory Self-Contol Index, Emergent Metacognition Index, and Flexibility Index.  For school-aged children, the BRIEF provides subscale scores for Inhibit, Shift, Emotional Control, Initiate, Working Memory, Plan/Organize, Organization of Materials, and Monitor.  Composite scores are computed for a Global Executive Index, Behavioral Regulation Index, and a Metacognition Index.  The BRIEF has been used in many studies of executive function in special populations, including autism, fragile X syndrome and Down syndrome.

Gioia et al, (2003).  Manual for the Preschool Version of the Behavior Rating Inventory of Executive Functions.  Lutz, Florida:  Psychological Assessment Resources. 

 

Gioia et al, (2000).  Manual for the School-age Version of the Behavior Rating Inventory of Executive Functions.  Lutz, Florida:  Psychological Assessment Resources. 

Emotion Regulation Checklist (ERC) (Shields & Cicchetti, 1997) is a brief (24-item) parent/teacher report measure that provides information regarding a child’s typical responses to emotionally intense experiences.  The instrument has good reliability and validity across adult informants and provides indices regarding the child’s ability to modulate and express affect in a manner that is context-appropriate.  The ERC has been shown to be sensitive to change in effectiveness studies of CBT protocols with anxious youth (Suveg, Kendall, Comer, & Robin, 2006).

Shields, A., & Cicchetti, D. (1997).  Emotion-regulation among school-age children:  The development and validation of a new Q-sort scale.  Developmental Psychology, 33, 906-917.

Short Sensory Profile (SSP) (MacIntosh, Miller, Shyu & Dunn, 1999).  The SSP is a 38-item parent questionnaire designed to provide information about a child’s sensory responses in daily life. Norming procedures for the SSP included a national US sample of 117 children and the measure shows high internal reliability (.91). The SSP is a brief version of the more extensive 125 item Sensory Profile assessment measure, and includes the domains: Tactile Sensitivity, Taste/Smell Sensitivity, Movement Sensitivity, Underresponsive/Seeks sensation, Auditory Filtering, Low Energy/Weak, and Visual/Auditory Sensitivity.

McIntosh, D.N., Miller L. J., Shyu, V., & Dunn, W.. The Sensory Profile: Examiner’s Manual, 1999.

The Developmental Behavioral Checklist (DBC)  (Einfeld & Tonge, 1994) is a 96-item checklist (each item scored on a 3 point likert scale) completed by parents or teachers to assess behavioral and emotional problems in children with a developmental disability. A Total Behavior Problem score is derived in addition to five subscale factor scores: Disruptive/Antisocial behavior, Self Absorbed Behavior, Communications Disturbance, Anxiety Problems and Social Relating Problems.  The DBC is considered to have good reliability and validity (Einfeld & Tonge, 1994) and is sometimes used in intervention effectiveness studies on children with developmental disabilities, including autism.  Two versions of the checklist are available: the Parent/Carer version (DBC-P) and the Teacher version (DBC-T).  

Einfeld, S. L., & Tonge, B. J. (1994). Manual for the developmental behaviour checklist. Clayton, Australia: Monash University Centre for Developmental Psychiatry and School of Psychiatry, University of New South Wales.

TOOLS FOR ASSESSING IMPACT AND ADAPTIVE FUNCTIONING

The Sheehan Disability Scale (Sheehan, 1983; Leon, Olfson, Portera, Farber & Sheehan, 1997) is a 4 item scale (each item scored on a 10 point likert scale) that assesses the impact of a disability (i.e., a child’s intellectual disability or anxiety symptoms) on global functioning: work, social life/leisure activities, and family life/home responsibilities.

Sheehan, D. (1983).  The anxiety diseases.  New York:  Scribner.

Supports Intensity Scale (SIS) (American Association on Intellectual and Developmental Disabilities, 2004-2012).  The SSIS is an interview tool that was designed to quantify an adult’s service needs.  The first section includes 49 “life activities”, which comprise 6 subscales, and provides a snapshot of the person’s adaptive skills and areas where additional help is needed.  The second section focuses on self-preservation, protection and advocacy skills.  The third section focuses on specific medical and behavioral needs that may or may not be relevant for the adult being discussed.  The SIS is commonly used nationwide to develop and modify service plans for adults with developmental disabilities.  It is sometimes used in epidemiological or descriptive research, but is not often used as an assessment of treatment response. 

Thompson, J.R. et al. (2004-2012).  User’s Manual for the Supports Intensity Scale.  Washington DC:  American Association on Intellectual and Developmental Disabilities.

Family Impact Questionnaire (FIQ)  (Donenberg & Baker, 1993).  The FIQ is a 50-item parent report measure concerning the extent and significance of the impact of a family member’s special needs on the family.  The Negative Impact Summary Score has good internal consistency and test-retest reliability (Peris & Baker, 2000) and is sensitive to change.  Higher scores are indicative of more deleterious impact.

Donenberg, G., and Baker, BL 1993. The impact of young children with externalizing behaviors on their families. Journal of abnormal Child psychology, 21, 179 – 198.

Pediatric Evaluation of Disability Inventory (PEDI) (Haley et al, 1998).  The PEDI is a functional skill inventory that can be administered as an interview with a parent/caregiver/person with a disability or can be administered as a checklist.  The PEDI includes several functional skill areas, which are broken down into components.  Items are scored on a range of 0-1 (person either does skill independently or not), followed by ratings that specify the amount/type of support required for the person to complete the task.  The PEDI is particularly useful (in my opinion) for education and treatment planning; however, it can also be used to describe a person’s overall level of impairment as a function of his/her disability for research studies.  It is not clear from existing research if the PEDI is sensitive to change over time.

Haley, S. et al (1998).  Manual for the Pediatric Evaluation of Disability Inventory (PEDI).  Boston, MA:  PEDI Research Group.  To order: Phone:  617 358-0175.

Vineland Adaptive Scales of Behavior-II (Sparrow, Balla, & Cicchetti, 1984).   The VABS-II is a standardized 403-item caregiver interview about their child’s adaptive behavior that has been revised and updated from its original form (VABS; (Sparrow, Balla, & Cicchetti, 1984), with an expanded age range and updated items to reflect cultural changes and increased research knowledge.  The VABS-II is made up of the same domains and subdomains as the original VABS and consists of the following 3 domains for all children older than 6-years-old:  Communication, Daily Living, and Socialization.  Motor functioning is also assessed for children younger than 6 years. The VABS-II was standardized on a representative sample of over 3,000 individuals developing typically and atypically and shows a high degree of consistency with the VABS (Sparrow et al., 2005).  Like its predecessor the VABS, the VABS-II demonstrates good psychometric properties.

Sparrow, S., Balla, D., & Cicchetti, D. (1984). Vineland adaptive behavior scales. Circle Pines, MN: American Guidance Service.

Sparrow, S.S., Cicchetti, D.V., & Balla, D.A. (2005).  Vineland-II adaptive behavior scales.  Circle Pines, MN: American Guidance Service.

Scales of Independent Behavior–Revised (SIB- R). (Bruininks,Woodcock,Weatherman, & Hill, 1996) is a measure of adaptive behaviour comprising 14 subscales organized into four adaptive behaviorr domains: (1) Motor Skills, (2) Social Interaction/Communication, (3) Personal Living Skills, and (4) Community Skills. It also assesses eight areas of problem behavior. The SIB-R has good psychometric properties and provides norms across the lifespan.  Each item is scored on a 4-point scale ranging from 0 to 3, (0 =never or rarely, 1 = does, but not well, 2 = does fairly well, and 3 = does very well. The SIB-R is intended to be completed as a semi-structured interview, but it can also be completed as a rating scale (Bruininks et al., 1996).

Bruininks, R. H., Woodcock, R. W., Weatherman, R. F., & Hill, B. K. (1996). Scales of Independent Behavior–Revised: Comprehensive Manual. Boston: Riverside Publishing Company.

Social Skills Improvement System (SSIS) (Gresham & Elliot, 2008) is a 55-item questionnaire that provides information regarding the social behavior of children ages 3-18.  The SSIS is comprised of two scales: Social Skills scale and Problem Behavior scale. The Social Skills scale contains five subscales (Cooperation, Empathy, Assertion, Self-Control, and Responsibility) and the Problem Behavior scale contains three subscales (Externalizing Behavior, Internalizing Behavior, and Hyperactivity). The SSIS was standardized on a sample of 4,000 children (Gresham & Elliot, 1990) and moderate to high correlations were obtained between the SSIS and other measures of social competence.  The SSIS also has a companion teacher version.

Gresham, F.M. & Elliot, S.E. (1990; 2008).  Social Skills Improvement System.  Minneapolis, MN:  Pearson Publishing.

QUALITY OF LIFE:  MEASURES OF BROAD OUTCOMES REGARDING REAL-LIFE EXPERIENCES OF SATISFACTION WITH SCHOOL/WORK, SOCIAL INTERACTIONS, FAMILY LIFE.

The Quality of Student Life Questionnaire (QSL)  (Keith & Schalock, 1994).  The QSL is a 40-item questionnaire (each scored on a 3 point Likert scale) that can be completed by children with developmental disabilities and by parents either in interview format or as a written questionnaire.  For children who are nonverbal or who have mental retardation, the questionnaire is completed by two raters and average scores are used.  A total quality of life score is derived in addition to separate percentile scores for Satisfaction, Well Being, Social Belonging, and Empowerment/Control.  The QSLQ was normed on K through 12 and college-age samples with good test-retest reliability (Keith & Schalock, 1994).

The Modified Life in School Checklist—Junior School Version (Arora, 1987). The Modified Life in School Checklist—Junior School Version is a 39-item self report questionnaire in which children with intellectual disabilities  are provided with incomplete sentences (“During this week another student”) followed by items that describe positive and negative treatment as a means of assessing stigmatizing treatment from peers.  Responses to these items are recorded on a 3-point Likert scale. Follow-up questions are then asked to describe examples to justify the child’s ratings. Two raters independently assess whether the examples provided are categorized as stigma experiences.