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INTRODUCTION AND HISTORY OF ADAPTIVE BEHAVIOR

INTRODUCTION

The construct of adaptive behavior is defined as the independent performance of daily activities that are required for personal and social sufficiency (Sparrow, Cicchetti, & Saulnier, 2016). This is qualitatively different from intelligence, which is conceptualized more as a repertoire of skills that is innate or acquired over time. This book provides a comprehensive overview of profiles of adaptive behavior seen across neurodevelopmental disorders. Though there are many distinct or complex and multiplex causes for neurodevelopmental complications that result in extremely heterogeneous presentations, the delays or deficits in practical, "real-life" skills are the common thread throughout these disorders. Moreover, positive outcome is often associated with adaptive functioning and, as such, interventions to target adaptive behavior can be successful in an individual's ability to attain levels of independence in life.

DON'T FORGET

If cognition or IQ is an individual's repertoire of skills or capacity to perform a given behavior, adaptive behavior is an individual's independent performance of the behavior when life demands it.

THE BIRTH OF ADAPTIVE BEHAVIOR

When measures of cognitive ability were introduced in the early 1900s, the classification of intellectual disability (ID) relied solely on the assessment of intelligence quotient (IQ). Henry Herbert Goddard was one of the first to bring comprehensive intelligence tests to the United States when he translated and modified the Binet Intelligence Scale that was developed in France by Alfred Binet (Zenderland, 2001). Goddard's version, the Binet and Simon Tests of Intellectual Capacity, was published in 1908. At the time, Goddard was working as the research director at the Training School for Feeble-Minded Girls and Boys in Vineland, New Jersey, seeking ways to accurately assess children with IDs. The Vineland Training School was dedicated to the study of ID and, thus, defining and measuring intelligence became a strong focus.

Goddard defined feeble-mindedness as mental deficits originating at birth or early in development that resulted in an individual's incapacity for functioning independently in society (Goddard, 1914). The following labels were designated based on levels of cognitive impairment:

• Idiot designated a person with a mental age up to 2 years
• Imbecile designated a 3-7 years mental age
• Morons designated a 7-12 years mental age (though still designating cognitive delay, these individuals were not regarded as "defective" or "incapable of learning")

Goddard, similar to many of his time, believed in the heritable nature of feeble-mindedness, publishing a book about a family with mental retardation that crossed generations (Goddard, 1912). The notion that cognitive impairment was inherited reinforced the eugenics movement-one of selective breeding and sterilization in an attempt to eliminate undesired traits and maximize desired ones. This resulted in the institutionalization, sterilization, and limited immigration of many individuals with ID in the United States so as to increase the average IQ. These practices would not be fully eradicated until the 1960s and, thus, intelligence tests remained at the forefront of identifying the cognitively inferior, including children (Reilly, 1987). Despite the controversy surrounding his early involvement in the eugenics movement, Goddard is considered one of the founders of intelligence testing in our country and, in some regards, of the field of clinical psychology (Gelb, 1999).

During Goddard's tenure at the Vineland Training School, he had an assistant named Edgar Doll. Doll had recently received his bachelor's degree from Cornell University and began working with Goddard as a clinical psychologist. Doll believed that level of impairment was dependent on one's limited ability to meet designated social expectations, highlighting the necessity of social competence for functional independence (Doll, 1936). He therefore advocated that social criteria be established against which to measure intelligence. In 1917, Doll publishedClinical Studies in Feeble-Mindedness calling for clarification of the definition of intellectual disability.

After spending several years training with Goddard, Doll left the Vineland Training School to obtain his doctorate in psychology at Princeton University. He took a break from graduate school to join the Army during World War I, where he conducted cognitive assessments on army recruits. After leaving the Army and completing his doctorate at Princeton in 1920, Doll directed the Division of Classification and Education in the New Jersey State Department of Institutions and Agencies, where he assessed prisoners up for parole. Doll's experiences working with army recruits and prisoners revealed similar IQ levels between the groups. This was against the thinking at the time that criminality was caused by mental retardation (Doll, 1941). Doll's research debunking the theory that prisoners were "mentally deficient" was seminal to the field. However, this work would become overshadowed by Doll's subsequent focus on adaptive behavior.

In 1925, Doll returned to the Vineland Training School as the director of research where he remained through 1949. The practice of defining cognitive impairment on a single measure had become highly controversial, as had the theories of what caused ID (Brockley, 1999). Although some professionals such as Doll believed ID to be a genetically based and constitutional condition that resulted in social deficiencies, others argued that it was more developmental in nature arising from impaired social competence (Reschly, Myers, Hartel, & National Research Council, 2002). Evidence arose that not all individuals with ID had parents with cognitive impairment and it was discovered that ID could actually result from a host of non-genetically related factors, such as disease, physical trauma, poverty, and so on, placing into question the heritability of ID. These discoveries helped contribute to the demise of the eugenics theory and encouraged more sympathetic views toward the intellectually disabled.

Doll was a pioneer in developing the construct of adaptive behavior and emphasizing the need for assessing adaptive functioning in addition to IQ when diagnosing ID. Doll's definition for what was then called mental deficiency evolved over time. In his earlier work, Doll described a threefold criterion for diagnosing mental deficiency: "social incompetence, due to low intelligence, which has been developmentally arrested" (Doll, 1936, p. 429). Yet, he would later expand on this definition to include the following six criteria: (1) social incompetence, (2) mental subnormality, (3) developmental arrest, (4) obtains at maturity, (5) constitutional origin, and (6) essentially incurable (Doll, 1941, 1953).

Rapid Reference 1.1

Doll's Criteria for Mental Deficiency

• Social incompetence
• Mental subnormality
• Developmental arrest
• Obtains at maturity
• Constitutional origin
• Essentially incurable

Although some of Doll's proposed criteria for mental deficiency were controversial for his time (e.g., that mental deficiency was constitutional and incurable), several of his principles have sustained generations and still hold true in our contemporary definitions of ID. In fact, it was in one of his earliest works, Clinical Studies in Feeble-Mindedness, that Doll wrote about the criteria for intellectual disability: "social inefficiency is at present prerequisite, and is the most important practical manifestation of the condition" (Doll, 1917, p. 23). He stipulated that although all people with cognitive impairment were socially incompetent to some degree, not all people who were socially incompetent were "feeble-minded."

CAUTION

Despite early theories that intellectual deficiencies were innate and incurable, current views of cognition are more forgiving in that intelligence levels can improve with intervention.

Doll was instrumental in highlighting the role of social competence in intelligence. He believed that social competence was a universal human attribute, but one that was challenging to measure. He struggled with the barriers that prevented a universal definition of social competence and took strides to identify the behaviors that defined personal responsibility and independence across all individuals who were not influenced by factors such as race, geographic location, culture, or sex. These behaviors were, however, age-based in that one's repertoire of adaptive skills expanded with age. He ultimately defined social competence as the ability to demonstrate personal independence and social responsibility in everyday contexts, stating that "in short, social competence may be defined as a functional composite of human traits which subserves social usefulness as reflected in self-sufficiency and in service to others" (Doll, 1953, p. 2).

With an increased focus on self-sufficiency and social competence for functional independence, Doll developed the first standardized assessment of adaptive behavior. The Vineland...