Jay W. Bamburg

A validity study on the Questions About Behavioral Function (QABF) Scale: predicting treatment success for self-injury, aggression, and stereotypies.

We investigated the validity of the Questions About Behavioral Function (QABF), a checklist designed to assess antecedent behavior, using a sample of 398 persons with mental retardation and a targeted maladaptive behavior of self-injurious behavior, aggression, or stereotypies. The QABF was used successfully to derive clear behavioral functions for most individuals (84%) across all three target behaviors. Further, subjects with treatments developed from functional assessment (QABF results) improved significantly when compared to controls receiving standard treatments not based on functional analysis. Implications of the present findings for assessing and treating maladaptive behaviors are discussed.

The relationship of self-injurious behavior and aggression to social skills in persons with severe and profound learning disability.

In this study, we investigated differences in social skills among four groups of individuals with severe and profound learning disabilities. The comparison groups were composed of individuals engaging in self-injurious behavior, aggression, both behaviors, or neither of the behaviors. We measured social skills using the Matson Evaluation of Social Skills for Individuals with Severe Retardation, a standardized assessment of social skills in persons with severe or profound learning disability. The results indicated that individuals displaying maladaptive behaviors exhibited a restricted range of social behaviors compared to controls. Also, group membership based on self-injury and aggression was predicted based on profiles of scores on the Matson Evaluation of Social Skills for Individuals with Severe Retardation. These findings are consistent with reports in other studies that note social skills deficits in aggressive and self-injurious persons with learning disabilities. However, in this case a standardized assessment of these deficits was possible and specific skills problems were identified. Implications of the findings for identification and treatment of self-injury and aggression are discussed.

The effect of stereotypies on adaptive skills as assessed with the DASH-II and Vineland Adaptive Behavior Scales

The relationship of the Stereotypy subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) to adaptive functioning was investigated. Differences in adaptive skills measured with the Vineland Adaptive Behavior Scales (VABS) for individuals scoring at or above the cutoff of the Stereotypy scale and below the cutoff of the scale were analyzed. Individuals with high stereotypy scores had significantly lower VABS scores. Implications of these findings for assessment and treatment are discussed.

Reliability of the Assessment of Dual Diagnosis (ADD).

Emotional and behavioral problems are a major source of additional handicap for children, adolescents, and adults with mental retardation. To address these problems, clinicians need psychometrically sound instruments for assessing psychopathology in individuals with mental retardation. The initial psychometric properties of the Assessment for Dual Diagnosis (ADD), a new scale designed to screen for psychopathology in individuals with mild and moderate mental retardation, was examined. The authors conducted a preliminary evaluation of the interrater and test-retest reliability of the ADD. It was determined that the ADD had high stability across raters and high stability over time. In addition, good internal consistency was established with coefficient alpha. Potential uses for the scale and directions for future research are discussed.

The Convergent Validity of the Matson Evaluation of Social Skills for Individuals with Severe Retardation (MESSIER).

The convergent validity of the Matson Evaluation of Social Skills for Persons with Severe Retardation (MESSIER) was examined. We administered the MESSIER and the Vineland Adaptive Behavior Scales (VABS) to 892 individuals with severe and profound mental retardation residing in a residential state facility. The MESSIER subscales were compared to equivalent subdomains from the VABS that have been demonstrated through research to be both reliable and valid. Significant positive correlations were found between corresponding MESSIER subscales and VABS subdomains on social behaviors. The findings also indicated that this pattern of positive correlation remained constant when comparing both verbal and nonverbal social behaviors. The implications and clinical utility of the findings are discussed.

The Relationship of Social Skills to Psychopathology for Individuals with Severe or Profound Mental Retardation.

The relationship between social skills and psychopathology in 846 individuals with severe or profound intellectual disability was examined. A linear regression analysis was performed and showed that increases in psychopathological symptoms were related to increases in negative behaviours. Results of six one-way ANOVAs comparing individuals with no diagnosis and those diagnosed with stereotypic movement disorder showed that these two groups differed in general positive and positive nonverbal skills. Implications of the findings are discussed.

Reliability of the Matson Evaluation of Drug Side Effects scale (MEDS)

The potential negative effects of psychoactive medication are well documented. Given the high rate of their use in persons with mental retardation, the need to assess and identify these negative effects is great. The Matson Evaluation of Drug Side Effects (MEDS) was designed to evaluate commonly identified side effects with a psychometrically sound checklist. The initial psychometric properties of this scale are presented and discussed. An examination of interrater reliability and internal consistency revealed that the MEDS has excellent consistency across raters and good internal consistency. Potential uses for the scale and directions for future research are reviewed as well.

A Descriptive Study of Pica Behavior in Persons with Mental Retardation

Individual variables of 45 persons residing in an institutional setting who displayed pica behavior were studied. Included in the analysis were the demographics of the sample, the types of materials being ingested, the samples psychiatric diagnoses, and social skills deficits in persons with pica. Pica was prevalent in all age ranges of lower functioning clients with mental retardation. Furthermore, subjects in the study engaged in pica for predominantly nonsocial reasons (automatic reinforcement). Persons who displayed the mental disorders of pica, autism, and stereotypic movement disorder were more likely to exhibit pica. Implications of these results are discussed.

Assessment of Schizophrenia in Persons with Severe and Profound Mental Retardation Using the Diagnostic Assessment for the Severely Handicapped-II (DASH-II)

The identification and diagnosis of schizophrenia in persons with severe and profound mental retardation has been a controversial issue. Although it has been established that schizophrenia occurs in this clinical population, persons with odd behaviors characteristic of mental retardation or severe behavior disturbances are often diagnosed with schizophrenia and treated with traditional or atypical antipsychotic medications. The present study assessed schizophrenia in a sample of persons with severe and profound mental retardation using the Diagnositic Assessment for the Severly Handicapped-II (DASH-II), a rating scale which contains purely behavioral criteria that are essential features of various DSM-IV disorders. Three groups of participants were compared; (a) those with an independent psychiatric diagnosis of schizophrenia and a significant elevation on the schizophrenia subscale of the DASH-II; (b) those with a significant elevation on this subscale, but no formal diagnosis of schizophrenia; and (c) controls without any elevation of the DASH-II subscales. Results indicated that the three groups were empirically distinguished across the frequency, duration, and severity dimensions of the DASH-II schizophrenia subscale. Item analyses demonstrated that individuals with a diagnosis of schizophrenia and an elevation of the subscale had higher scores on items containing verbal symptoms of the disorder. Implications of these findings are discussed with respect to the diagnosis of schizophrenia in persons with severe and profound mental retardation, with particular emphasis on the efficacy of the DASH-II for assessing the disorder.

The Relationship of Social Skills to Psychopathology for Individuals with Mild and Moderate Mental Retardation

Recent advances in the field of m ental retardation have included the development of instrum ents for assessm ent of both psychopathology and social skills in individuals w ith mental retardation. Researchers have subsequently begun investigating relationships between between psychopathology and social skills in individuals with m ental retardation. Initial studies have focused on persons with severe and profound m ental retardation. The present study examined the relationship between psychopathology and social skills in individuals with mild and m oderate mental retardation. This investigation used the A ssessm ent for Dual Diagnosis (ADD) to m easure psychopathology and the Social Performance Survey Schedule (SPSS) to evaluate social skills. Significant differences were observed between groups that were high or low in symptoms of psychopathology. Group patterns of social skills, item s which significantly differentiate the groups, and future research implications are discussed.