A Critical Appraisal of Current Adaptive Behavior Measurement in Comprehensive Intensive Behavioral Intervention Outcome Assessment

Purpose: This critical review examines the application of two commonly-used adaptive functioning measures, the Vineland Adaptive Behavior Scales – Third Edition (Vineland-3) and the Adaptive Behavior Assessment System – Third Edition (ABAS-3), to the behavioral intervention context. The review focuses on periodic outcome and treatment planning assessment in people with autism spectrum disorder receiving comprehensive and intensive behavioral intervention (CIBI) programs. Methods: Instrument technical manuals were reviewed and a PubMed search was used to identify published manuscripts that included the Vineland-3 and ABAS-3 as a primary focus with relevance to development, psychometric properties, or measure interpretation. Results: 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 practical aspects of their implementation to inform everyday practice. Examination of each measure’s development indicates that they were not specifically designed for use with individuals with autism spectrum disorder or within CIBI programs. Furthermore, the evidence for several key psychometric characteristics is either unavailable or suggests less than desirable properties, while evaluation of practical considerations for implementation revealed weaknesses in ongoing intervention monitoring and clinical decision support. Conclusions: The Vineland-3 and ABAS-3 have significant weaknesses relevant to their application in CIBI outcome assessment. Alternative approaches are offered, including developing and adopting measures specifically developed for individuals with autism spectrum disorder and the CIBI intervention context.