Maladaptive Behaviours and Associated Characteristics within Individuals with Autism and Intellectual Disability

Background:

Maladaptive behaviours have been referred to by many different labels, including; problem behaviour, aberrant behaviour, and challenging behaviour. All of these descriptors are umbrella terms for a collection of specific behaviours thought to be dangerous, disruptive, threatening, or harmful to one’s self or others. Generally, the intellectual disability literature has focused on three specific forms of maladaptive behaviour; aggression, self injurious behaviour, and stereotyped behaviour (Dawson, Matson, & Cherry, 1998).

It has been suggested that among individuals with intellectual disabilities the rates of those engaging in some form of maladaptive behaviour may be as high as 50% (Atkinson, Feldman, & Condillac, 1998), but rates vary considerably across studies, in large part because of differences in the way maladaptive behaviour is defined and measured. The situation is considerably more complicated when the individual also has autism, since the maladaptive behaviours may be attributed to the autism (e.g., agitation), but also because symptoms of autism may appear to mimic other forms of psychopathology or maladaptive behaviour (e.g., delayed echolalia may appear psychotic, lack of social initiation may mimic depression).

Age, cognitive ability, gender, and communicative skills have all been found to correlate with the occurrence of maladaptive behaviours in individuals with an intellectual disability (McClintock, Hall, & Oliver, 2003). It is unclear the degree to which certain types of maladative behaviour may be a function of degree of intellectual disability and severity of autism when these disorders are comorbid.

Objectives:

Very few studies have examined the characteristics associated with maladaptive behaviours within individuals who have comorbid autism and intellectual disability. This is despite the fact that both autism and impaired cognitive functioning have been associated with higher levels of maladaptive behaviours. The purpose of this study is to examine those characteristics that may be associated with maladaptive behaviours within such a population.

Methods:

This was a file review study at a school and residential setting for individuals with autism in Toronto, Ontario, Canada. The sample includes 60 participants ages 8 to 41. The Vineland Adaptive Behaviour Scales – 2^nd Edition was used as a measure of the participants’ level of engagement in maladaptive behaviours, as well as a measure of their adaptive behaviours. Measures of cognitive skills, communication, and severity of autism were also administered to the participants. All measures were given within the context of routine clinical assessments by a team of trained clinicians.

Results:

Data analysis is currently underway. Four maladaptive scores were derived from the Vineland-II: internalizing, externalizing, other, and critical items. Each of these will be examined in relation to age and gender as well as the following developmental and diagnostic variables: severity of autism, verbal and nonverbal mental age, expressive and receptive communication, daily living skills, and social skills.

Conclusions:

Conclusions will focus on the conceptualization and clinical implications of the results regarding maladaptive behaviours in this population, including the risk of possible misinterpretations of scales or items in children with low cognitive levels and severe autism.