Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-04T18:40:18.813Z Has data issue: false hasContentIssue false
  • English
  • Français

More than Intelligence: Distinct Cognitive/Behavioral Clusters Linked to Adaptive Dysfunction in Children

Published online by Cambridge University Press:  08 January 2013

Aimilia Papazoglou ,
Lisa A. Jacobson  and
T. Andrew Zabel
Aimilia Papazoglou
Affiliation:
Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, Georgia
Lisa A. Jacobson
Affiliation:
Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
T. Andrew Zabel*
Affiliation:
Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
*
Correspondence and reprint requests to: T. Andrew Zabel, Department of Neuropsychology, Kennedy Krieger Institute, 1750 East Fairmount Avenue, Baltimore, MD 21231. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Impairments in adaptive functioning are frequently associated with intellectual disability (ID); however, adaptive dysfunction can be seen in many individuals with a variety of neurological conditions without ID. The extent to which other variables may be associated with adaptive dysfunction is unclear. In a mixed clinical sample of children (n = 348) consecutively referred for neuropsychological evaluation, the majority were rated as showing weak adaptive skills (ABAS-II, >1 SD below the mean; 71%), with a substantial proportion evidencing frank impairment (>2 SD below the mean, 45%). We examined patterns of scores on measures of intelligence (WISC-IV) and behavioral/affective dysregulation (BRIEF and BASC-2). Using hierarchical cluster analysis, a four cluster model yielded the most appropriate fit and adaptive functioning was subsequently examined across clusters. As expected, adaptive functioning was most intact in the cluster characterized by average IQ and minimal behavioral dysregulation. Other clusters were marked by adaptive dysfunction and distinguished by sub-average intellectual functioning and varying behavioral/emotional dysregulation. In contrast to traditional views associating low IQ with adaptive dysfunction, adaptive impairment was comparable between the cluster characterized by low intelligence and the cluster with average intelligence but significant behavioral dysregulation. These data suggest that adaptive functioning should be considered across various cognitive/behavioral conditions. (JINS, 2013, 19, 1–9)

Keywords

Activities of daily livingExecutive functionIntellectual disabilityCluster analysisMoodBehavioral symptoms
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 2 , February 2013 , pp. 189 - 197
Copyright
Copyright © The International Neuropsychological Society 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T.M. (2009). Some needed changes in DSM-V: But what about children? Clinical Psychology: Science and Practice, 16, 50–53. doi:10.1111/j.1468-2850.2009.01142.xGoogle Scholar
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental Disorders (4th ed., text revision). Arlington, VA: American Psychiatric Association.Google Scholar
Austin, J., Smith, M., Risinger, M., McNelis, A. (1994). Childhood epilepsy and asthma comparison of quality of life. Epilepsia, 35, 608–615. doi:10.1111/j.1528-1157.1994.tb02481.xCrossRefGoogle ScholarPubMed
Barkley, R.A., Fischer, M., Smallish, L., Fletcher, K. (2006). Young adult outcome of hyperactive children: Adaptive functioning in major life activities. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 192–202. doi:10.1097/01.chi.0000189134.97436.e2CrossRefGoogle ScholarPubMed
Barkley, R.A., Shelton, T.L., Crosswait, C., Moorehouse, M., Fletcher, K., Barrett, S., Metevia, L. (2002). Preschool children with disruptive behavior: Three-year outcome as a function of adaptive disability. Developmental Psychopathology, 14, 45–67.CrossRefGoogle ScholarPubMed
Carpentieri, S., Morgan, S.B. (1996). Adaptive and intellectual functioning in autistic and nonautistic retarded children. Journal of Autism and Developmental Disorders, 26(6), 611–620. doi:10.1007/BF02172350CrossRefGoogle ScholarPubMed
Crocker, N., Vaurio, L., Riley, E.P., Mattson, S.N. (2009). Comparison of adaptive behavior in children with heavy prenatal alcohol exposure or attention-deficit/hyperactivity disorder. Alcoholism: Clinical & Experimental Research, 33, 2015–2023. doi:10.1111/j.1530-0277.2009.01040.xCrossRefGoogle ScholarPubMed
Culhane-Shelburne, K., Chapieski, L., Hiscock, M., Glaze, D. (2002). Executive functions in children with frontal and temporal lobe epilepsy. Journal of the International Neuropsychological Society, 8, 623–632. doi:10.1017/S1355617702801308CrossRefGoogle ScholarPubMed
Davis, B.E., Shurtleff, D.B., Walker, W.O., Seidel, K.D., Duguay, S. (2004). Acquisition of autonomy skills in adolescents with myelomeningocele. Developmental Medicine & Child Neurology, 48, 253–258. doi:10.1017/S0012162206000569CrossRefGoogle Scholar
Everitt, B.S., Landau, S., Leese, M., Stahl, D. (2011). Cluster analysis (5th ed.). United Kingdom: John Wiley and Sons Ltd.CrossRefGoogle Scholar
Gioia, G.A., Isquith, P.K., Guy, S.C., Kenworthy, L. (2000). Behavior rating inventory of executive functioning professional manual. Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
Harrison, P.L. (1987). Research with adaptive behavior scales. The Journal of Special Education, 21, 37–68. doi:10.1177/002246698702100108CrossRefGoogle Scholar
Harrison, P., Oakland, T. (2003). Adaptive behavior assessment system (2nd ed.). San Antonio: The Psychological Corporation.Google Scholar
Hermens, D.F., Redoblado Hodge, M.A., Naismith, S.L., Kaur, M., Scott, E., Hickie, I.B. (2011). Neuropsychological clustering highlights cognitive differences in young people presenting with depressive symptoms. Journal of the International Neuropsychological Society, 17, 267–276. doi:10.1017/S1355617710001566CrossRefGoogle ScholarPubMed
Jacobson, L.A., Tarazi, R.A., Levy, E.B., Mahone, E.M., Zabel, T.A. (2012). The Kennedy Independence Skills – Spina Bifida Version: Introducing a web-based measure of adaptive self-care and executive skills. Second World Congress on Spina Bifida Research and Care, Las Vegas, Nevada.Google Scholar
Liss, M., Harel, B., Fein, D., Allen, D., Dunn, M., Feinstein, C., Rapin, I. (2001). Predictors and correlates of adaptive functioning in children with developmental disorders. Journal of Autism and Developmental Disorders, 31, 219–230. doi:10.1023/A:1010707417274CrossRefGoogle ScholarPubMed
Maser, J.D., Norman, S.B., Zisook, S., Everall, I.P., Stein, M.B., Schettler, P.J., Judd, L.L. (2009). Psychiatric nosology is ready for a paradigm shift in DSM-V. Clinical Psychology: Science and Practice, 16, 24–40. doi:10.1111/j.1468-2850.2009.01140.xGoogle Scholar
McCurdy, M., Jacobson, L.A., Tarazi, R.A., Mahone, E.M., Zabel, T.A. (2012). Initial validation of the Kennedy Independence Scales: A measure of self-care initiation in Spina Bifida. Second World Congress on Spina Bifida Research and Care, Las Vegas, Nevada.Google Scholar
Papazoglou, A., King, T.Z., Morris, R., Krawiecki, N. (2008). Cognitive predictors of adaptive functioning vary according to pediatric brain tumor location. Developmental Neuropsychology, 33, 505–520. doi:10.1080/87565640802101490CrossRefGoogle ScholarPubMed
Poggi, G., Liscio, M., Galbiati, S., Adduci, A., Massimino, M., Gandola, L., Castelli, E. (2005). Brain tumors in children and adolescents: Cognitive and psychological disorders at different ages. Psychooncology, 14, 386–395. doi:10.1002/pon.855CrossRefGoogle ScholarPubMed
Reynolds, C.R., Kamphaus, R.W. (2004). Behavior assessment system for children, Manual (2nd ed.). Circle Pines, MN: AGS Publishing.Google Scholar
Ries, J., Zabel, T.A., Mahone, E.M. (2003). Parent report of adaptive abilities and executive functions in children and adolescents with myelomeningocele and hydrocephalus [Abstract]. Archives of Clinical Neuropsychology, 18, 762.Google Scholar
Roizen, N.J., Blondis, T.A., Irwin, M., Stein, M. (1994). Adaptive functioning in children with attention-deficit hyperactivity disorder. Archives of Pediatrics & Adolescent Medicine, 148, 1137–1142.CrossRefGoogle ScholarPubMed
Schatz, J., Hamdan-Allen, G. (1995). Effects of age and IQ on adaptive behavior domains for children with autism. Journal of Autism and Developmental Disorders, 25, 51–60. doi:10.1007/BF02178167CrossRefGoogle ScholarPubMed
Shelton, T.L., Barkley, R.A., Crosswait, C., Moorehouse, M., Fletcher, K., Barrett, S., Metevia, L. (1998). Psychiatric and psychological morbidity as a function of adaptive disability in preschool children with aggressive and hyperactive-impulsive-inattentive behavior. Journal of Abnormal Child Psychology, 26, 475–494. doi:10.1023/A:1022603902905CrossRefGoogle ScholarPubMed
Soenen, S., Van Berckelaer-Onnes, I., Scholte, E. (2009). Patterns of intellectual, adaptive and behavioral functioning in individuals with mild mental retardation. Research in Developmental Disabilities, 30, 433–444. doi:10.1016/j.ridd.2008.04.003CrossRefGoogle ScholarPubMed
Sparrow, S.S., Cicchetti, D.V., Balla, D.A. (2005). Vineland adaptive behavior scales, survey forms manual (2nd ed.). Circle Pines, MN: AGS Publishing.Google Scholar
Stein, M.A., Szumowski, E., Blondis, T.A., Roizen, N.J. (1995). Adaptive skills dysfunction in ADD and ADHD children. Journal of Child Psychology and Psychiatry, 36, 665–670. doi:10.1111/j.1469-7610.1995.tb02320.xCrossRefGoogle ScholarPubMed
Thaler, N.S., Bello, D.T., Randall, C., Goldstein, G., Mayfield, J., Allen, D.N. (2010). IQ profiles are associated with differences in behavioral functioning following pediatric traumatic brain injury. Archives of Clinical Neuropsychology, 25, 781–790. doi:10.1093/arclin/acq073CrossRefGoogle ScholarPubMed
Wechsler, D. (2003). WISC-IV technical and interpretive manual. San Antonio: The Psychological Corporation.Google Scholar
Woolf, S., Woolf, C.M., Oakland, T. (2010). Adaptive behavior among adults with intellectual disabilities and its relationship to community independence. Intellectual and Developmental Disabilities, 48, 209–215. doi:10.1352/1944-7558-48.3.209CrossRefGoogle ScholarPubMed