Sunday, September 6, 2009

Rethinking adaptive behavior in light of MR Atkin's cases: Greespan and Switzky (2006) chapter

Although the primary focus of this blog is on the intellectual component of MR definition, assessment, etc. in Atkin's cases, material related to the second component of the MR definition (adaptive behavior) will also be covered. I have a long standing research interest in adaptive behavior which I will mention in a future post. When appropriate this blog will comment on conceptual, theoretical, and esp. measurement issues surrounding both intellectual competence and adaptive behavior

I just read a the following very thought provoking book chapter by Greenspan and Switzky.

  • Stephen Greenspan & Harvey N. Switzky (2006). Lessons from the Atkins decision for the next AAMR manual. In H.N. Switzky & S. Greenspan (Eds.), What is Mental Retardation?: Ideas for an evolving disability in the 21st century. (pp. 281- 300). Washington, DC: American Association on Mental Retardation. (click here to view chapter; click here to view book at AAIDD web page)

Based on their considerable experience as testifying experts in Atkin's MR/death penalty case, primarily with reference to the definition, assessment, and theoretical issues related to adaptive behavior, Greenspan and Switzky make numerous suggestions re: how the next version of the AAMR/AAIDD mental retardation manual should be changed, in light of the emerging prominent role of the manual in Atkin's cases. Atkin's cases have, more-or-less, forced the need to reexamine some of the underlying concepts and thinking related to the conceptualization and measurement of adaptive functioning.

Some of the key issues and ideas discussed are:
  • Problems and potential solutions to the self-rating format of adaptive behavior (AB) assessment tools
  • The need for multiple raters
  • "Reverse malingering" - individuals with mild MR having a tendency to exaggerate their level of skills and competence to try hide their disability
  • The failure of many AB instruments to provide adequate coverage of one of the critical components of AB: social skill deficits, social vulnerabilty, guillability, etc.
  • The problems in judging level of adaptive functioning based on the tasks involved in completing a crime
  • The suggestion to change the name of the construct to adaptive functioning--to jetison some of the historical baggage that is associated with the current AB term.
  • The inherent problems in judging adaptive functioning from clinical interviews, given the ability of many individuals with mild MR to "sound" more intelligent than they are.
  • Issues and ideas for establishing levels of AB retroactively (e.g., at the time the crime occured; the person's functioning before the age of 18)
  • The over-reliance on IQ scores and the suggesting to reverse the weight given to IQ and AB in the definition of MR.
  • The suggestion to bring back the "borderline" category of MR
It is clear that Greespan and Switzky have had considerable experience in addressing the AB component in Atkin's cases and their experiences have produced keen insights (and possible ideas) for improving the conceptualization, measurement, and use of AB definitions, measures, and scores in court settings. I can't wait to see the entire book.

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