AAIDD Annual MeetingPittsburgh, PA, June 3-6, 2013 - PDF document

AAIDD Annual MeetingPittsburgh, PA, June 3-6, 2013 Finally...an Adaptive Behavior Scale Focused on Providing Precision at the Diagnostic Cut-Off Psychometric Qualities f th DABS o f th e DABS Giulia Balboni, Ph.D. y of Pisa, Ital y yy AAIDD Annual MeetingPittsburgh, PA, June 3-6, 2013 Psychometric Qualities of the DABS C th Co - au Marc, J. Tassé, Ph.D.NisongerCenter-UCEDDDavid M. Thissen, Ph.D. University of North Carolina - Robert L. Schalock, Ph.D. University of North Carolina - Keith Widaman, Ph.D. Sharon A. Borthwick-Duffy, Ph.D.University of California-RiversideUniversity of California-DavisDalunZhang, Ph.D. Scott Spreat, Ed.D.Woodland Center for Challenging BehaviorsTexas A&M University Background facilitate the diagnosisof ID of 4-21 y.o. i n determine if the individual presents determine if the individual presents in AB necessary for an ID diagnosis Background Significant in AB are operationally defined Significant in AB are operationally defined as performance that is approximately 2 SDs below the mean of either the mean of either (a)oneof the following three types of AB: on a standardized measure Standard Error of Measurementof the AB scale must be considered in the determination of the cut - must be considered in the determination of the cut - off point Background DABS should be conceptual social and practical AB conceptual , social , and practical AB skills that, in individuals aged 4-21, the mean of g p ulation gpp Background 4-8 9-15 16-21 y.o. 3 DABS f hld ll 3 DABS f orms h correctly and discriminate between persons Purposes y to correctly identify persons with an ID diagnosis - with an and discriminate them from those (a) who do not have an ID diagnosis or (a) who do not have an ID diagnosis or (b)have another non-IDverified conditions if DABS accuracy is the individual ’ individuals if 3 DABS forms show the same accuracy Participants n 111 (49) 1 (4 . Gender Male -Female50 -50 Individuals recruited during the phase of DABS phase of DABS Participants % ID-related125Non-ID933 Typically developing Other verified conditions Autism Spectrum Disorder Learning disability 6 4 Learning disability Language impairment Emotional disturbance Hearing impairment 4 31 Visual impairment Participants DABS FORM 4 1 1 1 4 -8= 388)9- (n= 432) 1 6-2 = 238)A g e g Mean (SD)6.00 (1.41)11.69 (2.00)18.19 (1.63) Ml l e - F - – - Non ID – – - Non ID Instrument 4-8 9-15 16-21 y.o. • Practical Skills Total Adaptive Behavior score ID Diagnosis Cut-off Point • 3 DABS Domains Total Adaptive Behavior • 3 DABS Domains , Total Behavior Standard Score obtainedwith IRT model - Mean = 100 SD = 15 - Mean = 100 SD = 15 • “ 2 SDs below the mean ” cut - off = 2 SDs below the mean cut - off = ID Diagnosis Cut-off Point • To take into account the of the To take into account the of the sources of measurement errors •2 SEM must be added to this ID diagnosis cut - off Standard Score 3 DABS FORMS Average ID Diagnosis Cut - off SS - off Standard Score 3 DABS FORMS off SS Conceptual SSSocial SS3376 Practical SS376TotalAdaptive Behavior SS274 Results: Standard scores obtained on the DABS do ainsand on the Total Ada p tive Behavior m p by the participants withan ID-related diagnosis DABS Total Adaptive Behavior DABS Total Adaptive Behavior Participants with had a Mean SS consistentl the Mean SS of ld dii re l d di DABS Total Adaptive Behavior For almost all the age groups, age groups, the Mean SS of individuals with an ID-related dia g nosis diagnosis cut-off SS of 74 DABS Domains Conceptual Skills Social Skills Practical Skills Non-ID ID-related diagnosis Conceptual Skills Social Skills Practical Skills DABS Domains Conceptual Skills Social Skills Practical Skills Non-ID ID-related diagnosis Conceptual Skills Social Skills Practical Skills Al f DABS di tiit ith ID ltd dii Al so or DABS d i t e d di had Mean SSs consistently the Mean SS of participants an ID-related diagnosis DABS Domains Conceptual Skills Social Skills Practical Skills Non-ID ID-related diagnosis Conceptual Skills Social Skills Practical Skills Th M SS f th idiidl ith ID ltd dii bl Th e SS f th e n v ua l s w t e d di l the ID diagnosis cut-off SS of in all the age groups with the exception of a few age groups for the Social and Practical skills DABS Domains Conceptual Skills Social Skills Practical Skills Non-ID ID-related diagnosis Conceptual Skills Social Skills Practical Skills H it i imptnt t ndlin tht f th p th Mn H owever, it i imp nt t o u th a t f th grou th e Total Adaptive Behavior SS was generally below the ID cut-off point Results: Standard scores obtained on the DABS do ains and on the Total Ada p tive Behavior mp by participants with and without an ID-related diagnosis DABS i i idifi i idiidl DABS i s id i n v of different ages, the in AB consistent with an ID diagnosis Results: 2. Sensitivityand of the three DABS orms in identi fy in p ffygpp an ID-related diagnosis Sensitivity & Specificity Accuracy of DABS in correctly classifying individuals Accuracy of DABS in correctly classifying individuals and ID-related diagnosis, based on thi lt th Sl th e i r th Sitiit S yUsing DABS SS to correctly IDENTIFY WITH an ID related diagnosis WITH an ID related diagnosis ) S p WITHOUT an ID-related diagnosis Sensitivity & Specificity Accuracy of DABS in correctly classifying individuals Accuracy of DABS in correctly classifying individuals and ID-related diagnosis, based on thi lt th Sl th e i r th Sitiit S Percentage of all the individuals WITH an ID-related diagnosis who have a DABS SS BELOW the cut - diagnosis who have a DABS SS the cut Pt f ll th idiidl WITHOUT ID t a ll th e n v ua l s WITHOUT ID related diagnosis who have a DABS SS DABS Form 4-8 N = 388 ID-relatedNon-ID = 388 Significantlimitations in AB( n = 57)2631 in AB ( n 331) 6 325 in AB ( n = 331) 6 DABS Form 4-8 N = 388 DIAGNOSIS = 388 Significantlimitations in AB( n = 57)2631 in AB ( n 331) 6 325 in AB ( n = 331) 6 Of ll th 388 tiit ll th e 388 i -32 had an ID-related diagnosis DABS Form 4-8 N = 388 DIAGNOSIS = 388 Significantlimitations in AB( n = 57)2631 in AB ( n 331) 6 325 in AB ( n = 331) 6 Of ll th 388 tiit ll th e 388 i 32had an ID-related diagnosis -356 yp ical develo p ment or a non-ID verified ypp condition DABS Form 4-8 N = 388 ID-relatedNon-ID = 388 Significantlimitations in AB( n 2631 in AB ( n 331) 6 325 in AB ( n = 331) 6 Of th 388 tiit Of th 388 i -57Behavior, or on at least one of the three domains the ID diagnosis cut-off point DABS Form 4-8 N = 388 ID-relatedNon-ID = 388 Significantlimitations in AB( n = 57)2631 in AB ( n 331) 6 325 in AB ( n = 331) Of th 388 tiit • Of th 388 i 57 had a SS on the DABS Total Adaptive Behavior, or on at least one of the three domains below the ID diagnosis cut-off point -331did not have significant limitations in AB DABS Form 4-8 N = 388 DIAGNOSIS = 388 Significantlimitations in AB( n = 57)2631Non-significant limitations in AB ( n 331) 6 325 in AB ( n = 331) 6 DABS f 4 8 tl lifid DABS f c l ass e d : diagnosis who obtained g nosis cut-off g DABS Form 4-8 N = 388 DIAGNOSIS = 388 Significantlimitations in AB( n = 57)2631 in AB ( n 331) 6 325 in AB ( n = 331) 6 DABS f 4 8 tl lifid DABS f c l ass e d : the 26 with an ID-related diagnosis who obtained g nosis cut-off g 325withoutan ID-related diagnosis who DABS Form 4-8 N = 388 DIAGNOSIS = 388 Significantlimitations in AB( n = 57)2631 in AB ( n 331) 6 325 in AB ( n = 331) DABS f 4 8 did tl lif DABS f 8 did c l ass the ID dia g nosis cut-off g (i.e., did not present significant limitations) DABS Form 4-8 N = 388 DIAGNOSIS = 388 Significantlimitations in AB( n = 57)26 in AB ( n 331) 6 325 in AB ( n = 331) 6 DABS f 4 8 did t tl lif DABS f 8 did c l ass 6 with an ID-related diagnosis but who obtained g nosis cut-off g -31withoutan ID-related diagnosis but who p resented si g nificant limitations ) DABS Form 4-8 N = 388 ID-relatedNon-ID = 388 Significantlimitations in AB( n = 57)2631 in AB ( n 331) 6 325 in AB ( n = 331) 6 Sitiit v accuracy in correctly persons who have an nosis DABS Form 4-8 N = 388 ID-relatedNon-ID = 388 Significantlimitations in AB( n = 57)2631Non-significant limitations in AB ( n 331) 6 325 in AB ( n = 331) 6 f ll th idiidl ith ID ltd P ercen t a ll th e n v ua l s w ID t e diagnosis who were identified by the DABS Sensitivity = 26/(26+6) = 26/32 = 081 81% • Sensitivity = 26/(26+6) = 26/32 = 0 DABS correctly classified 81% of 4-8 individuals with DABS Form 4-8 N = 388 ID-relatedNon-ID = 388 Significantlimitations in AB( n = 57)2631 in AB ( n 331) 6 325 in AB ( n = 331) 6 Sifiit accuracy in correctly have an ID-related dia g nosis DABS Form 4-8 N = 388 ID-relatedNon-ID = 388 Significantlimitations in AB( n = 57)2631 in AB ( n 331) 6 325 in AB ( n = 331) 6 f ll th idiidl itht ID P ercen t a ll th e n v ua l s w ID related diagnosis who were excluded by the DABS • Specificity = 325/(325+31) = 325/356 = 091 91% • Specificity = 325/(325+31) = 325/356 = 0 . DABS correctly classified 91% of 4-8 individuals DABS Form 4-8 N = 388 ID-relatedNon-ID = 388 Significantlimitations in AB( n = 57)2631 in AB ( n 331) 6 325 in AB ( n = 331) 6 Sitiit v y = Specificity = 91% DABS Form 4-8 N = 388 ID-relatedNon-ID = 388 Significantlimitations in AB( n = 57)26 in AB ( n 331) 6 325 in AB ( n = 331) 6 Sitiit v Specificity = 91% Of th 31 48% hd ID ifid diti Of th 31 48% h a a (e.g., learning disability) limitations in AB in absence of an ID dia g nosis DABS Form 9-15 N = 432 ID-relatedNon-ID = 432 Significantlimitations in AB( n = 79)3643 in AB ( n 353) 6 347 in AB ( n = 353) 6 DABS Form 9-15 N = 432 ID-relatedNon-ID = 432 Significantlimitations in AB( n = 79)3643Non-significant limitations in AB ( n 353) 6 347 in AB ( n = 353) 6 Sitiit 36/42 086 v y = 36/42 = . DABS correctl y identified 86% of individuals y 9-15 y.o. withan ID-related diagnosis DABS Form 9-15 N = 432 ID-relatedNon-ID = 432 Significantlimitations in AB( n = 79)3643 in AB ( n 353) 6 347 in AB ( n = 353) 6 Sifiit 347/390 089 y = 347/390 = . DABS correctl y excluded 89% of individuals y 9-15 y.o. withoutan ID-related diagnosis DABS Form 9-15 N = 432 ID-relatedNon-ID = 432 Significantlimitations in AB( n = 79)3643 in AB ( n 353) 6 347 in AB ( n = 353) 6 Sitiit v y = Specificity = 89% DABS Form 9-15 N = 432 ID-relatedNon-ID = 432 Significantlimitations in AB( n = 79)36 in AB ( n 353) 6 347 in AB ( n = 353) 6 Sitiit v Specificity = 89% Of these 43 74% had a non ID verified condition Of these 43 74% had a non - ID verified condition that may explain the low score on DABS in absence of an ID diagnosis DABS Form 16-21 N = 238 ID-relatedNon-ID = 238 Significantlimitations in AB( n = 69)5019 in AB ( n 169) 1 168 in AB ( n = 169) 1 DABS Form 16-21 N = 238 ID-relatedNon-ID = 238 Significantlimitations in AB( n = 69)50Non-significant limitations in AB ( n 169) 1 168 in AB ( n = 169) 1 Sitiit 50/51 098 v y = 50/51 = . DABS correctl y identified 98% of individuals y 16-21 y.o. withan ID-related diagnosis DABS Form 16-21 N = 238 ID-relatedNon-ID = 238 Significantlimitations in AB( n = 69)5019 in AB ( n 169) 1 168 in AB ( n = 169) 1 Sifiit 168/187 090 y = 168/187 = . DABS correctl y excluded 90% of individuals y 16-21 y.o. withoutan ID-related diagnosis DABS Form 16-21 N = 238 ID-relatedNon-ID = 238 Significantlimitations in AB( n = 69)5019 in AB ( n 169) 1 168 in AB ( n = 169) 1 Sitiit v y = Specificity = 90% DABS Form 16-21 N = 238 ID-relatedNon-ID = 238 Significantlimitations in AB( n = 69)50 in AB ( n 169) 1 168 in AB ( n = 169) 1 Sitiit v Specificity = 90% Of these 19 74% had a non ID verified condition Of these 19 74% had a non - ID verified condition that may explain the low score on DABS in absence of an ID diagnosis Results: Sensitivity and specificity of the three DABS orms in identi fy in p ants with ffygpp and without an ID-related diagnosis Three DABS forms are idtifi idiidl ith ID ltd i v w ID t e excludingindividuals without an ID diagnosis In Conclusion… s are accurate in correctly classifying individuals, aged 4 - 21 aged 4 , a formal diagnosis of ID This property is consistent regardless of the individual ’ individuals