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.
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:
Technorati Tags: psychology, developmental disabilities, MR, mental retardation, AAIDD, AAMR, Atkins cases, SCOTUS, malingering, adaptive behavior, death penalty, capital punishment, intellectual disability
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
Technorati Tags: psychology, developmental disabilities, MR, mental retardation, AAIDD, AAMR, Atkins cases, SCOTUS, malingering, adaptive behavior, death penalty, capital punishment, intellectual disability
I appreciate the kind comments (which I understand are in a guest blog by Dr. Ted Judd) on the chapter “lessons from Atkins” that appeared in WHAT IS MENTAL RETARDATION edited by Harvey Switzky and myself. Unfortunately those lessons do not appear to have been learned. The main point in that chapter is that adaptive behavior as applied in court settings has turned out to be a nightmare, because of the failure to ground it in the notion of “everyday intelligence”. This is a point I have been making in print since 1979, but Atkins experience has proved me more correct than I realized. In Indiana court decisions for example, “adaptive behavior” is frequently described as “adaptation” and any behavior that a defendant engages in which meet a basic need (an example given was eating out of a garbage can when hungry) is used as evidence of normal functioning. Then of course there are the ridiculous “Briseno facors” in Texas, in which their high court came up with a list of adaptive behaviors (such as any evidence of planning) that bear little or no resemblance to mild ID as we know it. What we need is to come up with a notion of “adaptive age” (and eating out of a garbage can would I think be at a pre-toddler—or German Shepherd-- adaptive age equivalent) and get across the notion of adaptive behavior as involving problem-solving at a more abstract level (such as understanding when an interrogator assuring you that confessing is in your interest is being deceptive. The forthcoming AAIDD manual (which I understand is likely to become known as “the green book”) basically just changes MR to ID, makes a few format improvements, but keeps the same primary emphasis on IQ and retains a construct of adaptive behavior that lacks any connection to “intelligence” broadly defined. My self-assigned task has been to try to find aspects of adaptive behavior deficit (such as “gullibility” and “foolish action” that are more intellectually-grounded and that could be considered universal diagnostic indicators of ID (as framed by the red/ green books, there is no aspect of adaptive behavior which is central to the ID construct). I am working on a paper (invited by AAIDD classification committee chair Robert Schalock) that elaborates on all the reasons why I think the green book missed the boat (I will preview it as a guest blog here, by kind invitation of Dr. McGrew). Chief among these (which has profound implications for Atkins cases) is that AAIDD missed the opportunity to define the construct more broadly, to include the many people with brain-based disorders who fit the behavioral phenotype for ID but have IQ scores that are a little too high. (Harvey and I wrote our chapter very early in our Atkins experiences, and we naively wrote that attorneys in these cases do not make a bid deal out of one or two IQ points. We have of course course learned that everything is disputed, especially one or two IQ points). I am honored that AAIDD cites me as providing the theoretical framework for the model of adaptive behavior but I need to point out that what I had in mind was a tripartite model of “adaptive intelligence” (which cause adaptive behavior to fade away) and and not continuing to view adaptive behavior as some vague add-on construct that involves such things as “has good breath” (an item on the ABAS-2)--better would be “understands the social and physical risks of having bad breath.”
ReplyDeleteSteve Greenspan (for my recent paper on “foolish action”, click on www.stephen-greenspan.com)