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ABAS-3 45Case Illustrations
Case Illustrations
Chris
A 29-Year-Old Adult With Intellectual Disability
Sources of Information
Adaptive Behavior Assessment System, Third 
Edition (ABAS-3), Adult Form completed by:
 ·Mother, Karen Jones
 ·Supervisor, Regional Vocational Day Center, 
Michael Smith
Stanford-Binet Intelligence Scale, Fifth Edition
Woodcock-Johnson® IV Tests of Achievement
Review of school, vocational, and medical records
Behavioral observations at the Regional Vocational 
Day Center
Interviews with client, parent, and supervisor
Referral
Chris Jones, a 29-year-old male with intellectual 
disability, was referred for evaluation in order to 
better understand his current levels of achieve-
ment, adaptive behavior, and intellectual devel-
opment, and to review and possibly change his 
intervention program. His parents, together with 
a supervisor from the Regional Vocational Day 
Center, requested current assessment data as 
well as help in developing an intervention program 
designed to increase Chris’s independence and 
improve his social behaviors. The publicly sup-
ported center provides assistance and on-site work 
programs, including training in daily living, social, 
and vocational skills, for adults with intellectual 
disability and other neurodevelopmental disorders.
The clinician interviewed Chris and his parents, 
Karen and Joe Jones, during a home visit. The fam-
ily conveyed information in an open and friendly 
manner. They reside in a rural area 20 miles from 
a town of 18,000. Chris enjoyed showing his yard 
and room. Chris’s father works irregular hours at 
an electric generation plant. His mother has not 
worked outside their home since Chris’s birth and 
has devoted most of her time to his care.
The clinician interviewed Chris’s supervisor, 
Michael Smith, during a visit to the vocational 
center. Chris was observed for 90 minutes while he 
was engaged with five other adults in a T-shirt sort-
ing and packing job, and later during lunch.
Background Information
Chris’s mother reported no prenatal, perinatal, 
or postnatal complications associated with her 
pregnancy with him. At about 6 months of age, 
Chris appeared to have “spells” that were diag-
nosed, in part through an abnormal EEG, as petit 
mal seizures. At about the same time, Chris was 
diagnosed with hemophilia. Several medications 
have been tried in an attempt to control his seiz-
ures. However, the medications have had limited 
success, and he has continued to have seizures 
every 2 to 3 months. Chris is an only child, and 
his parents described their parenting style as 
“overprotective.”
At age 4, Chris was enrolled in a private kindergar-
ten. The school staff felt that Chris’s development 
was slow but within the normal range. At age 5, 
Chris entered a public kindergarten, was evaluated, 
and was placed in a special-education program 
for children with developmental delays. At age 7, 
he was reevaluated and qualified for a program for 
students with mental retardation (now intellectual 
disability). Throughout his public schooling, Chris 
received most of his instruction in self-contained 
special-education classes along with a few inclu-
sive regular-education classes (e.g., physical 
education and art).
46 ABAS-3 Chapter 3 Interpretation and Intervention
Chris’s parents reported that his mother typically 
gets Chris up about 7:00 a.m. He eats breakfast 
and watches television before his mother drives 
him to the vocational center. He remains there 
from 8:30 to 2:00. His mother takes Chris to a 
community physical fitness program on Thursday 
afternoons. Following the program, they often 
shop and eat out. Chris typically spends evenings 
at home playing video games. He has his bath at 
10:30. His bedtime varies depending on the shift 
his father works. Chris sometimes goes to bed 
as late as 2:00 a.m. when his father returns after 
working the late shift.
Chris has no ongoing or regular peer relationships 
outside the vocational center. Children of family 
friends come to Chris’s home on occasion. Also, at 
the invitation of Chris’s mother, a 13-year-old boy 
who lives down the road visits Chris at home occa-
sionally for brief chats about video games. Chris 
has some peer contact as a result of his attending 
local high school football games in the fall. How-
ever, none of these relationships can be considered 
strong and supportive.
Chris left public school at age 19 and immediately 
began attending the center daily. Michael Smith, 
Chris’s supervisor at the center, noted that while 
Chris’s cognitive skills are limited, his behavior is 
not problematic, and that he complies with instruc-
tions and rules. Chris’s social engagements with 
other clients and with staff are limited and occur 
only when required during training and vocational 
routines. When he was observed at the center, 
Chris had no verbal interactions with other clients 
during work time, and he ate alone during lunch.
The assessment of Chris’s cognitive abilities and 
achievement was conducted at the center. Chris’s 
test-taking behaviors displayed suitable levels 
of attentiveness, engagement, and cooperation. 
Thus, the cognitive test data reported below are 
considered to be a valid indication of his abilities. 
Moreover, they are consistent with prior assess-
ment data.
Assessment Results
Intellectual abilities: Chris’s general intellectual 
ability, as assessed by the Stanford-Binet Intel-
ligence Scale, Fifth Edition, is at the 1st percentile, 
with a Full Scale IQ of 40. His standard scores are 
55 on visual–spatial processing, 50 on knowledge, 
46 on working memory, 45 on fluid reasoning, 
and 42 on quantitative reasoning. All are at the 
1st percentile. Among these five abilities, Chris’s 
visual–spatial processing ability is more advanced 
than his quantitative reasoning.
Achievement: Chris’s achievement, as measured 
by the Woodcock-Johnson IV Tests of Achievement, 
is consistent with his intellectual abilities and well 
below average compared to other adults his age. 
Chris’s cluster standard scores, 52 on reading and 
46 on mathematics, are at the 1st percentile.
Adaptive behavior and skills: Chris’s adaptive 
skills were assessed using the ABAS-3 Adult Form. 
Chris’s mother and supervisor each completed this 
form. Chris’s scores are reported in Table 3.3.
Chris’s General Adaptive Composite and Con-
ceptual, Practical, and Social adaptive domain 
standard scores are below the 1st percentile 
and consistent with his intelligence and achieve-
ment. His mother and supervisor report the need 
to provide mild to moderate levels of adaptive 
behavior support at home and the center, such 
as assistance with selecting appropriate clothes, 
reminders to respond verbally when others speak 
to him, all forms of meal preparation, and house-
hold cleaning. Thus, the data support a continued 
diagnosis of intellectual disability.
Most of Chris’s adaptive skills are also in the 
extremely low range, with no significant strengths 
and weaknesses in the profiles of adaptive skill 
area scaled scores completed by the mother or 
supervisor. Additionally, there are no significant 
differences between the scores from the mother 
and supervisor.
ABAS-3 47Case Illustrations
Table 3.3. ABAS-3 Adult Form Scores for Chris: 
A 29-Year, 6-Month-Old Adult With Intellectual Disability
ABAS-3 GAC and adaptive domain standard scores (M = 100, SD = 15)
Mother’s score Supervisor’s score
GAC/Adaptive 
domain
Standard score with 
90% confidence 
interval
Percentile 
rank
Standard score with 
90% confidence 
interval
Percentile 
rank
General Adaptive 
Composite (GAC)
52
(49–55)
0.1 52
(49–55)
0.1
Conceptual domain 57
(52–62)
0.2 57
(52–62)
0.2
Social domain 61
(56–66)
0.5 61
(56–66)
0.5
Practical domain 51
(46–56)
0.1 52
(47–57)
0.1
ABAS-3 adaptive skill area scaled scores (M = 10, SD = 3)
Adaptive domain and 
adaptive skill area
Mother’s 
scaled score
Supervisor’s 
scaled score
Conceptual domainCommunication 3 2
Functional 
Pre-Academics
1 2
Self-Direction 1 1
Social domain 
Leisure 3 2
Social 1 2
Practical domain 
Community Use 1 1
Home Living 1 1
Health and Safety 2 3
Self-Care 1 1
48 ABAS-3 Chapter 3 Interpretation and Intervention
Interventions
Chris’s parents acknowledged that the develop-
ment of his adaptive skills has been constrained by 
their desire to shelter him and to personally pro-
vide for his daily needs. For example, his parents 
said they have never encouraged Chris to spend 
time with peers by himself, and that his few social 
interactions have been under their supervision. 
They stated that they have never expected Chris 
to follow time lines or take initiative to do things on 
his own. However, they expressed their belief that, 
with training, Chris could perform more indepen-
dently. These types of skills can now be addressed 
through attention to his adaptive skills.
The ABAS-3 data supported that belief of Mr. 
and Mrs. Jones and motivated a commitment to 
an intervention plan leading to increased inde-
pendence. A meeting with Chris, his parents, and 
his vocational center supervisor helped identify 
specific long-term behavioral goals. These included 
the need to prepare Chris for work in a location 
other than his current restricted center placement 
and to live in an intermediate-care facility when his 
parents are no longer able to care for him.
Chris’s parents and supervisor agreed that his 
limitations should be viewed in light of his current 
and emerging adaptive skill needs. They decided to 
focus on those skills that Chris needs to use daily 
now and in the future, are considered important 
and thus valued by his caretakers and Chris, and 
can be sustained through daily practice over time. 
The ABAS-3 Intervention Planner was used to help 
identify intervention tips for Chris’s priority needs. 
Three examples follow.
Chris and his caretakers agreed that he needs to 
rely on himself to wake up in the morning. They 
therefore determined to teach him to set and rely 
on an alarm clock rather than his mother. Addition-
ally, Chris eventually will live in a group home and 
be required to socialize with peers. However, he 
does not currently seek friendships. To help Chris 
engage with peers, his parents and supervisor 
developed interventions to encourage his social 
skills development. For example, social skills will 
be taught during his lunch period. Finally, Chris’s 
work style is highly dependent on directions from 
his supervisor and others. His supervisor agreed 
to institute an intervention designed to help Chris 
develop more independent work habits. For exam-
ple, Chris will be encouraged to work by himself on 
tasks that his supervisor considers within his range 
of emerging skills. His supervisor will provide train-
ing and support as needed, along with assuring 
Chris that he is able to perform the desired tasks. 
His supervisor will praise and reward Chris finan-
cially for completing those tasks independently.
ABAS-3 49Case Illustrations
Mary
A 3-Year, 4-Month-Old Child With Autism Spectrum Disorder
Sources of Information
Adaptive Behavior Assessment System, Third 
Edition (ABAS-3)
 ·Parent/Primary Caregiver Form completed by 
mother, Anita
 ·Teacher/Daycare Provider Form completed by 
Lane Lopez, teacher, supervisor, Community 
Autism Center
Autism Diagnostic Observation Schedule™, 
Second Edition (ADOS™-2)
Bayley Scales of Infant and Toddler Development®, 
Third Edition
Clinical Evaluation of Language 
Fundamentals®–Preschool-2
Fine motor evaluation by occupational therapist
Behavioral observations at Community 
Autism Center
Review of autism center and medical records
Interviews with mother and teacher
Referral
Mary first received a diagnosis of autism spectrum 
disorder at age 2 after an evaluation by a university 
autism program. Now age 3 years, 4 months, she 
was referred by her parents for the current evalu-
ation. It included an assessment of her adaptive 
behavior and cognitive, language, and motor 
development. The purposes of this assessment 
are to describe Mary’s development in these areas, 
assist in program planning at her home and a 
community autism center, establish baseline data 
needed to monitor her progress, and inform tran-
sition plans for her enrollment in a public school 
prekindergarten program next year.
Background Information
Mary lives with her biological mother, stepfather, 
14-year-old stepsister, and 65-year-old maternal 
grandmother. Mary’s mother owns a financial 
consulting business. Her stepfather is employed 
as manager of a local pharmacy. The flexibility of 
the parents’ jobs, along with the availability of the 
grandmother, allow an adult family member to 
always be with Mary outside of her participation at 
the community center.
Mary was born full-term, of average length and 
weight, and, except for a C-section, the delivery 
was normal. Her mother was 27, in good health, 
reportedly consumed no alcohol or illegal drugs 
during her pregnancy, and smoked about eight 
cigarettes a day.
Mary’s early gross motor development generally 
was normal. For example, she sat up at 7 months 
and walked at 12 months. She displayed oral/
sensory sensitivity from infancy. Recently, she 
has refused all but a limited range of foods (e.g., 
peanut butter and jelly sandwiches, grilled cheese 
sandwiches, toast). She eats with her hands and 
smells her food before eating it. Mary is not fully 
toilet trained.
Mary attends an intensive day-care program on 
weekdays at a community program for children 
diagnosed with autism spectrum disorder. Her 
teacher reports considerable improvement in 
Mary’s behavior and achievement during the last 
6 months, following implementation of applied 
behavior management principles. In addition, 
Mary is beginning to exhibit parallel play, an ability 
considered to be a precursor to the development 
of more advanced social skills.
Her parents report that Mary displays no fears 
and shows minimal awareness of danger at home. 
They both describe her as “bouncing off the walls,” 
displaying potentially dangerous behaviors (e.g., 
climbing on top of the TV), almost always in action, 
and able to sustain her active behavior over a long 
period of time. When told “no” at home, Mary runs, 
throws tantrums, bangs her head, twirls, kicks, and 
hits. In contrast, her teacher reports that Mary 
does not throw tantrums at the autism center.
There are no reports of serious injuries, illnesses, 
allergies, or problems with visual or auditory acu-
ity. She takes medication twice daily to improve 
concentration and attention. Mary typically goes 
to bed at 8:00 p.m. and sleeps through the night 
without nightmares.
50 ABAS-3 Chapter 3 Interpretation and Intervention
Her parents and teachers agreed that Mary enjoys 
placing objects (e.g., blocks, magnets, colors) in a 
line, spinning toys, and watching television pro-
grams that present captioned information at the 
bottom of the screen. Mary does not interact with 
family members, has no neighborhood friends, 
and displays limited interaction with peers in her 
autism program.
Assessment Results 
Adaptive behavior and skills: Mary’s mother com-
pleted the ABAS-3 Parent/Primary Caregiver Form, 
and her teacher completed the ABAS-3 Teacher/
Daycare Provider Form. Scores are reported in 
Table 3.4. ABAS-3 ratings from Mary’s mother and 
teacher generally are consistent. Her mother’s 
and teacher’s ratings indicate that most areas 
of Mary’s adaptive behavior are in the extremely 
low range as reflected in scores from the General 
Adaptive Composite, the three adaptive domains, 
and eight of the ten adaptive skill areas.
However, ratings from both her mother and 
teacher suggest that Mary’s relative strengths are 
found in her Functional Pre-Academic and Motor 
adaptive skill areas, compared to her extremely 
low adaptive functioning in other skill areas. Rat-
ings from both her mother and teacher indicatethat Mary’s Motor adaptive skills are in the below 
average range, and an inspection of their item 
ratings suggests that Mary’s gross motor skills are 
more developed than her fine motor skills. Mary’s 
Functional Pre-Academic adaptive skills, as rated 
by her mother, are in the low range. In contrast, at 
the autism center, Mary’s Functional Pre-Academic 
adaptive skills are rated by the teacher as being in 
the average range.
Autism spectrum disorder: Behaviors associated 
with an autism spectrum disorder were assessed 
through the use of the Autism Diagnostic Observa-
tion Schedule™, Second Edition (ADOS™-2). Mary 
was administered Module 1 of the ADOS-2, as this 
module is designed specifically for children who 
are 31 months of age and older and who are pre-
verbal or using single words.
Mary was quite active during the assessment and 
seemed to enjoy exploring the toys and materials, 
though she showed little interest in interacting 
with the examiner and did not exhibit pretend play. 
For example, although she was not receptive to the 
examiner’s attempts to engage her during the Free 
Play activity, she actively explored the materials by 
pressing buttons repetitively on cause-and-effect 
toys, spinning the wheels of the toy car, and engag-
ing in sensory examination of the objects such as 
lining up the toy silverware, peering at it out of the 
corner of her eye, and then smelling it. During the 
pretend birthday party, she did not display inter-
est in the doll or the party, though she did seem to 
enjoy placing the pretend candles into the birthday 
cake. Mary did not approach the examiner or her 
mother to communicate during the assessment; 
for example, she did not request help or show or 
share objects. Mary’s Overall Total score on the 
Module 1: Few to No Words algorithm (selected 
for children who use fewer than five words during 
the session) exceeded the autism cutoff and was 
consistent with an ADOS-2 classification of autism. 
Her ADOS-2 Comparison Score further indicated 
that, on the ADOS-2, she displayed a high level of 
autism spectrum–related symptoms as compared 
with children who have autism spectrum disorder 
and are of the same chronological age and language 
level. These results support a continued diagnosis 
of autism spectrum disorder.
Cognitive and language development: Mary’s 
development was assessed with the Bayley Scales 
of Infant and Toddler Development, Third Edition. 
Mary’s cognitive and motor composites of 76 and 
80, respectively, are in the low to low-average 
range. However, her language composite of 60 is 
extremely low and below the 1st percentile. She 
displayed little meaningful language during the 
assessment, an indication that her speech and 
language development are delayed. She does 
not engage in conversation with others. When 
speaking, her words are unrelated to questions or 
comments made by others, or to the nature of her 
activities.
Given the importance of language to early devel-
opment, including the development of children 
with autism spectrum disorder, Mary’s language 
also was assessed by a speech–language patholo-
gist using the Clinical Evaluation of Language 
Fundamentals–Preschool-2. Her core language 
standard score, as well as receptive and expressive 
language indexes, were again extremely low (at or 
below the 1st percentile). Her language develop-
ment is similar to that of toddlers between 16 and 
20 months of age.
ABAS-3 51Case Illustrations
Table 3.4. ABAS-3 Parent/Primary Caregiver and Teacher/Daycare Provider Scores for Mary: 
A 3-Year, 4-Month-Old Child With Autism Spectrum Disorder
ABAS-3 GAC and adaptive domain standard scores (M = 100, SD = 15)
Parent/Primary Caregiver Form Teacher/Daycare Provider Form
GAC/Adaptive 
domain
Standard score with 
90% confidence 
interval
Percentile 
rank
Standard score with 
90% confidence 
interval
Percentile 
rank
General Adaptive 
Composite (GAC)
55
(51–59)
0.1 58
(56–60)
0.3
Conceptual domain 57
(51–63)
0.2 67
(63–71)
1
Social domain 51
(44–58)
0.1 51
(47–55)
0.1
Practical domain 53
(48–58)
0.1 53
(49–57)
0.1
ABAS-3 adaptive skill area scaled scores (M = 10, SD = 3)
Adaptive domain and 
adaptive skill area
Parent/Primary 
Caregiver Form
Teacher/Daycare 
Provider Form
Conceptual domain
Communication 1 1
Functional 
Pre-Academics
5 10
Self-Direction 1 2
Social domain 
Leisure 1 1
Social 1 2
Practical domain 
Community Use 1 —
Home/School Living 1 2
Health and Safety 2 2
Self-Care 1 2
Motor 6 7
52 ABAS-3 Chapter 3 Interpretation and Intervention
Fine motor: An evaluation by an occupational 
therapist indicated that Mary displays delays in 
fine motor, self-care, and play skills along with 
decreased attention, limited communication, and 
sensory integration. Her gross motor skills, includ-
ing mobility, were relative strengths.
Interventions
Mary’s parents and teacher agreed that her skill 
development and program implementation must 
focus on developing more control of her behaviors 
(e.g., running, head-banging, twirling, hitting, kick-
ing) at home. The use of applied behavior manage-
ment principles at the autism day-care program 
has resulted in important behavioral improve-
ments there. Mary’s mother, father, and grand-
mother agreed to be trained in the use of applied 
behavior management principles and to work with 
the school psychologist to implement a similar 
program at home.
Mary’s parents and teacher discussed current and 
emerging adaptive skill needs. They are especially 
concerned about preparing Mary to transition to a 
public preschool program. Mary’s current program 
is producing positive results. However, parents and 
teacher agree that combined home and school 
intervention efforts that further promote com-
munication, social, and self-care skills are needed. 
Information from the ABAS-3 Intervention Planner 
was used to help identify intervention strategies. 
Some examples follow.
In reference to communication skills, receptive 
language typically precedes expressive language. 
Consistent with suggestions from the ABAS-3 
Intervention Planner, Mary’s parents and teacher 
agreed to verbally label common objects or events 
in Mary’s environment as they occur (e.g., washing 
hands, dressing, toileting) to promote receptive 
language. They then will prompt her to repeat the 
words to facilitate expressive language. Rewards 
will be contingent on successful prompting. The 
goal is for Mary to label 10 or more new objects or 
events weekly.
In reference to social skills, Mary has not initiated 
social relationships with peers. At times, young 
children with autism spectrum disorder are willing 
to engage with others who show curiosity about 
these children’s unusual interests. Thus, others 
need to initiate relationships for Mary. As sug-
gested by the ABAS-3 Intervention Planner, at 
school, the teacher will encourage a connection 
between Mary and high-performing children with 
autism by assigning a common task to them (e.g., 
to color a page or to build with blocks). Also, the 
teacher will identify an older student to engage 
with Mary in common activities once or twice 
weekly. The teacher will gradually encourage Mary 
to play with other children by having her try differ-
ent activities within the program. Similar efforts 
are needed at home. The parents agreed to involve 
Mary’s older stepsister and grandmother in similar 
efforts to interest Mary in social interaction.
In reference to self-care skills, students in the 
public prekindergarten program are expected to 
use the restroom by themselves. Mary has not 
achieved this important developmental milestone 
and needs to do so before beginning the public 
school program next year. The ABAS-3 Interven-
tion Planner provides suggestions for promoting 
behaviors that, in succession, can result in com-
pleted toilet training. Efforts begin by encouraging 
behaviors that occur at the end of the toileting 
cycle (e.g., flushing the toilet) and successivelywork backward to include earlier skills (e.g., 
throwing the toilet paper in the toilet, wiping with 
toilet paper, pulling toilet paper off the roll, pulling 
clothes down). Coordinating interventions at home 
and school is critical to improving self-care and 
other adaptive skills.
ABAS-3 53Other Examples
Other Examples
These two brief case illustrations provide examples of 
the use of the ABAS-3 with an adult with intellectual 
disability and a young child with autism spectrum 
disorder. Indeed, adaptive skills are important for 
everyone, especially those who display various types 
of limitations, disabilities, problems, or needs. Adap-
tive skills should be assessed routinely for children or 
adults who have difficulties, disabilities, or disorders 
that may interfere with daily functioning, as part of 
comprehensive assessments for evaluating strengths 
and limitations, diagnosis and classification, or iden-
tifying needs for services and support.
Additional examples of uses of the ABAS-3 include 
the following:
 ·The parents of a 4-year-old child request assess-
ment by school psychologists because the child 
has not met major developmental milestones.
 ·An early intervention specialist in a public 
health clinic evaluates a 1-year-old child with 
cerebral palsy.
 ·A school district requests adaptive behavior 
assessment to assist in planning and coordinat-
ing home-school programs for children with 
special needs.
 ·A fourth-grade student diagnosed with an emo-
tional disturbance displays various social and 
self-direction problems at home, for which the 
parents have requested help from a psychologist 
in independent practice.
 ·Parents of a child with a visual impairment 
request consultation with a school’s Individual 
Education Plan (IEP) committee on home inter-
ventions for adaptive skill development.
 ·A third-grade student with a learning disability 
is referred to the school psychologist because of 
problems in daily behaviors and practical skills.
 ·A fifth-grade student diagnosed with ADHD is 
referred to a mental health center for compre-
hensive assessment, based on reports of dimin-
ished self-direction, self-care, and school/home 
living skills.
 ·A school district collects assessment data to assist 
and monitor high-school students with disabilities 
in their transition from school to work settings.
 ·An occupational therapist is responsible for coor-
dinating the rehabilitation of a young adult with 
traumatic brain injury.
 ·A speech–language pathologist routinely con-
ducts evaluations to better understand adult cli-
ents’ development and use of communication in 
social and daily living activities in home, school, 
and work settings.
 ·An assisted living facility uses assessment data 
to help clinicians make decisions regarding 
program planning and monitoring of residents’ 
self-help skills.
 ·The family of a person with Alzheimer’s disease 
requests that a community agency conduct an 
evaluation to help improve functional behaviors 
and skills of daily living.
 ·A social worker evaluates people with depression 
and anxiety to assess effects of the mental disor-
ders on daily functioning.
 ·A psychiatrist assesses a person to monitor 
changes in daily behaviors in response to 
medication.
 ·For more examples of adaptive behavior assess-
ment and intervention, see Oakland and Har-
rison (2008).