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Differential Profiles of Adaptive Behavior of Maltreated Children

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 Psychological Trauma: Theory, Research, Practice, and Policy © 2014 American Psychological Association
2014, Vol. 6, No. 5, 574 –579 1942-9681/14/$12.00 http://dx.doi.org/10.1037/a0036718

Differential Profiles of Adaptive Behavior of Maltreated Children

Kathleen D. Viezel and Ari Lowell Andrew S. Davis

Fairleigh Dickinson University Ball State University

Jenean Castillo
New York Medical College

Although it is well established that maltreatment is associated with a host of developmental, emotional,
and behavioral challenges, relatively little is known about the adaptive behavior of children who have
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

been abused or neglected. The present study examined 160 children in foster care; 42 were removed from
This document is copyrighted by the American Psychological Association or one of its allied publishers.

their families because of abuse and 118 were removed because of neglect. A demographically matched
comparison group was obtained from the standardization sample of the Vineland Adaptive Behavior
Scales and Vineland Adaptive Behavior Scales, Second Edition. The 3 groups of children were compared
in order to examine potential differences in communication, daily living, and socialization skills. A
multivariate analysis of variance and follow-up descriptive discriminant analysis concluded that the 3
groups had significantly different mean scores on all 3 Vineland domains, and children who were
neglected had the most clinically significant delays in all areas. Clinical and practice implications are
discussed.

Keywords: abuse, neglect, adaptive behavior, Vineland, foster care

Child abuse and neglect continue to be a salient societal prob-
lem. According to data collected through the National Child Abuse
and Neglect Data System, 676,579 unique incidents of child abuse
and neglect were substantiated in the United States in 2011 (U.S.
Department of Health & Human Services, 2012). The negative
consequences of child maltreatment are numerous, including im-
paired developmental trajectory (Cahill, Kaminer, & Johnson,
1999; Cicchetti & Toth, 1995; Schatz & Lounds, 2007); significant
neurobiological changes (Heim, Shugart, Craighead, & Nemeroff,
2010; Palaszynski & Nemeroff, 2009); cognitive and academic
deficits (Crozier & Barth, 2005; Jaffee & Maikovich-Fong, 2011;
Kurtz, Gaudin, Wodarski, & Howing, 1993); and emotional, social
functioning, and behavioral problems (Lee & Hoaken, 2007;
Shonk & Cicchetti, 2001; Teisl & Cicchetti, 2008). A history of
childhood abuse and neglect has also been associated with a higher
prevalence of depression, anxiety, and relationship difficulties in
college students (Gauthier, Stollak, Messe, & Aronoff, 1996), as
well as numerous psychological and physical health problems in
adulthood (Chartier, Walker, & Naimark, 2007; Cromer & Sachs-
Ericsson, 2006).
Although psychological, social, and behavioral consequences of
child maltreatment are well documented, there is a paucity of
literature on the adaptive behavior of these children. “Adaptive
This article was published Online First June 2, 2014.
Kathleen D. Viezel and Ari Lowell, School of Psychology, Fairleigh
Dickinson University; Andrew S. Davis, Department of Educational Psy-
chology, Ball State University; Jenean Castillo, Westchester Institute for
Human Development, New York Medical College.
Correspondence concerning this article should be addressed to Kathleen
D. Viezel, School of Psychology, Fairleigh Dickinson University, 1000
River Road, T-WH1-01, Teaneck, NJ 07666. E-mail: kmdavis@fdu.edu
behavior” is generally accepted to mean basic conceptual, social,
and practical skills that people acquire throughout their lifetime
and use in everyday life. Although first used within the context of
identifying criteria for an intellectual disability, the term’s use has
grown beyond that field. Broadly, “conceptual skills” include
language, number concepts, and related skills; “social skills” in-
clude interpersonal skills, self-concept, and rule-following behav-
ior; and “practical skills” include skills such as self-care, handling
of household items, and ability to handle time management, simple
travel, and money (Tasse et al., 2012).
The lack of knowledge of the adaptive behavior of maltreated
children is concerning, as knowledge of an individual’s ability to
perform activities of daily living is important in designing appro-
priate interventions. Deficits in adaptive functioning should be
directly addressed in treatment plans, as children’s adaptive be-
havior skills may respond better to intervention than other char-
acteristics, such as cognitive ability (Atkinson, 1990). Addition-
ally, comprehensive knowledge of a child’s skills and abilities can
also help determine which type of therapeutic interventions will be
feasible and effective. The present study evaluated the adaptive
behavior of children who have been abused or neglected by ex-
amining scores on the Vineland Adaptive Behavior Scales
(Vineland; Sparrow, Balla, & Cicchetti, 1984) and Vineland Adap-
tive Behavior Scales, Second Edition (Vineland-II; Sparrow, Cic-
chetti, & Balla, 2005). Examining adaptive behavior using the
Vineland scales may be particularly useful, as it is sensitive to
change in skill attainment resulting from intervention (Williams,
1996).
Although often referenced as a single construct, the phrase
“child abuse and neglect” subsumes numerous maltreatment cat-
egories, among which “abuse” and “neglect” are the broadest in
scope. “Abuse” is generally defined in the United States as a
nonaccidental injury, whereas “neglect” refers to “the failure of a

574
 ADAPTIVE BEHAVIOR
parent, guardian, or other caregiver to provide for a child’s basic
needs” (Child Welfare Information Gateway, 2008, pp. 2–3). State
definitions vary in the extent to which sexual and emotional abuse
are distinguished from physical abuse, and neglect may include
failure to provide for medical, education, or emotional needs
(Child Welfare Information Gateway, 2008). Despite the inherent
difficulties associated with attempting to classify children as either
having been abused or neglected, dividing maltreated children into
somewhat more heterogeneous groups has been beneficial in re-
search. Numerous studies have demonstrated significant differ-
ences between children broadly classified as physically abused,
sexually abused, neglected, and emotionally abused when using
either legal definitions or the principle reason for a report in order
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
to determine categorization, a common approach in differentiated
This document is copyrighted by the American Psychological Association or one of its allied publishers.
maltreatment research (Zuravin, 1999). In addition to the cogni-
tive, academic, and other deficits generally present across undif-
ferentiated groups of maltreated children, reviews of studies in
which children are divided by maltreatment type have consistently
revealed physically abused children to be comparably more ag-
gressive and violent than other maltreated groups, sexually abused
children to be more anxious and depressed, neglected children to
be more socially unskilled, and psychologically abused children to
be more emotionally blunted and guarded (Rodriguez-Srednicki &
Twaite, 2004; Trickett & McBride-Chang, 1995; Twaite &
Rodriguez-Srednicki, 2004; Veltman & Browne, 2001). Therefore,
it is reasonable to suspect there may be differences in various
domains of adaptive functioning between children who have ex-
perienced different types of maltreatment.
One particular finding of note among maltreatment studies that
distinguish between maltreatment type is that among all groups,
the lowest scores for cognitive, academic, and social functioning
have most often been found for neglected children (e.g., Ecken-
rode, Laird, & Doris, 1993; Hildyard & Wolfe, 2002; Wodarski,
Kurtz, Gaudin, & Howing, 1990). Garbarino and Collins (1999)
suggested that deficits relating to neglect occur because of the
absence of critical parental and caregiver support during stages of
development. Others (e.g., Nightingale & Walker, 1991) have
argued that the effects of maltreatment are potentially confounded
by socioeconomic status (SES), which is especially difficult to
separate from the effects of neglect (Hearn, 2011). However,
although correlations between poverty and neglect are generally
acknowledged, the suggestion of an equivalence of the two is
challenged by the notion that neglect has not been demonstrably
improved by reduction of poverty, and a concern that neglect is
simply easier to detect among the poor, creating the impression of
greater prevalence (Crittenden, 1999; McSherry, 2007). Further-
more, in studies that controlled for SES, maltreated children con-
tinued to display deficits (e.g., Kurtz et al., 1993; Shonk & Cic-
chetti, 2001).
The present study proposes to add to the current literature
concerning abused and neglected children by comparing maltreat-
ment groups using the Vineland and Vineland-II, which are well-
validated and reliable measures of adaptive behavior that provide
domain scores for communication, daily living, and socialization
functioning (Sparrow et al., 2005). Measures of adaptive behavior
(such as the Vineland scales) have been demonstrated to be useful
as an important component of a general diagnostic assessment in
conjunction with other assessment tools, and as a means of eval-
575
uating an individual’s capacity to function in relation to society’s
expectations (Cabrera, Grimes-Gaa, & Thyer, 1999).
There have been some studies examining the adaptive behavior
of maltreated children using the Vineland. For example, Clausen,
Landsverk, Ganger, Chadwick, and Litrownik (1998) examined
the adaptive behavior of 128 children in foster care, and found
deficits across all scales, particularly in the areas of communica-
tion and socialization. Similarly, Urquiza, Wirtz, Peterson, and
Singer (1994) found deficits across all domains of the Vineland in
a population of 134 children who had been abused and/or ne-
glected. Similar findings were reproduced more recently using the
Vineland-II in a study showing an average developmental and
chronological age discrepancy of over 5 years in a sample of 57
maltreated children with reactive attachment disorder (Becker-
Weidman, 2009).
The results of the current literature review revealed only one
previous study that attempted to examine the differences in adap-
tive behavior between children who have been abused, children
who have been neglected, and nonmaltreated children. Wodarski et
al. (1990) used the Scales of Independent Behavior from the
Woodcock-Johnson Psycho-Educational Battery (Bruininks,
Woodcock, Weatherman, & Hill, 1984), which contained three
scales the authors identified as measuring adaptive behavior: Mo-
tor Development, Personal Living Skills, and Community Adap-
tation. No significant differences between the three groups were
found. It should be noted the current study uses a more compre-
hensive measure of adaptive functioning. Therefore, the present
investigation appears to be the first study to thoroughly examine
the differences in a variety of adaptive skills between different
classifications of maltreated children (such as abused vs. ne-
glected) as well as to compare maltreated children with a demo-
graphically matched comparison group on well-validated measures
of adaptive functioning.
Method
Participants
Data from participants was collected via chart review of chil-
dren in foster care in the southeast area of New York State
following approval by the institutional review boards of the coop-
erating facilities. Every child who enters family foster care in the
county is referred for a developmental assessment to screen for
developmental, educational, and mental health problems in order
to identify appropriate services, with the goal of stabilizing chil-
dren and helping them reach their maximum potential. Participants
in the current study were assessed at the Westchester Institute for
Human Development (WIHD). WIHD is one of 67 University
Centers of Excellence in Developmental Disabilities, Education,
Research and Service. WIHD’s mission focuses on the develop-
ment of children, the safety of vulnerable children, and the support
of families and communities to promote health and well-being
among people of all ages with disabilities. All evaluations were
completed between 2003 and 2009. Inclusionary criteria for the
present study included age of between 5 and 18 years at the time
of the evaluation, an assessment of adaptive behavior skills as part
of the psychological evaluation, and a stated reason for foster care
placement (either abuse or neglect). Types of abuse include phys-
ical and sexual, and types of neglect include medical, educational,
 576 VIEZEL, LOWELL, DAVIS, AND CASTILLO

and physical. Because the present study relied on archival data, it
was not possible to further delineate groups by abuse or neglect
type; the most reliable information was the Department of Social
Services determination of reason for removal (abuse or neglect). In
the event of multiple foster care placements over time, only the
initial evaluation was used, thereby maximizing the likelihood that
the sample represents children who are entering replacement care
of the first time. The total number of participants included in the
present study was 160 children, 42 of whom had been placed in
foster care because of abuse, and 118 of whom had been placed for
reasons of neglect. The proportion of children who were neglected
versus those who were abused is approximately equivalent to
nationally collected data (U.S. Department of Health & Human
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
has known the child for several weeks fits the required criteria for
serving as a reporter on the Vineland (Sparrow et al., 2005).
The Communication domain assesses the individual’s expres-
sive language, receptive language, and written language skills. The
Daily Living Skills domain examines personal, community, and
domestic skill acquisition. The Socialization domain includes in-
terpersonal relationships, play/leisure skills, and coping skills.
Importantly, as with most measures of adaptive functioning, the
Vineland scales assess typical performance, not maximal perfor-
mance. Results are useful for diagnosis and special-education
classification decisions, treatment planning, and progress monitor-
ing (Sparrow et al., 2005). The instrument has a long history of
popular use (the Vineland Social Maturity Scale was developed in

Services, 2012). Table 1 details the demographic information for 1935) and is technically sound, including demonstrating good
This document is copyrighted by the American Psychological Association or one of its allied publishers.

the participants. In addition, a sample of matched controls was reliability and validity (e.g., Stein, 2010; Widaman, 2010).
provided by NCS Pearson, Inc.1,2 from the standardization samples
of the Vineland and Vineland II. Participants were matched on sex, Data Analysis
ethnicity, and age. The demographic information for the compar-
ison group is also presented in Table 1. A one-way ANOVA and a chi-square analysis were used to
confirm there were no differences between the three groups (chil-
dren who have been abused, children who have been neglected,
Measures
and the comparison group) on age and gender. To examine poten-
The primary measure for the current study was the Vineland tial differences in adaptive behavior between the three groups, a
Adaptive Behavior Scales; depending on the date of the evaluation MANOVA was conducted in which group served as the indepen-
either the first (Vineland; Sparrow et al., 1984) or second dent variable and the three Vineland indexes (Communication,
(Vineland-II; Sparrow et al., 2005) edition was administered. The Daily Living Skills, and Socialization) were the dependent vari-
correlations between the two versions of the scale are high, with ables. Following a significant result, a descriptive discriminant
coefficients for the overall Adaptive Behavior Composite score analysis (DDA) was conducted to determine where the differences
ranging from .87 to .94, depending on the age of the subject lay.
(Sparrow et al., 2005). Both forms yield composite scores in the
area of Communication, Daily Living Skills, and Socialization. A Results
Motor Skills domain is also available; however, as it was designed
primarily for children 6 and younger, it was inappropriate for most A one-way ANOVA confirmed there were no differences be-
of the children in this sample and therefore excluded from the tween the three groups for age, F(2) ⫽ .671, p ⫽ .512. A chi-
present study. The Vineland is an individually administered mea- square analysis confirmed there were no differences by gender,
sure of adaptive behavior and is typically completed by an adult ␹2(2, N ⫽ 160) ⫽ .346, p ⫽ .841. Because of the small number of
who knows the child well. For the present study, the informant was some ethnicities, it was not possible to run an accurate chi-square
the child’s foster parent. It is WIHD’s policy to administer the analysis to determine if there was a difference between the groups
Vineland 4 to 6 weeks following the child’s placement. This time on ethnicity; an examination of Table 1 confirms group similarity
frame ensures the foster parent knows the child well enough to in this regard.
provide reliable information, while still allowing for early assess- A MANOVA revealed that Wilks’ lambda was significant
ment and intervention planning. Additionally, a foster parent who (Wilks’ ␭ ⫽ .778), F(3, 313) ⫽ 13.95 p ⬍ .000, which indicated
the three groups differed on at least one of the three Vineland
indices. For all three of the Vineland composites, the group of
neglected children had lower scores than both the group of abused
Table 1 children and the comparison group, and the group of abused
Demographic Information of the Sample children had lower scores than the comparison group. Table 2
displays the mean scores of all three groups across the three
Abused Neglected Comparison Vineland composites. DDA was used to ascertain which index
Demographic children children group
most contributed to this significant result. All of the indices of the
Age (mean years) 8.45 8.95 9.44 Vineland scales contributed to the between group difference iden-
Gender (% male) 47.6 42.4 43.8 tified by the MANOVA. The results of the DDA are displayed in
Race (% of sample)
Table 3.
African American 47.6 65.3 67.5
Hispanic 23.8 18.6 20
Caucasian 7.1 5.9 9.4 1
Asian 2.4 0 .6 Standardization data from the Vineland Adaptive Behavior Scales
Multiracial 7.1 .8 N/A (Vineland). Copyright© 1984 NCS Pearson, Inc. Used with permission. All
Other/Unknown 11.9 9.3 2.5 rights reserved.
2
FSIQ 87.93 87.97 N/A Standardization data from the Vineland Adaptive Behavior Scales,
Second Edition (Vineland II). Copyright© 2005 NCS Pearson, Inc. Used
Note. FSIQ ⫽ Full Scale IQ. with permission. All rights reserved.
 ADAPTIVE BEHAVIOR
Table 2
Means and Standard Deviations of Vineland Scores by Group
Abused Neglected Comparison
children children group
Composite M (SD) M (SD) M (SD)
Communication 93.83 (15.42) 85.65 (16.57) 100.34 (15.90)
Daily living skills 94.69 (15.96) 84.69 (17.81) 99.07 (15.72)
Socialization 90.69 (12.91) 83.29 (12.93) 98.41 (15.41)
Discussion
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
The current study examined differences in the adaptive behavior
This document is copyrighted by the American Psychological Association or one of its allied publishers.
of children who have been abused, children who have been ne-
glected, and a demographically matched comparison group. A
MANOVA, with a follow-up DDA, concluded the three groups
differed significantly across all Vineland domains (Communica-
tion, Daily Living Skills, and Socialization). An examination of the
means (see Table 2) is helpful in determining the profile of
adaptive skill differences between the groups. Across all three
adaptive domains, the comparison group displayed the highest
level of skill; the children who were abused had lower adaptive
behavior than the comparison group, but higher adaptive behavior
than neglected children; and the children who were neglected had
the lowest levels of adaptive behavior. As would be expected, the
comparison group demonstrated mean Daily Living, Communica-
tion, and Socialization scores very close to the standard score mean
of 100. Although the children who were abused had somewhat
lower scores, all three domain means remained in the adequate
range, according to interpretation guidelines offered by the
Vineland. Conversely, children who have been neglected dis-
played means in the moderately low range for all three adaptive
domains. Overall, the largest functional difference was seen with
children who have been neglected, as they displayed significantly
lower Daily Living, Communication, and Socialization scores than
what would be expected given their chronological age.
Findings from the current study suggest children who have
experienced neglect are at risk of demonstrating significant adap-
tive skill deficits across multiple domains, more so than their peers
who have been abused (as well as demographically matched com-
parison children). In this study, the children who had been ne-
glected demonstrated significant language skill deficits, including
expressive communication, receptive understanding of language,
and written language. Additionally, findings indicate children who
have been neglected may present with limited activities of daily
living, including delayed personal care skills, ability to complete
domestic tasks, and community living skills. Finally, results sug-
gest neglected children likely have delayed attainment of social
skills, including the ability to form interpersonal connections,
engage in appropriate play and leisure activities, and express
adequate coping strategies. This is consistent with previous re-
search that suggested youth who were neglected (rather than
physically abused) experienced difficulties in social interaction,
social withdrawal, and isolation (Hildyard & Wolfe, 2002; Wil-
liamson, Borduin, & Howe, 1991). A possible explanation for the
current findings is that children who have been neglected may not
have been exposed to environments rich with opportunities to
engage in a variety of communication and play activities, and may
577
not have been taught (or expected to complete) many self-care and
domestic skills.
The current results suggest that children who have been ne-
glected experience more significant delays in adaptive functioning
than children who have been abused. This is a particularly critical
finding, given that child neglect remains considerably less fre-
quently studied and tends to engender far less attention, interven-
tion, and supporting services than child physical and sexual abuse
(Barber & Delfabbro, 2009; McSherry, 2007; Wolock & Horowitz,
1984; Zuravin, 1999). Numerous reasons have been suggested for
this phenomenon, often termed the “neglect of neglect” (Wolock &
Horowitz, 1984), such as underestimations of risk and harm by
social workers, difficulties defining and substantiating neglect, and
lack of prioritization by social and government agencies (Dubow-
itz, 2007; McSherry, 2007, 2011). And yet the “neglect of neglect”
remains a matter of considerable concern, especially given that,
according to the most recently available data, child neglect ac-
counted for more than 75% of all unique substantiated maltreat-
ment cases in 2011, as well as about one third of all child
maltreatment fatalities (U.S. Department of Health & Human
Services, 2012).
There are some limitations to the present study. It must be
acknowledged that the classification of children as either being
“abused” or “neglected” can be somewhat nebulous. For example,
different forms of abuse or neglect could introduce some possible
heterogeneity in the sample. Despite this concern, the nature of
classifying reasons for removal from primary caregivers is, by
nature, imperfect, and the present study provides some evidence
for important differences between children who have been placed
in foster care for different reasons, and highlights the unique needs
of children who have been neglected. Future research that focuses
on further defining groups of children in substitute care would be
helpful. A second limitation is the potential lack of generalizabil-
ity, as the sample was restricted to a southeastern county in New
York. However, the ethnic diversity of the sample could be con-
sidered a strength. Finally, for the children in this study, the
informant on the Vineland was a foster parent, which could war-
rant a degree of caution in interpreting Vineland scores, as children
who have recently transitioned to a new home may have some
difficulty across items (e.g., remembering address or participating
in long-term school or community activities; Urquiza et al., 1994).
However, as the informant was a foster parent for both the abused
and neglected groups, this concern is somewhat minimized.
Despite these potential limitations, the policy, practice, and
clinical implications of the results of the present investigation are
significant. Because it may be more difficult to appreciate the
significance of neglect relative to abuse (McSherry, 2007), case-
workers and other child protective personnel should be trained in
recognizing all forms of neglect, and should be careful not to
Table 3
Structure Coefficients From the DDA
Vineland indices structure coefficient
Socialization .934
Communication .801
Daily living .783
Note. DDA ⫽ Descriptive Discriminant Analysis.
 578 VIEZEL, LOWELL, DAVIS, AND CASTILLO
deprioritize suspected cases. Further, there is evidence that parents
who neglect their children are more likely to be impoverished,
have substance problems, or have inadequate support, suggesting
other social agencies (outside of child welfare) could have a role in
preventing cases of neglect (Mayer, Lavergne, Tourigny, &
Wright, 2007). It is also recommended that children entering
substitute care following allegations of abuse or neglect participate
in a comprehensive evaluation of their needs, including an assess-
ment of their adaptive functioning. Although children who have
survived physical or sexual abuse may typically get more support
than children who have been neglected (Barber & Delfabbro,
2009; McSherry, 2007), the authors of the present study urge that
children who are removed for reason of neglect also receive
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
comprehensive screenings and targeted interventions. Indeed, an
This document is copyrighted by the American Psychological Association or one of its allied publishers.
evaluation of their adaptive functioning seems particularly impor-
tant. Administration of a thorough instrument examining adaptive
behavior, such as the Vineland, can assist in developing individ-
ualized treatment plans.
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Received July 29, 2013
Revision received January 25, 2014
Accepted March 2, 2014 䡲