Journal of Pedialric Psychology, Vol. 10, No.

2, 1985

Diagnostic Uses of the Vineland Adaptive

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Behavior Scales
Sara S. Sparrow1
Yale University Child Study Center

Domenic V. Cicchetti
Veterans Administration Medical Center, West Haven, Connecticut

Received November 16, 1984; revised January 8, 1985

This report presents an overview of the Vineland Adaptive Behavior Scales

and two measures of cognitive ability: the Kaufman Assessment Battery for
Children (i.e., sequential and simultaneous processing, levels of achieve-
ment) and the revised Peabody Picture Vocabulary Test (i.e., listening
vocabulary). These three instruments are applied and directly compared to
demonstrate the interplay between adaptive behavior and cognitive func-
tioning in the broader context of a pediatric setting. Two hypothetical case
histories are discussed, one in which the child's levels of adaptive function-
ing are adequate while cognitive functioning is low; and a second one in
which the reverse phenomenon is true, namely, high levels of cognitive
functioning are coupled with impairments in adaptive functioning. The
direct comparisons between the various areas of functioning are made
possible by large Vineland standardization samples of children whose
abilities were assessed by all three instruments.
KEY WORDS: Vineland Adaptive Behavior Scales; K-ABC; PPVT-R; social sufficiency.

'All correspondence should be sent to Dr. Sara S. Sparrow at The Yale Child Study Center,
P.O. Box 3333, New Haven, Connecticut 06510-8009.
215
0146-8693/85/0600-0251 KM.50/0 © 1985 Plenum Publishing Corporation
216 Sparrow and Cicchetti

In a recent report we discussed, within a developmental framework, the

psychological assessment of children by critically evaluating some of the
major instruments available for measuring cognition, language develop-
ment, personality, perceptual and visual motor skills, and levels of adaptive
functioning (Sparrow, Fletcher, & Cicchetti, in press). In the present report
we focus upon how the Vineland Adaptive Behavior Scales (Sparrow, Balla,
& Cicchetti, 1984a) can be used, in conjunction with standardized measures
of cognitive development, as a valuable clinical assessment tool in a

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pediatric setting. We first describe the standardization samples to which the
Vineland and two cognitive measures, the Kaufman Assessment Battery for
Children (K-ABC, Kaufman & Kaufman, 1983a, 1983b), and the Revised
Peabody Picture Vocabularly Test (PPVT-R; Dunn & Dunn, 1981) were ad-
ministered. This is followed by a discussion of the properties of the three in-
struments. The last section focuses upon the application, interpretation,
and implications of the interplay of these instruments in selected
hypothetical case histories.

STANDARDIZATION SAMPLES

During the period 1981-1982, the revised Vineland was administered

to a large, random, stratified sample of parents who were respondents for
3000 children ranging in age between birth and 19 years old. The
Vineland-K-ABC overlap sample consisted of 719 children aged 2.5 to 12.5
years. The Vineland-PPVT-R overlap sample consisted of 2018 children,
ranging in age between 2'/i and 19 years old. The full standardization
sample of 3000, as well as the Vineland, K-ABC, and PPVT-R subsamples,
were closely matched to the 1980 census on the following variables: (a)
region of the country (East, North Central, South, and West); (b) commu-
nity size (central city, suburb or small town, or rural area); (c) race or ethnic
group (white, black, hispanic, native American, Asian, or Pacific Islander);
and (d) parental education (less than high school, high school, some college,
college degree). The objective of the overlapping samples was to provide a
means whereby the performance of any given child in both adaptive and
cognitive areas could be compared meaningfully. This would be especially
useful in childern who varied considerably in these two important areas of
assessment.
The ability to make such comparisons is particularly significant in the
light of current trends in diagnostic classifications. This is particularly true
in the area of mental retardation. The introduction and burgeoning of indi-
vidually administered intelligence tests took place in the early part of the
twentieth century (e.g., Binet & Simon, 1905; Terman, 1916). The develop-
ment of these IQ tests resulted in defining and classifying levels of mental
Diagnostic Uses of the Vineland Adaptive Behavior Scales Z17

retardation solely on the basis of intelligence test scores. This practice con-
tinued for many years until a countertrend, based upon levels of adaptive
functioning, was initiated by Edgar Doll (1935, 1953). It was several years
before the importance of adaptive behavior in helping to classify mentally
retarded individuals was understood and appreciated widely. Thus, in 1959
the American Association on Mental Deficiency (AAMD) published an
official manual which indicated that deficits in both adaptive and cognitive
functioning were both necessary and sufficient conditions for classifying

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individuals as mentally retarded (i.e., Heber, 1959, 1961). The AAMD
manual stipulated that there were two major defining aspects of adaptive
behavior: (a) the extent to which an individual functions and maintains
himself independently, and (b) the extent to which the individual satisfies
culturally imposed requirements of personal and social responsibility. In
revised editions of the AAMD manual, the major defining aspects of Heber
(1961) were retained (i.e., Grossman, 1973, 1977, 1983).
The further development of the adaptive behavior concept in terms of
its wider application beyond the specific area of mental retardation was
given impetus and reinforcement by the passage of the Education for All
Handicapped Children Act (Public Law 94-142, U.S. Department of
Health, Education and Welfare, 1977). This law defined mental retardation
in a manner similar to the AAMD definition and also recognized the impor-
tance of assessing levels of adaptive behavior for children with handicaps
that included not only mental deficits but also physical, emotional, learn-
ing, and linguistic impairments. Consistent with these developments, the
two hypothetical case histories we discuss involve (a) a child with adequate
adaptive skills despite poor levels of cognitive functioning, and (b) a child
with the reverse presenting problem, namely, poor adaptive functioning in
the context of very high levels of cognitive abilities. In describing these
cases, we demonstrate the interplay of adaptive and cognitive behaviors in
the context of relative strengths and weaknesses. To illustrate our point, we
focus upon the Vineland, the K-ABC, and the PPVT-R as our primary
assessment instruments.

THE ASSESSMENT INSTRUMENTS

The Vineland Adaptive Behavior Scales

Despite the past utility of the Vineland Social Maturity Scale (Doll,
1935, 1953), it was almost inevitable that the original Vineland would have
to be revised in accord with (a) the need for norms based upon represen-
218 Sparrow and Cicchetti

tative, national samples of children and adults; (b) cultural changes, which
made a number of original Vineland items obsolete; and (c) advances in
statistical and computer technology.
Our 7-year effort produced the present Vineland Adaptive Behavior
Scales (Sparrow et al., 1984a, 1984b, 1985) with three versions: (a) a Survey
Form (for screening, placement, and diagnostic purposes); (b) an Expanded
Form (for developing specific educational or treatment plans, in accord
with the provisions of Public Law 94-142); and (c) a Classroom Edition.

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This report focuses upon the Survey Form since the primary focus of this
report is on diagnostic rather than remedial issues, which are more the focus
of the Expanded Form of the Vineland.
The Survey Form provides a general assessment of adaptive behavior
as well as more specific information useful in further exploration of in-
dividual strengths and weaknesses. It is used to assess adaptive behavior of
nonhandicapped individuals from birth to 19 years of age and low-
functioning children and adults. A semistructured 30- to 60-minute inter-
view is used by a trained interviewer to administer the Survey Form (in-
cluding the Maladaptive domain) to parents or primary caregivers. Several
lines of evidence, derived from our ongoing program of research in the
development of adaptive behavior instruments, support the hypothesis that
the mother (or other primary caregiver) is a reliable and valid source of in-
mation: (a) The semistructured interview is one in which the primary
caregiver is not asked specific questions, which tend to bias the responses
(e.g., produce halo effects). Rather, the respondent is asked to tell the inter-
viewer what the child does in a given area of adaptive behavior (e.g.,
grooming, helping around the kitchen, engaging in sports). From the ensu-
ing responses, as well as additional probes (as required), the specific infor-
mation required for the interviewer to complete each Vineland item is ob-
tained; (b) In some of our earlier research (Sparrow & Cicchetti, 1978) we
found very high correlations between what primary caregivers estimated as
levels of adaptive behaviors and what independent assessments of the
behaviors revealed; and (c) most recently, we found the agreement levels
between mothers (Survey Form of the Vineland) and teachers' ratings
(Classroom Edition) of the adaptive behavior of the same group of 420
children, in the national standardization sample, to be high (e.g., the
criteria of Cicchetti & Sparrow, 1981; and those of Fleiss, 1981). The
Vineland Adaptive Behavior Scales measure functioning across the follow-
ing domains and subdomains: (a) Communication (receptive, expressive,
written subdomains); (b) Daily living skills (personal, domestic, community
subdomains); (c) Socialization (interpersonal, play and leisure time, and
coping subdomains); (d) Motor (gross, fine subdomains).
Derived scores for the Vineland Adaptive Behavior Scales include
standard scores for each adaptive behavior domain and for the Adaptive
Diagnostic Uses of the Vineland Adaptive Behavior Scales 219

Behavior Composite (Mean = 100, SD = 15). Percentile ranks, stanines,

age equivalents, and adaptive levels are also available. Reliability coeffi-
cients for the Vineland Adaptive Behavior Scales were obtained from test-
retest and interrater reliability studies conducted during the national stan-
dardization period. Results indicate excellent reliability for subdomains,
domains, and the Adaptive Behavior Composite, as well as good to ex-
cellent reliability for 95% of individual items and moderate reliability for
the remaining 5% (e.g., the criteria of Cicchetti & Sparrow, 1981, and
Fleiss, 1981). Studies investigating construct, concurrent, factorial, dif-

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ferential, and predictive validity of the Vineland were also successfully con-
ducted (Sparrow et al., 1984a, 1984b, 1985). As one example, as predicted,
DSM Ill-diagnosed emotionally disturbed children evidenced significantly
more maladaptive behaviors than did age- and IQ-matched visually and
hearing-impaired individuals.

The Kaufman Assessment Battery for Children (K-ABC)

The K-ABC is an individually adminsitered intelligence test for assess-

ing cognitive development of children from the ages 2Vi to \2Vi years. It
can also be used for handicapped individuals with mental ages within this
range. The K-ABC measures intelligence in terms of the individual's style of
problem solving and information processing, using simultaneous processing
and sequential processing tasks. Sequential processing involves the integra-
tion of separate elements into a series or into groups that are related tem-
porally. Simultaneous processing involves the synthesis of various separate
elements into groups that are spatially rather than temporally related. While
sequential processing seems to be associated more with left-brain
phenomena, simultaneous processing is thought to be more a function of
right-brain activity. The K-ABC derives from a strong theoretical founda-
tion based upon principles of neuropsychology and cognitive psychology. It
has 10 mental processing subtests, 3 using sequential and 7 using
simultaneous processing procedures.
The mental processing subtests include many tasks that demand little
or no speech from the individual being assessed. The Kaufmans used these
subtests to form a Nonverbal scale which represents a well-normed, reliable,
and valid measure of intelligence. The K-ABC also includes an Achievement
scale. It is a measure of acquired knowledge and includes six subtests.
Derived scores obtained from the K-ABC include scaled scores (Mean = 10,
SD = 3) for all the mental processing subtests and standard scores (Mean =
100, SD = 15) for the Mental Processing Composite and the individual
Achievement subtests. National percentile ranks, sociocultural percentile
ranks, and age equivalents are also available. Construct validity has been
220 Sparrow and Cicchetti

demonstrated for the K-ABC through factor-analytic investigations. Con-

struct, concurrent, and predictive validity have been investigated in approx-
imately 40 validity studies. Reliability coeficients for the K-ABC subtests
are good to excellent or comparable to those obtained by other standard
intelligence measures.

The Peabody Picture Vocabulary Test-Revised (PPVT-R)

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The PPVT-R is an individually administered measure of receptive or
hearing vocabulary for ages 2.5 years to adulthood. The instrument also
provides an estimate of verbal ability or scholastic aptitude. The PPVT-R,
because of its quick administration, is often applied in clinical, educational,
or research settings to screen for mental retardation and giftedness; to com-
plement other ability and achievement measures; and as an aid to adult
placement programs. Like the Vineland, derived scores (Mean = 100, SD
= 15) are available for the PPVT-R, as well as percentile ranks, stanines,
and age equivalency scores.
Correlations between scores on the revised Vineland and both the
K-ABC and the PPVT-R are low to modest, indicating that these adaptive
and cognitive measures are tapping relatively independent functions. Table
1 shows correlations of the Vineland domains and Adaptive Behavior Com-
posite with Sequential and Simultaneous Processing, the K-ABC Mental
Processing Composite, the Achievement scale, and the Nonverbal scale. As
expected, the correlations between the Communication domain of the
Vineland and the K-ABC scales are highest (.32 with Simultaneous Process-
ing to .52 for Achievement). Correlations of the remaining three Vineland
domains range between a low of .07 (Nonverbal scale with the Motor Skills)
to .23 (Achievement with Socialization). These results make good clinical
sense, since the Communication domain of the Vineland is the most
"cognitively loaded" of the major Vineland domains (e.g., includes under-
standing and use of written symbols).
Correlations of the Vineland domains and the Adaptive Behavior
Composite with PPVT-R scores (Table II) show a similar pattern. Once
again, Communication shows the highest correlation (r = .37) while the re-
maining three Vineland domains range between .12 (Daily Living Skills) and
.21 (Socialization).

HYPOTHETICAL CASE HISTORIES

The Case of Richard

Richard is a 6-year-old boy whose mother consulted her pediatrician,

in a primary care facility, about his learning difficulties. The pediatrician,
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a
o

Table I. Correlations Between Vineland Survey Form Adaptive Behavior Domain and Adaptive Behavior Composite Standard Scores
and K-ABC Global Scale Standard Scores"

land
Correlation between Vineland and K-ABC standard scores
Vineland
Mental
standard score
Sequential Simultaneous processing t
' Vineland domain Mean SD processing processing composite Achievement Nonverbal €
Communication 100.3 14.8 .40 .32 .41 .52 .36 S?
Daily Living Skills 100.4 14.6 .21 .14 .19 .20 .15
Socialization 99.5 15.1 .20 .18 .22 .23 .18 I
Motor Skills 99.9 13.5 .15 .08 .13 .17 .07 o'
Adaptive Behavior Composite 100.1 16.0 .32 .25 .32 .37 " .27 SP
E
K-ABC Mean 101.6 103.3 103.0 102.6 103.8 3
K-ABC SD 15.0 15.2 15.0 14.6 15.2
"Ages 2 years 6 months through 12 years 11 months. Total N = 719 except for the Vineland Motor Skills domain and K-ABC Nonverbal
scale. The N for the Motor Skills domain is 226 because standard scores are available through age 5-11-30 only. The N for the K-ABC
Nonverbal scale was 599 because Nonverbal standard scores are available only for ages 4-0-0 and above. The /Vfor the correlation be-
tween the Motor Skills domain and Nonverbal scale was 106.
222 Sparrow and Cicchelti

Table II. Correlations Between Vineland Survey Form Adaptive Behavior Domain and Adap-
tive Behavior Composite Standard Scores and PPVT-R Standard Scores"
Vineland
standard score
Vineland and PPVT-R
Vineland domain Mean SD standard scores
Communication 99.7 14.9 .37
Daily Living Skills 99.9 14.7 .12
Socialization 99.5 15.0 .21
Motor Skills* 100.0 13.8 .17
Adaptive Behavior Composite 99.6 15.6 .28

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PPVT-R mean 99.0
PPVT-R SD 17.4
°yv = 2018. Ages 2 years 6 months through 18 years 11 months.
'The sample size for the Motor Skills domain, for which standard scores are available through
age 5-11-30 only, was 559. The mean PPVT-R standard score for the portion of the sample
used in the correlation with the Motor Skills domain was 98.9, with a standard deviation of
16.4.

after examining Richard, referred the boy to a pediatric psychologist for

assessment of his adaptive and cognitive competencies.
Table III presents Richard's data based upon his performance on the
K-ABC, the PPVT-R, and the results of a Vineland interview with his
mother. As can be seen, Richard's overall cognitive ability, based upon his
Mental Processing Composite, falls more than 2 standard deviations below
the mean (i.e., a score of 67). All of Richard's Vineland Survey Form scores
are in the adequate range, including his Adaptive Behavior Composite score
of 85. Richard's scores on the K-ABC range between 66 and 76. The dif-
ference of 18 points between his Adaptive Behavior Composite (85) and
Mental Processing Composite (67) is significant at the .01 level for 6-year-
old children. The difference of 14 points between his Adaptive Behavior
Composite and his Achievement scale score exceeds the value required for
significance at the .01 level (i.e., see Sparrow et al., 1984a, p. 58).
There is ample support for the suggestion that Richard is not mentally
retarded. Even though his cognitive ability falls in the retarded range,
Richard's adequate levels of adaptive behavior preclude his being classified
as mentally retarded. It is noteworthy that the PPVT-R score of 76 is in the
same general range as several of the K-ABC cognitive areas and is consistent
with the findings of many studies showing moderate to high correlations
between the PPVT-R and K-ABC areas of assessment (e.g., Kaufman &
Kaufman, 1983a, p. 138). In a much broader sense the case of Richard is
important because all his cognitive scores cluster about the cutoff range of
70-75 for the classification of mental retardation (see Grossman, 1983). In
such a situation, the assessment of adaptive behavior becomes crucial to
either rule in or rule out a diagnosis of mental retardation.
 Diagnostic Uses of (he Vineland Adaptive Behavior Scales 223

Table III. Adaptive and Cognitive Assessment of Richard, a

6-Year-Old Boy, Suspected of Mental Retardation
Assessment Standard score
I. Adaptive domains Vineland
A. Communication 88
B. Daily living 85
C. Socialization 92
Adaptive behavior composite 85
11. Maladaptive functioning Nonsignificant

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111. Cognitive areas K-ABC
A. Sequential processing 76
B. Simultaneous processing 66
Mental processing composite 67
C. Achievement 71
D. Listening vocabulary PPVT-R
76

The Case of Genevieve

Genevieve is a 9-year 3-month-old girl referred to a pediatric clinic for

behavioral and emotional problems. Her fourth-grade teacher was partic-
ularly concerned about her lack of friends and acting-out behavior in the
classroom. The pediatric psychologist administered a battery of tests in-
cluding the Vineland, the K-ABC, and the PPVT-R. As can be seen from
the data presented in Table IV, Genevieve excels in cognitive ability, listen-
ing vocabulary, and achievement.
The Vineland was administered to Genevieve's mother and the results
(once again seen in Table IV) indicate that Genevieve exhibits varying levels
of functioning across the different domains. Her Communication domain
performance is classified in the Vineland Survey manual as moderately high
(between 116 and 130). The items in this domain measure verbal skills as
well as school-related skills of reading and writing. Genevieve's perfor-
mance in this area is consistent with her high level of performance on the
PPVT-R and the K-ABC. Her level of functioning in the Daily Living Skills
domain is at the lower end of the adequate range (i.e., 85-115), while her
performance in the Socialization domain is classified as moderately low
(i.e., between 70 and 84). The Socialization domain is an area of particular
clinical interest because it is related to the reason for referral, namely, a
suspected emotional and behavioral disorder. Genevieve's score on the
Maladaptive domain places her in the significant range (i.e., a score that far
exceeds the 85th percentile for the frequency of maladaptive behavior ex-
hibited by 9-year-old children in the Vineland standardization sample). This
finding also has importance in terms of the reason for referral.
224 Sparrow and Cicchetli

Table IV. Adaptive and Cognitive Assessment of Genevieve, a

9-Year-Old Girl, Referred to Clinic for Emotional Problems
Assessment Standard score
I. Adaptive domains Vine/and
A. Communication 120°
B. Daily living 86
C. Socialization 72'
Adaptive behavior composite 90
11. Maladaptive functioning Significant

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III. Cognitive areas K-ABC
A. Sequential processing 144
B. Simultaneous processing 124
Mental processing composite 138
C. Achievement 122
D. Listening vocabulary PPVT-R
136
"Significant strength at the .01 level.
""Significant weakness at the .01 level.

In terms of summary (or global) scores, Genevieve's Adaptive

Behavior Composite score, though in the adequate range (85-115), is
significantly lower than either her Mental Processing Composite score (p <
.01) or her Achievement scores (p also < .01). Thus it appears that
Genevieve's emotional and behavioral difficulties have not greatly impaired
her cognitive abilities and level of achievement. However, the noncognitive
aspects of Genevieve's behavior appear to have been well documented by
her specific deficits in various areas of the Vineland.
In conclusion, we have presented two hypothetical cases in which the
diagnostic value of the Vineland was highlighted. In the case of Richard this
may be as far as one needs to probe. However, in the case of Genevieve,
there might be an interest in remedial issues. Although we have already im-
plied that this issue is beyond the scope of this report, the Expanded Form
of the Vineland would be appropriate for beginning to develop a specific
educational plan for Genevieve, which in all likelihood would involve a
dose collaboration between pediatric psychology, school, and home setting.

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