DOUGLASCOUNTY

PROGRAM FOR EXCEPTIONAL CHILDREN

DIFFERENTIAL ADAPTIVE BEHAVIOR SCALE

Date:

has been referred for an educational evaluation. Please check the following items to help determine possible adaptive behavior strengths and weaknesses. If the student is not usually different from the “normal” student in his/her age group, score 1. If the student is somewhat different, score 2. If very different from most students in his/her age group, score 3. Also please elaborate on two of the items per category in the appropriate blanks.

Score

Logic/Cognition1, 2. 3

1.Student uses less than complete thoughts to describe a television program, and

has much more difficulty following his/her train of thought, than most students in

this age range.

2.Student has a much shorter attention span, and is more highly distractible (for

example, continues to be distracted by the sound of a heater starting) than most

students in his/her age range.

3.In order to learn (and know) a concept, more constant repetition (drill work) is

needed than most students in his/her age range.

4.Student come from a more impoverished educational background than most

students in his/her age range.

5.Student has more difficulty remembering his/her address, phone number, etc.,

than most students in his/her age range.

6.Student tends to be more “concrete” and not as abstract (generalizations,

adverbs, “likenesses”, etc.) as most students in his/her age range.

7.Student displays more short and long-term memory deficits than most students

in his/her age range.

8.Student has a greater tendency to forget what they had for lunch the previous

day than most students in his/her age range.

Please select any two (2) of the above items and add anecdotal details for examples:

Score

Independent Functioning1, 2, 3

1.Student has more difficulty than most students in his/her age group remembering

to bring proper materials (e.g., pencil/paper) to class.

2.When student is finished with his/her assignments, he/she does not pretend to

look busy, rather he/she simply awaits further instruction.

3.Delayed gratification and the relationship between behavior and natural consequence

are more difficult for this student to grasp than most other students in his/her age group.

4.In musical activities, student more often concentrates on the rhythm rather than

the melody or harmony.

5.Student shows weaker problem-solving skills than most students in his/her age group.

For example, if the student lost a pencil, he/she would be more likely than most

students in his/her age group to ask for assistance as opposed to initiating the logical

steps to solve the problem.

6.Student appears to be more comfortable than most students in his/her age group

with a regular routine (over-reacts when there is a break in the routine).

7.Student more likely to imitate the behavior of others than most students in his/her

age group.

8.Student more likely to lie to get what he/she wants than most students in his/her

age group.

Please select any two (2) of the above items and add anecdotal details for examples:

Score

Socialization/Emotional1, 2, 3

1.Student has a lower self-concept than most students in his/her age group.

2.Student has more difficulty than most students in his/her age group elaborating on

how he/she feels. Often he/she can’t verbalize why he/she feels the way

he/she does.

3.Student shows poorer interaction skills than most students in his/her age group,

in that he/she is more likely to give tangibles (like dessert) to “buy” friends. Or

he/she might be likely to aggravate peers in trying to make friends.

4.Student is more hostile/aggressive than most students in his/her age group.

5.Student’s sense of humor tends to be more slapstick than most students in

his/her age group, with less irony or sarcasm. Often, jokes need to be explained

to student.

6.Student has more difficulty than most students in his/her age group with

cooperative play (including taking turns) for an extended period of time (unless

being a “total” follower).

7.Student tends to follow others naively (as a “tag-along”), often getting taken

advantage of more frequently than most students in his/her age group.

8.Student likes adult attention more than most students in his/her age group.

Please select any two (2) of the above items and add anecdotal details for examples: