Defining and measuring adaptive behaviour in deaf adults

Moore, Kathryn (2016) Defining and measuring adaptive behaviour in deaf adults. DClinPsy thesis, University of Nottingham.

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Adaptive behaviour has become increasingly important in the assessment of intellectual disabilities (ID), but is also useful in terms of developing individual behavioural goals. Although measures of adaptive behaviour are widely used, there is little agreement on how to conceptualise the construct and how this may vary cross-culturally. Researchers have previously noted methodological and validity difficulties with the assessment of ID. This research aimed to clarify the construct of adaptive behaviour and consider how to measure this with d/Deaf adults with suspected ID.


A systematic literature review, identification of critique of current measures, and gaps within the literature formed the structure of a new item pool. An expert panel (N = 13) were consulted about the usefulness and relevance of these items through a Delphi consensus methodology. Based on the feedback obtained throughout the research process, the design was modified from pursuing a statistics-driven approach to item refinement, to using mixed-methods to clarify issues of construct validity before the content could be further addressed. The second round of the Delphi comprised a feedback report, concluding with a working definition of adaptive behaviour. Participants were asked to comment upon the findings, and provide additional responses to develop a normal base standard of adaptability of a Deaf adult of average functioning.


The first round of the Delphi consensus yielded wide variation in item ratings. A thematic analysis of the questionnaire comments identified two overarching themes related to the way in which adaptive behaviour was conceptualised: ‘structure’ and ‘content’. The theme of structure contained sub-themes of ‘assessment’, ‘language’, and ‘repetition’ which are arguably common to all psychometric development. The ‘content’ factors pertained to ‘accessibility’, ‘developmental factors’, and ‘cultural differences’, highlighting differences in the expression of adaptive behaviour based on the unique experiences of d/Deaf people. The second round of the Delphi procedure elicited feedback on a working definition of adaptive behaviour generated from the analysis, showing that the adaptive behaviour of d/Deaf people may be conceptualised differently, particularly in hearing contexts where there are differential communication demands. These research findings have been summarised to form initial guidelines for the assessment of adaptive behaviour in Deaf people.


This research provided some insight into how adaptive behaviour may be measured with Deaf people. Limitations of this research included not being able to generate consensus through the Delphi methodology used and, due to the newly developed understanding of adaptability for this population advanced throughout the research process, it was not possible to subject the items from the proposed scale to further psychometric testing. However, recommendations for further research were made in terms of expanding and validating this preliminary work with a sample of Deaf adults.

Word count: 497

Item Type: Thesis (University of Nottingham only) (DClinPsy)
Supervisors: Gresswell, D.M.
Merdian, H.
Baker, K.
Keywords: Deaf, Adaptive behaviour, Construct validity, Delphi methodology, Thematic analysis, ID
Subjects: W Medicine and related subjects (NLM Classification) > WV Otolaryngology
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 35888
Depositing User: Moore, Kathryn
Date Deposited: 16 Dec 2016 06:40
Last Modified: 24 Nov 2017 10:16

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