influenced by the behavioral characteristics of autism. For example, in a study of sleep patterns of 22 children with autism, aged 3 through 22, parental responses on a questionnaire were compared to direct measurement of ambulatory behavior with an actigraphic device (Hering et al., 1999). More than half of the parents reported that their children had sleep problems, including difficulty in getting to sleep, early morning awakening, and multiple night arousals. However, direct measures of non-sleep activity suggested fewer differences between the children with autism and a comparison group of normally developing children. Children with autism, on average, tended to awaken approximately 1 hour earlier than the typical children. The investigators speculated that parents of children with autism might be more sensitive to sleep issues with their children. Other studies have reported rates of sleep disorders that equal or exceed those of children with other developmental disorders (Dahlgren and Gillberg, 1989, Thompson et al., 1994).
Other adaptive behaviors pertain to home and community living skills, with applicable areas for young children including dressing, grooming, and safety-related behaviors. A broader perspective on adaptive behaviors may expand to school-related skills, such as academic behaviors (McGee et al., 1986), play skills (Haring, 1985), or overall engagement with work materials or the social environment (McGee et al., 1997). For example, children with autism often need to be directly taught how to request help when facing challenging tasks (Carr and Durand, 1985). Finally, most views of adaptive behaviors also cover domains of language, social, and motor skills, which are reviewed in other sections of this report.
Not surprisingly, there are correlations between levels of adaptive skills and intellectual ability (Carter et al., 1996). For example, lower cognitive and verbal levels are highly correlated with age of accomplishment of bowel and urine training (Dalrymple and Ruble, 1992). However, successful use of toileting intervention procedures based on operant and classical conditioning may be more related to physical maturity and social responsiveness than to cognitive level (Azrin and Foxx, 1971). There is some evidence that levels of adaptive behavior predict future independent functioning more accurately than measures of cognitive or academic functioning (Carter et al., 1996).
The aim of assessment of adaptive skills is to obtain a measure of the child’s typical functioning in familiar environments such as the home and the school. Such measures provide clinicians with an estimate of the degree to which the child can meet the demands of daily life and respond