#adaptive functioning

[bebsi-cola]

What is adaptive functioning?

directly inspired by this post by @five-thousand-loaves-of-bread

In short, adaptive functioning is a holistic view of someone's ability to adjust and change their behaviour in different environments and situations. This is a term primarily used to discuss people with developmental and intellectual disabilities and how they fare in comparison to their peers.

Someone's adaptive functioning is measured in three domains, which is why I called it holistic. All of these domains, separately and together, can affect someone's adaptive functioning.

There's the conceptual domain, the social domain, and the practical domain.

Conceptual domain: This refers to a person's cognitive skills, including their aptitude for knowledge acquisition, logical and critical thinking skills.

Social domain: This refers to a person's interpersonal skills. That includes things like the ability to understand other people's thoughts and emotions, the ability to create and maintain healthy interpersonal relationships, the ability to understand social situations and make judgements on them, and the ability to communicate in interpersonal relations.

Practical domain: This is where things like activities of daily living would come in. The practical domain measures how much a person can carry out daily tasks independently. Yes it includes things like shopping for food, maintaining hygiene, making meals. But overall you can think of it as the ability of self-management. Being able to keep track of what you need to do and when, initiate those tasks, plan for future tasks, manage your finances and time to make tasks possible, etc. There's a lot of organisation that goes into the practical domain.

Well how does it differ from basic and instrumental activities of daily living (b&iADLs)?

While ADLs are part of how we measure adaptive functioning, they can also be entirely distinct. ADLs are about being able to independently carry out regular activities.

Basic ADLs woule include self maintenance or self care tasks that are daily necessities. Things like brushing, showering, toileting, feeding oneself, dressing oneself, walking independently, transferring oneself. These are things that are directly related to one's immediate wellbeing and basic needs.

Instrumental ADLs include more long-term maintenance and self care, like going shopping and meal prepping, managing money, managing transport to places, managing medications, managing housecare and chores. Being able to do iADLs dramatically improves one's quality of life and allows them to live independently, work jobs, and such.

When measuring ADLs, we only consider whether or not someone can do them or not. This doesn't necessarily measure their overall ability or what sort of care they will need, because that depends on the reasons why they can't perform these activities. This can be a measurement of someone's support needs, but it's not comprehensive.

For example if someone can't meal prep because they don't have the ability to grip kitchen utensils, certain adaptive equipment or pre-cut foods can facilitate them being able to do this. They still can't perform that iADL without intervention or support.

If someone can't meal prep because they don't understand that knives are dangerous and will hurt themselves, or they can't connect that chopping some carrots will eventually lead to having vegetable soup because of cognitive difficulties, or simply don't understand that meal prepping is a necessity and can't direct their attention to anything that doesn't immediately intrest them, they still can't perform that iADL. Sometimes their cognitive issues may mean that they don't have the ability to independently manage tasks that need to be doing in order to facilitate necessities such as meals. This would be because of low adaptive functioning. The support they would need for cooking might be constant supervision, or to be disallowed from cooking altogether and have other people prepare meals.

Likewise if someone has no ability to hold utensils, depending on why, they might need a different method to get food into their mouth. Someone without the ability to understand the steps of feeding, such as getting food on the spoon, opening the mouth, chewing, swallowing they struggle with the same bADL. But the intervention needed to make feeding possible would be different. A carer might have to feed them, remind them to open their mouth, close their mouth, chew and swallow for each bite.

In these situations considering only the fact that someone cannot perform an ADL doesn't really represent what support needs that they have. It's not a comprehensive measurement of support needs specifically, even if it is an indication of impairment. If we understand adaptive functioning and what it means, then we can better understand the support needs of disabled people. We will understand that someone might have low adaptive functioning but is able to do certain ADLs and someone with high adaptive functioning might not be able to perform certain ADLs. We can also understand the difficulties, barriers, and support needs of intellectual and/or developmentally disabled people.

[five-thousand-loaves-of-bread]

support needs… expanded! (part 1)

[pt: support needs… expanded! (part 1)]

low/medium/high support needs (& everything in between) get more awareness n talk about here, which great! you may able now remember support needs as amount of support someone need for basic & instrumental activities of daily living (bADLs & iADLs), n more n more of you able explain what bADLs iADLs are. if so, then, congrats, you graduated support needs 101! now, you need take next mandatory class… support needs 201 >:) where we talk about more concepts n expand on old concepts with more nuance.

.

adaptive functioning skills

[pt: adaptive functioning skills]

this very well known word in intellectual/developmental disability (I/DD) services circle, but think there things people with start-as-adult neurological & cognitive disabilities n people w physical disabilities can borrow too. this a thing talked here a few times briefly, but never know how explain it.

adaptive functioning skills are conceptual, social, & practical skills need for independent daily life. it includes bADLs & iADLs, but also bigger wider than that, n also include skills need for do these ADLs. some examples:

conceptual skills

reading/literacy & writing

understand numbers, money, time

self direction, plan, organize

social skills

listening & understanding others (communication)

talk to & communicate with others (communication)

recognize danger, avoid harm

ask for help

social responsibility, follow rules n laws

practical skills

personal care (bADLs & beyond)

caring for home (iADLs & beyond)

being in community

manage money

& so much more! sometimes skill belong in multiple category, move between category, different people group them differently, but this general idea.

each bullet point can (&often is) broken down to even smaller skills, from most basic skill many people don’t even consider it learned skill (but is! n many I/DD n otherwise disabled people struggle with), to more advanced ones. example:

under personal care > feeding (orally)

open mouth when fed

eat solid food

suck or chew food

feed self with spoon

feed self with fork

(now do those without spilling)

spread soft things like butter n jam with not-sharp knife

cut easy to cut food with knife (e.g. pancakes)

cut hard to cut food with knife (e.g meat)

under listening & understanding

looks at (familiar person) when hear their voice

looks when someone call own name

understand (e.g. at least 3) basic gestures (head nod yes, shake head no, reaching, waving, clapping, etc)

understand at least 10 words

look when other people point

point to (e.g) at least 3 object when asked

follow one step directions. then two related directions. if-then directions. then two unrelated directions. then three step directions. then directions for do something a lil later. then directions for something much much later. etc

pay attention to story for short amount time. pay attention to show for medium amount of time. pay attention to information talk for short amount of time. n understand it. etc

some examples of be in community skills

understand money used to buy thing, clock used to tell time

communicate with familiar people on phone/computer/etc - when other people place the call. n start by self

respect privacy, like use bathroom change clothes, not go through other people stuff

look both ways when cross road

understand symbols for danger, like 🚫, ⚠️, skull n crossbones for poison

follow cross road signs like walk/don’t walk

know how make call in emergency

use money buy small things. big things. use credit debit card. have bank account. have own credit debit card.

keep money n phone save when out

consider price n quality when buy things

travel independently to place been many times before. travel independently to new place.

buy grocery n household stuff when need. pay bill on time.

you see list start with easy, basic-of-the-basic skills. then get more complicated, next skill often depend on n build on previous skills. because it idea from I/DD services n professionals, list tend focus on development & developmental skills, & tend have cognitive focus. but, again, can see these be help for non-I/DD disabilities (& many I/DD people have comorbid physical & neurological disabilities to begin with!).

also because of I/DD focus, may see first few bullet points (or maybe most of the list) as easy, “well duh” skills you not think twice about, skills babies & toddlers learn that have nothing do with teens n adults. because this, you may see adaptive functioning as infantilizing or childish. but, they not infantilizing or childish at all—it reality that I/DD (& other disabilities), it affect babies n toddlers n children, developmentally delayed children who don’t have n struggling with n learning these skills. and, there plenty teens and adults (including older adults) with I/DD, cognitive disabilities, n other disabilities who do not have these skills.

—so, think it really helpful, even much needed, for disability allies & advocates & disabled people (if can) to read through more detail list of adaptive functioning skills. n while do that, remember, there people your age & older than you, who not able do these.

personally find this a lot more helpful than just bADLs & iADLs. because adaptive functioning more accurate include ALL skills need for daily life, from very small to more advanced. it more well rounded, n group in way make sense for own brain. (but that also make idea infinitely harder to explain for my brain for some reason)

next part, want talk about amount of support, & supported independence/modified independence

(edit: part 2 link here)

[spooksforsammy]

I’ve been trying to understand how adaptive function plays into my support needs. But truthfully I don’t understand. I don’t understand adaptive function or how it plays a role in my support needs. I’ve read posts, looked on google etc. there’s no simple explanation on adaptive function,, I don’t know what I’m reading or how to apply it to my support needs.

I wanted to make sure wasn’t wrong. And really was msn,, because if not want make sure. Using correct label. But now knowing adaptive function plays a role I genuinely don’t know. Without applying adaptive function I am msn,, I can’t live independently I need support and support in most to all areas of my basic life. But with adaptive function I’m not sure.

I found a like. I don’t know.. template could fill out. And most in the middle column. I think that would say am msn,, but I genuinely don’t know. (If anyone else want it just let me know)

My Brain hurts now :(

[antlerkitty]

Think maybe a goal for eventually (by the time I move out) could be to figure out how to do all bADLs independently or with minimal prompting? And not sure if that will actually work, and have obviously more support needs (like adaptive functioning support needs) outside of bADLs, but would be nice to maybe be able to stay physically bare minimum of health on my own? Because have never really had that…

Maybe visual schedules or something? Right now wouldn’t work for me, but am thinking that if I get lots more support in other areas of life, especially iADLs and adaptive functioning skills, maybe will be able to manage? But it’s hard because still will not be fully independent ever I think, or even mostly independent. And already get fair bit of support in those areas and it’s still not enough.

[mochasucculent]

Was looking at refs and since Viktor has two different leg braces I was wondering, do we think he wears them simultaneously?? The refs don't perfectly line up perspective-wise so it's hard to tell but parts of the one he wears during the Hexcore scenes look like they could maybe line up with the brace that he wears over his clothes, but also some parts really don't and look like they'd be super uncomfy. Also HOW does he take these on and off. Experts weigh in

[ofswordsandpens]

90% sure this is just the nostalgia speaking but god if you were a kid in the early 2000s it was like the crème de la crème of live action fantasy kid movies. like big budget, high production value, (mostly) well acted kid movies and I really don't feel like those get made much anymore

[willyhoos]

the mikes.. the michaels, even...

[tapakah0]

[simplyender]

spiderpeople that could defeat spot first try:

1. spider-ham (cartoon logic dictates that he can just pick up the holes)

2. sun-spider (disabled solidarity. would probably get spot to come to the realization that hes 100% disabled and be empathetic about it)

3. spider-punk (would explain that a majority of spots problems originate from the shitty system hes in and that capitalism is the problem, not miles)

[five-thousand-loaves-of-bread]

a lot us been talk about & define support needs for autism (& honestly all intellectual/developmental disorders (I/DD)) in term of basic + instrumental activities of daily living (bADLs, iADLs).

but think it useful (& needed) add adaptive functioning in there

because many skills & ability involve in do one ADL - “dressing” “shower” “cook” “shop” all big catagories. and many skill come before it.

and, need help with, for example, communication is support need, even if not ADL (phone call & technology can be iADL but much more to communication than that).

adaptive functioning contain broken down version of both bADLs & iADLs, but also so much beyond. for example:

conceptual skills: able understand words, numbers, time, idea of money, etc

social skills: understand social rules & cues, follow rules, interpersonal skills, how gullible & naive, etc

practical skills: personal care (bADLs), ability use money, able keep safe, healthcare, travel & transportation, phone & technology use, keep job, etc.

also communication skills & motor skills, etc.

even these are quite big summaries. each individual thing list here, often able break down into even smaller specific skills. which make hard explain. haven’t figure out great way yet.

these very often used in professional clinical places with neurodevelopmental disorders but especially intellectual disability, & so sometimes described in negative way, but think idea itself still helpful when push back against those ableism that often come with.

[tonyglowheart]

one of my favorite but also again alas relatively rare flavor of fic is where actually, it turns out Q is the well-adjusted one (well, as well-adjusted as anyone working at MI6 can be), and Bond is the manic pixie disaster nightmare

[antlerkitty]

Agree with adaptive functioning being part of support needs labels but:

Very confusing for me to adjust to new thing.

Scared I’ll no longer be MSN since I can do good amount (believe slightly less/more than half depending on assessment used) of adaptive functioning skills at the same level as my peers, and others I either do somewhat or significantly below. Because not sure how autism community will define and if people who used to be MSN will be pushed into LSN if they don’t need help with most adaptive functioning.

[rosecorcoranwrites]

BBC' Sherlock: Don't make people into heroes, John. Heroes don't exist, and if they did, I wouldn't be one of them.

Canon Sherlock: I am not the law, but I represent justice so far as my feeble powers go. With the help of the god of justice I will give you a case which will make England ring!

[perfectwitchcrown]

Ekuoto 81 thoughts

Spoilers below! CWs: references to abuse, suicidal ideation/suicide

Before this week's chapter I had been wondering how we might see the Dante and Vergilius fight resolve since Dante had so clearly expressed that this was the end of the line chapters ago and Bel had just been defeated, but I somehow did not expect this to be what happened… :’)

Tbh I think he’s going to live if only bc I think that there was a reason we were shown that Vergilius has healing powers when he kissed Charlotte chapters ago. Maybe this is just cope tho lmao. On the other hand, I’d be really interested to see Priest’s (and Barbara and Leah, who were in France with Dante) reaction to Dante being dead so I’m torn lol.

I think it's interesting how often Dante's advice to fall in love from the first chapter has come up in the series, and how tonally different Priest vs Dante treat that moment in this chapter. Dante sort of broods on it and considers it a curse he's left on Priest, whereas Priest kind of brushes it off to Imuri as uncool advice from an unreliable adult. On the other hand, I think it’s super interesting that Priest seems to consider the hug Dante gave him as having saved his life as a child. In chapter three, when Priest saves the children in the aquarium, he similarly gives them a hug.

I’m sure a lot of it has to do w most of his experience with adults throughout his life involved physical pain (the abuse he suffered from his father, the abuse he suffered from the church, etc) so like I am sure positive physical contact was not something he really experienced. But also, this moment in the first chapter comes after Priest breaks down about how hard he finds living--outside of Bel, who Priest had forgotten about at this point, Dante was likely one of the first adults that actually listened to his cry for help as a child and saw his idealization of religious martyrdom that was really, at its core, suicidal ideation.

Dante’s whole thing about being tired of chasing Vergilius is interesting too. It uses the same language as when he spoke of his failure to chase after Vergilius in chapter 20. Vergilius naming himself Vergilius is also such a "come follow me" move since Virgil was Dante’s guide in Inferno. Interested to see how this shift in the dynamic affects Vergilius.

Also excited to see what happens w Marco next chapter. His relationship w Priest seems fascinating to me bc it’s kinda hard to tell what level of distance they have from each other. Marco completely idolizes him, and it’s also been mentioned that he was present at the previous offscreen exorcism of Mammon prior to the start of the series, and he’s also visible in a flashback panel to that exorcism. They've known each other for like three years then so it's kind of interesting how obsessive Marco is and how little he actually knows about Priest as a person for having known him for all that time.

Even in the first chapter we're shown that Marco's understanding of Priest is completely misguided, where he assumes Priest's studying the bible when he's actually reading poetry by Goethe and Song of Songs (the second of which is in the bible, but the unifying theme between the works he's reading is romantic love. Also, this is the dorkiest form of romantic texts for him to be interested in LMAO).

Also can’t wait to see what goes down w Leah Barbara and the others. While Marco looks pissed, Leah looks more worried than anything else, and Mikhail looks sort of solemn. Daniel sort of has resting bitch face so idk what’s going through his mind. Last we saw of them all, Leah and Barbara very much dodged mentioning that Imuri is a demon and said to focus on fighting the witches first. Now that they’ve clearly finished with that, I wonder if they’ve told the rest or if they’re still hiding it. Either way Marco would be pissed since Priest did work with Bel.

Anyways, what a chapter, I'm so excited to see what happens next chapter. If Imuri and Priest have to be on the run from the church for awhile I wonder if Imuri's friend Cass from the file extras might finally make an appearance...

[ddagent]

Me, Yesterday: I should write a '5 times Margo and Sergei went to bed together (g-rated)' story. Nah. No one wants to read just domestic fluff.

Y'all, commenting on Convenience today...