PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Research Article

Volume 6 Issue 1

Comparative Adaptive-Behavior Outcomes in Autism: A Meta-Analytic Synthesis Versus A Multicultural Vineland-3 Clinical Cohort

Henry A Montero*

June 30, 2025

DOI : 10.56831/PSSRP-06-198

View PDF

Abstract

Purpose: To juxtapose recent meta-analytic effect sizes for adaptive-behavior interventions in autism with domain-level deficits observed in a multicultural Vineland-3 clinical cohort (N = 16).

Methods: Eight systematic reviews (k = 119 trials) were identified through a PRISMA-compliant search (May 11, 2025). Hedges' g values were compared with baseline standard-score gaps in the Vineland-3 Communication, Daily Living Skills (DLS), Socialization, and the Adaptive Behavior Composite (ABC). Risk of bias was appraised with RoB 2/ROBINS-I.

Results: Pooled meta-analytic gains were moderate for Communication (g = 0.63) and Socialization (g = 0.53) but attenuated by 0.29 SD per year above age 9. The clinical cohort’s Communication mean was 54 (1.5 SD below norms) and declined by 4 points per year (ρ = -.71). DLS was the “strongest” domain (M = 63), yet it was 2.5 SD sub-normative; meta-analytic g = 0.49 covered only 20% of that gap. Six participants (38%) met the criteria for maladaptive cut-offs.

Conclusions: Meta-analytic effect sizes achieve meaningful coverage only when delivered ≥ 20 h/week before age nine years. Expressive-language weakness and widening adaptive gaps in bilingual contexts require Naturalistic Developmental Behavioral Interventions with augmentative communication support, plus sustained DLS coaching.

Keywords: autism spectrum disorder; adaptive behavior; Vineland-3; support lysis; multicultural

References

  1. Ahn S-N and Hwang S. “Cognitive rehabilitation of adaptive behaviour in children with neurodevelopmental disorders: A meta-analysis”. Occupational Therapy International (2018): 5029571.
  2. Farmer C., et al. “Concordance of the Vineland Adaptive Behavior Scales, Second and Third Editions”. Journal of Intellectual Disability Research 64 (2020): 18-26.
  3. Jin W-Y., et al. “Effects of intelligence levels and autistic severity on adaptive functioning and cognitive-adaptive gaps in school-aged children with autism”. Neuropsychiatric Disease and Treatment 21 (2025): 1131-1142.
  4. Lord C., et al. “The Lancet Commission on the future of care and clinical research in autism”. The Lancet 399.10321 (2022): 271-334.
  5. Mutschler Collins I., et al. “A meta-analysis of applied behavior analysis-based interventions to improve communication, adaptive, and cognitive skills in children on the autism spectrum”. Review Journal of Autism and Developmental Disorders (2025).
  6. Rosales MR., et al. “Systematic review and meta-analysis of the effect of motor intervention on cognition, communication, and social interaction in children with autism spectrum disorder”. Physical & Occupational Therapy in Pediatrics 45.2 (2025): 1-23.
  7. Selau T., et al. “Systematic review and meta-analysis of interventions in adaptive behaviors for children and adolescents with intellectual disabilities”. Journal of Intellectual Disability - Diagnosis and Treatment 10 (2022): 238-247.
  8. Sparrow SS, Cicchetti DV and Saulnier CA. “Vineland Adaptive Behavior Scales (3rd ed.)”. Pearson (2016).
  9. (Additional references in Online Appendices A & B).