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229© Springer International Publishing Switzerland 2016 N.N. Singh (ed.), Handbook of Evidence-Based Practices in Intellectual and Developmental Disabilities, Evidence-Based Practices in Behavioral Health, DOI 10.1007/978-3-319-26583-4_9 Functional Skills Robert H. LaRue , Christopher J. Manente , Erica Dashow , and Kimberly N. Sloman R. H. LaRue (*) • C. J. Manente • E. Dashow K. N. Sloman Rutgers, The State University of New Jersey, Douglass Developmental Disabilities Center , 151 Ryders Lane , New Brunswick , NJ 08901 , USA e-mail: larue@rci.rutgers.edu 9 Introduction The acquisition and maintenance of functional skills are among the most important educational targets for individuals with intellectual and devel- opmental disabilities. Functional skills are those skills we possess that allow us to take care of our- selves and function independently in our natural environment. For most of us, these skills are readily acquired through typical life experiences. For individuals with cognitive impairments, these skills may require specifi c teaching strategies. The acquisition of functional skills results in sev- eral favorable outcomes, including increased opportunities for community integration and bet- ter overall quality of life (Ayres, Lowrey, Douglas, & Sievers, 2011 ). In addition, func- tional skills allow individuals with disabilities to have more opportunities to access reinforcers and make choices in their daily lives, which has shown to have positive effects on work comple- tion and inappropriate behavior (e.g., Shogren, Fagella-Luby, Bae, & Wehmeyer, 2004 ; Watanabe & Sturmey, 2003 ). The goal of any educational program should be to prepare individuals to function as indepen- dently in their environment as their abilities will allow. Experts have noted that individuals with intellectual and developmental disabilities encounter a myriad of challenges as they transi- tion out of school placements, including increased unemployment and placement in more restrictive programs (Ayres et al., 2011 ; Courtade, Spooner, Browder, & Jimenez, 2012 ). Consequently, these researchers have argued that functional skills should be incorporated into students’ individual- ized educational programming and practiced on a daily basis. Ideally, each educational goal should be linked to a terminal skill that will be useful to the individual in the natural setting (Bannerman, Sheldon, Sherman, & Harchik, 1990 ; Favell, Favell, Riddle, & Risley, 1984 ). This should be accomplished through systematic assessment and planning which allows parents and practi- tioners to produce the best outcomes for this population. What Are Functional Skills? Functional skills refer to a broad range of abili- ties that are needed to navigate the demands of everyday life. Functional skills are often referred to by a variety of names, such as self-help skills, life skills, or skills of daily living. Functional skills, simply put, are those skills that are mailto:larue@rci.rutgers.edu 230 practical and helpful in fostering independence. According to Brown et al. ( 1979 ) functional skills are “… the variety of skills that are fre- quently demanded in natural domestic, voca- tional, and community environments. Functional skills are not limited to performances, which affect the actual survival or physical well-being of an individual; they also include the variety of skills which infl uence a student’s ability to per- form as independently and productively as pos- sible in home, school, and community. Nonfunctional skills, by contrast, are those that have an extremely low probability of being required in daily activities.” (p. 83). All too often, practitioners implement aca- demic goals that have no functional outcome. For example, an instructor may teach an adolescent to put plastic shapes into a shape sorter while they are unable to place coins in a vending machine. Students may be taught to identify the pictures of lesser-known U.S. Presidents (e.g., James K. Polk) or list the characteristics of sedi- mentary rock as a part of their academic pro- gramming. These kinds of goals can be a concern in that they do not translate in any meaningful way to an individual’s daily life. From this per- spective, instructional time that is devoted to teaching nonfunctional skills is a waste of valu- able educational resources. The failure to acquire functional skills across domains results in more restrictive placements as a result of the need for additional support and resources. Many of us take the ability to perform func- tional skills for granted, such as feeding one- self, toileting oneself, and the ability to interact successfully with the world. While these skills are established during the normal developmen- tal process, most individuals with intellectual and developmental disabilities, require specifi c and sometimes intensive instruction to acquire these skills. The spectrum of functional skills is quite diverse. Functional skills encompass mul- tiple domains of performance, such as self-care, domestic, recreational, community safety, pre- vocational/vocational, social and behavior management skills. Types of Functional Skills Self-Care Skills . Self-care skills are among the most important and basic kinds of functional skills in that they contribute to the maintenance of well-being and are necessary to sustain one’s health. Self-care skills include the ability to bathe oneself, self-grooming (e.g., teeth brushing, shaving, hair brushing, putting on deodorant), washing (e.g., hand and face wash- ing, showering), self-toileting, and getting dressed (e.g., choosing clothes, tying shoes, dressing independently). Domestic Skills . Domestic skills encompass skills related to household affairs. These skills involve maintaining one’s home as well as pro- viding necessary daily sustenance. Domestic skills may include food preparation and safety (e.g., using a microwave or an oven to cook food), meal planning, sweeping/vacuuming the fl oor, doing dishes (e.g., loading a dishwasher), making a bed, and doing laundry (e.g., washing, drying, folding, and sorting clothing), Community Skills . Community skills include those abilities that are required to navigate and access resources within one’s specifi c locality. Important community skill targets may include the ability to cross a street safely (e.g., using a crosswalk, observing “Walk/Don’t Walk” signs), the ability to recognize stores (e.g., grocery store, pharmacy, laundromat), the use of public transit (e.g., using the bus or train), or purchasing items in a store (e.g., paying for items, counting change). Vocational Skills . A common goal for many individuals with intellectual and developmental disabilities and their families is the procurement of employment. Vocational skills include those skills that involve the production aspects of jobs, such as the ability to bus tables at a restaurant or fi ling paperwork at a doctor’s offi ce. Vocational targets often depend on a number of factors, such as opportunities in the community, individual skill level, and parent/student preference. Such instruction may begin with prevocational skills to teach the prerequisite skills (e.g., sorting tasks, R.H. LaRue et al. 231 discrimination tasks) that are components of more complex skills (e.g., delivering inter-offi ce mail). Recreational Skills . Recreational skills typi- cally involve an individual’s engagement with activities or items that they fi nd interesting, rewarding, relaxing, or enjoyable. For most indi- viduals, recreational activities are acquired with- out specifi c training as a part of typical development. The ability to exercise (e.g.,run- ning), playing games/sports (e.g., bowling, soc- cer, playing “Tag”), or engaging in leisure activities (e.g., playing video games, reading a book) are learned by most without teaching. Alternatively, individuals with intellectual and developmental disabilities may require formal teaching strategies in order to encourage the development of repertoires of appropriate leisure- time activities. Social Skills . An individual’s ability to partici- pate in their community is, to a large extent, dependent upon their ability to interact with oth- ers. Social skills are those skills that facilitate interaction and communication with others. Under normal circumstances, social rules and relations are developed without specifi c teaching. However, for individuals with intellectual and developmental disabilities, specifi c teaching strategies may be necessary to develop appropri- ate social behavior, such as respecting personal space, perspective-taking, conversation skills, turn taking, sharing with others, asking for or offering to help, giving an appropriate greeting, and giving/accepting compliments . Behavior Management Skills . The ability to be integrated into the community is often directly dependent on the absence of maladaptive behav- ior. Individuals exhibiting problem behavior often have signifi cant limitations in their ability to par- ticipate in functional activities. Effective, func- tion-based behavioral intervention is imperative for improving outcomes in individuals with intel- lectual and developmental disabilities. Behavioral intervention should involve a systematic plan that includes antecedent strategies to prevent the occurrence of problem behavior, the reinforce- Table 9.1 Types of functional skills Functional skill type Examples Self-care skills Self-bathing/showering oneself Teeth brushing Hair brushing Wash/dry hands Self-toileting Dressing independently Self-feeding Domestic skills Using a microwave Cutting fruits/vegetables Washing, drying, folding, and sorting clothing Vacuuming Sweeping Doing dishes Making the bed Community skills Street crossing Store recognition Using public transit Making purchases Counting money/change Pre-vocational skills Sorting Alphabetizing Reading Simple assembly (components of a larger task) Vocational skills Product assembly Filing Mail delivery Cleaning (e.g., mopping, washing windows) Recreational skills Exercise Bowling Playing video games Reading a book Social skills Respecting personal space Perspective-taking Conversation skills Turn taking Sharing Asking for or offering to help Greeting others Giving/accepting compliments Behavior management skills Choice making Communicating preferences Functional communication Self-management 9 Functional Skills 232 ment of appropriate alternative behavior, and strategies for responding to problem behavior (e.g., extinction). In terms of functional behavior management skills, individuals should be taught to make choices and state their preferences, func- tional communication skills (e.g., appropriate ways to ask for a break, attention, preferred items and activities), in addition to various strategies for managing their own behavior (i.e., self-manage- ment techniques). It is important to note that the list of functional skills provided in this chapter is not all encom- passing (see Table 9.1 ). In fact, functional skills span a wide variety of domains, are specifi c to an individual’s natural environment, and are more than just what an individual needs to survive. These skills are essential to achieving indepen- dence and can signifi cantly affect quality of life for both an individual and their caregivers. More specifi cally, if an individual is unable to perform these skills on their own, they will require more restrictive environments with fewer opportunities for choice and produce greater strain for caregivers. Functional Skills Across the Life Span Many practitioners make the mistake of a ssuming that functional skills only become a priority immediately prior to aging out of educational programs. Instruction designed to encourage the development of functional skills for young chil- dren with intellectual and developmental disabil- ities often involves a primary focus on language skills and social behavior with little time spent targeting other functional life skills. In many cases, school curriculum requirements result in teachers focusing on academic tasks that have little functional value (e.g., learning the life cycle of insects). In fact, in some cases, practitioners maintain this focus at the exclusion of other important functional tasks. This can result in ado- lescents who make limited gains in some non- functional domains but lack the ability to adequately care for themselves (e.g., the individ- ual can discriminate colors in a discrete trial for- mat but is unable to tie their shoes or make a sandwich). While there is no universally correct stance as to when it is most appropriate to shift curricular focus for students with disabilities to the acquisi- tion of functional skills, the severity of an indi- vidual’s intellectual disability may require that educators target these skills early in the educa- tional process. Brown et al. ( 1979 ) argue that a decision to focus on the development of func- tional skills should be guided by an examination of the settings, which encompass a learner’s “nat- ural environments.” In this approach, the focus on functional skills as a primary objective is not linked to chronological or mental age, but to the degree to which a particular objective is meaning- ful within the least restrictive environments that a learner is likely to inhabit. That is, caregivers and educators should work toward building functional skills as they are needed in their daily environ- ment, rather than arbitrarily based on their age. When children are young, focus is usually placed on language acquisition as well as con- ceptual learning tasks, such as sorting, sequenc- ing, or grouping items. As children grow older, targeted functional skills should change to adapt to the living circumstances of the individual with a focus on those skills that will make them more independent. As a general rule, it may be helpful to shift from conceptual learning or from teach- ing a developmental language sequence to more practical skills that are immediately useful and can assist the individual to become less depen- dent on others as the individual ages. Functional skills should be taught as early as possible, start- ing with simple skills. For example, children can be taught to pick up toys, wash their hands, and put dirty clothes in a hamper. As they grow older, they may be taught to fold and put away clothes, bathe themselves, or assist with housekeeping. The teaching of functional skills is a process that should continue throughout the life span, and will allow the individual increased independence as well as the opportunity to play a more active role in the home and community. Unfortunately, many of the barriers encoun- tered by students are those imposed by parents and caregivers. In the interest of saving time or R.H. LaRue et al. 233 protecting them from failure, parents and teachers often neglect to create opportunities for students to do things independently. While these may seem like logical options in the short term, they can have signifi cant side effects. Slow progress and the increased likelihood of prompt depen- dence (relying on prompts from others to com- plete tasks) are consequences of not providing opportunities to complete tasks independently. Functional skills training is best approached as a lifelong process. The development of func- tional skills is important forindividuals of all ages. There will always be skills that can lead to increased independence, better social skills, and less dependence on others. The selection of appropriate functional skills to be targeted for instruction is a complex process which should be determined by considering an individual’s cogni- tive ability, environment, and lifestyle rather than his/her chronological age. These factors high- light the importance of systematic assessment to select appropriate functional goals . Functional Skills Assessments In order to evaluate an individual’s current level of functioning and identify skills to target for intervention, it is important for practitioners/ caregivers to conduct assessments of an indi- vidual’s capacity to perform various functional skills. Specifi cally, functional skill assessments may be valuable in the identifi cation of meaning- ful instructional targets, in determining the level and type of support that an individual may need in a residential setting, or in the identifi cation of appropriate vocational placements. These evalu- ations are typically conducted via indirect assessment involving the completion of an inter- view or survey by the individuals themselves or their primary caregivers. Alternatively, func- tional skills assessments can be conducted via direct methods involving planned observation of an individual’s behavior in a natural setting or via the completion of a performance-based eval- uation involving the exposure of the individual to a battery of contrived tasks related to general functional ability. While there are numerous assessments of functional skills for individuals across various populations in existence (for a thorough review see Moore, Palmer, Patterson, & Jeste, 2007 ), there are only a handful of assessments that are recognized as being appropriate for use specifi - cally with individuals that have intellectual and developmental disabilities. The assessments that are most widely used for evaluating the existence of functional skills among individuals from this population are the Vineland Adaptive Behavior Scales II (Sparrow, Cicchetti, & Balla, 2008 ) and the Scales of Independent Behavior-Revised (Bruininks, Woodcock, Weatherman, & Hill, 1996 ). In addition to these more established eval- uations, the Assessment of Functional Living Skills (Partington & Mueller, 2012 ) is a recent addition to existing assessments designed for the evaluation of functional skills among individuals with autism and developmental disabilities. While observational methods of assessment are regarded as the most accurate means of deter- mining an individual’s true ability with regard to functional skill, these methods are also the most time consuming. Consequently, when conducting assessments related to functional ability, caregiv- ers and professionals often attempt to strike a bal- ance between acquiring an accurate representation of a learner’s abilities and completing an assess- ment in the most effi cient way possible via the use of indirect methods of assessment such as surveys or interviews. The aforementioned com- mercially available assessments of functional ability are similar in that they provide an exten- sive list of functional skills in order to provide the caregiver with the ability to either approximate the learner’s ability based on their previous observations or by staff accounts of the learner’s ability, or conduct some form of direct assess- ment to determine the current level of function- ing. However, there are distinctive characteristics of each assessment that may make them more or less appropriate for use with a particular learner. The Vineland Adaptive Behavior Scales ( ABS ), which was fi rst published in 1984 (Sparrow, Balla, & Cicchetti, 1984 ), and the revised edition of the assessment the Vineland Adaptive Behavior Scales II (Vineland II) which 9 Functional Skills 234 was released in 2005 and expanded in 2008 (Sparrow, Cicchetti, & Balla, 2005 /2008), are regarded as the most widely used adaptive behav- ior tests in the world. There have been thousands of research studies involving all forms of intel- lectual disability conducted using the ABS and the Vineland II since its initial publication in 1984 (Sparrow, 2011 ). The Vineland II has four forms, two of which (Survey and Expanded report forms) are completed via structured inter- views with parents or caregivers and two that involve the completion of a rating form by a teacher or parent/caregiver (Parent/caregiver and Teacher report forms). The Survey, Parent/care- giver, and Expanded report forms of the Vineland II are deemed appropriate for learners from birth through 90 years of age and beyond, while the Teacher report form of the Vineland II is appro- priate for learners from 3 to 21 years of age. The Vineland II assesses performance across four domains of adaptive behavior including communication, daily living skills, socialization, and motor skills. In addition, the Vineland II includes an optional Maladaptive Behavior Index to assess the degree to which problem behavior is likely to interfere with adaptive functioning. Each of the four primary domains of adaptive behavior are further categorized by multiple sub- domains. For example, the communication domain is broken down into the subdomains: receptive, expressive, and written forms of com- munication. The daily living skills domain is separated into the subdomains personal, domes- tic, and community skills. The socialization domain is organized by the subdomains interper- sonal, play and leisure time, and coping skills. The motor domain is separated into tasks that either require gross motor or fi ne motor perfor- mance. Lastly, the subdomains of the optional primary domain for maladaptive behavior is organized by behavior that is described as inter- nalizing, externalizing, or other. The Assessment of Functional Living Skills (AFLS) was developed as an extension of the widely used Assessment of Basic Language and Learning Skills (ABLLS-R) as a means of focusing primarily on the evaluation of learners’ abilities within the realm of functional perfor- mance (Partington & Mueller, 2012 ). The AFLS is a tool for caregivers that meets the needs of learners from 2 years of age and extending throughout the life span for which a guiding assessment, tracking grid, and curriculum is needed. The creators of the AFLS defi ne the term “caregiver” as an individual who knows, cares for, supports, and works with a learner. Caregivers include parents, teachers, paraprofessionals, behavior analysts, group home staff, community or government-agency personnel, and a variety of other professionals. The AFLS consists of six assessment modules designed to evaluate an indi- vidual’s performance of functional skills across the domains of Basic Living Skills, Home Skills, Community Participation Skills, School Skills, Vocational Skills, and Independent Living Skills . Specifi cally, the skills that are targeted in the Basic Living Skills module of the AFLS include those skills related to self-management, basic communication, dressing, toileting, grooming, bathing, health, safety and fi rst aid, and nighttime routines. The Home Skills module targets skills related to living at home with a caregiver includ- ing the consumption of meals, doing dishes, laundry, chores and general housekeeping, household mechanics, kitchen-related tasks, cooking, and leisure activities. The Community Skills module targets an individual’s ability across the categories of basic mobility, commu- nity knowledge, shopping, eating in public, money, using a phone, telling time, and social awareness and manners. The School Skills mod- ule targets those skills related to academics, school routines, navigating the school environ- ment, and social skills. The VocationalSkills module includes job seeking skills, compliance, rule following, vocational interests, confl ict reso- lution, job readiness skills, working with others, hygiene, transportation, job training skills, social skills, clerical skills, attendance, punctuality, organization, and fi nancial issues. The Independent Living Skills module targets household organization, household maintenance, household cleaning, community travel, transportation, advanced kitchen skills, meal R.H. LaRue et al. 235 planning, cooking, advanced self-care, advanced health, social awareness, social skills, social interactions, relationships, sexuality, fi nancial planning, banking, self-management, emotional regulation, and living with others. The information to complete the AFLS is typically obtained from three sources, including caregiver report, direct observation of the learner in a natural setting, and through con- trived performance- based measures. To com- plete the AFLS via indirect assessment, information is gathered from individuals who are well- acquainted with the individual’s skill level. The AFLS assessment guide specifi cally notes the importance of using reporters who know the learner’s true skill level rather than those who may guess about skill levels. This is critically important as the utility of the assess- ment results is largely dependent upon the accu- racy of the person reporting on skill levels in the different content areas. If the learner’s true skill level is not known, it should be obtained via observation of the completion of tasks in a natu- ral setting or through the formal presentation of the tasks . The Scales of Independent Behavior (SIB-R) is described as a comprehensive measure of func- tional independence and adaptive functioning in school, home, employment, and community set- tings for use with individuals from infancy to age 80 years and older (Bruininks et al., 1996 ). The information to complete the SIB-R is obtained either via a structured interview with a family member or other caregiver that is well acquainted with an individual’s ability related to the perfor- mance of functional skills or alternatively the family member or caregiver can complete a series of checklists directly in the SIB-R response booklet. The administration of the SIB-R can be customized to meet the needs of the practitioner giving the assessment or the individual being assessed in that there are four separate forms that can be given independent of one another or com- bined in various confi gurations. The SIB-R forms include the Full Scale, the Short Form, the Early Development Form, and the Problem Behavior Scale . The SIB-R Full Scale is designed to be a broad measure of adaptive ability across four categories of functioning including motor function, social interaction and communication, personal living, and community living. Each of the four catego- ries is further divided into 2–5 subscales with each subscale comprised of approximately 20 specifi c skills/tasks to be assessed for a total of 259 assessable items. The SIB-R Full Scale is designed to be administered in less than an hour. The SIB-R Short Form is designed to be a brief overall screening tool containing a total of 40 assessable items from across all 14 of the sub- scales of the SIB-R Full Scale that can be com- pleted in 15–20 min. The SIB-R Early Development Form is designed to focus on the functional skills that are relevant to the develop- ment of learners from infancy to 6 years of age. The Early Development Form consists of 40 assessable items from the developmental areas of the SIB-R Full Scale that are suitable for the assessment of preschool aged children or older learners with severe developmental delays. The Problem Behavior Scale is designed to be used alone or in conjunction with any of the other three forms of the SIB-R. The Problem Behavior Scale is designed to assess the severity of mal- adaptive behavior across eight categories includ- ing behavior that is hurtful to self, unusual or repetitive, involving withdrawal or inattention, socially offensive, uncooperative, hurtful to oth- ers, destructive to property, or disruptive to oth- ers. One aspect of the SIB-R that many practitioners fi nd useful is the ability to devise a “Support Score” which combines an individual’s score from The Problem Behavior Scale and their raw score from the other SIB-R scales to deter- mine the level of caregiver support that an indi- vidual is likely to need. Another distinctive feature of the SIB-R is that it has a direct relationship to the Woodcock- Johnson Psycho-Educational Battery (WJ-R) in that scores from the SIB-R can be used in combi- nation with those from the WJ-R to devise a comprehensive assessment of an individual’s ability across the dimensions of adaptive behav- ior, problem behavior, cognitive ability, language 9 Functional Skills 236 profi ciency, and achievement. Additionally, each of the forms of the SIB-R provides a procedure for comparing an individual’s current level of functioning with respect to their adaptive behav- ior to his or her cognitive ability as measured by the WJ-R. This aspect of the SIB-R makes it a useful tool for diagnostic purposes with individu- als with intellectual disability . Summary. The ABS/Vineland II, AFLS, and SIB-R are all valuable instruments for the identi- fi cation of strengths and weaknesses related to functional skills (see Table 9.2 ). They can be a useful guide for parents and practitioners when selecting curricular targets. These measures pro- vide an objective way to guide programming and can be used to determine socially signifi cant short and long-term goals Although a wealth of knowledge can be gath- ered through indirect means, it is also important to include direct measures of performance in the assessment process as indirect assessments may not always yield results that are indicative of a learner’s true ability. Direct measures may include presenting tasks (or components of tasks) to the individual in natural context or in a more contrived setting and evaluating his/her performance (i.e., how independent they are). For example, during the assessment process, a reporter might state that the individual being evaluated is capable of brushing their teeth inde- pendently. The evaluator may then observe the individual completing the skill directly and doc- ument which steps they are capable of complet- ing independently (e.g., Are they brushing all surfaces? Are they brushing long enough?). Another scenario could be a practitioner seeking possible job placements for a student. While assessments may suggest some of the job skills the individual possesses (e.g., they are capable or sorting), they may not provide a reliable mea- sure of their preference for jobs or if they have the skill to perform a skill fl uently enough to meet the needs of an employer. Direct measures, such as job sampling, could allow practitioners to determine job preference and job aptitude under controlled conditions. While using direct measures can be more labor-intensive and time- consuming, they can help to confi rm or deny the fi ndings from assessments conducted in an inter- view format and can lead to a more precise mea- sure of functioning. Direct measurement can strengthen the assessment results and help par- ents and practitioners to prioritize skill defi cits in need of intervention. Table 9.2 Primary features of assessment instruments Instrument Age range Assessment method Duration Domains ABS II Parent = birth and up Rating scalesVocational Independent living SIB-R Infant and up Rating scalesdeter- mine the current level of support needed, and provide feedback on the individual’s progress during the training process. Functional programming leads to a number of tangible benefi ts including increased indepen- dence, more opportunities for community inte- gration, the broadening of interests and leisure activities, more opportunities to establish mean- ingful social relationships, and the opportunity to make choices for oneself. The importance of appropriate goal selection for individuals with intellectual and developmen- tal disabilities cannot be underestimated. Functional skills assessments allow us to select these goals appropriately. We should always be focused on the acquisition of skills that are imme- diately useful, practical, helpful, and benefi cial. As parents and practitioners, we should question the need for each goal being addressed. Is this skill important? Is this skill a component of a larger, important skill? Is this goal going to make a meaningful difference in 10 years? Will this skill make the individual more independent at some point in the future? If the answer to any of these questions is “no,” then we need to seriously consider why the goals are being targeted. All too often, goals are selected for the wrong reasons R.H. LaRue et al. 239 (e.g., because other students in a classroom are working on similar goals), which can lead to wasted time and frustration on the part of the individual. As a general rule, if a program is not promoting independence, parents and practitio- ners should be doing something else. Everything that we target as educators should prepare indi- viduals with intellectual and developmental dis- abilities for the post-school environment that they will be living in. References Ayres, K. M., Lowrey, K. A., Douglas, K. H., & Sievers, C. (2011). I can identify Saturn but I can’t brush my teeth: What happens when the curricular focus for students with severe disabilities shifts. Education and Training in Autism and Developmental Disabilities, 46 , 11–21. Bannerman, D., Sheldon, J. B., Sherman, J. A., & Harchik, A. E. (1990). Balancing the right to habilitation with the right to personal liberties: The rights of people with developmental disabilities to eat too many dough- nuts and take a nap. Journal of Applied Behavior Analysis, 23 , 79–89. Brown, L., Branston, M. B., Hamre-Nietupski, S., Pumpian, I., Certo, N., & Gruenewald, L. (1979). 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Circle Pines, MN: American Guidance Service. Sparrow, S. S., Cicchetti, D. V., & Balla, D. A. (2008). Vineland adaptive behavior scales: (Vineland II), the expanded interview form . Livonia, MN: Pearson Assessments. Watanabe, M., & Sturmey, P. (2003). The effect of choice- making opportunities during activity schedules on task engagement of adults with autism. Journal of Autism and Developmental Disorders, 33 , 535–538. 9 Functional Skills 9: Functional Skills Introduction What Are Functional Skills? Types of Functional Skills Functional Skills Across the Life Span Functional Skills Assessments Benefits of Functional Skill Development Conclusion References