Education and Training in Autism and Developmental Disabilities

eliability (r .92) and good inter-rater reliability
(r .83) (Tassé & Maurice, 1993).
Maladaptive behavior. The second section
of the ÉQCA measures maladaptive behavior.
This section contains 99 items divided into
seven dimensions. These dimensions are related
to stereotyped behaviors and odd postures,
withdrawal and carelessness behaviors,
unacceptable practices and habits, antisocial
or inappropriate interpersonal manners, inadequate
or divergent sexual behaviors, violence
or aggression behaviors, and self-mutilation
behaviors. Each item is assigned a score from
0 to 3 according to the severity of the inadequate
behavior (0 does not exhibit the behavior;
1 mild; 2 moderate; 3 severe).
A mild inadequate behavior refers to an occasional
or benign behavior that may require an
isolated intervention from caregivers. The
moderate type behavior is the one that requires
a generalized or concerted action leading
to the application of a treatment strategy
to modify the presented behavior. Finally, a
severe behavior is considered to be so when it
may constitute a danger to the person or
other people, or lead to the rejection of the
individual.
Mental health problems. The translation and
transcultural adaptation section (Lecavalier &
Tassé, 2001) of the questionnaire Reiss Screen
for Maladaptive Behavior (Reiss, 1988) was used
with the intention of creating a portrait of the
mental health condition of the participants.
The instrument was originally developed to
detect the presence of mental health problems
of teenagers and adults presenting intellectual
disabilities. The instrument is composed
of 36 items describing the symptoms of
one or more mental health issues, as described
in the DSM-III. For each item, the
respondent must indicate if the behavior does
not represent a problem (0); a problem (1); a
major problem (2); a problem that can be
identified by one of the multiple criteria defining
psychopathology: the frequency, the intensity,
the circumstances of appearance and
the impact for the evaluated person or for his
environment. It is composed of eight subscales:
aggressiveness, autism, psychosis, paranoia,
depression (behavioral signs), depression
(physical signs), dependent personality
and avoidance disorder. In addition to these
eight sub-scales, six items describe problem-
atic behaviors: drug abuse, self-mutilation, suicidal
tendencies, robbery, inappropriate sexual
behaviors and hyperactivity. A positive
score is obtained with this evaluation if the
total score measured by the eight subscales
exceeds a cutoff or when a major problem is
detected on one of the six items. The translation
and French adaptation of this instrument
was made up by two committees composed of
bilingual professionals with expertise in the
field of mental retardation. The internal coherence
indices for the eight sub-scales of the
original version of the instrument vary between
.57 and .84 and that associated with the
total score is .84 (Reiss). As is mentioned by
Lecavalier and Tassé (2001), the translated
French version of the instrument adapted to
the Quebec reality obtains similar internal coherence
indices, that is, between .53 and .83
for the eight subscales and .80 for the total
score.
Medication. The data related to psychoactive
drug medication were collected and recorded
on cards designed for this purpose.
The drug’s name and its posology, as well as
the dates related to some modifications in the
regulation of medication, were recorded. This
type of drug could either be in the nerve
sedative (antipsychotic) or anxiolytic (benzodiazepines)
families. With the intention of obtaining
a measurement common to the various
prescribed drugs, equivalences were
calculated: the amounts of drug prescribed in
the nerve sedative family were converted in
CPZ (chlorpromazine) and the amounts for
those in the anxiolytic family, in Diazépam (or
Valium).
Procedure. The questionnaires used to
measure the adaptive and maladaptive behaviors
and mental health problems were completed
by caregivers who knew the person, in
collaboration with a member of the staff in
charge of the residence where each resident
lived. Each person was evaluated at two time
points: at the third month (Time 1) at the
27th month (Time 2) following discharge
from the Hôpital Saint-Julien. For each person,
a specific personal observation file entitled
Individual observation file (IOF) was created.
This IOF included the instruments, the grids
of notation and the instructions to be followed
with every person evaluated. The original data
were recorded in this file and, in some cases,
368 / Education and Training in Autism and Developmental Disabilities-September 2010