The ICAP Service Score, which ranges from 0 to 100, is indicative of the service intensity required by an individual, considering both adaptive and maladaptive behavior.
A severely handicapped child with many serious problem behaviors would require intensive supervision (a Service Score below 20). A non-handicapped adult with no behavior problems would live independently without supervision (a Service Score of about 90 or more). The Service Score was developed with the knowledge that neither adaptive behavior nor problem behavior alone can predict “difficulty.”
An individual may require close supervision or intense assistance because he/she is severely disabled (limited adaptive behavior) or simply because he is young. Someone with advanced adaptive skills may require even closer supervision because of serious problem behaviors.
Development of the Service Score was possible because of the ICAP’s highly reliable measure of problem behaviors and because of much supplemental information that was gathered during its national norming. In addition to adaptive and maladaptive behavior the ICAP records information about a person’s demographic characteristics, diagnosis, health status, physical handicaps, services received, family and social support, and more.
Statistical analyses were carried out to determine an objective manner of combining all of this information in a way that would accurately predict the appropriate service intensity (level of care or supervision and training) required by individuals with varying characteristics.
A series of exploratory regression analyses used as dependent variables each individual’s type of educational, employment, or residential setting and information from teachers, parents, and residential and habilitation service providers about the appropriateness of each client’s current placement.
Independent variables included diagnosis (mental retardation, mental health, physical health), mobility, and arm-hand use, recent hospitalization, medication usage, vision, hearing, adaptive behavior domain scores (motor, social and communication, personal, community, and broad independence), and the maladaptive behavior indexes (internalized, externalized, asocial, and general).
Although each of these variables showed a simple correlation with level of service, each was also well reflected in adaptive and maladaptive behavior together. Controlled stepwise regression analyses indicated that other variables did not significantly add to the predictive power of the combined Broad Independence and General Maladaptive Index scores in predicting service intensity for many groups of handicapped and non-handicapped individuals of different ages.
Based on results of these analyses, the Service Score was derived to reflect the level of care, supervision, or training needed by individuals at home, or in educational and human service programs.
Although not a simple formula, the Service Score is weighted combination of approximately 70% adaptive behavior and 30% maladaptive behavior. In research done for the ICAP, this score was able to differentiate not only levels of placement, such as regular classroom or special classroom, but also level of success within a classroom, a group home, etc., and even rank among peers.