Psychological Assessments and Diagnostics -1

Vineland Social Maturity Scale Report

Submitted by: Vrinda Gupta

Enrollment Number: M2022APCCP051

Socio-Demographic Details

Based on an imagined case:

Name Aditya Socio-Economic Class Upper Middle-Class

Age 6 years Religion Hindu

Sex Male Language Spoken Hindi and English

Education 1st Standard Testing Language English

Date of Testing 9th March 2023 No of Sessions 3

Presenting Complaints

Aditya’s parents have observed severe deficits in his communication and social skills,
interpersonal interactions, language proficiency, academic performance and understanding of age
and context appropriate behaviour. Their social judgment and decision-making also appear
impaired. Besides this, Aditya struggles to carry out activities of daily living independently.

Test Administered:

1. Binet-Kamat Test of General Mental Abilities was used to assess intelligence as it is a

standardised IQ test for the Indian population.
2. Vineland Adaptive Behavior Scale, Second Edition.
3. Vineland Social Maturity Scale (VSMS) was administered to assess socio-adaptive
functioning.

Test Findings

As per the VSMS assessment, the Social Age of Aditya is 3.88 years. Consequently, since Aditya
is 6 years old, his Social Quotient of 64.7. The following table contains the domain wise
functionality profile of the client.

Serial No. Domain Social Age

1. Self-Help Dressing 4 years 8 months

2. Occupation 5 years
 3. Socialization 3 years

4. Self-Help Eating 2 years

5. Locomotion 6 years

6. Self-Direction There doesn’t exist any items to assess self-direction

for a child who’s six years old or younger.

7. Communication 3 years

8. Self-Help General 2 years 6 months

A domain wise analysis of the client’s responses indicates severe deficits in the domain of
self-help eating, moderate deficits in the domains of self-help general, communication, and
socialisation and mild deficits in self-help dressing and occupation.

The child has achieved all developmental milestones as far as the domain of locomotion is
concerned, which can be identified as a potential strength of the child that we can build upon
while suggesting interventions.

Self-direction could not be assessed as there aren’t any items for children under the age of 6
years that measure the development of autonomy or a sense of responsibility.

A qualitative analysis of development in individual domains helps us identify specific activities

in each domain that haven’t been learnt in alignment with the normative timeline for
development and thus requires intervention.

● Self-Help Eating: The child is currently incapable of eating from a bowl or a plate using
his own hands or a spoon or drinking from a cup or a glass without assistance or
appreciable spilling.
● Self-Help General: The child shows impaired social judgment and fails to avoid simple
hazards such as being wary of strangers, being careful while using the stairs, or
cautiously using matches and sharp articles. He fails to discriminate between safe and
unsafe stimuli. He also can’t care for himself at the toilet and needs assistance with the
same.
● Communication: The child struggles with relaying simple experiences or telling
unprompted stories that are sequential, coherent and relevant. The child struggles with the
articulation of long or complex sentences. The handwriting of the child is also illegible.
 ● Socialization: The child fails to engage in cooperative group play or activities that
necessitate reciprocal or mutual action. Consequently, he also fails to engage in
competitive, physically exerting games or play simple indoor games that require
turn-taking or understanding rules and goals. Further, the child hasn’t reached a level of
maturity wherein they can perform for other people.
● Self-Help Dressing: While the child can dress up with assistance and knows how to
button their clothes, they can’t dress up entirely unassisted, even if the clothes are laid
out.
● Occupation: As of now, the child hasn’t learnt to use hoops, fly kites or use any kind of
tools.

However, it's important to acknowledge that there exist several skills that the child has acquired
that can be built upon in a strengths-based approach. For instance, the child has brilliant
locomotion skills and can navigate his way to school or around the neighbourhood unattended.
He also helps with small household errands like picking up things, wiping, and setting up the
table. Moreover, while the child may not be able to write, he has demonstrated abilities of
drawing and colouring. Further, he can dress himself up with some supervision and direction.

Summary
According to the VSMS evaluation, Aditya's social age is 3.88 years. The Social Quotient of
Aditya is 64.7. This is indicative of mild disability in socio-adaptive functioning.

Suggestions

These results suggest that Aditya may benefit from additional support and interventions to
improve his socio-adaptive functioning. This may include
● The parents need to be psychoeducated and sensitized to the needs of Aditya. They also
need to be connected to counselling and support groups to help process their own
emotions around this.
● Additionally, the child may benefit from the following interventions.

Interventions for Social Skills Training

Serial Rationale/Concept Intervention Learning Outcome

No.

1. The child is already The child is invited and This can be the first step to
capable of helping with involved in simple tasks helping the child learn
 small tasks around the like folding clothes, cooperative play.
household. We can build washing utensils or wiping
on this strength to help the utensils as somebody Further, it also helps
them learn cooperation washes them. inculcate a sense of
and collaboration. responsibility and
autonomy in the child. This
may help the child also to
build advanced skills of
self-direction.

2. Turn-Taking Behaviour - The back-and-forth or the The child will learn

This can be taught by turn-taking structure can turn-taking behaviour that
building on the child's be taught to the child by can be used to then help the
strength to use simple trying to hold simple child further build on their
sentences. conversations with them, skill to engage in
wherein you encourage cooperative play and
them to respond after competitive indoor and
you’ve stopped speaking, outdoor games that require
and you let them finish turn-taking, which has
before responding to them. currently been recognised
as a deficit.
Additionally, you can also
incorporate turn-taking
behaviour in simple
activities like playing with
building blocks or
arranging plates on the
table.

Intervention Module for Occupational Therapy

Serial No. Concept Intervention Learning Outcome

1. Self-Feeding Bead Scooping - A large container The child learns to

Techniques can be filled with water, and beads scoop using a spoon.
can be added to it. The child can be
handed a spoon and asked to scoop
out beads from the water. The spoon
size can be varied according to the
child’s capacity.

2. Improved Practicing writing strokes on foamy This intervention

Writing sheets as the surface of these sheets targets the illegible
offers feedback and resistance handwriting of the
through the pencil as the person child and helps them
 writes on them. write clearly and
legibly.

3. Self-Dressing The child can be offered Helps build the

Skills opportunities to learn to dress up child's capacity to
through pretend play and wearing dress self without
dress-up clothes. assistance.

Toilet training offers another

opportunity to learn to manage lower
body clothing.

We can also introduce toys that the

child can dress up in order to learn
that skill.

Intervention Module for Speech and Language Therapy

Serial No. Concept/Rationale Intervention Learning Outcome

1. Storytelling The parent can make it a habit to tell It helps the child
the child stories about their day and learn to communicate
help the child model this behaviour their experiences in a
in order to learn relaying of coherent, continuous,
experiences. relevant manner.

2. Introducing Music It’s easier to learn words and The child learns to
Sessions - The sentences when they are rhymed to verbalise sentences.
child struggles music. So you can organise a play
with the date and help them rhyme sentences
formulation or to music.
articulation of
long sentences.
This is a skill that
can be built upon
by introduction of
music.

REFLECTIONS ON 'VSMS' ADMINISTRATION

The cultural applicability of VSMS has been a point of contention among researchers and
practitioners for many years now. I had similar apprehensions and contentions during the
administration of the scale. I do not believe there exists a normative timeline of development that
pervades all societies and cultures alike. There are some cultures that emphasize group harmony,
cohesion and interdependence a lot more than freedom, autonomy and independence.

In the Indian subcontinent itself, the timeline for individuation from the caregiving figures is
much slower as opposed to the western countries, wherein this test has been contextualized. For
instance, according to the VSMS scale, a child should develop the ability to eat biscuits, bread
etc., from their own hands, drink from a cup and walk upstairs unassisted before they are two
years old. However, the expectation to develop this skill may not be imposed on the child before
they are two in the Indian context. Thus, they may not even receive a real opportunity to acquire
this skill. While there is a provision to give half credit in situations when the child hasn’t had an
opportunity to master a skill, the fact remains that they would receive a lower score on the scale
for no fault of their own. Moreover, this reflects a clear bias towards certain cultural norms.

Furthermore, certain items are so deeply contextualized in a particular culture that they hold
absolutely no relevance to many cultures or societies beyond that culture that weren’t colonized
or are untouched by their influence. For instance, items like “removes shirt or frock if
unbuttoned” assume that shirts and frocks are a part of the dressing style embraced by the
culture. Prior to colonization, buttoned clothes weren’t a part of the cultural dressing style of the
Indian Diaspora. Even today, if we were to analyze the traditional clothing of various Indian
states or subcultures, buttoned clothes won’t feature in them. I am certain that there exist tribal
groups on the Indian mainland itself who haven’t embraced colonial ways of dressing and would
be at an unfair disadvantage in an assessment of this sort. Moreover, children from cultures that
differ significantly from the W.E.I.R.D. cultural world may have an entirely different set of skills
and abilities, like following the trail of animals, that do not feature in an assessment of this sort.

Furthermore, the class privilege reflected in these items can not be discounted in the least.
Underlying items like “can go about the house or yard unattended” is the assumption that the
family owns a house that too one with a yard. Class privilege is also reflected in the items “plays
cooperatively at the kindergarten level” or "goes to school unattended”, wherein the assumption
is that the child has been enrolled in a school. These are some of my contentions as far as the
test in itself is concerned. They reflect the scope for improvement in the test construction.

My other apprehensions are with respect to the process of administration. I have realized that the
presence of both the child and the guardian are necessary during the administration process for
the results to be accurate. After speaking to the clinical psychologist at my fieldwork setting and
observing cases of screening for neurodevelopmental disorders myself, I’ve realized that parents
or informants may not accurately respond to all the questions. This may not be reflective of any
malicious intent on their part, but they may themselves not have recognised certain deficits in
their child or may be in denial about them and may implicitly wish for their child to perform well
on the assessment. This may lead them to respond in the affirmative to skills which haven’t been
acquired sufficiently. This may skew the overall results.

However, inversely, it’s also a possibility that the parents may respond negatively even to skills
that have been acquired, which again leads to inaccurate results. I personally observed a case
wherein when the parents were asked about the child’s ability to perform certain tasks, they said
that the child couldn’t perform any of those tasks, and the child complied, saying that he couldn’t
do it, but when the counsellor presented the apparatus to him and asked him to do it, he
performed quite efficiently. The point I’m trying to make is that the parents may sometimes be
overly critical of their child’s performance, and the child may internalize this criticism. The child
may also evaluate themselves in a manner that isn’t at par with their capabilities and capacities.

In both the above stated cases, assessing the functionality, if possible, in real-time becomes
important. The child can be encouraged to display skills that can be demonstrated easily for the
counsellor to be absolutely sure that this skill has been sufficiently acquired.