Adaptive Behavior Assessment System, Third Edition (ABAS-3) 

---

Light & high-contrast Mobile friendly Scoring & CSV

Double Board Certified Counseling Services

Adaptive Behavior Intake (ABAS-style Domains)

Note: This screening form references adaptive behavior across the conceptual, social, and practical domains. It is not the copyrighted ABAS-3 and is not a diagnostic tool. For standardized scores, use the official publisher platform.

Rater & Context

Name

Rater

Relationship

Age Child (5–10) Adolescent (11–17) Adult (18+)

Date

Context

Rating scale

Rate the typical performance (past 4–6 weeks): 0 = Never   1 = Rarely   2 = Sometimes   3 = Usually   NA = Not applicable

Communication (Conceptual)

1. Understands simple directions without repetition.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

2. Expresses needs and ideas clearly in everyday situations.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

3. Shares information from the day with appropriate detail.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

Functional Academics (Conceptual)

1. Uses numbers and time concepts for daily routines (e.g., schedules, money).

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

2. Reads signs/labels needed for safety and navigation.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

3. Completes forms or simple written tasks when asked.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

Self-Direction (Conceptual)

1. Starts tasks without repeated prompting.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

2. Stays with tasks to completion or requests help appropriately.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

3. Plans simple activities and follows a basic routine.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

Social (Social)

1. Greets and interacts with others in a friendly manner.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

2. Understands personal boundaries and social cues.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

3. Manages disagreements with age-appropriate behavior.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

Leisure (Social)

1. Chooses and engages in age-appropriate leisure activities.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

2. Shares/turn-takes during play or group activities.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

3. Wraps up activities and transitions without significant distress.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

Self-Care (Practical)

1. Manages basic hygiene and grooming independently.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

2. Dresses appropriately for weather/setting.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

3. Prepares simple snacks/meals or helps as able.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

Home Living (Practical)

1. Keeps personal space reasonably neat with reminders as needed.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

2. Completes simple chores suited to age/ability.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

3. Follows household rules and routines.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

Community Use (Practical)

1. Follows safety rules in public (e.g., streets, stores).

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

2. Handles simple purchases or asks for assistance.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

3. Uses transportation/rides safely with support as needed.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

Health & Safety (Practical)

1. Recognizes when help is needed and seeks it appropriately.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

2. Uses medications/health routines with support as needed.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

3. Avoids dangerous situations and follows safety instructions.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

Work/School Participation (Practical)

1. Arrives on time and follows schedules/expectations.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

2. Accepts feedback and adjusts performance as needed.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

3. Manages materials/tools responsibly.

Usually (3) Sometimes (2) Rarely (1) Never (0) N/A

Results

Domain	Raw total	Items rated	Mean
Overall (all items)	0	0	0.00

Calculate scores Download CSV Print Reset form

Raw totals are simple sums for screening. They are not ABAS-3 scaled scores, composites, or percentiles. Use official materials for standardized scores.

© Double Board Certified Counseling Services. This tool is an independent intake/screening form referencing adaptive behavior domains commonly discussed in the literature. ABAS-3 is a registered trademark of its publisher and is not reproduced here.