I. Introduction:

This module is designed to provide you with an understanding of the assessment process for young children (birth to five) with special needs. The purpose of this module is to extend your knowledge about assessment of exceptional learners to include information specific to very young children and their families. Therefore, it is assumed that you have a sufficient background about assessment principles and practices before you begin. In most cases this means that you have taken a class on assessment.

This module is required for either undergraduate or graduate students focusing their studies in early childhood special education. Ideally, prior to starting this module you should have completed one of the following:

ESE 423 Assessment (undergraduate) or ESE 655 (graduate) - Assessment of Exceptional Learners

It is also recommended that you should be taken in conjunction with one of the following courses:

ESE 450 (undergraduate) or ESE 550 (graduate) - Methods in Early Childhood Special Education

Other students in special education and other disability-related fields will also benefit from the information presented in this module.

Objectives:

The student will:

1. Demonstrate an understanding of the purpose of assessment and the unique issues surrounding assessment of very young children.

2. Be knowledgeable about range of behaviors of the child and characteristics of learning environment that are included in the assessment.

3. Display an understanding of the different types of assessment approaches and their associated merits and limitations.

4. Demonstrate an awareness of the standards of practices pertaining to assessment procedures.

5. Comprehend the importance of linking assessment to intervention.

Module Topics:

I. IntroductionII. Goals and challenges in the assessment of very young childrenIII. What do we assess?

IV. Assessment approaches and criteria for selection of measuresV. Procedural considerationsVI. Linking assessment to intervention

Overview

This module provides you with an understanding of the unique issues involved in the assessment of very young children with special needs. Because it is intended to be a module and not an entire course, only the most salient information is included. It is highly recommended that you extend your studies to gain a more thorough understanding of the topics addressed. A list of selected references is included at the end of the module for this purpose.

The following is an expanded outline of the module topics:

I. Introduction to the moduleII. Goals and challenges in the assessment of very young children

A. Purpose of assessment1. To determine eligibility for services under IDEA2. Assist in planning intervention3. Monitor progress

B. Assessment challenges1. Characteristics of young children2. Measurement issues3. Engaging the family in the assessment process4. Conducting assessments in natural environments5. Promoting collaboration among team members

III. What do we assess?A. Requirements under IDEAB. Focus of newborn assessments

1. Neurological integrity2. Behavioral organization3. Temperament

C. Infants and young children older than one month of age1. Physical development (including vision and hearing)2. Cognitive development3. Communication skills4. Social-emotional development5. Adaptive or self-help skills

D. Assessing environmentsIV. Assessment approaches and criteria for selection of measures

A. Formal assessment approachesB. Informal assessment approachesC. Criteria for selection of measures – LINK DimensionsD. Description of selected measures

V. Procedural considerationsA. Collaborating with the family and other team membersB. Cultural considerationsC. Natural environmentsD. Recommended practices from DEC

VI. Linking assessment to interventionA. Assessment reportsB. Translating assessment information into IFSP/IEP planning

II. Goals and challenges in the assessment of very young children

Online Lesson:

Welcome to the world of infants, toddlers and preschoolers with special needs and their families! The best place to begin is at the beginning.

SCAN IN A PICTURE OF A NEWBORN AND MOTHER

It is very unlikely that you will begin here, but always remember that you are just one person entering the world of this very special person, and that you will travel only a short distance in the life long journey of this child and his/her family.

SCAN IN A PICTURE OF A CHILD/FAMILY WITH OTHER PEOPLE (MAYBE A PROGRESSION OF SHOTS OF ONE FAMILY ACROSS TIME THAT

SHOWS THE CHILD AND FAMILY YOUNG AND THEN OLDER, ETC.)

II. A: Purpose of Assessment

There are many reasons we conduct assessments of young children. In this module we will focus primarily on the purpose of assessment in the system of services under the Individuals with Disabilities Education Act (IDEA) – Parts B and C. Different assessment activities are described under IDEA including screening (Child Find) and comprehensive multidisciplinary evaluation.

NOTE: DOUBLE CHECK THE WORDING ABOVE

Part C of IDEA, pertaining to services for infants and toddlers with special needs delineates between the terms evaluation and assessment. Evaluation is defined as the procedures used by appropriate qualified personnel to

determine a child’s initial and continuing eligibility under this part consistent with the definition of “infants and toddlers with disabilities” including determining the status of the child in each of the developmental areas: cognitive development, physical development (including vision and hearing), communication development, social or emotional development, adaptive development.

Assessment is defined as the ongoing procedures used by appropriate qualified personnel throughout the period of the child’s eligibility under this part to identify (I) the child’s unique strengths and needs and the services appropriate to meet those needs; and (ii) the resources, priorities, and concerns of the family and the supports and services necessary to enhance the family’s capacity to meet the developmental needs of their infant or toddler with a disability (34 CFR 303.322, Federal Register, July 30, 1993)

Screening and evaluation procedures are usually conducted for the purpose of determining eligibility under IDEA.

Assignment: IDEA defines who is eligible for services under the law. Part B uses a categorical model while Part C uses a developmental model. Review the definitions for eligibility for both of these parts.

Part B: IDEA (Sec. 303.7 (c 1-13)) http://www.ideapractices.org/regs/definitionsmain.htm

Part C: IDEA (sec. 303.322 (b)(1))http://www.ideapractices.org/regs/mainpartc.htm

SCAN IN SOME FIGURE THAT SHOWS THE PROCESS (See folder)

Once a child has been determined eligible for services under IDEA a yearly plan must be developed that identifies long range goals for the child/ family and appropriate supports and services. Information collected through assessment activities should be used for planning the Individualized Family Service Plan (IFSP) or the Individualized Education Plan (IEP). Therefore, as assessment strategies are planned, members of the team should consider measures and approaches that will assist in developing the IFSP or the IEP.

After the IFSP or IEP is developed and services are in place, the team should monitor the child’s progress on a routine basis and modify intervention strategies as necessary.

II.B: Assessment Challenges

Assignment: Consider what you know about the assessment of school-aged children. Now, let’s talk about two children, one is Elizabeth who is ten years old and has Down Syndrome. Her counterpart, Erica, is 18 months and also has Down Syndrome. How might these two assessments look different? How might they be similar?

Online Lesson:

SCAN IN A PICTURE OF SOME CHILDREN WITH SPECIAL NEEDS OFF THE INTERNET

I.B.1. Traditional assessment approaches used with older children are ineffective with very young children for the following reasons.

a. Regardless of the disability, young children lack the verbal ability to respond to appropriately to instructions. While preschool children may have more verbal ability, they may not yet understand the expectations of the testing situation.

b. Young children have limited attention spans which prohibits the use of measures requiring sustained attention for a significant period of time.

These issues are illustrated in a scenario described by Linder (1990) who asks the reader to imagine him or herself as a 3-year-old child who is being evaluated in a more traditional manner.

After a necessary potty break and a few tears, the lady lets you see your Mommy and Daddy. But not for long. Here comes another lady to take you to another little room with another table and chairs and different pictures on the wall. This lady doesn’t talk much. She just keeps putting pictures in front of you and asking you what they are. Many of the pictures are things that you have seen, but you just don’t know what to call them. So you look down at the floor and up at the pictures on the wall. You pull on your shirt and wiggle a lot. You wish this lady would quit with the pictures. You’ve seen more than enough pictures. Then the lady gets another suitcase, only it’s a different color. She pulls out a couple of toys at a time and tells you what she wants you to do with them. Some of these are neat toys and you’d really like to play with them. Every time you start to do something other than what the lady told you to do, however, she takes the toys away. This lady sure is stingy. You are getting tired, so you put your head down on the table. The lady makes you sit up. Finally, she is through. She takes you back to your Mommy and Daddy and tells them that you were “somewhat resistant”.

(Linder, 1990, pp. 9-10)

I.B.2: There are several issues related to measurement in the assessment of young children with special needs.

SCAN IN A FIGURE OF YARDSTICKS, MEASURING CUPS, ETC.

First, there are a limited number of appropriate instruments that can be used with this population. Because there are so few, practitioners often inappropriately use instruments designed for a specific purpose such as screening (i.e., the Denver Developmental Screening Test) to determine eligibility. In other instances, some instruments that are designed for a specific age group, or for children with specific characteristics are misused with children for whom the instrument was not developed. An example of this is the use of the Bayley Scales of Infant Development, an instrument that is designed for use with children up to 30 months of age with children who are older than 30 months with

significant developmental delays. These practices must be eliminated as there is a requirement contained within the law that mandates that a test is validated for the purpose for which it is used (Federal Register, 1992, Section 300.532). Therefore, a test must be valid for the child being assessed and for the determined intent of the assessment.

Secondly, some of the instruments used by practitioners with very young children lack information about their validity or reliability. Some measures that have not undergone any kind of norming procedures yield developmental age scores that are inappropriately used to determine eligibility. For an assessment tool to be considered for inclusion in the assessment battery, it should have been normed on a representative sample of children. It is incumbent upon the individual conducting the assessment to consider reliability and validity of instruments that may be selected for use to determine eligibility.

Finally, the use of intelligence tests of infants and young children is inappropriate as these tests have poor predictive validity. Patterns of development vary considerably across children and there is a lot of variability in these patterns for each child during their early years. Because of this, intelligence tests fail to do a reliable job of forecasting a child’s cognitive abilities. Some practitioners continue to rely on these tools, in spite of their limitation. School psychologists surveyed to determine why they use intelligence tests with very young children indicated that they were required to do so by their administrator and that they lacked sufficient training to use alternative assessment approaches (Bagnato & Neisworth, 1994).

II.B.3: Public Law 99-457, passed in 1986, established a framework for states to develop systems of services for infants and toddlers with special needs and their families. This law emphasized the role of the family in the all aspects of the service system from the design and evaluation of programs to their participation in all early intervention activities. The literature contains numerous articles and books about this “paradigm shift” from services focused on the child to services focused on the family. Predictably, considerable attention has been given to the role of the family in the assessment process.

There are several reasons why families should be actively engaged in the assessment process. The first reason stems from our understanding of child development and the contextual factors influencing it. Below if a figure depicting the ecology of the young child with special needs (Bailey, 1992) adapted from Bronfenbrenner (1979) model. This “nested” view of the young developing child shows the centrality of the family among the many influences on the child. Artificially separating the child from family members in an assessment fails to account for their role in the child’s development.

SCAN IN BAILEY’S FIGURE

Secondly, family members contribute important information about the child’s typical behaviors, his or her strengths and areas of need, approaches that may be more effective and contexts that will promote optimum performance. This results in a more accurate picture of the child’s developmental status that has more ecological validity.

Not only can family members contribute important information about the child throughout the assessment process, but the law stipulates the IFSP must consider the family’s resources, concerns and priorities as they relate to the child and include both child and family outcomes. Accordingly, IFSP planning must result in outcomes linked to family resources, concerns and priorities and the child’s developmental needs.

Lastly, the assessment process often sets the stage for future interactions between early intervention practitioners and families. If they are actively engaged in the assessment process, they may feel they are truly partners in the early intervention enterprise.

II.B.4: The earlier scenario of a three-year old girl’s experience in a more traditional testing situation represents another challenge in conducting assessments with very young children. That challenge is responding to the legal requirement that all early intervention services must be delivered in a child’s “natural environment”. There are many advantages to conducting assessments in settings that are familiar to the child under predictable conditions. On the other hand, it may be difficult for all team members to complete assessment activities in these settings for a variety of reasons.

II.B.5: The final challenge facing early intervention personnel is collaboration among team members. In recent years there has been an emphasis placed on interdisciplinary and transdisciplinary approaches. This trend toward more collaborative approaches in the assessment process is in response to the need to view the child more wholistically rather than segmenting development into separate domains. All of the five developmental domains (physical development, cognitive development, communication development, social or emotional development or adaptive development) are interrelated and as such should not be separated artificially in the assessment process. Yet bringing the team together represents a challenge because of logistical factors and the fact that many early intervention practitioners are not prepared for inter- or transdisciplinary roles.

I. What do we assess?

IIIA: IDEA spells out what must be the focus of developmental assessments of young children under Parts B and C.

Let us begin with infants and toddlers who may be eligible under Part C. In your first assignment you reviewed the eligibility criteria for Parts B and C. Remember that eligibility under Part C includes several criteria and states developed their own definitions for eligibility.

First, let’s discuss those children who have an established risk. In most circumstances you will not be the one to determine if a child has a “diagnosed physical or mental condition which has a high probability of resulting in a developmental delay”. These conditions are generally determined through medical and or genetic testing. Established conditions identified under Arizona’s definitions include Down Syndrome, Fetal Alcohol Syndrome

NOTE: LOOK THIS UP AND FIND OUT IF THERE IS A LINK THAT THE STUDENTS CAN REFERENCE.

Now, let’s consider those children who are experiencing developmental delays. If we return to the language of the law we will find that for a child to be eligible for services he or she must be experiencing developmental delays in one of the following areas:

physical development cognitive development communication development, social or emotional development adaptive development

Let’s shift our focus to preschool children eligible under Part B. Children may be eligible if they qualify for any of the categories under Part B including:

Autism Mental retardation Hearing impairments including deafness Speech or language impairments Visual impairments including blindness Emotional Disturbance Orthopedic Impairments Traumatic Brain Injury Other Health Impairments Specific Learning Disabilities Developmental Delays

They may also be eligible under the definition of “children with disabilities”. The definition mirrors that for Part C (see above) and the specific criteria are determined by the state. In the state of Arizona there are five categories for preschool children including: Visual ImpairmentsHearing ImpairmentsSevere Preschool DelayModerate Preschool DelayPreschool Speech/Language Delay

http://www.azleg.state.az.us/ars/15/771.htm

III.B: In recent years diagnostic procedures are increasingly available to families who are expecting a child. Maternal serum testing is a procedure where the mother’s blood is analyzed. It can be an effective way to screen for meningomyeolocele, Down Syndrome and trisomy 18. The status of the fetus can be monitored through several tests including: ultrasound; chronic villus sampling (minute biopsies of the outermost membrane surrounding the embryo); amniocentesis (small amount of amniotic fluid is drawn from

the placenta and analyzed); and percutaneous umbilical blood sampling (fetal blood is drawn from the umbilical cord for testing). As a practitioner, you will not be involved in the administration of any of these tests. However, this brief description is included as it is important that you know about these tests and their role in identifying established conditions and or other risk factors that may impact the health and well being of the newborn. As we learn more about human genetics, we will undoubtedly expand prenatal testing and develop more sophisticated techniques of fetal therapy that will help to minimize the severity of some disorders or conditions.

To begin our discussion about infant assessment first let us consider a framework from which we can operate. Heidi Als (1986) proposes the synactive theory of infant development that depicts the various systemic influences on the developing child and their interrelatedness.

SCAN IN AL’S FIGURE

There are several broad dimensions of newborn behavior that are the focus of assessment. These dimensions are neurological integrity, behavioral organization, and individual differences or temperament and will be discussed briefly below.

Neurological integrity: To assess the adequacy of the Central Nervous System functioning, reflexes, postural responses, attainment of age level skills and organizational patterns consistent with gestational age are assessed. It is generally recommended that assessments be repeated to assess overall patterns as newborn behaviors can be very transient.

Behavioral organization: How well does the baby organize his or her behaviors in response to the demands of the environment? For example, can a newborn maintain alertness, minimize excessive body movement, stabilize breathing patterns, regulate body temperature, etc.? When a newborn is unable to regulate these behavioral subsystems, it can be a sign that there may be brain damage.

Temperament: What are the individual behavioral differences demonstrated by the newborn in his or her interactions with others. This where we begin to look at neonatal competence and the capacity of the baby to effectively communicate his wants and needs to others.

Prechtl and Beintema (1964) described newborn states that range from sleep states to alert states. Newborns possessing effective organizational competencies are able to control their states by managing input through habituation and attend to stimuli appropriately through orientation.

III.C:1: In the previous section we discussed the various patterns of behavior that we observe in the newborn that reflect overall neurological functioning and capacity to respond to environmental stimuli. As babies become more sophisticated in their ability to manage physiological and environmental demands, we must look at a child’s competence through multiple lenses. IDEA asks that we look at various dimensions of development including 1) physical development, 1) cognitive development, 3) communication

development, 4) social or emotional development and 5) adaptive development. In the following section we will examine what is the focus of assessment in each of the five dimensions.

Physical Development

SCAN IN A PICTURE OF A BABY CRAWLING

First let us consider the child’s physical development. IDEA uses the term physical development that includes vision and hearing. Often, the term sensori-motor development is used instead as it encompasses the child’s sensory and motor systems.

The sensory system includes auditory, visual, tactile, proprioceptive or vestibular functioning. The child’s auditory and visual functioning should always be evaluated before any other testing is initiated to rule out vision or hearing loss. If a child’s visual or auditory modalities are compromised, then it stands to reason that other modalities will be impacted. Corrective procedures will provide the child with the opportunity to respond optimally to environmental demands and should ameliorate overall functioning.

Auditory Functioning:

There are several types of hearing impairments: conductive, sensorineural, or mixed. A conductive hearing loss occurs as the result of interference of sound passing between the external auditory canal and the inner ear because of damage to the external or middle ear. This type of loss is often the result of middle ear effusion of fluid from repeated episodes of otitis media (ear infections), and affects lower frequencies. Sensorineural loss is the result of damage to either the cochlear hair cells, the cochlea, the auditory nerve or the brain generally affecting higher frequencies of sound.

SCAN IN A DRAWING OF THE EAR WITH THE VARIOUS PARTS IDENTIFIED

So, what is assessed? Trained personnel, generally audiologists, Ear Nose and Throat Specialists or speech language pathologists assess auditory functioning. They determine the minimal level of intensity of sound the child can hear. They assess this by using one or more of the following approaches. Behavioral observation tests where various toys having different intensity of sounds

are presented to the young child. Visual reinforcement audiometry involves the use of headphones where sounds are

presented and the child is reinforced visually with a toy when the correct response is made. A toddler or preschool-aged child may be able to respond to this testing approach.

Pure-tone audiometry is often used with older children who can be trained to respond to sounds presented bilaterally through headphones by pressing a button.

Impedance audiometry is used to test the functioning of the outer or middle ear. Auditory Brain-Stem Evoked Responses is a test of auditory functioning using

electrodes that assess neural activity. Children are generally sedated for this test and only high frequency intensities are reliably measured.

Since other professionals are responsible for assessing auditory functioning your role is more limited. You can however, familiarize yourself with the factors associated with hearing loss. The ABC’s of deafness (Northern & Downs, 1991) include:

AsphyxiaBacterial meningitisCongenital perinatal infectionsDefects of the head an dneckElevated bilirubinFamily history Gram birthweight less than 1500

Other behaviors are associated with hearing problems in young children. Can you guess what these are?

LINK?? (Some site that describes signs of hearing loss in young children)

Visual Functioning

Assessment of visual functioning focuses on acuity and the use of visual fields. Vision specialists, optometrists and ophthalmologists are usually trained to perform visual assessments. In young children the Teller Acuity Cards can be used to estimate visual acuity. Visual Evoked Responses can be obtained by placing electrodes over the occipital cortex to detect disturbances of the visual pathway. When the child is older and can match or label, picture cards can be used. There are a number of these types of tests available, including the Snellen E charts. The New York Flashcards (or the Lighthouse Test) is preferred for use with preschool children with disabilities. The Lighthouse Test have cards with three different symbols, an apple, a house and a umbrella representing visual acuities from 10/15 to 20/200.

In some cases, other professionals are trained to conduct vision screenings which may include tests such as the Lighthouse Test. However, if a visual acuity problem is detected in a screening, then the child should be referred to a specialist for more thorough testing. It is important that the child be tested for structural abnormalities in addition to a more intensive measure of acuity. Stangler, Huber, and Routh (1980) described behaviors suggestive of visual disorders including:

Child does not turn her head toward a source of light

Lack of visual responses expected a certain ages such as visual regard of another’s face, inspection of hands, etc.

Little or no interest in visual stimuli Shifting head to one side to see Atypical eye movements Requiring visual stimuli to be close to the face Closing one eye to see Avoidance of tasks requiring close vision Poking or pressing the eyes Light sensitivity Excessive blinking or squinting Excessive light gazing

Vestibular, Tactile and Proprioceptive Modalities

Some definitions are in order:

Vestibular system: orientation of the head in space an dis responsible for balance and posture

Tactile system: responsible for perception of touch, pressure, temperature and pain

Proprioceptive system: awareness of the body’s position in space.

Each of these systems work together with visual and auditory functioning to organize all input to the senses. Children who demonstrate sensory dysfunctions often have difficulty with other developmental tasks. The functioning of these three systems are often assessed by occupational or physical therapists. Assessment measures include the Miller Assessment for Preschoolers (MAP) (Miller, 1982) and the Test of Sensory Functioning in Infants (DeGangi & Greenspan, 1989). Some of the developmental scales that will be discussed later in this module include items that assess functioning in these modalities.

Motor Skills

Several areas of motor skills are generally included in an assessment. These are gross motor, fine motor and oral-motor skills. Gross motor skills refer to activities involve large muscles of the body and include rolling, crawling, walking and running. Fine motor skills involve the use of small muscles, particularly muscles of the arms and hands. Fine motor skills include reaching and grasping and releasing. Oral-motor skills involve the use of the lips, mouth, tongue, teeth and facial and jaw muscles. Assessment of oral-motor skills focuses on sucking, swallowing, biting and chewing.

Pediatric occupational and physical therapists are prepared to conduct assessments of motor skills. Increasingly, however, there is a shift toward more transdisciplinary approaches in assessment that underscore the need for all professionals to understand assessments across all developmental domains. This module will not prepare you

sufficiently for this new role. You are encouraged to do further reading in this area and observe occupational or physical therapists conducting assessments. Examples of instruments used to assess motoric functioning include Movement Assessment of Infants (MAI) (Chandler, 1980), Bayley Scales of Infant Development – Motor Scale (Bayley, 1969), Revised Gesell and Amatruda Developmental and Neurological Examination

(Knoblock, Stevens, & Malone, 1987), Peabody Developmental Motor Scales (Folio & Fewell, 1983) Battelle Developmental Inventory (Newborg, Stock, Wnek, Guidubaldi & Svinicki,

1984)

Cognitive Development

Historically, tests of cognitive functioning have focused upon the construct of intelligence. Intelligence testing has been a major enterprise for many years. It is only in recent years that we have considered the meaning and measurement of intelligence in very young children. There are a number of different theoretical models that contribute to our understanding (and sometimes confusion) about what cognitive development is and how we assess it.

1. Traditional psychometric views of intelligence use two approaches. One is the global theory model where intelligence is defined as the ability to think abstractly and to solve problems. Many factors contribute to the overall large “g” factor of intelligence. The second model is the factor analytic model where a number of specific factors are connected to the construct of intelligence. This approach has limited application for young children, however, as only two factors have been found for infants and toddlers (Snyder, Lawson, Thompson, Stricklin & Sexton, 1993). Psychometrists generally emphasize norm-referenced instruments such as the Bayley Scales of Infant Development that are based on statistical criteria.

2. Piaget, a well-known stage theorist identified several stages of cognitive development. The first stage is the sensorimotor stage occurring during the first two years of life. It is during this phase that children are responding to stimuli through their sensory and motor systems. The second stage is the preoperational stage and it is in this stage that children begin to shift their understanding of the world from the concrete to the abstract. He goes on to describe various ways the young child constructs meaning in his world using terms such as schema, assimilation and accommodation.

3. Information processing is based upon the work of Vygotsky, among others. He proposes that memory, attention, and conceptualizations result from interactions with objects and people. He developed the term of proximal development which means that that the parents guide the child’s learning by building upon the current thinking to the next level. This model is highly related to social learning models originally discussed by Bandura (1978) and emphasizes that learning occurs through the

interaction of socialization, developmental status, motivation and environmental factors.

4. In his work in the 1920’s Gesell identified developmental markers for children. He and his colleagues believed that development occurred on a set biologically-determined course.

5. The functional model is rooted in operant learning theory and behaviorism. Based on the belief that behaviors are repeated as they are reinforced this model views learning occurs as a result of the stimulus response patterns.

These models are presented so that you understand the multiple perspectives of cognition in the developing child. Assessment approaches are often built upon one of these models.

Cognitive assessments of young children generally look at a variety of cognitive behaviors including motor behaviors, vocabulary, comprehension, general information, generalization, abstract reasoning etc. Sensory and motor behaviors of infants and toddlers are generally the focus of cognitive testing. As children age, cognitive behaviors are expected to expand to include language and other markers of abstract reasoning (i.e., vocabulary, memory, problem-solving).

Many norm-referenced and criterion-referenced measures of cognitive development look similar. Behaviors observed and described by Piaget are often measured (i.e., spatial awareness, object permanence, etc.). One of the first examples of this is the Ordinal Scales of Psychological Development (Uzgiris & Hunt, 1975).

DO WE HAVE SOME ITEMS FROM UZGIRIS/HUNT SCALES WE COULD SHOW HERE?

Therefore, assessment of cognitive functioning of very young children focuses on the child’s interaction with objects and people. Some measures require specific testing materials and conditions (i.e., Bayley Scales of Infant Development) while others allow more flexibility in the testing situation where the behavior repertoire of the young child is observed using a variety of materials and conditions (i.e., Carolina Curriculum for Handicapped Infants and Infants at Risk). Linder (1993) proposes an approach called Play-Based Assessment that includes six phases ranging from unstructured to structured and focusing on the child's interactions with object and people in a naturalistic setting.

Examples of instruments to assess cognitive functioning include: Batelle Developmental Inventory (Newborg et al., 1984) Bayley Scales of Infant Development II revision of earlier version (Bayley, 1969) Cattell Infant Intelligence Scale (Cattell, 1960) Differential Ability Scale (Elliott, 1990) McCarthy Scales of Children’s Abilities (McCarthy, 1972) Stanford-Binet Intelligence Scale – 4th edition of the Stanford Binet (Thorndike,

Hagen, & Sattler, 1985)

Wechsler Preschool and Primary Scale of Intelligence – Revised (Wechsler, 1989) Brigance Diagnostic Inventory of Early Development (Brigance, 1991) Carolina Curriculum for Handicapped Infants and Invants at Risk and the Carolina

Curriculum for Preschoolers (Johnson-Martin, Jens, Attermeier, & Hacker, 1991) Gesell Developmental Schedules revised by (Knobloch, Stevens & Mnalone, 1980) Hawaii Early Learning Profile (Furuno et al., 1988)

Communication Development

The term communication is a broad term and includes both verbal and nonverbal exchanges. Language is considered a code of symbols and rules for combining those symbols. Speech is the means to express verbal language. Accordingly, the focus of assessing communication development is language and speech. Language is comprised of four components including the following.

Phonology: production of sounds and combination of sounds Syntax: rules for combining words into phrases and sentences Semantics: rules for meanings of words Pragmatics: the use of language in social contexts

Assessment of language may also focus on receptive language (what the child understands) and expressive language (what the child uses to communicate).

The assessment of speech examines the child’s articulation patterns, voice quality and fluency. Many young children are referred for screening or evaluation because of articulation difficulties including additions, omissions, and substitutions. It is important that the assessment determine the extent to which the articulation errors are consistent with the developmental age of the child.

A trained speech and language pathologist should conduct a thorough assessment of a child’s communication. They may use norm-referenced or criterion referenced tools to determine the nature of a child’s communication skills. Often they will take a language sample that is later analyzed to determine the level and use of language used by the child. Through the language sample they will obtain a Mean Length of Utterance and investigate the child’s use of phonology, syntax, semantics and pragmatics. Because a child’s communication skills are highly related to the other developmental domains, it is critical that all areas of functioning are considered. For example, a child with Down Syndrome may demonstrate developmental delays in his communication skills, but it may be commiserate with his cognitive functioning. Another example is a child with cerebral palsy who lacks the physical ability to produce speech and is nonverbal.

Examples of assessments of communication skills include:

Preschool Language Scale – Third Edition (Zimmerman, Steiner, & Pond, 1992) Receptive-Expressive-Emergent Language – Second Edition (Bzoch & League, 1991)

Sequenced Inventory of Communication Development – Revised (Hedrick, Prather, & Tobin, 1984)

Infant Toddler Language Scale (Rossetti, 1990) Expressive One-Word Vocabulary Test - Revised (Gardner, 1990) Peabody Picture Vocabulary Test – Revised (Dunn & Dunn, 1981)

Social and Emotional Development

SCAN IN TWO PICTURES – ONE OF A BABY AND A PARENT AND ONE OF TWO CHILDREN INTERACTING

Social competence of children from birth to five begins within the caregiver/child relationship and extends to peers when a child enters preschool. Some researchers argue that priority should be placed on social competence in early intervention programs. Assessment of social competence focuses on the child’s social behavior, the patterns of interaction with others and contextual factors influencing social responses.

Infants develop and expand behaviors that are designed to engage with and disengage from others. These behaviors are sometimes described as cues and are limited in some children who lack the means to use the full range of cues available to most children. For example, a child who is blind is unable to engage adults through eye gaze and will not respond to any of the caregiver’s responses that must be seen. Behaviors are assessed through direct observation and may be described anecdotally, or through the use of several data collection systems. These systems include momentary time sampling systems (recording occurs at specified times during the observation), interval sampling (recording occurs during a specified period of time) or event recording systems (each instance of a specific behavior occurring during a specified time period is recorded). Data collection may occur during the interaction or the assessor may elect to videotape the interaction and record the data later.

Patterns of interactions are generally assessed through the use of rating scales where the rater makes a judgement regarding the quantity or quality of behaviors. There are a number of scales that assess the interaction patterns between the child and the caregiver. The focus of the scale may be on either the child, the caregiver, or the dyad (child and caregiver). An example of a rating scale is the Nursing Child Assessment Teaching Scale and the Nursing Child Feeding Scale (Barnard, 1978). These scales, used in teaching and feeding situations, include ratings of infant, and caregiver behaviors using a binary yes/no scoring system.

When considering the social competence of toddlers and preschoolers, the context of play is often used. Using a modification of Parten’s (1932) description of social behavior as a framework, one can assess the social interaction patterns with age peers.

Unoccupied

Onlooker Solitary Parallel Associative Cooperative

Some individuals conducting assessments of social acceptance, social preference or general likability of children use sociometric assessment procedures. These may include peer nominations, or peer ratings. There are both curriculum-based and norm-referenced measures that contain items related to social competence. Questionnaires are sometimes used to gather information from others about a child’s behavior. For example, the Early Childhood Friendship Survey (Buysse, 1991) was developed to obtain information about patterns of friendship among young children.

Examples of measures of social development include the following:

Social Interaction Assessment and Intervention ) (McCollum, & Stayton, 1985) Social Interaction Scan (Odom et al., 1988) Assessment of Peer Relations (Guralnick, 1992) Infant-Parent Social Interaction Code (Baird, Haas, McCormick, Carruth & Turner,

1992) Parten/Smilansky Combined Scale (Rubin et al., 1976)

In recent years there has been increased interest in the emotional development of children. Greenspan (198__) delineated several stages of emotional development in the young child. The Diagnostic and Statistical Manual (DSM-V) provides diagnostic criteria for identifying emotional and behavioral disorders in young children. Behaviors of concern usually are seen occurring within the infant/caregiver relationship. Interaction patterns that are not resulting in healthy attachments between both members of the dyad need to be addressed. While infants born with disabilities such as the child who is blind described earlier will have a more limited repertoire of social cues, the caregiver may also be unable to send or receive cues. The organization Zero to Three is dedicated to promoting healthy relationships between infants and others in their world. They have developed a handbook for practitioners that describes the various classifications for young children (Meisels, _____)

LINK TO WEBSITE ON ZERO TO THREE

Assessments of a child’s emotional development should be limited to practitioners who are trained and experienced in this area. If there are concerns about a child’s emotional development, a referral should be made to a mental health professional including psychiatrists, social workers and psychologists.

Adaptive Development

The term adaptive behavior is not always clearly understood by everyone. It generally refers to a range of behaviors a child acquires during the developmental process to function independently. Subdomains defined by the DEC Task Force on Recommended Practices (DEC, 1993) include: self care, community self-sufficiency, personal-social responsibility and social adjustment. Further delineation results in a longer list of dressing/undressing, eating/feeding, toileting and grooming, appropriate behavior in different settings, adjusting to new situations, attending appropriately, etc. Several approaches are used to assess adaptive behavior including developmental scales (child’s behavior is compared to same-age peers), criterion referenced lists (a child’s behavior is judged against a predetermined level of mastery) and ecological inventories (assessment of the environment in which the behavior occurs). While many practitioners can collect information about a child’s adaptive behavior development, it is most often included in the assessment completed by the school psychologist. A child’s adaptive behavior skills should be commensurate with his or her level of cognitive functioning. Not only is it required before a diagnosis of mental retardation can be made, but it is good practice.

Examples of measures of adaptive behavior include:

Adaptive Behavior Scale – School Edition (Lambert, Leland, & Nihira, 1993) Checklist of Adaptive Living Skill s(CALS) (Moreau & Bruininks, 1991) Early Coping Inventory (ECI) (Zeitlin, Williamson & Szczepanski, 1988) Vineland Adaptive Behavior Scales (Sparrow, Balla & Cicchetti, 1984)

III.D. Assessing Environments

It is important to assess environments of young children for the following reasons. information about the environment can be considered in determining the least

restrictive environment safety and overall quality should be considered understanding all aspects of the environment can be helpful in planning and delivery

intervention.

PLEASE SEE IF THERE IS A WEB SITE FOR THE NATIONAL ASSOCIATION FOR THE EDUCATION OF YOUNG CHILDREN (NAEYC) AND IF THEY

DISCUSS ENVIRONMENTAL ISSUES AT ALL

Assessments of environments generally consider the physical environment and the social/programmatic environment. The physical environment includes the dimensions of the available physical space, equipment and materials and the overall design and arrangement within the space. The social/programmatic environment includes a consideration of the teacher/child ratio, scheduling of activities, and opportunities to interact with peers.

The environment of the Neonatal Intensive Care Unit (NICU) has received considerable attention in recent years as researchers examined the effects of environmental factors. Levels of noise and light can affect the neonate as well as handling procedures. Modern NICUs are designed to minimize environmental stimuli and allow the child more time to rest and sleep between medical procedures. Family members are also encouraged to participate in the care of their newborn in the NICU setting.

There are several measures of the home environment including the HOME (Caldwell and Bradley, 1984) and the Purdue Home Stimulation Inventory (Wachs, 1979). As we shift to a focus on “natural environments” it is expected that additional measures will be developed.

Various measures were developed to assess preschool environments. One of the best known ones is the Early Childhood Environment Rating Scale (Harms & Clifford, 1980) which addresses a wide variety of environmental dimensions including space, materials, activities, schedule and supervision. Other instruments include the Early Childhood Physical Environment Scales (Moore, 1982 and the Preschool Assessment of the Classroom Environment – Revised (Raab, Dunst, Whaley, LeGrand & Taylor, 1994).

IV. Assessment approaches and criteria for selection of measures

IV.A: Formal assessment approaches include tests, developmental checklists and other measures that have an established protocol. In most cases it is standard procedure to use one or more norm-referenced instruments to determine eligibility because there needs to be a reliable and valid comparison of the child’s developmental status against other children the same age. Relying solely on norm-referenced instruments is not recommended, however, because they lack good predictive validity, particularly for children with developmental delays or disabilities. Additionally, few standardized measures have included children with disabilities in their norming population. Part C of IDEA recognizes these issues and allows evaluators to use informed clinical opinion to assist in their determination of eligibility for services.

IV.B: Information collected through more informal approaches can be quite useful, particularly when the purpose of assessment is program planning, or monitoring. Informal approaches include observation and interview. Observational data can be recorded anecdotally (after the observation occurs) or through a running record (during the observation). Observations in naturalistic settings can provide the evaluator with opportunities to see typical behavior patterns in familiar surroundings. While there are protocols for interviews, assessment information can also be collected from caregivers and family members and others using a non-structured format with open-ended questions.

IV.C: Assessment of young children with special needs should be:

Multi-measure – More than one measure should be used Multi-method – Both formal and informal assessment approaches should be used

Multi-context – Assessments should occur across a variety of settings Multi-purpose – Assessments can and should be used for more than one purpose

Assessment instruments generally fall into the following categories: play-based assessment, ecological assessment, judgment-based assessment and adaptive assessment.

Bagnato, Neisworth and Munson (1997) developed criteria for systematically reviewing assessment measures to determine their appropriateness for inclusion in an assessment of a young child with special needs.

Six Operational LINK Standards, Incorporating the Most Desirable Early Childhood Assessment Characteristics

Standard LINK Dimension

Authenticity Bases assessments on sequential authentic goals contained within a curriculum’s developmental hierarchy or task analysisTaps natural developmental competenciesEmphasizes areas of strength rather than areas of concernRequires use of developmentally appropriate and familiar toys and materials or necessary adaptive toysPromotes natural circumstances for assessmentsConverts contrived test items into authentic tasksBalances quantitative and qualitative performance information

Convergence Accepts/incorporates multiple data sources, including curriculum-compatible and authentic informationFocuses on assessment in natural contextsRelies on play-style stagings of assessments to complement natural displays of behaviorEnsures broader coverage of child and family’s developmental ecologyPromotes inter-or transdisciplinary modes of teamworkIs family centered in outlook and process

Collaboration Relies on family as the primary source or authentic child performance dataSupports consensus decision making and use of collaborative problem solving and judgments as the most valid assessment processFosters in situ cross-talking and consensus decisions among parents and professionals about the child’s capabilities, needs, and family priorities

Equity Adapts tasks to accommodate child’s functional limitationsEmphasizes critical task/competencies demonstrated by the child, irrespective of functional limitationUses test-teach-test approach to identify primary response mode and to generalize its use by the child with various materials, activities, and settings

Conducts assessments via a natural test-teach-test framework that blends testing and teachingSeeks to uncover and foster the child’s learning-to-learn skills and abilities

Sensitivity Uses sequential curricular goals and graduated metrics to monitor small increments of individual progressLinks authentic assessment tasks to authentic curriculum goals and authentic curriculum goals to authentic interventionsUnderscores activity-based interventions in natural home and preschool settings and using natural activitiesLinks to real-life IEP/IFSP goals

Congruence Accomplishes major purposes and missions of early childhood and special educationUses developmentally appropriate styles of assessment that emphasize play, natural observation and parent reportsContains tasks and procedures that allow flexible accommodations for young children with wide individual differences, in particular developmental delays and disabilitiesEncompasses content and procedures that have field-derived social and treatment validities to support their suitability for use with young children, particularly those with special needs.

Developmentally appropriate assessment ratings to gauge the quality of curriculum-based instruments

Assessment is When characterized by

Authentic Real-life activities, settings, and methods that provide goals for intervention

3. Clear emphasis on skills or activities that are useful and worthwhile in natural settings2. Many or most items have some relevance; items can be adapted

or contextualized to be useful objectives. 1. Emphasis on items with little real-life relevance; psychometric

tasks that were neither required nor desired in typical activities and settings.

Collaborative Consensual decision making through teamwork between parents and professionals

3. Assessment items and methods are readily useful by parents and various professionals2. Materials can be used by professional teams after coaching,

although parent use is minimal.

1. Content and methods are discipline specific; use by parents and other professionals not feasible.

Convergent A confluence of information from multiple sources, settings, occasions, domains, and measures of multiple purposes

3. Emphasizes the use of multiple sources of information, including observation across settings and interview, as well as scoring of activity in context.

2. Employs at least some information source other than testing (eg., interview, and observation in natural contexts).

1. Focuses on direct testing, with little or no reliance on other avenues for information gathering.

Equitable Flexible and adaptive modifications to accommodate the needs and priorities of young children and families

3. Activity is phrased functionally (what gets done), rather than requiring specific sensory or motor capability.

2. Administration permits normative skill or activity to be modified to accommodate special sensory, motor, or cultural needs.

1. Normative tasks or activities not feasible for child with special sensory (seeing or hearing), motor, or cultural needs.

Sensitive Range and density of tasks in the functional hierarchy to detect even small increments of change

3. Assessment procedures and wide range of high density of items designed to detect even small changes

2. Moderate array of items, but gaps between items that preclude tracking of modest changes

1. Psychometric high inference items; few items for gauging child attainment of major developmental stages and capabilities; spotty, low density.

Congruent The extent to which an assessment instrument and its procedures correspond, are compatible with the missions of early intervention, responsive to the developmental demands and special needs of young children, and suitable for and field validated with children similar to those to be assessed.

3. Assessment system shows specific design features, content and procedures to detect and accommodate individual early childhood needs; demonstrates its suitability through formative field validations and/or standardization and

norming studies that establish its social and treatment validities.

2. Assessment system shows general design features, content, and procedures that can accommodate individual early childhood needs; but evidence of field-derived social and treatment validities is weak or absent.

1. Assessment system is developmentally inappropriate in design, content, and procedures; fails to demonstrate field-derived social and treatment validity with special needs group(s) during its development; is normed and/or field-validated with typical children and misapplied to children

with special needs.

Bagnato, S.J., Neisworth, J.T., & Munson, S.M. (1997). LINKing assessment and early intervention: An authentic curriculum-based approach, Baltimore, MD: Paul Brookes.

IV.D. Several measures used in early childhood assessment will be described in this section.

Developmental Indicators for the Assessment of Learning – Revised (DIAL-R) (Mardell-Czudnowski & Goldenberg, 1990) is a norm referenced instrument that is designed to screen motor, concepts and language. It is designed for use with children ages 2 years and 5 years 9 months. The DIAL-R was normed on 2227 in 1990 and is often used in team screenings using a station format.

Bayley Scales of Infant Development II is a 1993 revision of the original scales which were developed by Bayley in 1969. The scales assess development of children from 1-42 months of age. There are three scales: 1) mental scale (assesses perceptual acuity, discrimination, object constancy and memory, learning and problem solving, verbal ability, generalization and classification) 2) motor scale (muscle control and coordination); and 3)behavior rating scale (subscales address orientation/engagement, attention, motor quality and emotional regulation). Developmental age equivalents for motor, personal/socail, language and cognition are offered. Reliability and validity reported by the authors seem adequate. 1700 children were included in the normative sample and included children with special needs. The Bayley Scales of Infant Development are frequently included in the assessment battery to determine eligibility under Part C. It is generally administered by a trained school psychologist.

Battelle Developmental Inventory (Newborg et al., 1984) is a norm referenced tool used to assess development of children birth to age 8. There are 341 items in five domains and yields standard scores, percentile ranks and age equivalent. The normative sample consisted of 800 children (50 infants). The instrument is considered by norm-referenced

and criterion referenced and can be used for evaluation and assessment purposes. The psychometric properties are sound, but because the sample included so few infants, it is a better choice for children 2 and older.

Hawaii Early Learning Profile (Furuno et al., 1988) is a criterion-referenced instrument that is accompanied by a curriculum that can be used for intervention planning. There are two versions, one for infants and toddlers and one for preschoolers. The Hawaii or HELP contains items across all five developmental domains.

Assessment, Evaluation, and Programming System (AEPS) for Infants and Children (Bricker, 1993; Cripe, Slentz, & Bricker, 1993) is designed for use with children from 1 month of age to 3 years and their families. The AEPS represents a departure from traditional assessment approaches in that it integrates assessment and intervention in one approach.

V. Procedural considerations

V.A: How can you conduct an assessment in partnership with the family and other members of the team? There is no sure answer to this question, but there are some strategies you can consider. Boone and Crais (1999) recommended the following ways to involve the family throughout all phases of the assessment process

Possible Validating Questions to Ask Families PRIOR to Assessment What kinds of information would be most useful to you? What kinds of activities or toys would bring out the best in your child? What have you or others tried that have been helpful to your child? Will the kinds of activities discussed reflect what your child does at home? Where and when would be the best place(s) and time(s) to gather information about your child?Possible Validating Questions to Ask Families DURING Assessment Are we getting a representative sample of what your child can do? Was that a correct interpretation of what your child just said (or did)? How could we approach this task in a way that would help your child feel more comfortable doing it? Are there better ways we should be working/playing with your child?Possible Validating Questions to Ask Families AFTER Assessment Did we address your primary concern(s)? How do you feel about the overall process and the results? Were the behaviors displayed by your child typical for your child? What other skills or behaviors does your child do that we were not able to see today? What could we have done differently?

It is always important to carefully explain the general assessment process to the family then ask give them the opportunity to decide how they would like to participate in the assessment.

In all aspects of the early intervention enterprise it is critical for all members of the team to collaborate. What does this mean in practice though? The law (IDEA) requires that assessments be multidisciplinary, meaning more than one discipline must be involved. Other teaming models further the opportunity to interact and exchange information. The interdisciplinary (between disciplines) model encourages team members to share information and communicate meaningfully among themselves and the family. In the transdisciplinary model (across disciplines) team members release their roles and in some cases individual team members may serve as the primary service provider.

The arena assessment uses a transdisciplinary approach where all members of the assessment team are involved in planning the assessment. One team member is selected to be the facilitator and takes the lead in conducting the assessment with the child and interviewing a member of the family for additional information. This approach allows all team members to be involved in planning the assessment and observing the child in the assessment setting. The child interacts with just one adult rather than all members of the assessment team.

A team decision-making format is proposed by Bagnato & Neisworth,(1990) that connects disciplines in the assessment process. The system is called the System to Plan Early Childhood Services (SPECS).

V.B.: IDEA mandates nondiscriminatory evaluations of children which means that diagnostic procedures cannot discriminate on the basis of language or culture. There has been much written about culturally appropriate practice and how you can become culturally competent. It is recommended that you become familiar with some of the guidelines for culturally appropriate practice. A good resource to consider perusing is the following book:

Lynch, E.W. & Hanson, M.J. (1997). Developing cross-cultural competence: A guide for working with young children and their families. Baltimore, MD: Paul H. Brookes.

Some families may view members of the assessment team as “experts” and elect to take a passive role in the process. As stated earlier is it is important that you take time to explain the assessment process to the family and discuss ways the can participate. It may be beneficial to use an interpreter during these meetings to help the family to more fully understand the information if they are bilingual. Sharing information with families in more informal settings or having a member of their community present to facilitate the process may also be helpful.

Not all measures are appropriate for all children. During the planning phase it is imperative that team members consider the child’s linguistic and cultural background before they select assessment instruments or approaches. If an instrument was not normed on children from this cultural or linguistic background then it should not be used. It may be necessary to rely on informal assessment strategies.

Cultural beliefs and customs may be broken by the use of some items included in assessment instruments or through assessment practices. For example, the original Bayley Scales of Infant Development contained an item where the child was presented with the torso of a figure and the head and they were expected to try to place the head on the top of the torso. Traditional Navajos have superstitions about broken dolls making this item culturally inappropriate. Assessors need to be familiar with the cultural values and practices of the family so that the assessment will be scheduled at a time on a date that is acceptable. Cultural mores regarding handling of children and interacting with all members of the family should be respected.

Good communication throughout the assessment process between professionals and family members is essential. The recommendations presented earlier for engaging the family in the assessment process should help communication with families from culturally diverse backgrounds. Translators may be necessary. Remember for almost all families it is the first time they have gone through this process and they are unfamiliar with the terminology or the protocols. Try to provide explanations of what is going to happen before it happens and avoid using jargon.

It is important that assessment information be presented clearly and that the child’s strengths be emphasized. Families need time to process the information, so periods of silence should be honored. Professionals need to be supportive of families if they are struggling with the information.

V.C: Part C of IDEA uses the term “natural environments” that we discussed earlier. Assessments should be conducted in naturalistic settings whenever it is possible. Not only does the law mandate this practice, but it will also result in more accurate results. Because standardized measures may be difficult to administer in natural environments (such as the home) the team should use other informal procedures to document the child’s current functioning and developmental needs.

V.D: There are several professional organizations that professionals working in the field of early intervention may consider joining. One of these is the Division of Early Childhood (DEC) of the Council for Exceptional Children. This organization represents the field of early childhood special education for children birth to 8 years of age. DEC proposed a set of recommended practices for the field in 1993. One of the areas of focus was assessment. They recommended the following:

VI. Linking assessment to intervention

C. Assessment reportsD. Translating assessment information into IFSP/IEP planning