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DEC Recommended Practices: Assessment (Part 2)

Last month, we considered the first five DEC Recommended Practices under the Assessment strand. Now, let’s look at practices A6-A11. These practices encourage early interventionists to consider information from a variety of sources about the child’s skills and abilities across different routines, activities, and settings and to do this on an ongoing basis. These practices really remind us to consider the big picture – how the child functions in his everyday life.

Let’s Consider an Example…

During Liam’s assessment, the occupational therapist and speech-language pathologist gather information from his parents and his grandmother, who cares for Liam while his parents are at work. While observing Liam’s attempts to complete assessment activities, they also ask his caregivers about what goes well at home and out in the community for Liam and what is challenging. They often ask for more details so that they can understand particular activities Liam enjoys and those that he struggles with. Because of Liam’s significant motor limitations due to his cerebral palsy, he’s unable to complete some of the assessment activities that require fine motor coordination (such as placing shapes in a puzzle), but he often shows his understanding through his gaze. The therapists use their informed clinical opinion to make some determinations about age equivalencies, in addition to using the information they gather from their assessment tools. They explain this when they report the assessment findings and try to help Liam’s caregivers understand the connection between their observations based on the assessment tool and his functional abilities in his everyday activities. The service coordinator summarizes this information and then helps the team use it during the development of IFSP outcomes and the discussion about services. Once The IFSP is written, the service provider who sees Liam and his family can use this information to provide meaningful support and monitor progress through the ongoing assessment that will continue throughout service delivery.

DEC Recommended Practices for Assessment

This sounds like a pretty good assessment, right? Let’s look at six more assessment practices from the DEC Recommended Practices and consider how this example illustrates these practices.

A6. Practitioners use a variety of methods, including observation and interviews, to gather assessment information from multiple sources, including the child’s family and other significant individuals in the child’s life.

Professionals on assessment teams often have two choices. They can rely solely on what they observe during the child’s performance of assessment tasks prescribed by the tool they are using. Or, they can integrate these observations with what they learn from talking with caregivers about the child’s abilities and challenges in everyday life. Relying on the child’s performance alone can be necessary, depending on the tool being used, but it is always important to remember that one tool, or even a child’s performance of discrete tasks, can never truly tell you all you need to know about a child’s abilities. Plus, Part C of IDEA requires that we use more than one method/tool to determine a child’s developmental status. The law also requires that we use our informed clinical opinion to make sense of assessment findings and consider the child’s functional abilities in multiple settings. Child development happens everywhere a child goes and with every interaction; the best assessments take all of this into account. 

A7. Practitioners obtain information about the child’s skills in daily activities, routines, and environments such as home, center, and community.

While it’s not always possible to observe a child across daily routines, activities, and environments, it sure would be an awesome way to conduct assessments if we could. If you can’t observe it, you certainly can ask about it. Liam’s team was mindful of this and asked about what he and his family enjoy, what they like to do, and what they would like to do. All of this information informs the IFSP outcomes and helps the ongoing service provider know when and where to provide support.

A8. Practitioners use clinical reasoning in addition to assessment results to identify the child’s current levels of functioning and to determine the child’s eligibility and plan for instruction.

As already mentioned, Part C of IDEA requires that we use informed clinical opinion to individualize the assessment. It’s important to help families like Liam’s understand this, especially when pure assessment results reported as age equivalents can be disheartening. A child like Liam, who is limited in what his body can do, can appear to be extremely delayed just according to test scores, but when functional abilities are taken into account, a more accurate and encouraging picture of development can emerge. 

A9. Practitioners implement systematic ongoing assessment to identify learning targets, plan activities, and monitor the child’s progress to revise instruction as needed.

After Liam’s assessment, the ongoing service provider will use the information gathered initially and the IFSP outcomes to inform service delivery. He or she will also conduct ongoing assessment to plan for intervention, revise outcomes as needed with the rest of the team, and monitor the child’s progress. Ongoing assessment may be a less formal process, but it is equally important to ensure that EI services are meeting the child’s and family’s needs.

A10. Practitioners use assessment tools with sufficient sensitivity to detect child progress, especially for the child with significant support needs.

Hopefully, the therapists on Liam’s team used assessment tools that allowed items to be adapted for children with significant motor needs. Some tools provide this guidance, while others require that adaptations are just noted and reported. Using the right tool matters because an assessment that results in findings that are not meaningful or reflective of the child’s abilities really isn’t very useful at all, and can be frustrating for families as well.

A11. Practitioners report assessment results so that they are understandable and useful to families.

Finally, the therapists shared assessment findings by relating them to Liam’s everyday activities so that they were easy to understand for his family. Helping families understand what discrete assessment tasks tell us about development and how that relates to what they see everyday with the child is one of the most important tasks of the professional team members. Assessments should not be an event where the “experts” talk “at” the parents. Instead, assessments should be a mutual and reciprocal sharing of information so that everyone learns more about the child. 

It’s your turn now! Take some time to review these two checklists to reflect on your own assessment skills. Consider how you use what you know to really get an accurate picture of a child’s development.

Informed Clinical Reasoning Checklist

Authentic Child Assessment Practices Checklist

Keep an eye out for next month’s post on the Environment Practices. In the meantime, consider…

How does an early interventionist develop clinical reasoning? How do you know when you’ve got it?

What strategies do you or your assessment team members use to gather information about a child’s functional abilities in everyday activities – including those that you might not typically see during a formal assessment? 

What tools or practices do you use when conducting ongoing assessment? How do you document when a child is making progress?

Share your ideas in the comments below!

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Be sure to check out my other posts on applying the DEC RPs to early intervention:

DEC Recommended Practices: Leadership in EI

DEC Recommended Practices: Assessment (Part 2)

DEC Recommended Practices: Environment

DEC Recommended Practices: Family

 

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