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Child's Name: Date of Birth: Address: Phone:

Caregivers' Names: Relationship:

Legal Guardians? Yes / No

What are your concerns?

What previous assessment(s) have been done? By whom? What services is this child receiving at this time?

What interventions have been tried up to this point, and with what results?

What do you know about the child's background, including medical, health, and family history?

What information would you like from this assessment?

Have you discussed this with the child's caregivers?

Have you attached a signed permission form for this assessment?

When are you available to meet to discuss this referral?

Lidz, Carol S. Early Childhood Assessment. Copyright 2003, John Wiley & Sons.

Referrers Name: Child's Age: Program: Program Address: Program Phone: Referral Date:

possible format. This format reflects the need to elicit relevant information that will help to inform the assessment while minimizing the time required for paperwork to initiate the assessment process. This is a delicate balance. Referrers should not take referral lightly, as it is costly and time-consuming, yet they should not be obstructed in their desire to refer by the amount of paperwork involved. Form 1.3 is useful to complete along with the referral form to provide a profile of areas of concern, as well as indications of intensity of concern. The combination of forms such as Forms 1.2 and 1.3 should provide the basis for communicating the basic concerns and degree of urgency to the assessor to begin the assessment planning process.

Completion of these forms, along with the signed permission of the legal guardians, is then followed by an interview of the referrer for clarifying the problem further and for soliciting the re-ferrer's collaboration in the assessment. Too many teachers assume that the act of referral forfeits their involvement with the special needs of the referred child or view assessment as intervention rather than as the route to intervention. Once this information has been gathered, decision making regarding procedures can begin. These decisions continue throughout the assessment process as questions and hypotheses develop in response to the results of the data gathered.

Bagnato et al. (1997) outlined six standards to guide selection of assessment methods for use with young children:

1. Authenticity: real behaviors in real settings

2. Convergence: multiple sources of information

3. Collaboration: working and sharing particularly with caregivers

4. Equity: accommodations to the child's special needs

5. Sensitivity: inclusion of sufficient items for planning decisions and for detecting change

6. Congruence: developed and field tested with children similar to those to whom the procedure will apply

Hubert and Wallander (1988) noted three primary issues in instrument selection: practical considerations, psychometric considerations, and assessment objectives. An example of a practical consideration would be the use of a play scale with a child with severe motor disability (not practical). Psychometric considerations involve the usual suspects of reliability and validity, as well as sensitivity and selectivity in the case of screening, with the addition of utility. Consideration of assessment objectives concerns the match between the data needed and the data collected in relation to the decisions to be made. Hubert and Wallander therefore suggested that assessors needed to know the objectives of the assessment, the decisions to be made, the characteristics of the child, and an appropriate repertory of procedures. No training program can prepare its students to be aware of or to develop competence with all of the available procedures. The most that any program can accomplish is to introduce students to a sample of the approaches that are available and to develop a beginner's level of mastery with a sample of these. It is up to each individual to gain further expertise in response to their professional needs, as well as in response to the developments in the field. Even the most familiar tests will change. (For example, I was trained to use the Stanford-Binet Intelligence Scale L-M, but most readers won't even know what that is!)

Assessment of young (I think all) children needs to be conducted with the view of optimizing their performance (Lidz, 1990). Particularly in the case of young children, the state of the organism can play a major role in the determination of manifest functions (e.g., whether the child is alert or sleepy). Although both the range and the typicality of behaviors

Referral Profile

Referral Profile for Completed by Date

[This form is intended as a support for making the decision to refer this child for assessment. It is not to be used for screening. Each of the items represents a possible reason for referral. Please attach a completed profile to the referral form. This will help to increase the appropriateness of the assessment process. Thank you.]

Key: NP (No problem)

NO (No opportunity to observe) MI (Observable to mild degree) MO (Observable to moderate degree) S (Observable to severe degree)

Behaviors

NP

NO

MI

MO

S

Comments

1. COGNITIVE AREA

• Requires more time/practice than others to learn something new

• Lacks concepts necessary for understanding lessons

• Lacks curiosity

• Uses materials inappropriately

• Poor attention

• Does not know how to use materials

• Impulsive with materials

• Hard time finishing work

2. SPEECH/LANGUAGE

• Drools, breathes with mouth open

• Repeats speech of others

• Responds inappropriately

• Uses single-word or short-phrase sentences

• Struggles to get words out

• Difficult to understand

• Difficulty following directions

• Delays before responding

• Voice volume unusually loud or soft

• Voice sounds hoarse or nasal

Behaviors

NP

NO

MI

MO

S

• Reactions not appropriate

• Excessively anxious

• Frequent changes in emotion

• Excessively withdrawn

• Excessively aggressive

• Excessively angry

• Excessively shy

• Flat; nonreactive

• Does not follow routines

• Easily frustrated

4. SOCIAL INTERACTION

• Does not initiate play

• Refuses invitations by others to play

• Problem maintaining interaction

• Does not comply with teacher's requests

• Disturbs play of others

• Seems to lack social skills

• Does not use teacher as resource for learning or solving problems

• Argues with peers

5. MOTOR

• Unable to use crayons or pencil for scribbling

• Unable to approximate drawing of circle

• Hands tremble/shake

• Unable to button or zip clothing

• Unable to catch a large ball

• Awkward movements

• Falls frequently

• Bumps into things

• Unable to ride tricycle

• Hard time stopping once gets going

• Moves constantly

• Tires quickly

Lidz, Carol S. Early Childhood Assessmer

t. Copyr

ght 2003

S, John W

Viley & S

ons.

Form 1.3 (continued)

are of relevance and interest, if we are to draw inferences about the child's capacities, we need to base these observations on optimal circumstances. This means that children need to be seen at times when they are alert and willing to interact. They need exposure to age-appropriate materials and directions, a pleasant and comfortable environment, and an assessor who is accessible, flexible, and comfortable with young children. Optimizing the assessment also reduces measurement error by reducing the variance, as the child is pushed to respond as close to the child's ceiling level as possible. Another way to optimize performance is to ensure that the child experiences sufficient competence during testing with minimal frustration. This may mean starting standardized tests below the baseline, interspersing easier with more challenging tasks, or providing for breaks or snacks. It may mean terminating a session if the child is too distressed, changing the assessment procedure, or even modifying the administration (see Chapter 6 and 7 for further discussion of dynamic and standardized assessment).

In the "olden" days, when I was trained, it was automatic to see children of all ages without their parents. Part of the description of the child in the report addressed the ease or difficulty of this separation. Somewhere along the line of my professional practice, I asked myself why and decided that there was not sufficient justification to sustain this practice, particularly if we keep in mind the issue of optimizing the child's performance. Once we have determined that the child will scream uncontrollably when separated from his parents, what do we accomplish by spending the next hour trying to calm him or her down? And what can we conclude from this reaction in any case? I now most often see very young children in the company of their care-givers and use the caregiver as a collaborator-informant to help me understand the child. This is not a rigid alternative. Children seen within programs do not always have parents who are available or willing to accompany them. In this case, I ensure that the child is familiar with me by visiting and interacting within the classroom, and consider asking an aid to accompany us if the child is too stressed to leave. Apparently, I am not alone in this practice. According to Greenspan and Meisels (1994), "young children should never be challenged during assessment by separation from their parents or familiar caregivers" (p. 7).

Although psychologists make a very important contribution to the assessment and planning for young children and their families, they also need to function as members of a team. Psychologists need to become familiar with their team members and their various areas of expertise. The individuals who are most likely to participate in a team would be a speech and language pathologist, occupational therapist (who usually focuses on fine motor functions, daily living skills, and sensorimotor integration), physical therapist (who usually focuses on gross motor functions, particularly lower extremities), and nurse. Teachers (regular and special education) are also team members, as are parents.

Nagle (2000) described the three basic types of team organizations: multidisciplinary, interdisciplinary, and transdisciplinary. In the case of multidisciplinary teams, each member functions independently, completes the assessment, sends it in, and hopes that someone coordinates the input and service delivery. In most cases the assessment is usually solicited by someone who is coordinating the service delivery and who solicits the assessment to inform this process. In the case of an interdisciplinary team, each member conducts an assessment within her or his area of expertise, but the team members also interact to formulate a coordinated plan and participate as a group in the various team meetings, and they are often available for further follow-up. Transdisciplinary teams delegate the primary assessment function to one or two of its members, and the others accomplish their assessment goals through these direct asses-

sors. Transdisciplinary teams are characterized by role release, in which the designated individuals carry out the functions of other team members. Needless to say, these teams are complex entities, and a significant aspect of professional functioning involves development of working relations among the team members. There are often significant turf issues. As a rule, psychologists are trained to consider and address the whole child. Therefore, it can become difficult to function within this role when a social worker does the developmental history, an educational diagnostician does the academic piece, and an occupational therapist includes cognitive testing among the fine motor scales. I assume that assessment is carried out as an integrated, holistic process. How this plays out within any particular team will vary, and each professional will have to negotiate a role and find a way to function effectively. In my view, the role of the psychologist and the psychological assessment is to solve a problem; humans function in an integrated way. To do the job properly, we have to consider all the many contributing pieces and how they are or are not integrated and how they reflect the many possible contributing factors.

Assessment of young children is not an easy task—certainly not one for the weak of mind or heart, as acknowledged by Goodman and Field (1991): "Preschool children in trouble mean trouble for diagnostic evaluators. The psychologist is apt to face reluctant subjects, extremely serious differential diagnostic questions, and an inadequate array of testing instruments" (p. 219). On the other hand, most of the children are also appealing, fun, and interesting. Work with children in this age range provides opportunities to help both children and their families find their way onto a productive developmental path. Although methods of assessment always need improvement, there is now a sufficient array of data sources to provide meaningful documentation of needs and guidelines to build a foundation for promising interventions. Despite the continuing need for more and better, we have come a long way.

As recently as 2000, Alfonso, Oakland, LaRocca, and Spanakos found that only 32% of their survey respondents from U.S. school psychology programs offered separate courses in preschool assessment. After reviewing the chapters in this book, readers should become convinced of the need for a special course in the area of early childhood assessment; in fact, some may well wonder if just one course is sufficient.

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