Hillel Goelman, Ph'D'

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Assessment in early child development

• Hillel Goelman, Ph.D.
• Human Early Learning Partnership
• UBC
• Vancouver Coastal Health Authority Seminar
• September 18, 2007

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Assessment in early child development

• With thanks to Dr. Laurie Ford, University of
  British Columbia, Dr. Neal Halfon, UCLA School of
  Medicine, Dr. Frances Glascoe, Dr. Dianne
  Bricker, National Association for the Education
  of Young Children, Mari Pighini, Research
  Coordinator, Social Development Partnerships
  Project on Social Inclusion, Dana Brynelsen,
  Provincial Advisor, Infant Development Program of
  British Columbia

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• Assessment is one tool that can be used to help
  provide positive child health and child
  development outcomes.
• It is never an end in itself.

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Outline to todays presentation

• Assessment as an activity to promote child health
  and development.
• Principles and practices in assessment
• Assessment as a conversation starter among
  parents and professionals.
• Some examples of formal assessment (IQ) and
  informal assessment (ASQ PEDS).
• Towards a system of authentic assessment.

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Factors that influence child development outcomes
Family Discord
Social-emotional, Physical Cognitive, Language
function
Lack of health services
Poverty
Lower trajectory With diminished function
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Factors that influence child development outcomes
Early intervention
Family Discord
Social-emotional, Physical Cognitive, Language
function
Lack of health services
Poverty
Lower trajectory With diminished function
Appropriate Assessment
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Optimizing Early Child Health and Development

• Optimizing early childhood health and brain
  development requires
• Integration of clinical, targeted prevention,
  universal and broader social interventions
• Strategies that minimize risks and maximize
  protective factors are necessary
• Policies that align levels of government and
  service delivery sectors (silos) within
  government in a common effort
• Place based programs that integrate early
  childhood services and program into a more
  integrated system of care

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Positive Child Development Outcomes Service
sectors and programs that influence healthy
development
Compliance to simple requests
Emotional control Functional
use of language Exploration of object world
Effective peer interactions
Nascent awareness of standards
Nascent emotional regulation Nascent
selfhood/identity Language Development
Social relationships
Physiological regulation Entry into verbal
milieu Attentional/motoric control of object
world
Birth 6 mo 12 mo 18 mo
24 mo 3 ys 4 ys
5ys
Health
Ongoing well child care, acute, developmental and
preventive care

Pre/perinatal care
Education
Early Intervention Programs (including Head Start
and Early Head Start)
Pre-school
Parenting and Family Literacy Programs

Social Family Services
Center and Home Based Family Resource Programs


Child Care Programs

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The range of early childhood education, care and
intervention programs
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3 Levels of assessment and intervention
ASD
LBW
EDI
3 Levels of recognition and response
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Continua and dichotomies
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Continua and dichotomies
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Continua and dichotomies
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Continua and dichotomies
Diagnostic
Domains
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What are the Key Considerations in Early
Childhood Assessment? National Association for
the Education of Young Children (NAEYC)
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How do experts define appropriate early
childhood assessment?(NAEYC)

• The process of obtaining information for the
  purpose of evaluative decisions (Meisels).
• The process of observing, recording, and
  otherwise documenting work that children do and
  how they do it, as a basis for a variety of
  educational decisions that affect the child.
  (NAEYC NAECS/SDE)

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Appropriate assessment

• provides information about child development
  over time in a naturalistic setting
• is reliable, valid, and fair.
• is culturally fair.
• is developmental, linked to curriculum and
  aligned with appropriate early childhood
  standards
• acknowledges that early childhood is a time of
  the most rapid developmental changes in a
  persons life.
• considers academic knowledge and skills in the
  context of the whole child.
• acknowledges that early childhood is a time of
  the most rapid developmental changes in a
  persons life.
• considers academic knowledge and skills in the
  context of the whole child.

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Purposes of Assessing Child Learning and
Developmental Outcomes

• To plan instruction, intervention or therapy for
  individuals and groups
• To effectively communicate with parents
• To identify children who may require specialized
  programs and interventions
• To provide information for program improvement
  and accountability
• NAEYC and NAECS/SDE

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Planning instruction, intervention or therapy for
individuals and Groups Considerations in
Appropriate Assessment

• Include data on multiple dimensions.
• Include data from multiple sources on multiple
  instruments (adopted through a broad-based
  consensus-building process).
• Collect data at multiple points over time and
  while children are engaged in regular activities
  in familiar surroundings.
• Goals 2000 Panel

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Effectively Communicating with Parents

• Providing families with a picture of their
  childrens on-going development.
• Demonstrate child progress over time
• Documenting and sharing childs work

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Identifying Children who Need Specialized
Programs and Interventions

• Developmental Screening
• Identify children with special characteristics
  and determine if further assessment is needed
• Diagnostic Assessment
• Describe childrens current level of functioning
• Determine intervention services

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Using the Right Data for the Right Reasons?

• Does the assessment system match the purpose?
• Does the assessment system stay true to the
  purpose when designing, reporting, and drawing
  implications from the results?
• Does the assessment system support young
  children, teachers, and families?
• Will the efforts of the assessment system assess
  the merit of the cumulative investments in young
  children?

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• The science of strange behavior of children in
  strange situations with strange adults for the
  briefest possible period of time

Bronfenbrenner, 1977
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Measuring Intelligence

• More broadly we think of measuring cognitive
  abilities
• Most tests provide an overall quotient or score
• Every test calls it something different
• The more meaningful information typically comes
  from examining the factor, component, or subtest
  scores.
• Dr. L. Ford, UBC

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Common Cognitive Assessment Instruments

• Intelligence Tests or Measures of Cognitive
  Abilities..
• Wechsler Scales (WISC-IV WPPSI-III WAIS-III)
• Stanford-Binet Scales of Intelligence (SB5)
• Differential Ability Scales (DAS)
• Woodcock-Johnson Tests of Cognitive Abilities
  (WJIII COG)
• Kaufman Assessment Battery for Children-II
  (KABC-II)
• Dr. L. Ford, UBC

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Differential Ability Scales

• Overall Score is the General Cognitive Ability
  score (GCA)
• Three Main Factors
• Verbal Reasoning
• Nonverbal Reasoning
• Spatial Reasoning
• Dr. L. Ford, UBC

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Woodcock-Johnson Tests of Cognitive Abilities

• Overall Score is called the General Intellectual
  Ability score (GIA)
• Seven Broad Factors
• Fluid Reasoning (Gf)
• Comprehension-Knowledge (Gc)
• Long-Term Retrieval (Glr)
• Visual-Spatial (Gv)
• Auditory Processing (Ga)
• Short-Term Memory (Gsm)
• Processing Speed (Gs)
• Dr. L. Ford, UBC

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Service Organization for Early Child Development
and Parenting
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Preventive Care
Acute Care
Chronic Care
Developmental Services
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Service Organization for Early Child Development
and Parenting
Preventive Care
Acute Care
Pediatric Office?
Chronic Care
Developmental Services
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PARENTS EVALUATION OF DEVELOPMENTAL STATUS
PEDS
A Method for Detecting and Addressing
Developmental and Behavioral Problems

• For children 0 to 8 years
• Takes about 5 minutes for parents to complete,
  1-2 2 minutes to score
• Elicits parents concerns (in multiple
  languages
• Sorts children into high, moderate or low risk
  for developmental and behavioral problems
• 4th 5th grade reading level so gt 90 can
  complete
• independently
• Score/Interpretation form used longitudinally
• Online application with automated
  scoring/results

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EXAMPLES OF PARENTS CONCERNS Expressive
Language He cant talk plain Receptive Language
She doesnt seem to understand us Gross Motor
Hes clumsy, falls a lot, awkward, late to
walk Fine Motor She cant write well, messy
eater Global/Cognitive Slow and behind, cant do
what other kids can Other trouble hearing,
seeing, health problems, family
issues Social/Emotional Hes mean, shes bossy,
doesnt have friends Behavior He wont mind me,
temper tantrums Academic/preacademic trouble in
school, doesnt know ABCs Self-Help Cant get
dressed by himself I used to be worried but now I
think hes doing OK
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PEDS Evidenced Based Decisions
Path A high risk of developmental disabilities,
shows what kinds of referrals are needed. Path
B moderate risk of disabilities, need for
additional screening, developmental promotion,
monitoring Path C low risk of developmental
disabilities but elevated risk for mental health
problems, need for parent education, monitoring,
and/ or additional behavioral screening Path D
moderate risk of developmental disabilities,
problems with parental communication and need for
hands-on screening Path E low risk for either
type of disability for which reassurance is the
best response
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PEDS Interpretation FormDescription Path A

• Path A is the High Risk path and suggests
  possible developmental disabilities. Refer for
  evaluations through EI promptly.
• Path A suggests the type of evaluations needed
  based on the types of concerns
• Add your clinical judgment about what other kinds
  of services may be needed (e.g., social work,
  mental health, etc.)
• Additional screening with the M-CHAT is wise

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Path B

• Path B suggests Moderate Risk for developmental
  disabilities
• In response screen further or refer for screening
• Offer developmental promotion to those who dont
  qualify for special services and provide
  watchful waiting/extra monitoring
• Consider referrals to Head Start, after school
  tutoring, etc.

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Path C

• Path C Low risk of developmental disability but
  elevated risk of mental health problems,
  especially in children 4 years and older
• For children under 4, give parents advice and
  written information, and monitor effectiveness
• If such counseling is not effective, provide
  mental health screening or refer for screening
  (both child and family-focused)
• For children 4 and older, give mental health
  screens or refer for screening (child and family)

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Path D

• Path D is rare but is used for parent-provider
  communication difficulties (e.g., no language in
  common, teen parent who doesnt know much his
  child, parents with serious mental health or
  language problems
• Refer these children for hands-on screening (e.g,
  with the Brigance or ASQ)

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Path E

• Path E Low risk for problems either in
  development or social-emotional areas
• Offer reassurance unless your clinical judgment
  suggests a problem

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PEDSInterpretation Form Details
The Interpretation Form has space on the right to
record your decisions, referrals, advise, etc.
This provides a longitudinal record of
services providedhelpful for audits, etc.
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Oh, by the way..
Reduces doorknob concerns Focuses visit and
facilitates patient flow Improves parent
satisfaction and positive parenting
practices Increases provider confidence in
decision- making Increases attendance at
well-child visits
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Positive screens require
Chart DocumentationLetters to referral
sourcesTelephone and contact info for
referralsBilling/Coding (96110)Parent summary
reports
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Delivering difficult news to parents

• Prepare parents for screening in a positive way
• Inform parents about the purpose for each test
• Validate concerns expressed by parents
• Use descriptive terms rather than diagnostic
  labels
• Present news in a thoughtful, caring way,
  preferably in person
• Provide hope

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Delivering difficult news to parents

• Help parents to establish action plan
• Provide contact information for resources in
  community
• Offer ongoing support
• Provide information handouts

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Service Organization for Early Brain and Child
Development
Programs influencing Early Brain, Child
Development School Readiness
Kindergarten
Pre/perinatal support
Parenting and Family Literacy Programs
Child care centers
Nursery Schools
Family Child Care
Pediatric services
Family Resource Programs
Child Care Resource Programs
Recreation Arts Programs
E.I. programs
Childrens Library Programs
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Community Planning Pathway for School Readiness
School Readiness
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UBC-ECEBC Annual Assessment Workshop
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Contact us

• Hillel Goelman hillel.goelman_at_ubc.ca
• Assessment workshop inquiries
• mpighini_at_ubc.ca
• HELP and the CHILD Project
• www.earlylearning.ubc.ca