Devlopmental Screening and Standardized Assessment of the Pediatric client Flashcards
Why are standardized assessments used in pediatrics?
Objectively measure (motor) skills and knowledge. Determine child's level of development and functioning Identify impairments and functional limitations Helps establish diagnosis, prognosis, plan of care. Select appropriate interventions and services. Support goals, interventions, and outcomes Determine/document progress, revise interventions Determine eligibility for services.
What developmental domains get standardized tests?
Cognitive ability, communication, motor/physical skills, adaptive skills, social emotional and behavioral functioning, sensory processing, hearing
What are components of developmental screening?
Standardized testing of all domains
Curriculum based assessments
Observation of child at informal or structured play and of parent child interactions.
Parental interview to elicit their concerns, obtain a history of the child’s early development, and gather info about the child’s current level of functioning
Review child’s records (health, education, daycare, etc) and family medical history
What are the two types of standardized assessments?
Norm referenced
Criterion referenced
What are norm reference tests?
Based on skill level sample of children; child is compared to the sample
What are criterion reference tests?
Based on child’s performance on specific test items
What are norm referenced tests used to determine?
Program eligibility
What are characteristics of norm referenced tests? (4)
Standardized on groups of normal children
Compares child’s performance against a known group performance
Considered discriminative measures: used to see if they have deviations from normal standard (identify kids with delays)
Deviations from normal distribution are determined
T/F: norm referenced assessments compare a kids performance against themselves?
False: They compare their performance against a known group performance
What are characteristics of criterion referenced assessments?
Consists of series of skills measured against a set criteria for performance.
Compares child to himself
Evaluative measure
Measures progress- used to determine child’s performance against previous performance on same measure
What is use for criterion referenced assessments?
May be used for program planning or to track change over time
T/F: Criterion referenced assessments compare kids performance to themselves?
True
What are considerations for choosing an assessment?
purpose
What the test measures
Child’s age
Developmental or functional areas to be examined
Standardization sample
Setting
Reliability- produces consistent, repeatable results
Validity- measures what they are supposed to measure
What are some of the most common types standardized assessments used?
Infant neurological international battery (Infanib)
Alberta infant motor scales (AIMS) and Motor Assessment of the Developing infant
Bayley scales of infant and toddler development, 3rd edition (BSID-III)
Peabody Developmental Motor scales- 2nd edition (PDMS-2)
Gross Motor Function Measure (GMFM)
Pediatric Evaluation of Disability Inventory (PEDI)
Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2)
School Function Assessment (SFA)
What does the Infant Neurological International Battery measure, what’s age range, what is its reference?
Age: 1-18 months, at risk infants including those born prematurely
Criterion referenced
Tests: spasticity, vestibular function, head and trunk control, French angles, and legs
Used to determine normal and abnormal neuromotor function
What does Alberta Infant Motor scales and Motor assessment of the developing infant measure, what is age range, what is its type of reference?
Age: birth to 18 months
Norm referenced
Identifies infants and toddlers with gross motor delay and evaluates gross motor maturation
Observation of gross motor skills in 4 positions: prone, supine, sitting, standing
What is age range, reference, and purpose for Bayley Scales of infant and toddler development?
Age: 1-42 months
Norm referenced
Assesse adaptive behavior, cognitive, language, motor (gross and fine), and socio-emotional development
Commonly used in early intervention and research
Determine developmental delay
What is age range, reference, and purpose for Peabody developmental motor scales?
Age: birth-6 years
Norm referenced
Assessment of gross and fine motor skills
Commonly used in early intervention services to determine eligibility for services
What are 6 subtests for Peabody developmental motor scales?
Reflexes, stationary, locomotion, object manipulation, grasping, and visual motor integration
Motor quotient determined to estimate overall motor abilities
What is age range, reference, and purpose of Gross motor function measure?
Age: birth to 16 years (5 months -16 years)
Criterion referenced
Assess gross motor function in children with CP
Common assessment to determine quality of movement in children with CP
Can have GMFM 88 for kids with down syndrome
What is age range, reference, and purpose of Pediatric evaluation of disability inventory?
Age: 6 months to 7.5 years
Norm referenced
Parent interview to determine self care (grooming, dressing, bathing, and toileting); mobility (including transfers), social function (communication, social interaction, household and community tasks), and need for modifications and assistance
What is age, reference and purpose of bruininks-ostetsky test of motor proficiency?
Age: 4-21 years
Norm referenced
Test of fine and gross motor skills
What are subscales for bruininks ostetsky test of motor proficiency?
Running, speed and agility, balance, bilateral coordination, strength, upper limb coordination, response speed, visual motor control, and upper limb speed and dexterity
What is age, reference, and purpose of school function assessment?
Age: children with disabilities K-6
Criterion referenced
Assess activity and function in school setting
Judgement based interview to determine child’s participation in all aspects of school environment (task supports needed to function in school, activity performance of school related activities, physical tasks- changing position, manipulation, using materials, eating, and written work, cognitive and behavioral tasks)
What is the gross motor functional classification system (GMFCS)?
Standardized method used to classify gross motor function in children with CP ages 1-18 months
Five level system
Valid and reliable
What are the differences in levels of the GMFCS?
Functional limitations
Use of assistive mobility devices (walkers, canes)
Use of wheeled mobility device
Quality of movement
What are the levels of the GMFCS?
Levels 1-V: one is the highest level of function, 5 is the lowest level of function
Group kids with CP by level of disability
What are the separate descriptions for five groups in the GMFCS?
Before 2n bday Between 2nd and 4th bday Between 4th and 6th bday Between 6th and 12th bday Between 12th and 18th bday
What is GMFCS level where child is able to perform all activities of age matched peers with some difficulties with speed, balance, and coordination?
Level 1
What is GMFCS level where child requires support when negotiating uneven surfaces or stairs?
Level 2
What is GMFCS level where child is independent walking but requires assistive device and also may need wheelchair for longer distances?
Level 3
What is GMFCS level where child is non ambulatory, and may weight bear for transfers and use a walker for exercise purposes?
Level 4
What is GMFCS level where child is non ambulatory, no functional weight bearing, usually totally dependent on caregivers?
Level 5
Do you have to adjust for prematurity?
Yes.
Convert weeks early to months and then subtract from chronological age to get adjusted age.
Only done for kids less than 24 months chronological age
What are characteristics of test administration for PDMS?
Competency- thorough understanding of test administration, scoring and interpretation
Test must be administered exactly as specified for test to be valid
Do not need to memorize assessment, use manuals as directed
T/F: you just use info you get from assessment to make a decision for treatment for kids?
False: use info from PT exam/eval AND info from standardized assessments to support decision making for intervention and services
What is scoring for PDMS?
2: child performs the item according to criteria specified for mastery
1: child’s performance shows clear semblance to item mastery criteria but does not fully meet criteria
0: child can’t or will not attempt the item or the attempt does not show that the skill is emerging
How do you calculate final score for PDMS?
Start at child’s age
Test until child scores 3 zeros in a row (ceiling level)
Score all items after ceiling zeros for each item.
Go back up and find last three 2’s before a zero or one (basal level), score all items above basal level 2 for each item
Add up scores for each subtest (raw score)\
Convert raw score to age equivalent, percentile and standard score.
Then find sum of standard scores
Then find quotients and percentiles
Then plot standard scores for each subtest on graph
What is basal, ceiling level?
Basal: item preceding first failed item
Ceiling: item representing most difficult success item
What is raw score, standard score, percentile score?
Raw: number of test items correct
Standard: expressed in terms of deviations, used to express deviation or variations from the mean score of a group
Percentile: used to indicate number of children of same age expected to score lower than the child
What is percentage, age equivalence, developmental quotient?
percentage: passed items out of total measured
Age equivalence: performance of child is compared with the mean age when 50% of kids would have mastered those skills
Developmental quotient: ratio between child’s actual score based on developmental age achieved on the test and child’s chronological age
