Module 7: Child and Developmental Assessment

Question 1

How do we assess children?

Answer 1

The four pillars of assessment - Sattler, 2008

1. Norm-referenced tests
2. Interviews
3. Observations
4. Informal assessment procedures

Question 2

Standardised intellectual/cognitive tests

Answer 2

• Wechsler Pre-School and Primary Scale of Intelligence – Fourth Edition (WPPSI-IV: ages 2:6 – 7:7)
• Wechsler Intelligence Scale for Children – Fifth Edition (WISK-V; ages 6:00- 16:11)

Question 3

Standardised academic achievement tests

Answer 3

• Weschler Individual achievement Test – Third Edition (WIAT-III; ages 4:00 – 50:11)

Question 4

Standardised behaviour rating scales - aspects of mood and behaviour in everyday life

Answer 4

• Conners Rating Scale – Third Edition
• Child Behaviour Check List (CBCL)
• Vineland Adaptive Behaviour Scales – Third Edition (VABS-III)

Question 5

History interviews

Answer 5

Child interview:

• Understanding of the assessment process
• Worries, likes and/or dislikes
• Feelings towards school
• Perception of the home environment
• Preceptions of their friendships with other children

Teacher interview:

• Academic achievement
• Classroom behaviour
• Interactions with other peers
• Onset, duration and triggers for any challenging behaviours

Parent interview

• Major medical history
• Developmental history, including milestones
• Family structure
• Conflict in the home?
• Perception of the child’s friendships
• Academic achievement
• Onset, duration and triggers for presenting problems

Question 6

Observations

Answer 6

Hygiene and physical condition
Eye-contact and quality of social interaction with parent and examiner
How does the child adjust to the testing situation?
Attitude toward testing and examiner- difficulty with authority look to you for reassurance?
Test-related anxiety - GAD or SAD? Is that performance difficulty or the construct?
Level of alertness and concentration - diagnostic/recommendation
Evidence of impulsivity? Diagnostic/recommendation
Problem solving approach on standardised tasks
Can they shift easily from one task to the next?

Question 7

Informance assessments may include (but not limited to)

Answer 7

• Samples of the child’s drawing writing or artwork (depending on their age)
• School report cards: considered informal, because psychologist has not given these assessment

Question 8

Assessment and diagnosis of intellectual disability

Answer 8

According to victorian law, the term ‘intellectual disability’ refers to two core features:

1- People with an intellectual disability display well below average intelligence (based on standardised IQ test performance)
2- Impairments in everyday adaptive living skilss (identified before age 18 years)

Question 9

DSM-V Intellectual Disability: Criterions

Answer 9

A. Deficits in intellectual functions, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience; confirmed by both clinical assessment and individualised, standardised intelligence testing.

B. Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation

C. Onset of intellectual and adaptive deficits during the developmental period.

Question 10

Adaptive functioning (AF)

Answer 10

• Conceptual skills: language, reading, writing, reasoning, knowledge, and memory
• Social skills: empathy, social responsibility, interpersonal communication skills, and the ability to establish and maintain friendships
• Practical skills: self-management in areas such as personal care, job responsibilities, money management, recreation, and organizing school and work tasks.

Question 11

Global Developmental Delay

Answer 11

• Until a standardised IQ test can be administered, professionals may use the term Global Developmental Delay to describe a child who is experiencing difficulties in various areas of their skill development
• According to the DSM-5, Global Developmental Delay is reserved for children under the age of 5 years, who are considered too young to receive a formal diagnosis of intellectual disability.

Question 12

Causes of intellectual disability

Answer 12

A specific cause of ID can be identified in approximately two-thirds of cases:

Known causes:

• Brain injury or infection occurring before, furing or after birth
• Growth or nutrition problems
• Faculty chromosomes and genes
• Extreme prematurity
• Drug misuse, alcohol, smoking
• Environmental deprivation
• Exposure to toxins

Question 13

Assessment of ID: Criterion A

Answer 13

• Need to establish the presence of intellectual deficits.
• Weschler Intelligence Scales
  o WPPSI-IV
  o WISC-V
• Stanford Binet – Fifth Edition

Question 14

Assessment of ID: Criterion B

Answer 14

Vineland Adaptive Behaviour Scales – 3RD Edition

• For use with individuals from birth – 90 years of age
• Used to establish the presence and severity of adaptive functioning deficits in the context of Intellectual Disability evaluation
• Includes Parent and Teacher version, with normative data from a large standardisation sample.
• Good evidence to support validity and reliability

Question 15

Achievement testing in clinical practise

Answer 15

• Academic achievement: the degree of previous learning or accomplishment in various types of subject matter, or specific subject areas.
• In clinical practise, psychologists use individually administered achievement tests to measures oral language, reading, writing and mathematics (among other areas too).
• Achievement tests are contrasted with intelligence tests, which measure aptitude or ability to learn.

Question 16

Why assess for a learning disorder?

Answer 16

• High prevalence 5-15% of children have learning difficulties
• Learning disorders have been shown to intensify symptoms of child and adolescent psychiatric disorders.
• Children with learning difficulties have been shown to have higher levels of aggressions and lower self esteem
• Children with learning difficulties are more likely to be bullied
• Increased anxiety among individuals with dyslexia

Question 17

DSM-V Diagnostic Criteria for SLD

Answer 17

A. Difficulties with learning and using academic skills, with symptoms that have persisted for at least 6 months, despite the provisions of interventions that target those difficulties.
B. Affected skills are substantially and quantifiably below those expected for the individual’s chronological age, and cause significant interference with academic or occupational performance, or activities of daily living, as confirmed by standardised assessment.
C. Learning difficulties begin during the school years but may not become fully manifest until the demands for those affected skills exceed the individuals limited capacities.
D. Difficulties are not better accounted for by intellectual disabilities, uncorrected visual or auditory activity, psychosocial adversity, lack of proficiency in the language of academic instruction or inadequate educational instruction.

Question 18

Key components of SLD assessment

Answer 18

• History (developmental, medical, family, educational)
• Teacher interview
• School reports
• Standardised psycho-educational assessment

Question 19

Standardised testing is essential in SLD

Answer 19

Standardised testing for SLD should include:
- Intelligence testing with the WISC-V or equivalent
o Understand the child’s information procession (attention, working memory, and memory skills) to guide recommendation
o Established intellectual strengths and weaknesses
- Achievement testing with the Wechsler Individual Achievement Test – 3rd Edition (WIAT-III).

Major concept in assessment of a learning disorder: a child of average intelligence may fail in school because of a specific deficit or disability that prevents learning.

Question 20

Wechsler Individual Achievement Test (WIAT-III) (A & NZ)

Answer 20

• Covers wide age-range: 4:00 – 50:11 years.
• Assesses a wide range of basic academic skills:
  o Oral language, reading, written expressions, and mathematics
• Standardisation sample included over 2500 students in the 4–19-year age brand.
• Excellent psychometric properties:
  o For composites, split-half reliability ranges from 0.91 to 0.98.
  o Re-test reliabilities range from .87 and .96 for composites.

Question 21

Measures of behaviour and emotion

Answer 21

• School problems may be a result of any one or a combination of many factors
• Characterising a child’s emotional functioning is critical component of anu psycho-educational assessment.
• High levels of emotional distress (e.g. low mood, social anxiety, PTSD) can impair a child’s capacity to learn and achieve their potential
• Emotional functioning can be assessed using standardised rating scales completed by someone who observes the behaviour and knows the child well (e.g. child, parent or teacher perspective.

Question 22

Achenbach Child Behaviour Check Lists (CBCL)

Answer 22

• Published to cover children and adolescents from 1 to 18 years.
• Assists to establish frequency of symptoms across a range of domains: depression, withdrawal, anxiety, hyperactivity and aggression.
• T-Score transformation is used to express T scores: M = 50; SD = 10 (US normed data)
• Scores above 60 are within Elevated/Borderline range and above 70 within Clinical range.

Question 23

Conner Rating Scales – Third Edition

Answer 23

• Covers children aged 2-18 years.
• Involves parent and teacher ratings of behavioural, emotional, social and academic functioning.
• Scales useful for evaluating the frequency of behaviours that might have clinical significance in diagnostic evaluation.
• For, example the scales can be used to document the presence of symptoms that might be consistent with a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD); includes Inattention and Hyperactivity Scales.