Future Reflections  Fall 2006

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Child Development and Assessment

by Alan Garrels

Reprinted from volume 2, number 1, of About Blind Children (ABC), a publication of the Washington State Department of Services for the Blind.

Editorís Note: The following article is one of two in this issue that are not blindness specific. This one, however, was written by a professional who has worked in services for blind children for many years. Alan Garrels is the program manager of Child and Family Services for the Department of Services for the Blind, Washington State. He wrote this piece because he wanted to help the parents he worked with to become better observers and supporters of their own childrenís development. He also wanted to introduce parents to the jargon and common assessment tools used by therapists and educators. Knowledge, so it is said, is power. As you read you will notice that in the two examples of how children develop, there is a strong emphasis on the importance of multi-sensory input in the learning process. Too often parents of blind children are bombarded with messages that tell them how key the visual sense is to learning and how hard it is going to be for their child to compensate for that missing sense. The straightforward facts presented in this short piece demonstrate how all systems work together to advance development. Here is what Garrels has to say:

ďWe judge our children by what we feel they are capable of doing, while others judge them by what they have done.Ē
--Longfellow

Child Development and Assessment
There are various theories on the subject of child development. It is not our intention to explore the particularities of individual theories but to discuss general themes and aspects of child development.

One of the more universally accepted theories is that child development is sequential in nature; that there is often a hierarchy of skills from which milestones can be determined, regardless of the skills that are being assessed.

For purposes of illustration let us review the development sequence most children experience when acquiring the ability to walk independently. A baby, resting on its back, will be observed to attempt trunk rotation and to lift his shoulders and hips up from his mattress.

From this position a baby can roll over to a prone or tummy position. This is an important milestone for once a child can position himself in a prone position several things are likely to occur. As a child lifts his head he strengthens his neck and shoulder muscles. He also begins to develop a sense of his environment using visual, auditory, and vestibular input. The next milestone occurs when the baby begins to roll and attempts forward locomotion. Working to keep babies resting in prone position will assist in development for they will begin to use their arms and legs for forward motion and pulling up to a crawling position. It is important to reinforce this milestone because through crawling a baby is acquiring several skills that will further assist his gross motor development. While crawling a child begins to practice reciprocal motion. This motor milestone is important to a childís quality of movement, gait pattern, and his ability to remain oriented to his environment. Secondly, in crawling a baby will begin reinforcing his sense of balance. As a baby crawls and learns more of his environment he is also working towards his next milestone, pulling himself up to a standing position. In a normal sequence it will be necessary for the large muscle groups to have the requisite strength to keep a child erect and balanced. While these muscles do not normally mature until a child is somewhere in the area of 6 to 12 months of age, look back on all of the important perceptual and motor skills that have been exercised before these large muscles are strong enough to help a baby stand. It is now that a child will take the next step on the developmental chart. When ready to begin walking a child will utilize all the skills they have mastered: motor development, sensory input, balance, and strength.

On a developmental continuum there can be many stops along the way and children will often plateau or remain at one level for a sustained period of time. This is often the situation with sensory and physically impaired children for they need to allow all the various component skills to catch up with another, or to compensate for one another, before they proceed.

To further illustrate the concept of sequential development, let us review visual perception and learning. Again, from a sequential perspective, a baby will understandably be reflexive in nature, but it is important to observe. The next developmental milestone usually is for a baby to begin attending to a light source or an object that contrasts with the background against which the object is perceived. The ability to attend to an object is often referred to as fixation and it is at this milestone that we observe a baby attempting to use her eyes together or in focus. This aspect of visual learning is perceptual and related to cognitive development. It is strengthening the eye muscles and training them to work in synchronization. Typically a baby will begin to localize objects in her near environment and after finding an object she will then fixate on it. With multi sensory input a baby will begin, to some extent, to show an ability to discriminate. The sound of her motherís voice paired with a touch will prompt a baby to look toward or fixate on her motherís face and she will begin to associate her motherís face, smell, voice, and touch.

After a baby begins to find and fixate on objects, the next developmental milestone is for her to track an object as it moves through her visual field. Once again, we are observing several systems working together: muscle development, visual perception, and cognitive development. As a baby is able to track an object, the next sequential phase is to involve other systems and it is then that we observe a child reaching out to the object and visually attending to their hands as they come into contact with the object.

Sequential visual development therefore calls for the development of that portion of the brain that perceives light and images, development of the muscles controlling eye movement, and control of the muscle groups which will enable a child to integrate what she perceives to what she can touch, feel, and relate to through a multitude of senses.

With respect to assessing what exactly a child is capable of seeing it is first necessary to observe the developmental milestones of visual perception and learning.

At this point in our discussion please notice that we have refrained from assigning an age to our phases or milestones. The purpose of this discussion has not been to look at child development in terms of chronology but rather to view achievement in terms of what sequential development is and how it is important to the quality of basic sensory and motor growth.

As parents you will most certainly be given reports and evaluations that place your childís ability to perform certain functions on a developmental chart or profile. At the same time you are cautioned by professionals not to compare your childís abilities to that of another child. There is a very real difference between comparing individuals to one another and attempting to place a childís abilities on a continuum of development. What a therapist or educator is trying to accomplish when assessing a child is to establish what the child has done and to assign those achievements to a spot on a developmental continuum. These profiles give the therapist/educator an opportunity to objectively view the skills in the context of normal sequential development and to work on the skills that will guide a child to the next developmental milestone.

Parents are often introduced to different checklists and assessment tools used by therapists and educators. CLOSER LOOK, available from Washington PAVE, prepared the following glossary:

Achievement test--Tests that measure the extent to which a person has acquired certain information or learned how to do something--usually because it has been taught.

Assessment--The gathering of information about strengths and weaknesses in a childís abilities, levels of functioning, and learning characteristics.

Behavioral objective--Statement, in measurable terms, of what a person will be able to do. Example: John will be able to correctly write the first ten spelling words in five minutes.

Chronological age--A personís actual age by the calendar, usually given by year and month.

Cognitive--Thinking, understanding, and being able to use judgment and memorization.

Correlation--Relationship between two scores or measures. Example: students who score well on language aptitude tests may also show aptitude for development of good reading skills (but not necessarily).

Criterion referenced tests--Tests, which do not produce a number or quotient, but show what a student can or cannot do. They compare a child not to other children, but to a set of standards or criteria. Tests to measure a childís own progress within himself/herself.

Development--Stages of growth from babyhood on up, observing in sequential steps. The approximate ages of which steps in development occur are charted in developmental scales. Generally, development is measured in the following areas: fine motor, gross motor, cognitive, self-help, social emotional, and expressive and receptive language.

Developmental lag or delay--A delay in the appearance of some steps or phases of growth in any of the developmental areas.

Diagnostic test--Test that diagnoses or locates specific areas of weakness and strength.

Grade equivalent--The average raw score for all children in the same school grade. That is, if the average raw score of all third graders was ten correct answers on the arithmetic test, then this raw score is converted into a grade equivalent score of 3.0 (meaning grade three, zero month). Most testers caution against putting stock in grade-equivalent scores when they are higher or lower than average. They provide a very rough estimate of a childís mastery of academic work or capacity to learn.

IQ Intelligence Quotient--A way of expressing the results of a score on an intelligence test. IQ scores, generally speaking, compare a person tested with a large number of other persons of the same age. Children with disabilities and children who donít understand questions based on cultural experience are at a disadvantage. Scores are no longer regarded as reliable for large sections of the population. IQ must never be used by itself as a measure of intellectual capacity.

Mental age--Refers to the score a person receives on an intelligence test. Compares scores to the results achieved by other children given the same test at the same age.

Norm--Statistical term describes the performance of some specific group. Norms indicate normal, usual, or average performance.

Norm-referenced test--Test that compares a learnerís performance to a norm or an average.

Objective test--Tests in which a single answer key is used. Scorers have no option as to rightness or wrongness of answer. Examples are multiple choice or true/false tests.

Percentile--A score that reflects a comparison of one childís performance with others who are taking the same test. Percentile rank refers to a point in a distribution of scores. Example: if a child scores in the eightieth percentile, it means that eighty percent of all children taking that test scored below that level.

Profile--A graphic representation of the results of several comparable tests. A profile is useful in identifying general areas of strength and those needing reinforcement.

Psychological test--Covers a range of tests used for studying people and how they behave. May be intelligence tests to study personality, or other tests to decide if there may be an organic impairment of functioning.

Readiness test--Test that ascertains whether a learner is ready for certain school tasks.

Standardized test--A test given to a group of students under uniform conditions, with the same instructions, time limits, etc. Tests are designed by sampling performance of other students, using results as a norm for judging achievement.

Subjective test--Tests in which different scorers may rate the answers differently. No set answer key. Example: essay test.

Infants and pre-schoolers are often assessed using informal skill inventories.

Two commonly used tools are the Hawaii Early Learning Profile (HELP) and the Oregon Project (OR).

The HELP consists of 685 developmental skills for children between 0-36 months. Formatted on a checklist it is a non-standardized test used to facilitate individual assessment, program planning, and recording of children's progress within the developmental areas of cognition, language, gross and fine motor, social-emotional, and self-help.

The OR consists of 640 behavioral statements organized in eight developmental areas: cognitive, language, socialization, vision, compensatory, self-help, fine motor, and gross motor. The Oregon Project is designed to provide assessment and curriculum guidance to educators and parents of young blind children from infancy to 6 years of age. A criterion-referenced assessment, the OR is not designed to provide precise scores. The Oregon Project includes curriculum guides and suggested teaching activities.

Commonly Used Tests

AAMD Adaptive Behavior Scale--Used with children 3 and up. This test uses a normed questionnaire that helps to determine the childís strengths and weaknesses in self-help and social skills. It is scored in percentile ranks and standard deviations.

Alpern Boll Developmental Profile--Children 6 months to 11 years. It is an interview measure although it is generally used as a direct test. Age scores are developed for each area in the test and an estimated overall IQ equivalent. Five areas are tested: gross/fine motor, self-help, social, cognitive, and language.

Baley Scale of Infant Development--Usually used with children 2 to 30 months in age. Has been used with children over 30 months with suspected delays to determine a possible age equivalent. It is divided into three scales and tests cognitive and gross motor skills.

Bender Gestalt Test for Young Children--Used with children 5 to 11 years. It tests perceptual motor functions of the child. Scores are given by age norms. It is used solely for sensory testing.

Columbia Mental Maturity Scale--Used mainly with hearing impaired children, non-verbal children, and children from different language and cultural backgrounds, ages 3.5 to 9 years. It tests non-verbal cognitive reasoning and ability. It gives an age deviation score and an estimate of the age level the childís performance is nearest.

Developmental Indicators for the Assessment of Learning (DIAL)--Tests children from 2.5 to 5.5 years. Used basically as a preschool screening tool. It is used in various school districts throughout Washington State. It has a tendency to test a false high. It generates scores in four areas that can be computed to age equivalents. It tests in gross motor, fine motor, concepts, and communication.

Peabody Developmental Scales--Children birth to 7 years. This is one of the more comprehensive tests. It is scored on scales to give age equivalents. It tests fine and gross motor skills.

Peabody Individual Achievement Test (PIAT)--Used with children kindergarten through twelfth grades. This is an individually administered test. It is broken down into five basic subtests. It provides scores in grade equivalent, percents, and a standard score. It tests the areas of math, reading, spelling, and general knowledge.

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