Early Childhood Assessment PDF

Early Childhood Assessment ♦ Carol S. Lidz John Wiley & Sons, Inc. Copyright © 2003 by John Wiley & Sons, Inc., Hoboken, New Jersey. All rights reserved. Published simultaneously in Canada. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 750-4470, or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008, e-mail: [email protected]. 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Some content that appears in print may not be available in electronic books. Library of Congress Cataloging-in-Publication Data: Lidz, Carol Schneider. Early childhood assessment / Carol S. Lidz. p. cm Includes bibliographical references and index. ISBN 0-471-41984-2 (alk. paper) 1. Behavioral assessment of children. 2. Psychological tests for children. 3. Observation (Psychology)— Methodology. I. Title. BF722.3.L53 2002 155.42′3′0287—dc21 2002028827 Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 This book is dedicated to the individuals who have played a direct role in providing me with the opportunities to work with preschool children and to gain whatever level of expertise I can now claim that gave me the courage (OK, chutzpah) to write this book. ♦ Acknowledgments After many years of working in school systems with school-age children, my ﬁrst opportunity to work intensively with preschool children was at Moss Rehabilitation Hospital, when the psy- chology department was under the direction of Phillip Spergel. Phil assigned me to the pedi- atric unit, where I had the good fortune to work with the large number of children brought to Moss through a contract with the Get Set day care program of the Philadelphia Board of Ed- ucation. It was through this work that I discovered I really enjoyed working with this age group and that I also discovered the limited information that was available at the time. Thanks, Phil. For the following ﬁve years, I worked at Hall-Mercer Community Mental Health/Mental Retardation Center of Pennsylvania Hospital, where I was assigned to consult with the thera- peutic nursery program. This was under the clinical directorship of Carl Gasta, who, sadly, died a number of years ago. I was next hired by Bill Dibble, the associate director of United Cerebral Palsy Association of Philadelphia and Vicinity to create and direct the (then) Head Start Clinic Team. For over eight years I was the administrator and senior psychologist for this team, which provided a model for services to children with special needs throughout the Philadelphia area. This was also my ﬁrst opportunity to carry out research as an applied psychologist. Thanks, Bill. Following my work with the Clinic Team (though continuing there on a part-time basis— not being able to let the baby go!), I was introduced to academia by Sylvia Rosenﬁeld, who in- vited me to be the coordinator of her grant for an early childhood specialization with Temple University’s School Psychology Program. This was my ﬁrst opportunity to teach the preschool assessment course, where I consistently overwhelmed students with the large number of hand- outs because there was no satisfactory text at that time. Thanks, Sylvia (and my apologies to my students; you can buy this book now!). My ﬁnal thanks go to H. Carl Haywood, who by inviting me to design and direct the School Psychology Program within the newly created Graduate School of Education and Psychology at Touro College, provided me with continued opportunities to teach and develop the pre- school assessment course, as well as to conduct research related to my work with dynamic as- sessment and parent-child interactions with young children. (The students there also com- plained about the workload. My apologies also to you. This is one response to the yet unasked question of what the Temple and Touro programs have in common. You, too, may buy this book!) Thanks (again), Carl. Of course I must express gratitude to the wonderful children and families, as well as the teachers and supervisors, with whom I have had the privilege of working over these many years. My special thanks to the darling children of the Head Start programs throughout Philadel- phia. We will never really know how we touched each other’s lives. vii ♦ Preface This is a book for practitioners by a practitioner. This is a book for academics by an academic. No, I am not having an identity crisis. I stand with my feet ﬁrmly planted in both worlds. Pri- marily, this is a book I need for teaching my graduate students in school psychology, and it is the book I wish I had had when I began my work as a school psychologist. There are other books that tackle the topic of assessment of preschool children, but while I have used them as references and greatly value their content, I never selected any of them as a text for my course in early childhood assessment. The books that are available focus on speciﬁc tests, are organized according to disability, or commit to one speciﬁc model. To my amaze- ment, some of these omit in-depth discussions of play, parent-child interaction, and dynamic assessment. Because most of them are edited volumes, there is inevitable redundancy across chapters. The greatest limitation is that it is difﬁcult for practitioners to walk away from these books feeling as if they were put on the road to application of the content. Although any book is limited in its ability to prepare practitioners for practice, there remains a gap in the avail- ability of a book that focuses primarily on such applications. The purpose of this book is to provide general guidelines for designing and conducting as- sessments of young children between the ages of 3 through 5 years: the preschool years. Al- though details are provided regarding some informal procedures (e.g., interviews, observa- tions), speciﬁc standardized procedures are mentioned only brieﬂy, with more space dedicated to issues regarding their administration and application. Similarly, this book does not cover speciﬁc disorders. However, to say that this book offers general guidelines is not to imply that it avoids speciﬁcs. Some areas neglected by other books are described in detail, such as parent- child interaction and dynamic assessment, and other areas, such as interviews and observa- tions, are detailed with forms and formats unique to this text. Another important aspect of this book is that it offers an integrated discussion and format for assessment of young children. Each chapter offers discussion of a specialized topic, but always with awareness of content in other chapters, and always with a sense of moving toward an integrated application of proce- dures to the whole child. This book is appropriate as a graduate school text in school or clinical psychology and for practitioners who either have never received formal training in the assessment of young chil- dren or wish to review and update their thinking and practices in this area. To facilitate the use of this book with graduate students, suggested activities are listed at the end of each chapter under the headings of scholarship and application. Course instructors can use these sugges- tions as they wish, for example, by asking students to select one or more scholarship and ap- plication activity from among the chapters to fulﬁll course requirements. This book also expresses an attitude and a commitment to the idea that best assessment practices should reﬂect what is good for families and for children and not just what is fast and cheap to implement. Of course, there are economic realities that must be faced, but we have an ethical obligation to resist and to protest against practices that threaten to cheat our clients of effective and meaningful services and interventions. This book walks the reader through a comprehensive assessment, touching each of the ma- jor data sources necessary for a full understanding of children and their environments. It is ix x PREFACE organized primarily in terms of these data sources, rather than in terms of diagnostic category, functional domain, or speciﬁc procedure. Assessment is a complex process, and any procedure generates information that crosses domains. There is no such thing as a purely cognitive or purely social-emotional measure. Although it may be helpful to divide the discussion into func- tional domains when assembling a ﬁnal report, during the course of the assessment the psy- chologist must ﬁrst parse out the information from each procedure to decide what that proce- dure is measuring at that time for that child, and ask the question: What did I learn about this child from what I just did? Only in this way can we put Humpty-Dumpty back together again and give meaning to our statements about the whole child. Assessment is a journey. We begin with an idea of where we want to go and carry a map to guide the way, but we can never predict what we meet along the way or exactly how that will af- fect the point at which we arrive. This text attempts to provide a map that reﬂects the richness and complexity of children’s development and the lives they live within their communities and families. The journey never fails to be interesting and challenging for those whose eyes and minds are open. Welcome to the world of early childhood assessment. ♦ Contents Supplementary Materials xv Chapter 1 In the Beginning... 1 Interviewing 4 Developmental History 11 Screening 12 Risk and Resilience 23 Assessment 26 Summary 33 Suggested Activities 34 Chapter 2 Observing Children, Programs, and Teachers 35 Issues of Observation 36 Observing Children 38 Observing Programs 44 Observing Teachers 45 Limitations 50 Summary 53 Suggested Activities 53 Chapter 3 Families, Homes, and Cultural Contexts 54 The Family as a System 54 Parenting a Child with Special Needs 56 Cultural Issues 58 Conducting a Family Interview 59 Caregiver-Child Interactions 61 Some Concluding Thoughts 79 Summary 79 Suggested Activities 79 Chapter 4 Assessment of Play 80 Relevance of Play 80 Historical Perspective 81 Characteristics of Play 82 Exploration versus Play 83 Developmental Aspects of Play 84 Children with Disabilities 86 Assessment of Play 87 xi xii CONTENTS Suggested Guidelines for Observing Play 88 General Assessment Considerations 93 Summary 94 Suggested Activities 94 Chapter 5 Development-, Curriculum-, and Performance-Based Assessment 95 Standards 99 Speciﬁc Procedures 100 Le Plus Ça Change... 110 Summary 110 Suggested Activities 111 Chapter 6 Dynamic Assessment 112 Deﬁnition and Characteristics 113 Historical-Theoretical Roots 114 Prevailing Models 114 A Generic Approach to Curriculum-Based Dynamic Assessment 117 The Application of Cognitive Functions Scale 129 Some Editorial Remarks 130 Summary 131 Suggested Activities 132 Chapter 7 Standardized Testing 133 Examples of Standardized Tests for Young Children 136 Standardized Testing and Issues of Cultural and Linguistic Diversity 151 Concluding Comments 153 Summary 154 Suggested Activities 154 Chapter 8 Social-Emotional Functioning 155 Social-Emotional Development 156 Temperament 167 Adaptive Behavior and Coping 172 Peer Relations 178 Functional Behavior Assessment 187 Summary 190 Suggested Activities 191 Chapter 9 The Neuropsychological Functioning of Young Children 192 The “Neuro” in Neuropsychological Assessment 193 The Mental Status Exam 194 Neuropsychological Assessment of Young Children 195 Luria’s Contributions 198 CONTENTS xiii Five Important Points 199 Electrophysiological Procedures 202 Implications for Assessment 203 Summary 203 Suggested Activities 204 Chapter 10 Assembling, Reporting, and Evaluating the Pieces 205 Writing Reports 205 Linking Assessment with Intervention 227 Communicating with Teachers and Parents 232 Evaluating the Effectiveness of Interventions 236 Final Thoughts 240 Summary 240 Suggested Activities 240 Appendix A National Association of School Psychologists Position Statement on Early Childhood Assessment 241 Appendix B New York Association of School Psychologists (NYASP) Guidelines for Preschool Psychological Assessment in New York State 245 Appendix C Division for Early Childhood of the Council for Exceptional Children Position Paper on Developmental Delay as an Eligibility Category 252 Appendix D National Association for the Education of Young Children Position Paper: Responding to Linguistic and Cultural Diversity: Recommendations for Effective Early Childhood Education 254 References 267 Author Index 295 Subject Index 305 About the Author 313 ♦ Supplementary Materials Tests Reviewed Test Review 1.1 Ages and Stages Questionnaires (ASQ): A Parent-Completed Child-Monitoring System–Second Edition (1999) 16 Test Review 1.2 Denver Developmental Screening Test–II (1990) 17 Test Review 1.3 Developmental Indicators for the Assessment of Learning–Third Edition (DIAL-3) (1998) 18 Test Review 1.4 Early Screening Inventory–Revised (1997) 19 Test Review 1.5 AGS Early Screening Proﬁles (ESP) (1990) 20 Test Review 1.6 FirstSTEP: Screening Test for Evaluating Preschoolers (1993) 21 Test Review 5.1 AEPS Measurement for Three to Six Years 103 Test Review 5.2 Boehm-3 Preschool/Boehm Test of Basic Concepts–Third Edition (2001) 104 Test Review 5.3 Bracken Basic Concept Scale–Revised (1998) 105 Test Review 5.4 Learning Accomplishment Proﬁle—Diagnostic Standardized Assessment (LAP-D) (1992) 107 Test Review 5.5 Developmental Tasks for Kindergarten Readiness-II (DTKR II) (1994) 108 Test Review 7.1 Bayley Scales of Infant Development: Second Edition (1993) 137 Test Review 7.2 Cognitive Abilities Scale: Second Edition (CAS-2) (2001) 138 Test Review 7.3 Differential Ability Scales (DAS) (1990) 139 Test Review 7.4 Kaufman Assessment Battery for Children (K-ABC) (1983) 141 Test Review 7.5 Leiter International Performance Scale–Revised (1997) 142 Test Review 7.6 McCarthy Scales of Children’s Abilities (1972) 145 Test Review 7.7 Mullen Scales of Early Learning: AGS Edition (1995) 146 Test Review 7.8 Stanford-Binet Intelligence Scales–Fifth Edition (2003) 148 Test Review 7.9 Wechsler Preschool and Primary Scale of Intelligence (2003) 149 Test Review 7.10 Woodcock-Johnson, Third Edition (WJ-III) (2150) 150 Test Review 8.1 Devereux Early Childhood Assessment (DECA) (1999) 161 Test Review 8.2 Ages and Stages Questionnaires: Social Emotional (ASQ:SE) (2002) 162 Test Review 8.3 Behavior Assessment System for Children (BASC) (1998) 164 Test Review 8.4 The Childhood Autism Rating Scale (CARS) (1986) 165 Test Review 8.5 Conners’ Rating Scales (1990) 166 Test Review 8.6 The Temperament Assessment Battery for Children (TABC) (1988) 170 Test Review 8.7 The Temperament and Atypical Behavior Scale: Early Childhood Indicators of Developmental Dysfunction (TABS) (1999) 171 Test Review 8.8 Scales of Independent Behavior–Revised (SIB-R) (1990) 175 Test Review 8.9 Vineland Adaptive Behavior Scales (VABS) (1984); Vineland Adaptive Behavior Scales, Classroom Edition (1985) 176 xv xvi SUPPLEMENTARY MATERIALS Test Review 8.10 Coping Inventory: A Measure of Adaptive Behavior (1985) 177 Test Review 8.11 Preschool and Kindergarten Behavior Scales (PKBS) (1994) 182 Test Review 8.12 Social Competence and Behavior Evaluation: Preschool Edition (SCBE) (1995) 183 Test Review 8.13 Social Skills Rating System (SSRS) (1990) 184 Forms Form 1.1 Intake Interview 5 Form 1.2 Referral for Services 28 Form 1.3 Referral Proﬁle 30 Form 2.1 Preobservation Teacher-Parent Questionnaire 40 Form 2.2 Observation Recording Sheet 41 Form 2.3 Guidelines for Observing Teaching Interactions 46 Form 3.1 Mediated Learning Experience Rating Scale 63 Form 3.2 Mediated Learning Experience Rating Scale–Parent (Self-Rating) Edition 69 Form 4.1 Object Play Observation Guide 90 Form 6.1 Instruction-Related Process Analysis 119 Form 6.2 Planning for Dynamic Assessment Mediation 122 Form 6.3 Response to Mediation Scale 124 Form 8.1 Behavior Observation Rating Scale 158 Form 8.2 Guidelines for Describing the Complex Peer Play of Preschool Children 181 Form 9.1 Guidelines for Neuropsychological Referral 196 Form 10.1 Suggested Format for Psychoeducational Assessments Reports 207 Form 10.2 Service Satisfaction Form 234 Tables Table 1.1 Assessment Sequence 27 Table 2.1 Elaborations and Examples of Components of Mediated Learning Experiences 51 Table 4.1 Developmental Progression of Play Behaviors 85 Table 10.1 Guildelines for Pain Reduction in Report Writing and for Generating Meaningful Reports 228 Table 10.2 Sample Goal Attainment Scale 238 Table 10.3 Goal Attainment Scale: Career Evaluation 239 SUPPLEMENTARY MATERIALS xvii Figures Figure 3.1 Eco Map 55 Figure 6.1 Flowchart for Curriculum-Based Dynamic Assessment 117 Reports Report 10.1 (Max) 209 Report 10.2 (Carl) 213 Report 10.3 (Peter) 217 Report 10.4 (Richard) 221 Early Childhood Assessment ♦ Chapter One ♦ In the Beginning... ♦ Prior to the 1960s, few psychologists conducted assessments of preschool children. Before this time, early childhood assessment was largely an activity for researchers and, particularly, for those engaged in longitudinal studies. With the 1960s the government established federally funded compensatory education programs such as Head Start and acknowledged the need to determine their effectiveness (Kelly & Surbeck, 2000). Programs for young children with and without special needs now abound, and psychologists are expected to be skilled in their as- sessment. It is increasingly clear that special skills and a knowledge base are necessary for the proper assessment of young children and that psychologists are not adequately prepared by merely including tests for young children within the general cognitive education course or through continuing education courses. This text provides guidelines for the challenging and in- teresting journey into early childhood assessment. A good journey begins with an itinerary, and a good itinerary balances careful preplanning with opportunities for exploration and spontaneous adventure. This is the goal of this intro- ductory chapter and, ultimately, the book. In this chapter I discuss issues and practices related to setting up an assessment. The emphasis is on assessment of individual children of preschool age (between the ages of 3 and 5 years) for diagnostic exploration of referral concerns, usually initiated by parents, teachers or program personnel, or physicians. These concerns most fre- quently involve language development or other developmental delays, as well as speciﬁc con- ditions or syndromes that may have consequences for development of learning and social competence. The early stages of the assessment process are arguably the most important; to a signiﬁcant extent, what is revealed at the beginning inﬂuences what follows, and what follows should ﬂow in an integrated way from the purposes of the assessment. Therefore, it is important for asses- sors to think about and plan for what needs to happen at the beginning so that what follows can develop logically from this foundation and so that a meaningful relationship among assess- ment, intervention, and follow-up can result. However, we must ﬁrst have an idea of what is meant by the term assessment, primarily to distinguish it from any specific activity such as testing (Bagnato, Neisworth, & Munson, 1 2 EARLY CHILDHOOD ASSESSMENT 1997). Assessment is a broad, comprehensive process, not any speciﬁc activity or technique (Batsche & Knoff, 1995; Danielson, Lynch, Moyano, Johnson, & Bettenburg, 1989; Lidz, 1981; McConnell, 2000). Primarily, assessment is a mental activity of the assessor, and the assessment tasks are chosen to facilitate this process; it does not take place on a sheet of paper, but within the brain of the individual who integrates and interprets the information. I deﬁne assessment as the process of data gathering that informs decision making. If this is the case, then the ﬁrst step of assessment is to be explicit regarding the nature of the decisions to be made, followed by determining the most likely sources of data that will inform these decisions. Such an ap- proach to assessment requires ﬂexibility, which is now increasingly advocated by lawmakers (Lidz, Eisenstat, Evangelista, Rubinson, Stokes, Thies, & Trachtman, 2000). Flexibility in as- sessment involves tailoring the procedures to ﬁt the referral questions and issues rather than re- ﬂexively administering the same battery of tests to all children. Contrary to some practices, ﬂexible assessment does not mean doing less; it may even mean doing more. It certainly means doing assessment differently—different from the past and from still existing practices, and dif- ferent for each child. If we expect teachers to individualize their classroom practices to meet the needs of their pupils, then assessors should be capable of this as well. The three major purposes of assessment are entitlement-classiﬁcation (also referred to as el- igibility for special education services), planning of interventions, and evaluation of outcomes (Rosenﬁeld & Nelson, 1995). Alternatively, the kinds of decisions to be made concern diagno- sis, description of current states, and generation of prescriptive interventions (Simeonsson & Bailey, 1988), as well as evaluation. This book focuses on procedures and methods for conducting an assessment with any preschool-age child, rather than on speciﬁc kinds of disorders. Disorders and disabilities are well reviewed in other texts, but other texts generally fail to provide in-depth coverage of the wide array of assessment approaches now available for application to young children, with the intent of facilitating the utilization of these procedures. There was a time when taking a course on preschool assessment meant learning the Bayley, the Wechsler scales, and the Stanford- Binet. In my many years of teaching a course on preschool assessment, such standardized in- struments were delegated about 3 to 4 of the total 15 weeks available, with the other weeks pro- viding hardly sufﬁcient time to squeeze in the many other viable and frequently more useful sources of data for this population. Thus, our journey is not limited to a review of tests, and is certainly not restricted to standardized tests; these are discussed when appropriate to the con- text. Our journey is through the many choices of approaches to data gathering available to the thinking assessor. The assessor who uses these approaches will never be functioning on auto- matic. This assessor will not become bored or burnt out. This assessor will don the cap of Sherlock Holmes and become a detective, generating hypotheses, searching for the pieces to construct a situation and solve a problem, and, most of all, ﬁnding ways to improve the com- petence of the children referred for services and their families who provide contexts for their development. The general model of assessment advocated in this text is best conceptualized as ecological or context-based (Bronfenbrenner, 1979; Paget & Nagle, 1986; Tharinger & Lambert, 1989). Our referrals may be child driven, but our assessments must be ecologically valid and look at the child in the contexts of home, community, and program. Using this model, we will never as- sume that a problem exists solely within the referred child, although the child’s predispositions and “hardware” may indeed be a signiﬁcant issue. We will always consider history, meaning, and opportunity in any approach to problem solving. We will work with families and other re- IN THE BEGINNING... 3 ferral sources as collaborative consultants, and we will invite and expect them to become part of the problem-solving process. We will not blame parents or teachers, but we will certainly consider their roles in the referral issues and work with them to ameliorate any problems that become apparent. We will not describe children solely in terms of deﬁcits but will consider their many positive characteristics and current methods of coping. We will write reports that link as- sessment with intervention and that describe children in a way that is recognizable and helpful to their caregivers. All of these resolutions are complex and challenging and require prepara- tion, supervision, and application. Good practitioners need good models and mentors, not just words in a book. This book offers as much as is possible on the printed page. Recommended activities appear at the end of each chapter, and a myriad of forms and formats for each as- sessment approach are illustrated throughout the book. Each chapter also features recom- mendations for additional readings. The rest is in the hands of the reader, who should take ad- vantage of the opportunities for additional study and practice that become available. Some of these are found, and some of these made. Readers must be active learners. One word that will guide our assessment is multiple (Barnett, Bell, Gilkey, et al., 1999; Lidz, 1986, 1990; Meisels & Provence, 1989; Wachs & Sheehan, 1988a). Particularly with young children, but with other clients as well, we will need multiple samples of data from multiple sources in multiple contexts. We need to observe in multiple settings and work with the child on multiple occasions using multiple measures that sample multiple domains (Bagnato et al., 1997). Will this take time? Yes. Good work takes time, and young children cannot be rushed. We can increase our efficiency with the use of interviews and well-selected rating scales and of procedures that address the referral issues, but good, comprehensive assessment will prob- ably require several hours over a number of days (some estimates average about 7 to 10; my team averaged at least that, with a range of 5 to 15). Fischetti (2000) surveyed psychologists in suburban Connecticut school districts and found that their assessments required a mean of 16.81 hrs per pupil for those determined to be eligible for special services, with a mean of 13.95 for those not eligible. In this study students with social-emotional issues required the most time. Fischetti also cited a study of psychologists in San Diego that reported an average of 8.4 hrs per assessment. Without adequate allotment of time, our role becomes reduced to that of screeners, and one of the messages of this chapter is that the activity that should fol- low screening is comprehensive assessment, not placement or programming. Fund providers who challenge these assertions need to be asked what they would want for their own chil- dren—would any less be acceptable? Good diagnostic assessment followed by good pro- gramming, guided by good assessment, should in the long run represent good economics and good ethics. Practitioners who are forced to provide services under considerably less than optimal cir- cumstances have the options of trying to work with their colleagues to pressure the system to become more aware of the existing service delivery problems, to join organizations that advo- cate for improved practice conditions, and to try to ﬁnd opportunities to improve practices within existing conditions. Although we need to acknowledge the fact that poor conditions for practice indeed exist, we must be aware of what good practice can be and try to advocate for these more ideal circumstances. Without this, there is no hope for improvement. Assessment of young children who are found to have special needs should never be a one- time event. Children who are eligible for services based on the assessment need to be monitored and reevaluated to follow their progress and to determine their ongoing needs. Certainly, any child who is found to be at risk, even if not actually eligible, should be reevaluated regularly. 4 EARLY CHILDHOOD ASSESSMENT Many children do not show their full array of needs until they become older and exposed to the challenges of school and social expectations in other settings. INTERVIEWING There are at least ﬁve purposes for interviews with caregivers, some of which occur prior to di- rect contact with the child and some afterward (Meisels & Provence, 1989). These include de- veloping rapport, which also involves beginning to establish a collaborative relationship, with the assessor primarily in a consultative role while providing expertise as appropriate. There is also the need to exchange information. Caregivers are the primary sources of historical infor- mation, and the assessor needs to offer information to prepare them regarding what to expect from the assessment and what the mutual roles will be. Following data collection, the assessor will meet with the caregivers to provide feedback and to begin the planning that will ultimately involve the full team. Being a good interviewer requires good clinical skill that is part common sense and part pro- fessional training and experience. Interviewers need to be sensitive to the underlying messages and concerns of their clients and would do well to function according to the golden rule of try- ing to walk in the other person’s moccasins. Some aspects of interviewing that are the most dif- ﬁcult to master are how to ask questions in an open-ended and nonleading way, how to express empathy and understanding while maintaining professional objectivity, how to keep focused on the purposes of the interaction, and how to avoid getting sucked into providing speciﬁc ad- vice when this is not appropriate. The new interviewer needs to make the important transition from interacting as a concerned friend to acting as a trained professional. Often it is necessary to suspend one’s value and belief systems in order to be helpful to clients, who need to be helped within their own values and beliefs unless these clearly conﬂict with reality and the prospects for helping the child. Active listening, with attention paid to clarifying communication and promoting the client’s ability to problem solve and cope, is a foundation skill. Clients need to leave the interaction feeling that they have been heard and understood and that they have a clear idea of the events and issues that will follow. They should not feel judged and evaluated or pressured. Sattler (2002) provided a helpful outline for the parent interview: Greet parents. Give your name and professional title. Make an introductory statement and invite the parents to give their reasons for coming. Review background questions (see questionnaire provided in Form 1.1). Describe assessment procedure (and expectations regarding parents’ roles). Arrange for future contacts and feedback. Summarize and close the interview. Form 1.1 provides a format for the initial interview to help assessors gather the necessary background information to allow them to make decisions about how to proceed with the as- sessment. Despite the structure of the interview, it must be communicated within a clinical style and not administered rigidly as if read directly from the page. Responses from the assessor should open communication, not close it down. However, assessors do need to record the re- sponses while at the same time maintain focus on the speaker. Recording should be carried out IN THE BEGINNING... 5 Intake Interview I need to ask you some questions that will give me information to help plan this assessment. Date of Interview: __________ Interviewer: ___________________________________ What is your child’s full name? __________________ Your full name? _______________ What is your relationship to the child? _________________________________________ What is your child’s birth date? ________________________ Age now? _____________ What is your address? _____________________________________________________ What program does your child attend? _________________________________________ What is the address and phone number of the program? ___________________________ ______________________________________________________________________ What is the teacher’s name? ________________________________________________ Who are the child’s primary caregivers? _______________________________________ What are the ages and occupations of primary caregivers? _________________________ ______________________________________________________________________ What was the ﬁnal school grade completed by primary caregivers? ___________________ Marital status of parents? __________________________________________________ If divorced or separated, what are the living arrangements regarding the child? _________ ______________________________________________________________________ Who are the legal guardians? _______________________________________________ Who lives in the home? ____________________________________________________ Names and ages of siblings? ________________________________________________ In what country/state/city was child born? ______________________________________ In what country/state were caregivers born? ____________________________________ What language(s) is spoken in the home? ______________________________________ If English is not dominant, who speaks which language to whom?____________________ ______________________________________________________________________ If parents are not U.S. born, what were the circumstances of immigration? ______________ ______________________________________________________________________ What is child’s dominant language? ___________________________________________ Who is primary medical care provider? ________________________________________ Please tell me what brings you here.__________________________________________ ______________________________________________________________________ Who referred you?________________________________________________________ Form 1.1 6 EARLY CHILDHOOD ASSESSMENT Have there been any previous evaluations? Please give me the approximate dates, and if you have not already provided copies of reports, please sign a release so that these can be obtained. _______________________________________________________________ ______________________________________________________________________ What speciﬁc questions do you have for the assessment? What information would you like to ﬁnd out?______________________________________________________________ ______________________________________________________________________ I need to ask you for some additional background information to help answer your questions. How would you describe your child? __________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ What do you enjoy the most about your child? ___________________________________ ______________________________________________________________________ ______________________________________________________________________ What do you ﬁnd the most challenging about raising your child? ____________________ ______________________________________________________________________ ______________________________________________________________________ Tell me about your child’s early development. What do you remember about the pregnancy and delivery? ____________________________________________________________ ______________________________________________________________________ [Note: If child was adopted, be careful regarding conﬁdentiality in front of child. Note cir- cumstances of adoption and anything known about early history. Does child know about adoption?] Complications regarding pregnancy? Medications while pregnant? Bleeding? Any substances (smoking, alcohol, drugs)? Emotional climate during pregnancy? Gestation period? Length/difﬁculty regarding labor? Birth weight? Delivery complications? Medications? Condition of baby? Do you remember the Apgar scores? Form 1.1 (continued) IN THE BEGINNING... 7 How was the baby when ﬁrst brought home? Any concerns? ________________________ ______________________________________________________________________ What is child’s current health status? Any illnesses? Accidents? Hospitalizations? Lead ingestion? Seizures? Allergies? Sleeping? Eating? High fevers? Ear infections? I will ask you some questions about the child’s early development. At what age did the child ﬁrst: Sit? Walk? Say ﬁrst words? (What were they?) Say full sentence? (What was it?) Toilet train? What is the child able to do independently now? Bathing? Dressing? Playing? Out in neighborhood? Who is involved in taking care of the child when not in a program or when caregivers are away? _________________________________________________________________ ______________________________________________________________________ What are the child’s experiences regarding separation other than day care or preschool? ______________________________________________________________________ ______________________________________________________________________ Status of child’s hearing and vision? When checked? _____________________________ ______________________________________________________________________ Is the child taking any medication? What? How much? For how long? With what results? ______________________________________________________________________ ______________________________________________________________________ Form 1.1 (continued) 8 EARLY CHILDHOOD ASSESSMENT Has anyone in the family needed any special help in school or have history of special edu- cation? ________________________________________________________________ ______________________________________________________________________ Is there any family history of mental illness? Please explain. ________________________ ______________________________________________________________________ Tell me about a typical day for you and your child; start when you get up. ________________ ______________________________________________________________________ ______________________________________________________________________ Now tell me about a typical week; start with Monday.______________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Tell me about your neighborhood. What is it like? _________________________________ ______________________________________________________________________ Tell me about your home. What is it like? _______________________________________ ______________________________________________________________________ Where and with whom does your child play? ____________________________________ ______________________________________________________________________ Describe your child’s play. __________________________________________________ ______________________________________________________________________ What opportunities does your child have to play with other children? __________________ ______________________________________________________________________ ______________________________________________________________________ Does your child participate in any organized recreation? ___________________________ ______________________________________________________________________ ______________________________________________________________________ Let’s review the sequence of program experiences for your child from the very earliest to the present. Also, tell me how well your child did in each. What did the teachers tell you? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ How do you handle discipline? Who does what regarding discipline? How often is it neces- sary to discipline your child, and for what? ______________________________________ ______________________________________________________________________ ______________________________________________________________________ Form 1.1 (continued) IN THE BEGINNING... 9 What are the primary sources of stress in your family? _____________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ What are the primary sources of support in your family? ___________________________ ______________________________________________________________________ ______________________________________________________________________ Are there any experiences that you think might have had an important impact on your child? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ You have already thought a lot about the reasons you brought your child here. What have you told yourself; what do you think is going on that accounts for your concerns? Also, what have others, perhaps in your family or from your friends, told you? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Is there anything else you think I should know that would be important for understanding you and your child? __________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Is there anyone who should get a copy of my report? ______________________________ ______________________________________________________________________ ______________________________________________________________________ To summarize: You are mainly concerned about: You are asking for information about: What I’ll be doing will be: You will be involved in the assessment, but... I won’t be able to answer your questions about how your child did until we are ﬁnished.Then I will meet with you and we will review your questions and look at what the assessment of- fers to address these. We will work together to make the best possible plan for your child. Lidz, Carol S. Early Childhood Assessment. Copyright 2003, John Wiley & Sons. Form 1.1 (continued) 10 EARLY CHILDHOOD ASSESSMENT as nonintrusively as possible, using abbreviations and shortened sentences for efﬁciency. It is advisable to apologize for the need to write but state that it is a necessary aid to memory and accuracy. Avoid burying your nose in the form, and maintain a conversational, clinically sen- sitive, and open style of communicating. The interviewees should never feel that the primary agenda is to complete the form; the form is a means to facilitate the interaction, and what they have to say is of utmost importance. Nevertheless, there is an agenda to secure this important information, and the assessor needs to exert subtle control over the interaction to reach this goal. In addition to determining this information, the interview also provides an opportunity for the caregivers to get a feeling for the assessor and for the assessor to get a feeling for the per- sonalities and interaction styles of the caregivers. If the child is present, this serves to introduce the assessor to the child as well, and it is useful for the child to hear the assessor interact with the caregivers without being pressured to respond. Of course, if the child is present, it is neces- sary to use good judgment regarding the content of the conversation, and the assessor may need to suggest an opportunity for a private conversation for sensitive material. Sattler (2002, p. 20) also listed a number of types of statements that are helpful for fur- ther probing without leading the interviewees in any particular direction. These include the fol- lowing: Tell me more about that. Is there anything else? Please go on. What happened then? Please expand on that. What happened before? What happened after? How did you feel? (Please do not overuse that one!) What were you thinking? Any other reasons? These of course need to be used appropriately. Sattler (p. 23) further offered a number of re- ﬂective statements that would contribute to a sense of active listening that is so important in in- terview situations: You felt that... As you see it... It seems to you that... In other words... What you seem to be saying is... You believe... It seems as if... I hear you saying... Such statements help convey a feeling of being heard and understood and avoid implications of evaluation or judgment by the assessor. Lentz and Wehmann (1995) also provided a number of helpful suggestions to facilitate ac- tive listening (p. 642): IN THE BEGINNING... 11 Decide to listen closely. Be alert, lean forward, maintain eye contact, use appropriate facial expressions. Keep in mind that the goal is to understand, not to evaluate. Be reactive, with nods and vocalizations. Allow the speaker to ﬁnish speaking. Show empathy with actions and words, try to see the situation from their point of view. Ask clarifying questions. Notice nonverbal behavior. Avoid thinking about yourself. Avoid hasty conclusions. Correct environmental distractions. Assessors need to learn about themselves as well, particularly in terms of how they come across to others and of the types of reactions that they tend to elicit in others. However, it is not advisable to bring this self-consciousness into the interview unless the assessor can quickly pro- cess how he or she may have provoked or elicited a particular response from the interviewee. As a general rule, I try to process what I am hearing in terms of how it will help me understand the situation, make decisions about how to proceed with the assessment, and communicate how I can (or cannot) be helpful. Assessors need to clarify the caregiver’s expectations and be explicit about how these will be addressed in ensuing sessions. DEVELOPMENTAL HISTORY One of the most important components of any assessment is to gather a comprehensive history of the child’s development, including family information, cultural background, and educa- tional experiences. This information relies considerably on the accuracy of recall and reliabil- ity of the informants, although assessors are also strongly encouraged to gather information that is available from hospital reports, as well as previous assessments. The accuracy of parent recall has mixed reviews, although it is documented to be generally reliable for parents of higher socioeconomic levels; however, some of these studies involve parents who are partici- pants in longitudinal studies, which would be expected to involve parents who not only have more stable life experiences (i.e., do not move to a signiﬁcant extent) but also are more aware of their child’s development because of anticipation of the periodic checkups from the study staff. The Wenar and Coulter (1962) study of mothers’ recall of their children’s early devel- opment 3 to 6 years following their child’s enrollment in a therapeutic nursery showed agree- ment for 57% of the statements reviewed; that is, there were differences for 43% of the items, with 40% of these considered to be “marked” differences. Although there were no definitive patterns regarding information recalled accurately or inaccurately, there was a tendency for information with affective content to be more distorted on later recollection. There was good reliability regarding information concerning whether the baby was wanted, the parents’ gender preference, whether the baby was breast-fed or bottle-fed, sleep patterns, illnesses, and motor development. Distortions concerned the mother’s health during pregnancy, discipline prac- tices, and relationships between the child and parents. Robbins (1963) found that parent recall was more accurate in terms of whether an event occurred than in terms of the specific times of onset. This study also found that in this highly educated sample, inaccuracies, particularly 12 EARLY CHILDHOOD ASSESSMENT by the mothers, were biased in the direction of the prevailing child development literature (Dr. Spock, for those of us with longer histories). Simons, Ritchie, Mullett, and Liechty (1986) reported high concordance of recall between mothers and fathers regarding the medical complications of their infants, but both parents tended to underreport the extent of the medical complications that their infants experienced following delivery. Treharne’s (1992) study reported highly reliable recall for toilet training and weaning and a pattern of better recall when milestones coincided with other meaningful events such as a birthday or holiday; there was generally poor recall of speech milestones. The impression from these studies, which tend to be limited by low numbers of participants, is that there is general accuracy for most parents regarding whether an event has occurred but less reliability regarding the details of onset. Better recall is more likely for parents of higher socioeconomic status (and those involved in longitudinal studies). The implication for the as- sessor is the need to make a judgment regarding the accuracy of the informants, with an at- tempt for further documentation of important information. It is probably more effective to ask parents whether they recall developmental milestones to have been generally on time or late rather than to seek speciﬁc times of onset. Some parents keep records of these events, however, and these should be accessed if available. In addition, information can be sought independently from more than one family member, although mothers tend to recall some information more accurately than do fathers (at least if the mothers were more involved during very early years). Information regarding delivery and birth complications should be available from the hospital. No assumptions can be made regarding the direction of inaccuracies; the assessor should look for inconsistencies in all of the information reported. SCREENING Brooks-Gunn and Lewis (1981) made a good case for the value of screening with measures that identify risk rather than relying on identiﬁcation of children in need through observing their accomplishments of developmental milestones. The researchers pointed out that reliance on milestones means that the potential problem will not be noticed until the milestone has not been accomplished, and the ranges for these accomplishments can be very wide. Furthermore, with such an approach, social-emotional needs are often ignored. Therefore, it is considered better practice to try to identify early signs of risk that are precursors to later development of dysfunctions (although milestones will nevertheless play a role in this identiﬁcation and are usually the alerting factors for parents and physicians). According to Kenny and Culbertson (1993) screening is the process of “sorting out from among a presumably normal population those individuals at risk for a certain disorder. The purpose of screening is not to diagnose a disorder or to plan a treatment approach, but rather to suggest to the professional when and to whom to refer for further diagnostic evaluation” (p. 73). Despite all-too-frequent practice, virtually all authors agree that screening is an activ- ity that should precede comprehensive assessment (e.g., Gredler, 1997; Lichtenstein & Ireton, 1984; Meisels & Provence, 1989; Satz & Fletcher, 1988; Telzrow, Fox, Sanders, Barnett & Cryan, 1989); that is, the next step following screening and determination of risk should be di- agnostic assessment, not placement—and certainly not exclusion. The purpose of screening is to categorize children into risk, caution, and no-risk groups. Children in the caution group would need to be rescreened at a later time. When screening is carried out with large groups, IN THE BEGINNING... 13 the procedures need to be brief, cheap, and accurate (Gridley, Mucha, & Hatﬁeld, 1995). This means that the procedures used for screening need to be selected carefully to meet standards of reliability, validity, and criteria of sensitivity and speciﬁcity and need to have a good hit rate (these terms are explained shortly). The screening program also needs to be designed with awareness of federal, state, and local regulations and policies and to be submitted to the dis- trict’s board of education prior to implementation (Telzrow et al., 1989). Authors generally agree that screening should be conducted only when there is treatment available for those individuals identiﬁed as being at risk (e.g., Frankenburg, 1985; Meisels, 1985; Telzrow et al., 1989). This is an ethical issue. Once need is determined, these needs should be addressed. Therefore, any screening program must be well thought-out, carefully planned, and adequately funded. The purpose of the screening needs to be determined, and the proce- dures should ﬁt the purpose. Because a screening program involves signiﬁcant investment of funds and personnel, it is also critical that the staff be well trained and monitored and that the effects of the program be evaluated: Did it accomplish its purpose? (Note therefore that it is necessary to have a clear purpose!) Although the psychologist is not necessarily directly involved in administering the screening procedures, it is appropriate for the psychologist to be involved in the planning and adminis- trative aspects of the screening (Harrington, 1984). Because of economic considerations, para- professionals (e.g., teacher aids or parent volunteers) are often used for large-scale screening, and they need to be trained and monitored. These tasks are appropriate for the psychologist. Critical steps in the screening process include designating a coordinator, establishing a plan- ning team, carrying out the planning process, collecting and interpreting the data (including selecting procedures), monitoring the process, and evaluating the results (Gridley et al., 1995). These are likewise tasks in which the psychologist can be appropriately involved. Sometimes the psychologist may decide to engage directly in screening for an individual child, as in the case of triennial reevaluations, when a comprehensive assessment may or may not be necessary. In this case, it is useful to screen the child’s primary functional domains such as cognition, language, motor, and preacademic to determine the need for further exploration. It is not always clear when a procedure is best described as intended for screening or diag- nosis. The purpose of the assessment instrument should be described in its manual, and if it is used for screening, it must be evaluated in relation to its success with identifying children in need of further evaluation, particularly by weighing overreferrals against underreferrals. Screening instruments are usually brief and more superﬁcial in coverage than are diagnostic in- struments, but the threshold for these qualities is not so clear. One person’s screener may be an- other person’s diagnostic procedure. There is often so much pressure on meeting timelines that what passes for diagnostic assessment all too often can best be described as screening. The outcome of assessment should be determination of the child’s needs for service with im- plications for programming. The outcome of screening should be determination of the child’s need for diagnostic assessment. Thus, intention and outcome play major roles, and procedures need to be selected with these in mind. As indicated previously, in addition to the usual psychometric standards of reliability and validity, screening procedures must also meet standards of sensitivity and speciﬁcity. These re- late to issues of over- and underreferral (referred to as hit rate). There will always be errors in identifying children. These need to be minimized as well as understood. Overreferral results in an economic penalty in which children who do not necessarily need special education services nevertheless receive costly diagnostic assessment and, possibly, costly intervention services. 14 EARLY CHILDHOOD ASSESSMENT Large expenditures of these funds can reduce the availability of funds for those truly in need. There are also consequences for the caregivers, who may become anxious or upset when they are told erroneously that their child is in a risk category. The primary consequence of underre- ferral is that children who need services are deprived of service. Many researchers have con- cluded that it is better to overrefer than to underrefer because the consequences appear to be more benign; that is, the child would be involved in services that may be helpful and are cer- tainly unlikely to cause harm (Kenny & Culbertson, 1993). Sensitivity refers to “the ability of a test to classify abnormal results as abnormal,” and speci- ﬁcity “refers to a test’s ability to identify normal performance as being normal” (Kenny & Cul- bertson, 1993, p. 87). That is, sensitivity detects need, whereas speciﬁcity detects normality. The methods for determining these derive from the following chart based on Frankenburg (1985) and Lichtenstein and Ireton (1984): Diagnostic Findings Screening Test Findings Child needs services Child does not need services A C Refer: High risk (+) Accurate referral Overreferral (valid positive) (false positive) B D Do not refer: Low risk (−) Underreferral Accurate nonreferral (false negative) (valid negative) A Sensitivity = ᎏᎏ × 100 A+B D Speciﬁcity = ᎏᎏ × 100 C+D C Overreferral rate = ᎏᎏ × 100 A+C B Underreferral rate = ᎏᎏ × 100 B+D According to Glascoe (1991), a desirable level for sensitivity is a minimum of 80%; for speci- ﬁcity, a minimum of 90%; and for overreferrals, a rate of no more than 1.5 to 2 times the num- ber of truly delayed, as determined by the follow-up assessment. He also suggested that inter- rater agreement (reliability) should be at least 80%, with test-retest stability of at least.90 and concurrent validity at least.60. It is also possible to determine base rates, which would vary between 5% and 10% of the total population; these would be the proportion, or prevalence, of children who are actually de- termined to have a problem. The referral rate would be the children who are referred for diag- nostic assessment based on their screening results; and according to Lichtenstein and Ireton IN THE BEGINNING... 15 (1984), these would range between 1.5 to 2.5 times the base rate; that is, more children would be referred for further assessment than would be determined eligible for treatment. Of course, if referrals are generated from a population already defined as being at risk, such as would typify a population of very low socioeconomic status, these rates will be greatly magniﬁed. Test Reviews 1.1 through 1.6 present a number of frequently used screening procedures available for working with preschool children. Tests used for screening are sometimes referred to as readiness tests, and these tests are at times inappropriately used to determine eligibility of children for inclusion in regular educa- tion (National Association for the Education of Young Children [NAEYC], no date). Screen- ing in this case does not concern eligibility for intervention, but for school entry itself. Readi- ness tests address skills that the child has acquired that relate to what will be learned in the regular school curriculum (Gredler, 1997; Gridley et al., 1995; Meisels, 1985, 1987). These are assumed to differ from developmental procedures, which are said to describe the child’s ability to learn or proﬁt from instruction, although this claim is disputable. According to Meisels (1987), readiness tests are appropriately used for curriculum planning, not for school entry de- cisions. They describe current characteristics and are not intended for (or very good at) pre- dicting long-range outcomes. Meisels speciﬁcally criticized the Gesell (Ilg & Ames, 1965) tests (with their norms based solely on White Connecticut residents), for which there is very little re- liability or validity information, and I pointed out that the information that is available pro- vides very mixed reviews (Lidz, 1991a). Furthermore, there is very little documentation of any positive effects of delayed school entrance over the long term (Guilford Press, 1997). Although this remains an option for individual children, it is not a viable general solution for those who show low levels of readiness and may in fact be denied access to experiences that they so badly need. Even in the Pianta and McCoy (1997) study, which documented ﬁne motor and cognitive skills of the child and mother’s educational level as signiﬁcant predictors regarding which child would not have problems in school, these authors concluded that the predictions were not a sufﬁcient basis for high-stakes decisions such as determination of school entry. Finally, it is no small point that there is no general agreement regarding preschool curriculum (Boehm & Sandberg, 1982); therefore, to use an existing preschool curriculum as a criterion for readiness is highly inappropriate, as the child may be ready in relation to one curriculum but not ready in relation to another. The increasing consensus is that schools should be ready for children rather than requiring children to be ready for school (NAEYC, 1995), and I suggested that the more important con- cern is to determine the basis for development of a good foundation for learning once children have entered school (Lidz, 1999), thus avoiding the circularity of the idea that children need to be ready to get ready to learn. Many of the procedures used for screening involve parent completion of questionnaires and rating scales. It is therefore relevant to determine the degree of concordance of the results from these two sources, and this has been the purpose of several investigations. For example, Gradel, Thompson, and Sheehan (1981) found moderate to high levels of agreement between the ratings of the mothers in their study and those of professional diagnosticians, and higher levels of agree- ment were found for children of preschool age than for infants. Meltzer et al. (1983) found gen- eral consistency among the ratings of parents, teachers, pediatricians, and psychologists on a 34-item checklist reporting developmental skills for preschool children; there was greater consistency regarding language, memory, and academic skills than regarding the motor do- main. Sexton, Miller, and Rotatori (1985) compared completion of a developmental proﬁle for 16 EARLY CHILDHOOD ASSESSMENT Test Review 1.1 Test Name Ages and Stages Questionnaires (ASQ): A Parent-Completed Child-Monitoring System–Second Edition (1999) Authors Diane Bricker and Jane Squires What the Test Measures There are 19 questionnaires for age intervals from infancy through preschool years, to be com- pleted by caregivers, based on 30 items/activities for the ﬁve domains of communication, gross mo- tor, ﬁne motor, problem solving, and personal-social. The questionnaires may be photocopied. Each item is scored in terms of yes, sometimes, or not yet, with cutoff points empirically determined to detect need for further assessment and referral. The items are written at a sixth-grade reading level, designed for cultural sensitivity. The forms are available in Spanish, French, and Korean, with plans to develop forms in Mandarin, Russian, and Arabic. Age Range 4 months through 60 months Administration Time 10 to 15 min Publisher Brookes Publishing PO Box 10624 Baltimore, MD 21285-0624 800-638-3775 www.brookespublishing.com Norms This is not a normed procedure. Reliability Internal consistency correlations ranged from.73 to.83 for 36 months, from.66 to.82 for 48 months, and from.44 to.58 for 60 months. Test-retest stability with a 2-week interval resulted in percentage of agreement of 94%. Interobserver reliability comparing scores of parents and profes- sional examiners was 94%, although many protocols had to be eliminated because the professional examiner had no opportunity to observe some behaviors. Validity Items were based on reviews of other tests, as well as texts and literature concerning developmental milestones; items were written to reﬂect behaviors that could be easily observed or elicited by par- ents, as well as those that would be likely to occur within the home. Information is presented to support concurrent validity. There was 92% agreement with other standardized tests at 36 months and 86% overall agreement. The questionnaires showed good ability to detect children with typical development but had a 72% hit rate for children with delayed development (separate analysis is reported at 96% hit rate for developmental delay). IN THE BEGINNING... 17 Test Review 1.2 Test Name Denver Developmental Screening Test-II (1990) Authors W. K. Frankenburg, J. B. Dodds, P. Archer, B. Bresnick, P. Maschka, N. Edelman, and H. Shapiro What the Test Measures There are 125 tasks in four areas, including personal-social, ﬁne motor–adaptive, language, and gross motor; all items are administered; examiners begin near the child’s chronological age level. Items are scored by direct administration, parent report, or observation. There is a training tape available. The test includes a behavior rating scale that rates the child’s test-taking behavior on dimensions of compliance, interest in surroundings, fearfulness, and attention span, as well as speech intelligibility. Scoring is bilevel, with one level indicating pass/fail/refused and another level indicating normal/advanced/caution/delay or no opportunity. These yield an overall classiﬁcation of normal, abnormal, questionable, or untestable. Age Range Birth to 6 years Administration Time 20 min Publisher Denver Developmental Materials 10200 E Girard Ave No. A111 Denver, CO 80231-5547 303-695-1462 Norms There were 2,096 in the norm group, all from the state of Colorado in an attempt to represent the Colorado population. Norms are stratiﬁed by age, race, region, and mother’s educational level, all within the state of Colorado. New, revised, and retained items were assigned to domains based on clinical judgment. Reliability Interrater agreement and test-retest reliability with 5- to 10-min interval and 7- to 10-day interval were determined. The authors report high levels of agreement between raters as well as between scores for pretest and posttest interval administrations. Validity The authors assigned ages at which each of the items was passed by 25%, 50%, 75%, and 90% of the population, and items were also examined for bias in relation to demographic variables. The ﬁ- nal items were selected from a much larger item pool based on criteria such as frequency of re- fusals or indications of no opportunity, reliability, amenability to observation or report, and minimal need for elaborate materials. The authors claim face validity in terms of representation of the growth curves of the items se- lected for the test. Other validity evidence remains to be determined. Neither the reliability nor the validity of the behavior rating scale was examined. 18 EARLY CHILDHOOD ASSESSMENT Test Review 1.3 Test Name Developmental Indicators for the Assessment of Learning–Third Edition (DIAL-3) (1998) Authors Carol Mardell-Czudnowski and Dorothea S. Goldenberg What the Test Measures DIAL-3 assesses the child’s functioning in the ﬁve domains of physical, cognitive, communication, social or emotional, and adaptive. There is also a 9-item rating scale of social-emotional behaviors and of intelligibility. The Speed DIAL uses 10 items from the Motor, Concepts, and Language do- mains. Forms are available in both English and Spanish. Parents complete a questionnaire with background information and their concerns. Scores yield conclusions regarding potential delay (re- quires further assessment), or OK (development appears satisfactory). There are also percentile ranks and standard scores with a mean of 100 and SD of 15. A training tape is available. Age Range 3 years to 6 years 11 months Administration Time 30 min; Speed DIAL: about 15 min Publisher American Guidance Service, Inc. 4201 Woodland Road Circle Pines, MN 55014-1796 800-328-2560 www.agsnet.com Norms The test was normed on 1,560 English-speaking children and 605 Spanish-speaking children. The norm group was stratiﬁed to reﬂect the 1994 U.S. Census on parameters of age, gender, race, re- gion, and parent education, and included some children who were involved with special services. Reliability Internal consistency ranged from.66 (motor) to.85 (social), with the total for Speed DIAL.80 and for DIAL-3.87. Test-retest total for DIAL-3 was.88 for children 3-6 to 4-5 and.84 for children 4-6 to 5-10 for Dial-3; and for Speed DIAL,.84 for children 3-6 to 4-5 and.82 for children 4-6 to 5-10. Subtest coefﬁcients were higher (above.80) for the younger children, with the exception of Motor (.69). Validity Information is presented to support concurrent, and content validity. IN THE BEGINNING... 19 Test Review 1.4 Test Name Early Screening Inventory–Revised (1997) Authors Samuel Meisels, Dorothea B. Marsden, Martha Stone Wiske, and Laura W. Henderson What the Test Measures Designed to identify children who may be appropriate for referral for special education; to be used along with the Parent Questionnaire (included) and a general physical exam. This is only to deter- mine risk and should be followed by more comprehensive assessment. Functioning in the areas of speech, language, cognition, perception, and ﬁne and gross motor coordination are sampled as de- velopmental tasks, not intelligence. Scores include “refer” and “rescreen” or no need for assess- ment. The tasks were selected to represent broad areas of development, as well as with regard to ease of administration and scoring, along with reliability. The content is grouped into the more general areas of Visual-Motor/Adaptive, Language and Cognition, and Gross Motor. The final rec- ommendation regarding referral reflects the total score. Memory is embedded within the Visual- Motor/Adaptive and Language and Cognition domains. The Parent Questionnaire provides family, developmental, and medical information. Age Range 3 to 6 years; Preschool Version for children ages 3 through 4 1/2 years Administration Time 15 to 20 min Publisher Rebus, Inc. 715 North University Avenue, Suite 6 PO Box 4479 Ann Arbor, MI 48106-4479 800-435-3085 Norms For Preschool Version: The total group N = 977, divided into three 6-month groups. The sample in- cludes an equal number of boys and girls, but a high proportion of children from African American and “other” background (Asian, American Indian...), which does not seem to include Hispanics. Most of the children attended Head Start programs. Reliability There is strong positive evidence of interrater reliability, test-retest stability, and low standard error of measurement. For example, test-retest results yielded a correlation of.98 and a mean standard error of.20. Validity The authors present evidence of discriminant validity of the items in terms of their ability to differen- tiate children who were referred from those who were not. Predictive validity in relation to the Mc- Carthy Scales administered 6 months later yielded a.73 correlation. Analysis of speciﬁcity and sen- sitivity showed some tendency to overrefer (false positives), but generally supportive results, with a Sensitivity score of.92 and Speciﬁcity score of.80. 20 EARLY CHILDHOOD ASSESSMENT Test Review 1.5 Test Name AGS Early Screening Proﬁles (ESP) (1990) Author Patti L. Harrison (with A. S. Kaufman, N. L. Kaufman, R. H. Bruininks, J. Rynders, S. Ilmer, S. S. Sparrow, and D. V. Ciccetti) What the Test Measures The ESP is intended for ecologically valid screening of children in order to identify those at risk for learning or developmental problems, who require more comprehensive assessment. There are seven components: a Cognitive/Language Proﬁle, Motor Proﬁle, and Self-Help/Social Proﬁle. There is an articulation survey, home survey, health history survey, and behavior survey. The ﬁrst three profiles are administered directly to each child, and the remaining components are in question- naire form to be completed by teachers, caregivers, and assessors as appropriate. The cognitive/ language profile includes four subtests: visual discrimination, logical relations, verbal concepts, and basic school skills. The Motor Proﬁle assesses ﬁne and gross motor skills. The Self-Help/Social Proﬁle includes communication, daily living skills, socialization, and motor skills domains. The en- tire battery or selected portions of it may be used. Age Range 2 years through 6 years 11 months Administration Time 15 to 30 min for direct testing and 10 to 15 min for parent and teacher questionnaires Publisher American Guidance Service, Inc. 4201 Woodland Road Circle Pines, MN 55014-1796 800-328-2560 www.agsnet.com Norms The national sample included 1,149 children representative of the data from the 1990 Census on variables of geographic region, parent education level, and race and ethnicity. The numbers in- cluded in the sample for each component vary, with the proﬁles completed for the larger sample numbers and the surveys for considerably lower numbers of children. Scores are determined in 3-month intervals. Subtest scores are standardized with a mean of 10 and SD of 3, and proﬁle scores, as well as cognitive and language subscales, have a mean of 100 and SD of 15. Reliability Internal consistency alpha coefﬁcients for all proﬁles except Motor are reported to range from the high.80s to mid.90s. The alphas for the Motor Proﬁle range from.60 to.78, with a median of.68. For the surveys, alpha coefﬁcients for Articulation are mostly in the high.80s to low.90s; for the Home Sur- vey, they range from.37 to.52 (median.41); and for the Behavior Survey, they are mostly in the.70s. IN THE BEGINNING... 21 Test-retest stability with an interval of 5 to 21 days were all above.80 except for the Motor Proﬁle at.70; coefﬁcients for the indexes were all above.70, with the exception of the indexes at.56. Sta- bility with an interval of 22 to 75 days were all above.70, with the exception of the Motor Proﬁle at.55; coefficients for the index scores ranged from the.60s to the.80s, with the exception of the Motor Proﬁle at.31. Interrater reliability was carried out only for the Motor Proﬁle, which is more subjective than the other subtests. All coefﬁcients were above.80, with many well above.90. Standard errors of mea- surement are generally low, with a slight tendency to increase at age 6, and with generally high standard errors of measurement for the Motor Proﬁle. Validity Evidence is presented in the manual to support content, construct, concurrent, predictive, and dis- criminant validity. Test Review 1.6 Test Name FirstSTEP: Screening Test for Evaluating Preschoolers (1993) Author Lucy J. Miller What the Test Measures The purpose is to screen children who are at risk for developmental delay for further comprehen- sive assessment. The 12 subtests tap the areas of cognition, communication, motor, social- emotional (optional), and adaptive (optional) functioning. Only the scores from the first three subtests make up the composite. There is also an optional parent-teacher scale that provides further information. Each of the three core domains has four subtests as follows: cognition (quanti- tative reasoning, picture comparison, visual position in space, and problem solving), language (auditory discrimination, word retrieval, association, and sentence-digit repetition), and motor (visual-motor integration, fine motor planning, balance, and gross motor planning). The social- emotional scale includes ratings by the assessor of the child’s behaviors during the test session; these include task conﬁdence, cooperative mood, temperament and emotionality, uncooperative antisocial behavior, and attention-communication difﬁculties. The adaptive behavior scale asks for the caregivers’ ratings regarding degree of the child’s independence in the areas of daily living, self- management and social interaction, and functioning within the community; there are three levels, administered according to age of the child. The adaptive behavior scale is completed by the asses- sor as a result of interviewing the caregiver, whereas the parent-teacher scale is completed by these individuals. The ﬁrst item of each subtest can be taught to the child if the child does not understand. The do- mains have a mean of 10 with SD of 3, and the composites are T scores with a mean of 50 and SD of 10. Zero scores are assigned a scaled score. The optional scales have cutoff scores to signal risk. (continued) 22 EARLY CHILDHOOD ASSESSMENT Age Range 2.9 years to 6.2 years Administration Time 15 min Publisher The Psychological Corporation 555 Academic Court San Antonio, TX 78204 800-211-8378 http://www.PsychCorp.com Norms The total sample consisted of 1,433 children, selected to reﬂect the 1988 U.S. Census on variables of gender, geographic region, community size, race and ethnicity, and parent education level. Scores are provided for 6-month age groups. Reliability Information is provided for internal consistency, decision consistency, interscorer agreement, test-retest stability, and standard error of measurement. The standard errors of measurement are generally low. The average coefﬁcients for internal consistency exceed.80 for all domains except cognitive (.75) and motor (.71). The test-retest interval for children randomly selected from the standardization sample was 1 to 2 weeks. These coefﬁcients all exceeded.80, with the composite of.93. For the same group, the consistencies of decision cutoff scores all exceeded.85. The inter- scorer agreement coefﬁcients also exceeded.80 except for the social-emotional ratings (.77). Validity Information regarding content, construct, concurrent, and criterion validity is presented in the man- ual. The domains were reviewed by experts for each area. Factor analysis supported a three-factor solution (language, motor, and cognition), except that two of the four of the cognitive subtests loaded at a higher level on the language rather than the cognitive factor. A second factor analysis appeared also to support a three-factor solution, but this time only the language factor was clearly supported, with the other two mixed. Classiﬁcation accuracy was 89% with more false positives than negatives, which is a more acceptable direction because the error would mean that somewhat more children would be referred for further evaluation than necessary (preferable to missing chil- dren with special needs). Correlations with other measures are at a high moderate level, supporting concurrent validity. Discriminant validity received strong support as well. children with a variety of disabilities resulting in developmental delays by their parents (moth- ers and fathers) and by professional evaluators and found high levels of agreement; they also re- viewed studies that documented generally high levels of agreement but that had a tendency for mothers to rate their children at a higher level than professionals rated them. In the Sexton et al. study, family income level positively related to congruence of results, and these authors also found that both parents rated their child as having passed more items than did professionals. Fi- nally, Dinnebeil and Rule (1994) reported

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