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LECTURE 1

INTRODUCTION TO ASSESSMENT TECHNIQUES USED WITH CHILDREN

Prepared By: SHAZIA IQBAL HASHIMI

Questions for considerationQuestions for consideration What is assessment What kinds of assessors conduct psychological

and psycho-educational evaluations? What kinds of classification systems do evaluators

use in making diagnoses and determinations? What tests and measures are most frequently

administered? What questions should advocates consider when

reviewing evaluations? What remedies are available if test results and/or

conclusions appear inaccurate or misleading?

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Assessment is the process of collecting data for the purpose of making decisions. Its main goal is to identify and understand the individual’s symptoms within the context of his her overall level of functioning and environment.

assessment ……….Is a processIs a decision making toolCan apply to an individual or groupGenerate products

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Purpose of Psych. Purpose of Psych. AssessmentAssessment

Goal DrivenBroad Screening versus Focused/Problem-

SpecificDiagnostic

◦Differential and Comorbid ConditionsTherapy Oriented

◦Identify target problems◦Develop preliminary intervention plan

Progress evaluation◦How well are ongoing interventions

working?

Testing vs. AssessmentTesting vs. AssessmentBoth involve

◦Identifying areas of concern◦Collecting data

Psychological Testing◦Administering tests◦Focuses solely on collection of data

Psychological Assessment◦More broad goals◦Involves several clinical tools◦Uses clinical skill to interpret data interpret data

and synthesize resultsand synthesize results

Psychological TestingPsychological TestingRequire standardized proceduresstandardized procedures

for behavior measurement◦Consistency and use of the same

Item content Administration procedures Scoring criteria

◦Designed to reduce personal differences and biases of examiners and other external influences on the child’s performance

Psychological AssessmentPsychological Assessment Main types of assessment

1. Norm-referenced tests2. Interviews3. Observations4. Informal assessment procedures5. Non-norm referenced tests

Consideration for comprehensive assessment system

The child is an individual and a group member.

The stakeholders- child , parents, teachers, administrators, policy board members, and legislators – as participants in the process as well as consumers of the products.

The program philosophy and the curriculum or intervention strategy of the program

The purpose of evaluating, measuring, or documenting progress

Available methods and accuracy, usability, and meaning of the results.

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ASSESSMENT DOMAIN Assessment involves the

specification and verification of problems for the purpose of making different kinds of decisions.

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Academic Problems. In academic settings, teachers usually make that decision on the basis of their observations of the pupils performance in core content areas; reading, mathematics, written language and communication.

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Behavior Problems. Behavior problems include failure to get along with peers, delinquent activities, and excessive withdrawn, as well as disruptive and non-compliant behavior.

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Physical problems. Physical problems include sensory disabilities such as vision or hearing, problems of physical structure for example spina-bifida or cerebral palsy and chronic health problems such as diabetes and asthma.

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Norm-Referenced TestsNorm-Referenced TestsTests that are standardized on a clearly defined group

◦Normative versus clinical reference groupsGoal: quantify the child’s functioningScores represent a rank within the comparison groupExamples

◦Intelligence◦Academic skills◦Neurocognitive skills◦Motor skills◦Behavioral and emotional functioning

Norm-Referenced TestsNorm-Referenced TestsPsychometric properties

◦Demographically representative standardization sample

◦Reliability Internal consistency, test-retest stability

◦Validity Correlation with other tests measuring same construct Ecological

Psychological tests are imperfect◦Examiner, the child, and the

environment can affect responses and scores

Most attempt to be normally distributedStandard deviation: Commonly used measure of the

extent to which scores deviate from the mean In a Normal distribution, 68% of cases fall between 1

SD above the mean and 1 SD below the meanThe threshold for meeting “clinical significance”

varies across tests, typically > 1 to 2 SDs above or below mean

““Normal” or “Bell” curveNormal” or “Bell” curve

Norm-Referenced TestsNorm-Referenced TestsPercentile ranks

◦Determines child’s position relative to the comparison group

◦Example: What does it mean when a child is in the 35th %tile on an Intelligence test??

Age-Equivalent and Grade-Equivalent scores◦Frequently used on academic

achievement tests◦Sometimes questionable validity

Tests are samples of behavior.

Tests do not reveal directly traits and capacities.

Tests should have adequate

reliability and validity

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Test scores and other test performances may be adversely affected by temporary states of fatigue, anxiety, stress.

Tests results should be

interpreted in light of the child’s cultural background, primary language and any handicapping conditions.

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Test results are dependent on child’s cooperation and motivation.

Tests purporting to measure the

same ability may produce different scores for that ability.

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Test results should be interpreted in relation to other behavioral data and to case history information, never in isolated.

Tests and other assessment

procedures are powerful tools, but their effectiveness will depend on skill and knowledge.

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TYPES OF TESTS Informal versus standardized testsIndividual versus group testsMastery versus survey testsSupply versus selection testsSpeed versus power testsObjective versus subjective tests

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InterviewingInterviewingTypes of interviews:

◦Unstructured—allow child/parent to “tell their story”

◦Semi-structured—provide flexible guidelines, a starting point

◦Structured—most often used to make diagnoses or in research studies, standardized May interfere with rapport Does not provide info on family interactions or a

functional analysis of behavior◦Which types of interview require the

most clinical skill??

Explaining ConfidentialityExplaining ConfidentialityParents sign releases of informationReview concept of confidentiality and its limits

early in clinical interactionLimits to confidentiality:

◦Specific threat to someone else (homicidal ideation)

◦Self-harm is threatened (suicidal plan/intent)◦Sexual and physical abuse (history or current)◦Insurance requests◦Courts◦Generally referral source

Interviewing TechniquesInterviewing TechniquesEstablishing rapport is crucialMoving from open-ended to closed-ended questions (general to specific)

◦Tell me about why you’re here today?◦What about school is most difficult for you?◦Are you failing math because you didn’t hand in your homework….not studying……didn’t understand the material?

Avoid◦Double-barreled questions (“and”, “or”)◦Long, multiple questions◦Leading questions◦Psychological jargon

Example Developmental Example Developmental InterviewInterview

A. History of presenting problemB. Prenatal, perinatal, and early postnatal

historyC. Medical historyD. Acquisition of age-related milestonesE. School historyF. Personality, social, emotional, behavioral

historyG. Family historyH. Expectations about assessment visit


A. History of presenting problem◦ Parental description of problem◦ Child’s view of problem◦ Onset◦ Duration◦ Interventions attempted◦ Prior assessments◦ Parents sense of effects of problem,

and sense of child’s understanding


B. Prenatal, perinatal, and early postnatal history

◦ Pregnancy◦ Labor and delivery ◦ Birth weight◦ Apgar scores◦ Complications post-birth


C. Medical history◦ Across all ages◦ Accidents & injures ◦ Major illnesses◦ Ear infections◦ Neurological conditions◦ Congenital and genetic conditions◦ Hearing and eyesight


D. Acquisition of age-related milestones◦ Motor◦ Language◦ Toileting

E. School history◦ Preschool experiences to present – Settings◦ Achievement, grades, strengths and

weaknesses◦ Behavioral, emotional, social functioning◦ IEPs, 504 Plans, accommodations,

modifications◦ What teachers think


F. Personality, social, emotional/mood, behavioral history across development◦ Temperament as an infant and toddler◦ 2.5-5 years: Development of play,

aggression, interests◦ 5-11 years: Hobbies, activities, friendships,

family relationships◦ 11 to adolescence: Development of interest

in opposite sex, dating and sex, activities, drug and alcohol use, family relationships, self-concept, goals and aspirations


G. Family history◦ Parental history: marriage(s), # children◦ Demographics, ages, education,

occupation, SES◦ Siblings: ages, problems, school history◦ Medical, genetic, developmental,

psychological, abuse problemsH. Expectations about assessment visit

Developmental Developmental ConsiderationsConsiderations

Young children tend to think in concrete ways, while teens may reflects more on feelings and motivations

While age is an obvious indicator of developmental level, language and cognitive levels may also vary with age

Interview format should be adjusted to the individual child’s level◦Open vs. Closed questions

Developmental Developmental ConsiderationsConsiderations

6 year olds might be asked about the difference between preschool and kindergarten

Young teens might be asked about the transition to individualized school schedules and homework, and peer pressures.

Older teens might be asked about college, vocational plans, or separating from parents

Format of the InterviewFormat of the InterviewWho will be interviewed is often a

question with young patients◦e.g., Children under 6 typically are

generally interviewed with parents, then sometimes parents are seen alone

◦e.g., Older children and adolescents are often seen as a family first and then later may be interviewed alone

◦Sex abuse may be an exception

Format of the InterviewFormat of the InterviewIf the clinicians sees family

together it allows for:◦Observation of interactional patterns◦Areas of agreement and

disagreementTell family how their time will be

structured◦Allow them to know if they can save

sensitive topics for when they are alone

Closing the InterviewClosing the InterviewSummarize what has been learned

◦Make sure you understand what the interviewee has reported

◦Helps determine what additional information might be needed

Ask the child/family if they have questions

“Is there anything else I didn’t ask about that you think it would be important for me to know?”

Behavioral ObservationsBehavioral ObservationsPsychological assessments always

include observations about the patient’s behavior during the assessment

Collected throughout the assessment Areas assessed/observed:

◦Orientation (person, place, time)◦General appearance and behavior

Gait, posture, dress, personal hygiene, activity level◦Speech and thought

Coherence, speed, open vs. guarded

Behavioral ObservationsBehavioral ObservationsGeneral response styleMood and affect

◦Euthymic vs. dysthymic◦Labile, blunted, etc.

Reactions to being evaluatedResponse to encouragementAttitude towards selfUnusual habits, mannerisms,

vocalizations

Behavioral ObservationsBehavioral ObservationsHow child relates to parent?How child relates to examiner?How child reacts to test materials

or toys?Is the child age appropriate in

behavior?How is the child’s concentration?

Behavioral ObservationsBehavioral ObservationsAre tantrums seen?Does the child cooperate?What is the extent of child’s

responses?◦short vs. elaborate

How is the child’s speech and language development?

Informal AssessmentInformal AssessmentSelf-monitoring recordsReport cardsPersonal documents

◦Diaries, poems, storiesRole playing

Consideration assessing young children

• Clearly specifying what is to be assessed has priority in the assessment process.

• An assessment procedure should be selected because of its relevance to the characteristics or performance to be measured

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• Comprehensive assessment requires a variety of procedures.

• Proper use of assessment procedures requires an awareness of their limitations.

• Assessment is a mean to an end and not end in itself.

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Multimodal AssessmentMultimodal AssessmentObtaining information from several

sources◦Integrate information from several sources◦Recognize limitations of any one source

Using several assessment methodsAssessing several areas of functioning

◦Strengths and weaknessesChild, parents, teachers, previous

evals, school recordsIntelligence, memory, academics,

mood, behavior

Interpreting ResultsInterpreting ResultsAre test results congruent with other

information obtained?How can you account for

discrepancies in teacher, parent, child reports?

Do findings appear to be reliable and valid?

INTEGRATING results from multiple sources is a critical clinical skill

Assessment is a process

1.Evaluating and selecting assessment battery

2.Establishing rapport3.Scoring the assessment battery 4.Interpreting assessment results 5.Formulating recommendations6.Communicating the assessment

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Final Steps in AssessmentFinal Steps in AssessmentDevelop intervention strategies

and recommendationsWrite a reportProvide feedbackFollow-up

Key IngredientsKey Ingredients

Successful assessment requires knowledge of:◦Psychological tests◦Psychopathology ◦Interviewing◦Statistics◦Development◦Hypothesis testing◦Your self

THANK YOU

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