Severe and Multiple Disabilities – ASSESSMENT
By Jeanette,
Jennifer, Lynn, and Shea
ASSESSMENT
OF HEARING
Children with multiple disabilities may
not respond to auditory stimulus for a variety of reasons. They may not be able
to hear or they are inattentive. Clinicians working with such children need to
use a wide range of sophisticated techniques to assess their true auditory
status. For these children, audiological assessment is divided into two major
methods: electrophysiological and behavioural (Winzer, 2008, p. 498) .
Electrodiagnostic procedures
provide information regarding responses to auditory stimuli. They include
electroencephalography-evoked (EEG) response audiometry. This is also known as
auditory brainstem evoked response. By evaluating a child’s brainwave patterns,
an estimate of hearing and loss can be made. This method tests the physical
elements of hearing, not whether a child has the ability to interpret the
auditory stimuli (Winzer, 2008, p. 498) .
Behavioural testing gives
further comparative results that may be used for prognostic purposes. These
methods include observation of behaviour, reflex audiometry, and play
audiometry. These methods involve watching children’s responses to sound and
its source. Children over the age of two
can be assessed using play audiomety as a technique to observe how a child
performs an activity in response to sound (Winzer, 2008, p. 499) .
Electrodiagnostic procedures assess the
electrical activity of the optic pathway and occipital cortex of the brain.
Behavioural measures include field tests that use objects and lights.
Functional tests assess the visual behaviour of a child, such as tracking
objects, using visual fields, and development of eye-hand coordination. (Winzer,
2008, p. 499)
PSYCHO-EDUCATIONAL
ASSESSMENT
For children with severe and multiple
disabilities psycho-educational assessment is a compilation of many separate
but equally important goals. This type of assessment investigates and attempts
to measure the child’s overall level of intellectual function, the child’s
impairments, and the child’s strengths. These assessments should be ongoing and
preformed on a regular (yearly) basis. This assessment data is used to develop
an individual educational plan (IEP) and appropriate placement (Winzer,
2008, p. 499) .
When assessing children with severe and
multiple disabilities it is very important to consider the environment or
setting the testing is taking place in. Adaptations may need to be made to
create an environment that is as natural to the child as possible. The
practitioner needs to establish a rapport with the child and the family. The
testing needs to take into account the child’s abilities and if it is relevant.
In psycho-education testing, direct
observation is the primary procedure. “Arena testing is an observational
assessment approach in which people from several disciplines focus on their
particular domains within the context of play. Activity-based assessment measures functional skills; collaborative ongoing assessment
follows a child through a day's activities” (Pearson Education, 2010) .
Questionnaires and interviews conducted with parents and teachers are important
indicators of a child’s strengths.
Educational assessments focus
on functional areas of competence in the domains of communication, social
behaviour, self-help, and independence skills.
STRUCTURE FOR PSYCHO-EDUCATIONAL
ASSESSMENTS
|
Type of
assessment
|
Purpose
|
Examples
|
|
Academic
achievement
|
To
identify level of performance, Identifying specific academic achievements
|
Achievement
tests Diagnostic tests
|
|
Learning/thinking
skills
|
To
explore/assess skills used in learning and thinking
|
Concentration,
memory, learning style, perception, questioning skills
|
|
Intellectual
|
To
explore strengths/ weaknesses in learning. Identify current levels of
intellectual functioning
|
Intelligence
scales
|
|
Personality/emotional
|
To
explore personal factors which may affect learning
|
Personality
tests Self-esteem inventories
|
|
Behaviour
|
To
explore behavioural factors affecting learning
|
Behaviour
checklists and rating scales
|
|
Physical/medical
(to be carried out by a medical practitioner)
|
To
identify any physical/ medical problems that may interfere with learning
|
Neurological
examination, vision, hearing, general medical examination
|
Source: Alberta Education (1994) Standards
for Psycho-Educational Assessment (Desforges & Lindsay, 2010, p. 68)
REFERENCES
Desforges, M., &
Lindsay, G. (2010). Procedures used to Diagnose a Disability and to Assess
Special Educational Needs: An International Review. Retrieved May 19, 2013,
from NCSE: The National Council for Special Education:
http://www.ncse.ie/uploads/1/5_NCSE_Diag_Ass.pdf
Pearson Education. (2010). Children
with Exceptionalities in Canadian Classrooms. Retrieved July 2012, from
Pearson Education:
http://wps.pearsoned.ca/ca_ph_winzer_children_8/66/16943/4337609.cw/-/t/index.html
Winzer, M. (2008). Children with
Exceptionalities in Canadian Classrooms. Toronto: Pearson Prentice Hall.
Assessments for children with severe or multiple disabilities can be an incredible challenge. For parents and the children themselves it can feel all consuming and overwhelming. When my daughter was young we started the long road of assessments. She has had: a neuropsychological assessment that took two full days (in a hospital setting and in her own classroom setting); EEG’s that average 2 hours each, every couple of years; a Video EEG that is a full day assessment matching video coverage to the digital EEG; CAT scans; MRI scans; Autism screening that took several hours; Autism assessment that took several hours; and many physical tests such as biopsies & blood work. Not only do the actual assessments take a long time, there is also the travel time to get to the specialist that are never in your local community. There then seems to be a million doctor appointments to get the referral for the assessments, the prep for the assessment and then the follow up after the assessment. I could go on and on, but my point is that assessments are important and as a parent you will do whatever it takes to help your child. The more you know about what your child is dealing with the more you know how to assist them and the more you can ask for assistance from agencies. However, there does come a time when you need to consider the quality of life for your child with the never ending pursuit of assessments. Acceptance is okay.
ReplyDeleteUnfortunately students have to wait a long time to get assessments through the school system, and like you said Jennifer it is exhausting. If only there was a faster simplier way to get an answer.
ReplyDeleteI do not know enough about the assessment process, but I wonder if there was a 'case manager' (perhaps a family doctor) to oversee and manage all the information? If you go to one specialist who sees symptoms one thing and another who sees symptoms of another disability are they communicating with each other? Its seems that this process can be riddled with stumbling blocks based on communication.
ReplyDeleteThe process of assessment is a continuous one. Children grow and develop. An assessment done at the age of 3 may not be the same as one done at the age of 8. It is a long road.
ReplyDeleteFor any child with an exceptionality, a multi-disciplinary approach needs to be used to assess the impact of the disability, and the possible causes. It is unfortunate that students have to wait for an assessment. I intend to read more about what is involved in the assessment process.
ReplyDelete