281 -Infant Toddler Development Part 3
Counselor Toolbox

 
 
00:00 / 59:38
 
1X

ITDS 3
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs Counselor Education
Podcast Host: Counselor Toolbox, Addiction Counselor Exam Review and Happiness Isn’t Brain Surgery

Objectives
~ Define the issues and trends related to assessment of young children with disabilities
~ Describe characteristics of and various formats for effective observation
~ Describe the critical role the family plays in the screening, evaluation and assessment processes
~ Identify strategies to establish a collaborative partnership with the family and engage them in the assessment process
~ Describe effective communication principles and techniques with families including consideration of cultural and linguistic differences
~ Demonstrate knowledge of home based and group-care based curriculum strategies for infants and toddlers with special needs.
~ Identify the relationship of an infant/toddler's functional outcome goals on his/her IFSP created by the family and other team members with integrated interventions.
~ Assist the family in accessing services in the most natural service delivery environments

Measurement Processes and Issues

~ Challenges and Opportunities
~ Children have short attention spans, limited expressive skills, struggle with separation issues, fatigue easily, adapt slowly to new surroundings, and exhibit a wide range of typical behaviors. (McLean, 2004)
~ The continuity and stability of the behavior of infants and toddlers varies from hour to hour or day to day. (Mindes 2003; Overton, 2003)
~ Many providers have difficulty accepting the role of the family in the evaluation and assessment process
~ The child is seen in the context of the familial, cultural and community systems which change as the child develops. (stationary to mobile; quiet to talking)
~ Consider transaction and reciprocity between the child, family, culture, community.
~ Be observant of the secondary effects of the disability on the child
~ Assessment of English Language Learners (ELLs*) and children from different cultures should focus on observation and informal procedures
Using Observation as a Strategy

~ 3 major purposes of observation:
~ to understand children's behavior
~ to evaluate children's development
~ to evaluate progress.
~ For young children who have not mastered the use of language and cannot explain the reasons for their behavior, observers gain a great deal of insight by watching and taking detailed notes.
~ A good observer pays attention to the context as well as the frequency of the behavior, facial expressions of children, their actions, and their reactions.
~ While observing, the observer records information about the child's strengths and perhaps areas of skill that have not been attained.
~ Observation is an excellent tool to determine progress and accomplishment of certain milestones and goals.

Types of Observation
~ An anecdotal record is a written episodic description of a child's behavior, event or incident (parent report)
~ Running records an effort is made to record everything that was said or happened within the observational period (transcription)
~ Event sampling is when the observer records the frequency of occurrence of the behavior of interest (tally)
~ A checklist is a list of sequential behaviors. The observer can use the checklist to determine whether the child exhibits the behaviors or skills listed. (greeting someone)
~ Rating scales are used to determine the degree to which the child exhibits a certain behavior or the quality of the behavior. (anxiety, attention, motivation)
Assessment and Observation
~ Information gathering should be viewed as an on-going process
~ Dangers in this form of assessment
~ Observer bias…a preconceived idea of the behavior
~ Children’s behavior may not be the same when being watched.
~ The early intervention provider should be continually modifying his/her understanding of a family's resources, priorities and concerns in relation to
~ Their child (child’s needs, child’s behaviors(“terrible 2s”)
~ Broader family issues (employment, discord, sibling rivalry)
~ To provide services for infants and toddlers and their families in natural environments, it is critical to involve parents in the assessment process within natural environments
Assessment and Trauma
~ Assess for the range and timing of traumatic events
~ Assess for a wide range of symptoms (beyond PTSD), risk behaviors, functional impairments, and developmental derailments.
~ Try to make sense of how each traumatic event might have impacted developmental tasks and derailed future development.
~ Note: this may be challenging given the number of pervasive and chronic traumatic events a child may have experienced throughout his or her young life.
~ Try to link traumatic events to trauma reminders that may trigger symptoms or avoidant behavior.
~ Trauma reminders can be remembered both in explicit memory and out of awareness in the child’s body and emotions.

Trauma and Development
~ Behavioral: Since most young children aren't good at verbalizing their feelings, behavioral changes (Increased oppositional behavior, aggression, impulsivity and self-destructive behavior ) often indicate they are struggling.
~ Physical: Kids who are exposed to repeated trauma may have physical developmental delays because they become hypersensitive to physical contact, may develop sensorimotor problems and have somatic complaints
~ Cognitive: Trauma can cause kids to have increased difficulty paying attention which can cause learning difficulties, and delays in speech and language development.
~ Attachment: Trouble with relationships, boundaries, empathy
~ Self-Concept: Lack of consistent sense of self, body image issues, low self-esteem, shame and guilt (Cook, et al 2005)

Linking Assessments to Interventions

~ Evaluation and Assessment Information Needed for Planning Intervention
~ Assessment data from criterion referenced instruments such as the HELP, AEPS, Bayley, or the ELAP
~ Simple checklist for screening
~ Assessment information for planning programs for individual infants and toddlers should be gathered from multiple sources and from multiple perspectives
Role of Family Members in the Assessment
~ The family member may assume the role of interpreter of the child's behavior to professionals.
~ The family or caregiver may be able to elicit a response or interact with the child.
~ Generate a list of persons, social organizations and agencies that they have contact with on a regular basis
~ Family members may be asked to participate by preparing in advance for the sharing session.
~ What were your overall impressions during the assessment today?
~ What did you think that your child did well?
~ What skills did you notice that your child needed help with?
~ What seemed difficult?
~ Did you notice anything that did not seem to be typical of your child?
Family in Play Assessment
~ Parents can suggest what the child likes to play and what their favorite toy is.
~ During the process the parent may be the person to interact with the child in order to elicit a more typical response.
~ After the session, parents should be involved in the discussion of the child's performance and how they view the next steps for interventions.
Skills Observed during Play Assessment
~ Engagement in pretend play
~ Curiosity/enjoyment
~ Frustration levels and response
~ On task
~ Interactions with peers
~ Types of symbolic play
~ Communication
~ Use of objects/toy
~ Interactions with facilitator
~ Task persistence
~ Toy preference (ribbons)
~ Problem Solving

Cognitive Assessment
~ Discrimination – When given a shape, can the child find another shape similar or one that is different.
~ Generalization – When given a stimulus, can the child find another item that goes with it such as when shown a cup, the child identifies a saucer.
~ Classification – Group similar items together based on a common trait.
~ Sequencing – The child put things in the correct order for a series of items such as organize blocks from biggest to smallest.
~ Detail recognition – The child determines the missing item. For example, if shown a face without a mouth, the child recognizes the missing mouth.
~ Vocabulary – For infants and toddlers, vocabulary development is often measured by naming or pointing to pictures of familiar objects.
~ Comprehension – The child is asked to demonstrate understanding of directions or certain situations such as what is something with wheels that you ride in.
~ Memory – These items typically ask a child to repeat a phrase, several words or numbers.
Motor Assessment
~ Domains of motor assessment include:
~ Gross motor skills that involve the large muscles and include rolling over, creeping, crawling, walking.
~ Functional gross motor skills include transferring from a wheelchair to the floor or toilet.
~ Fine motor skills include the use of small more distal muscles such as the fingers. Fine motor milestones include reaching, grasping, and releasing.
~ Functional fine motor skills include eating, drinking, and picking up small toy pieces.
~ Oral motor skills involve those with the mouth, tongue, teeth, facial and jaw muscles. Milestones in the oral motor area involve sucking, swallowing, biting, and chewing.
~ Functional oral motor skills include eating and talking.

Motor Assessment
~ Motor assessment with very young children should assess functional motor skills such as:
~ Patterns of locomotion
~ The child's ability to move in the environment, to act on their environment and to make meaningful use of information from their environmental interactions (Harris & McEwen, 1996).

Social Skill Assessment
~ A primary focus from birth to 12 months is the child's response to adults.
~ The child's ability to sustain his own wants and needs in order to share with others begins to increase as the child reaches his second birthday.
~ During the second year, the infant expands on his relationships with others, primarily adults and engages in increasingly sophisticated social behavior (Blasco, 2001).
~ From 24 to 36 months, the focus changes as the child's interest in peers increases
Social Skills Assessment
Developmentally Appropriate Practices (DAP)
~ Help children develop the same self-sufficient functional outcomes as their peers
~ Play-based learning in small groups, rather than one-to-one instruction
~ Small group activities are preferred to support social competency
~ Objectives for activities are embedded into everyday routines activities
~ Adult responsiveness to the child's interests and needs, supporting learning through scaffolding
~ Assessments are to be more natural and in context with the child's regular functions, play, and daily living activities.
~ Children are actively engaged in learning and participate as fully as possible in decision-making
~ Recognize the importance of children's families as their child's first teacher and advocate
Prioritizing Goals
~ In considering which goals and objectives should be selected, the following should be considered:
~ Does the outcome have immediate benefit and provide an opportunity for the child to become more independent and function better in natural environments?
~ Does the outcome allow the child to learn skills that will result in learning other skills?
~ Are the outcomes functional across multiple settings currently and in the future?
~ Can the outcomes be carried out in everyday routines, activities and places?

Activity-Based Intervention Model
~ Four key elements:
~ Activities and actions initiated by children are more likely to attract and hold a child's attention and as a result maintain their involvement.
~ Training and intervention (addressing IFSP/IEP goals and objectives) are embedded within routine, planned, or child-initiated activities.
~ Involves the systematic use of appropriate antecedents and consequences which naturally occur during ongoing classroom activities.
~ Address skills for the child that are functional and generative.
Seven Types of Learning
The child, parents and team all learn in the process.
~ Induction (comparisons between/among objects and ideas to make new discoveries)
~ Cognitive Dissonance (surprise and intrigue. So how did that happen…?)
~ Social interaction (ideas bounced around people with richer outcomes than any one person could have developed along)
~ Physical experiences (Get in there and move things around to learn to work children's muscle memory – the younger the child, the more important the need to learn through actions)
~ Revisiting (Hum…I used to think this, but when I looked again…)
~ Competence (I can do this!…and this skill helps me learn the next skill)
~ Play.
Characteristics of Play
~ Voluntary – freely chosen, desire is strong
~ Meaningful – involves deep mental activity that seems to take over so much that the people involved in play block out everything else around them
~ Symbolic – representation of behaviors and actions (Dress up)
~ Rule-governed, but rules explored – as they play people conform to conventions of life as they know it, but explore life as they would like it to reach for new goals and rules…taking it to another level or dimension
~ Pleasurable – You can see it on their faces. While seriously engaged, they are happy…
~ Episodic – They are involved in mutually developed “scripts” of play and negotiate and respond contingent to others; to objects in the play
Scaffolding
~ Scaffolding is a teaching method that enables a student to solve a problem, carry out a task, or achieve a goal through a gradual shedding of outside assistance.

Documenting Progress
~ A portfolio may include photographs, checklists of skills that children have achieved, monitoring forms, social play records, anecdotal records, scribbles and drawings, early attempts at painting, recordings of language samples, and a variety of other things to document progress
Guidelines to Enhance Development
~ Provide positive care and education from a consistent limited number of adults
~ Be sympathetic to the wide diversity of development and cultural diversity of children and families
~ Provide appropriate activities within a flexible, yet predictable schedule
~ Provide an attractive, inviting and safe physical environment for play and daily routines
~ Supervise children's activities, respecting their increasing need for exploration, risk-taking, and self-regulation of behaviors
Guidelines to Enhance Development
~ Maintain an atmosphere that supports problem-solving and increasingly more challenging activities to stimulate growth
~ Know when to be involved, direct, support, or guide children's play and daily routines and when to step back and observe to allow the child to take initiatives that are challenging, but not frustrating
~ Work collaboratively and in a coaching model with other adults/family in the best interest of the infant/toddler
~ Be willing to reflect on current strategies to change or adapt in the best interest of each infant/ toddler
Summary
~ Several methods were discussed for assessing children in the cognitive, communication, motor and social areas.
~ Developmental delays in any of these areas can impact all other areas.
~ Assessment is an on-going process especially with young children.