Early Childhood Assessment Why, What, and How (2008) / Chapter Skim
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4 Screening Young Children
4 Screening Young Children
Pages 61-84
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From page 61... ...
We describe various screens performed on infants and toddlers to detect possible physiological, sensorineural, (micro) nutritional, and environmental threats to healthy development, and then we review assessments of developmental status and their use for screening purposes.
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From page 62... ...
Over the past half-century, behavioral development has become an integral part of regular pediatric evaluation, and pediatricians routinely provide clinical information on behavioral, cognitive, and psycho social factors, thus providing a more comprehensive picture of each child's overall growth and development. The integration of biophysical examination with cognitive and socioemotional assessment links early infant assessment with the developmental outcomes of interest in this report.
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From page 63... ...
. Most of the assessment conducted in this age range is actually screening to identify potential problems, to be followed by more definitive diagnostic assessment.
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From page 64... ...
and regular developmental assessment is recommended for well-child care, the pediatric setting thus becomes the most likely site for infant and toddler screening. This fact has implications for the training of pediatric personnel, for the design of organized data systems useful in ensuring that all children are screened for developmental problems, and for an integrated service delivery system that spans medical and educational settings.
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From page 65... ...
The prevention of developmental disability requires a system of detection, validation, and treatment, and the treatments may be onerous, thereby affecting compliance. Finally, many more infants test positive on the screening tests than have the disease, and assessing these infants adds to the costs without preventing disability.
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From page 66... ...
Preventive Services Task Force concluded that the evidence at that time was incomplete as to the benefit of newborn hearing screening, but an updated review is in progress (U.S. Preventive Services Task Force, 2001)
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From page 67... ...
The U.S. Preventive Services Task Force concluded that the routine screening currently done has not been shown to be effective, although the potential benefit outweighed the minimal risk of the screening (U.S.
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From page 68... ...
DEVELOPMENTAL ASSESSMENT Newborns Developmental assessments provide useful information about overall physiological status and risk. Neurodevelopmental examinations initially focused on neurological reflexes and postural reactions that can be elicited in the newborn, which emerge and disappear within fairly specific time periods, as a means of assessing central nervous system integrity, especially early signs of cerebral palsy (Zafeieriou, 2003)
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From page 69... ...
It should be noted that the major outcome being predicted is cerebral palsy. More recently, neurodevelopmental assessment has also focused on behavioral attributes of the infant, particularly as they reflect organizational state and the ability to interact with the environment.
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From page 70... ...
Like the NBAS, the APIB forms the basis of an intervention, the Newborn Individualized Development Care and Assessment Program, intended to improve the develop mental outcomes of preterm infants by teaching caregivers in the neonatal intensive care unit how to interact more sensitively with the infant. If the intervention improves performance on the APIB and leads to better long-term outcomes in early childhood, then one might argue that the APIB has predictive validity, and Als et al.
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From page 71... ...
No matter which of these approaches is used initially, any child found to have developmental difficulties requires access to the third type, a more refined assessment with a professionally administered developmental tool. The large number of available assessment instruments has been summarized in several publications (Buros Institute of Mental Measurements, 2007; Child Trends, 2004; Glascoe, 2003, 2005; Glascoe et al., 1990; Mathematica Policy Research, 2003)
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From page 72... ...
Challenges in Effective Infant Screening There are two sets of challenges to be faced in generating an optimal system of infant assessment for screening purposes. The first set has to do with the inherent difficulty of assessing very young children reliably and validly, and the second with the many societal conditions that need to be in place to ensure effective infant assessment and use of infant assessment information The Difficulty of Assessing Young Children Very young children are hard to assess reliably and validly because of the relatively undifferentiated nature of their capabilities.
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From page 73... ...
By age 5, the child's major developmental challenges include expressive language and social communication skills, affect regulation in the context of broader social and peer relations, and cognitive maturation commensurate with instruction in a formal educational setting. The child's expanding repertoire of behavioral and social a bilities, including linguistic communication skills, opens up more options for assessment during the toddler years.
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From page 74... ...
Thus, the screening assessments may not be administered and, if they are, may not provide comparable information across providers. A recent assessment of the quality of pediatric ambulatory care revealed that children received fewer than half of the recommended procedures and that screening procedures were particularly unlikely to be performed (Mangione-Smith et al., 2007)
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From page 75... ...
This means that some infants and toddlers are not screened, and that those who are identified as requiring diagnostic assessments and other services may not receive them. As noted above, much of the early screening is accomplished in health care settings, and access to care is heavily dependent on having health insurance.
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From page 76... ...
Likewise, screening for iron deficiency should attend to the cognitive deficits associated with it as much as evaluating the child's nutritional status and addressing questions about the production and destruction of red blood cells and potential covert blood loss. Conclusion Assessment of important behavioral and physiological outcomes for infants and toddlers is an increasing focus of pediatricians, primary medical care providers, and providers of care and education to infants and toddlers.
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From page 77... ...
Test IIa Parents' Evaluation of Brigance Screens Developmental Statusa Fagan Test of Infant Intelligence Infant Monitoring Systema Denver Prescreening Developmental Questionnairea 77 continued
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From page 78... ...
Diagnostic Bayley Scales of Infant Development, Third ed. McCarthy Scales of Children's Ability Mullen Scales of Early Learning aIncludes questions on behavioral issues or personal-social development.
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From page 79... ...
Diagnostic Receptive Expressive Emergent Reynell Developmental Language Sequenced Inventory of Language Scale (REEL) a Scales Communication Development MacArthur-Bates Communicative Preschool Language Scale Development Inventories Test of Early Language Development aRequires trained interviewer/observer.
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From page 80... ...
Motor Quotient (Capute and Shapiro, 1985) Diagnostic Bayley Scales of Infant Development, Third ed.
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From page 81... ...
APPENDIX TABLE 4-4 Domain: Social-Emotional Data-Gathering Method Instrument Type Caregiver Report Observation Mixed/Both General Eyberg Child Behavior Inventory Bayley Scales of Infant Vineland Social-Emotional Maturity Infant-Toddler Social Emotional Development, Third ed. Scalea Assessment, ITSEA Brief Infant-Toddler Social Emotional Assessment, BITSEA Achenbach System of Empirically Based Assessment Devereux Early Childhood Assessment Temperament and Atypical Behavior Scale (TABS)
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From page 82... ...
aRequires trained interviewer/observer. APPENDIX TABLE 4-5 Domain: Function/Activities of Daily Living Data-Gathering Method Instrument Type Caregiver Report Observation Mixed/Both All Vineland Adaptive Behavior Scale-IIa aRequires trained interviewer/observer.
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From page 83... ...
APPENDIX TABLE 4-6 Domain: Temperament Data-Gathering Method Instrument Type Caregiver Report Observation Mixed/Both All Toddler Behavior Assessment Questionnaire (Carey Scales) Children's Behavior Questionnaire (Putnam and Rothbart, 2006)
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From page 84... ...
84 APPENDIX TABLE 4-7 Domain: Attachment/Caregiver-Child Interaction Data-Gathering Method Instrument Type Caregiver Report Observation Mixed/Both All Ainsworth Strange Situation Procedure Preschool Assessment of Attachment (Teti and Gelfand, 1997) Nursing Child Assessment Satellite Training
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