Unit II: Functional Assessment
1. Need for Functional Assessment
2. Types of assessment
3. Methods of Assessment
4. Assessment of - Language & communication - Social behavior - Motor skills - Learning styles & strategies - Challenging Behaviours
5. Tools of Functional Assessment – PEP-R, APEP, ABLLS, TTAP, VABS II
1. Need for Functional Assessment
Functional assessment is a continuous collaborative process that combines observing, asking meaningful questions, listening to family stories, and analyzing individual child skills and behaviors within naturally occurring everyday routines and activities across multiple situations and settings.
The subgroup that worked on the definition established a priority to describe what functional assessment looks like throughout the early intervention process. For the purposes of conversations and training materials, the subgroup offers the following visual representation example and definitions.
Functional assessment is a continuous collaborative process that combines observing, asking meaningful questions, listening to family stories, and analyzing individual child skills and behaviors within naturally occurring everyday routines and activities across multiple situations and settings.
CONTINUOUS-from referral throughout the early intervention experience
COLLABORATIVE PROCESS- building and maintaining rapport and relationships among early intervention team members including the service providers and family members/caregivers
OBSERVING- observations, including videos, of the child in the home and in other natural environments
ASKING MEANINGFUL QUESTIONS-promoting a conversation with the family using open-ended questions to convey respect that enhances family-centered services
LISTENING-connecting with the family to gain a comprehensive understanding of their priorities and concerns based on their resources, values and culture
ANALYZING- putting together information about the child from all sources (parent report, observation, age-anchored assessment tool, etc.) in order to understand the child’s functioning compared to same age peers
NATURALLY OCCURRING -the activities and routines the child participates in that are unique to the family’s culture, community, and values
MULTIPLE SITUATIONS AND SETTINGS- a skill becomes mastered when a child is able to do it in multiple places with multiple people.
A functional assessment examines antecedents to the problem behavior and the consequences that occur following the behavior. A hypothesis is then formed about what outcome the student gains by using this problem behavior.
The outcome, from the student's perspective, is in terms of either:
1. Getting something desired (This behavior is working, or has worked in the past, to gain something. In other words, the behavior maintains because it is "positively reinforced."), or
2. Protesting, Escaping or Avoiding something undesired (This behavior is working, or has worked in the past, to remove, partially remove, or communicate displeasure about something undesired by the student. In other words, the behavior maintains because it is "negatively reinforced.")
Importance of Functional Assessment
It is imperative that the team designing a behavior plan carefully develop the
hypothesis about the function of behavior. The plan will both teach a
replacement behavior that meets the same function and will specify
environmental alterations that remove the need for the student to use this
problem behavior to get his/her needs met. For example, if the hypothesis of
the behavior is "revenge," a plan would teach the child how to get
revenge in a better way, which is not a viable option. However, if the hypothesis
of the behavior is "a protest about the past action of peers," the
plan would teach the student a more appropriate protest form that would meet
his/her needs, which is a viable option.
2. Types of assessment
Assessments are the first step to identifying what services would help the individual seeking our services best.
Screening and Diagnostic Assessments
Screening and diagnostic assessments for autism are usually made after detailed interviews with the family members, and after observations of and interactions with the individual with autism. The specific protocol used will depend on the age, skills and interests of the individual, as well as his or her background. We base our diagnoses on internationally standardised diagnostic criteria (Diagnostic and Statistical Manual- 5) and a variety of standardised screening / diagnostic instruments.
The diagnostic team at AFA conducts screening and diagnostic assessments for individuals across all age groups and across the spectrum of autism. Our staff is trained in the reliable administration of the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R), and these tools may be used in the process of arriving at the diagnoses. We also use various other screening and diagnostic tools, including the SCQ, SRS, MCHAT-R and other different developmental assessments. Determining related disorders and differentiating ASD from other disorders is also a part of the diagnostic assessment.
Following the assessment, parents are provided with feedback about the process used to reach the diagnostic decision and information on autism and services necessary to start intervention. We find it useful for parents to bring or send, ahead of time any past diagnostic evaluations, where applicable. We also prepare a detailed report for the parents informing them about the diagnosis and our recommendations.
Functional Skills Assessments
Autism is hallmarked by an uneven skill profile. A functional assessment of the person with autism helps determine the existing skill sets and the future goals. It provides a detailed insight into the current level of performance of the child in various skill areas including motor, communication, speech, imitation, cognition and activities of daily living.
The assessment is made over multiple sessions through a series of observations, direct work sessions with the child and discussion with the family. An Individualised Education Programme (IEP) is prepared on the basis of functional assessments. The process therefore may require more than one visit with the child to AFA. Given the variability on the spectrum, as well as the unevenness in skill development, regular functional assessments can be used effectively to monitor progress.
Occupational and Sensory Assessment
A detailed assessment is made based on a sensory profile questionnaire which addresses all the sensory systems in depth, along with direct observation of the child and feedback from parents. The assessment is conducted by Occupational Therapists who are also trained in Sensory Integration Therapy. This evaluation provides a base for all subsequent occupational and sensory interventions for the child.
3. Methods of Assessment
The purpose of the Autism Assessment is to determine whether an individual is on the autism spectrum and to provide information about their presentation and support needs. This assessment is suitable for individuals 2 years and over who have never been diagnosed with autism before or where there has been conflicting opinions expressed by professionals and clarification is sought. Autism Assessments can be used to assist in applications for funding (e.g. NDIS eligibility, Disability Support Pension, school supports) and include information to assist with support planning.
Early Development assessments are for very young children (under 2 years) where parents are concerned about their developmental progress. This assessment provides information about the child’s functioning across all developmental areas and also determines whether or not early signs of autism are present.
Review assessments are for an individual previously diagnosed with autism. These assessments are very useful at times of transition (e.g. when commencing primary school or high school or post-school planning) or to assist in applications for funding (e.g. NDIS eligibility, Disability Support Pension, school supports). They are designed to provide updated information about an individual’s strengths and challenges and include recommendations to assist with support planning.
In your classroom, assessments generally have one of three purposes:
1. Assessment of learning
2. Assessment for learning
3. Assessment as learning
Assessment of learning
Assessments are a way to find out what students have learned and if they’re aligning to curriculum or grade-level standards.
Assessments of learning are usually grade-based, and can include:
· Exams
· Portfolios
· Final projects
· Standardized tests
They have a concrete grade attached to them that communicates student achievement to teachers, parents, students, school-level administrators and district leaders.
Common types of assessment of learning include:
· Summative assessments
· Norm-referenced assessments
· Criterion-referenced assessments
Assessment for learning
Assessments for learning provide you with a clear snapshot of student learning and understanding as you teach -- allowing you to adjust everything from your classroom management strategies to your lesson plans as you go. Assessments for learning should always be ongoing and actionable.
Assessment as learning actively involves students in the learning process. It teaches critical thinking skills, problem-solving and encourages students to set achievable goals for themselves and objectively measure their progress.
4. Assessment of - Language & communication - Social behavior - Motor skills - Learning styles & strategies - Challenging Behaviours
Communication deficits are a core symptom or ASD, and the assessment of individuals with these disorders requires both formal testing and careful observation of natural and seminatural communicative activities. For children in prelinguistic phases of communication, assessment is aimed at establishing the communicative basis for a formal language system and looking at the frequency, range, and means of expression of communicative acts. Children in the early stages of language use will need to be assessed not only in terms of their vocabularies and sentence structures, but with regard to the unusual communicative patterns that often accompany ASD, such as echolalia, pronoun errors, and significant deficits in pragmatics and receptive language. Some children at this level may require evaluation to determine the best alternative mode of communication if speech has not yet emerged, and an augmentative and alternative communication (AAC) system should be considered. For individuals at advanced language levels, assessment will focus on social uses of communication (particularly pragmatic, narrative, and prosodic skills), and may include an assessment of their written language. For people at all developmental levels and at all points along the autistic spectrum, a comprehensive evaluation of strengths and needs in the area of communication is essential to the development of an effective plan for improving communicative competence.
The ability of children with ASD to communicate and use language depends on their intellectual and social development. Some children with ASD may not be able to communicate using speech or language, and some may have very limited speaking skills. Others may have rich vocabularies and be able to talk about specific subjects in great detail. Many have problems with the meaning and rhythm of words and sentences. They also may be unable to understand body language and the meanings of different vocal tones. Taken together, these difficulties affect the ability of children with ASD to interact with others, especially people their own age.
Below are some patterns of language use and behaviors that are often found in children with ASD.
· Repetitive or rigid language. Often, children with ASD who can speak will say things that have no meaning or that do not relate to the conversations they are having with others. For example, a child may count from one to five repeatedly amid a conversation that is not related to numbers. Or a child may continuously repeat words he or she has heard—a condition called echolalia. Immediate echolalia occurs when the child repeats words someone has just said. For example, the child may respond to a question by asking the same question. In delayed echolalia, the child repeats words heard at an earlier time. The child may say “Do you want something to drink?” whenever he or she asks for a drink. Some children with ASD speak in a high-pitched or sing-song voice or use robot-like speech. Other children may use stock phrases to start a conversation. For example, a child may say, “My name is Tom,” even when he talks with friends or family. Still others may repeat what they hear on television programs or commercials.
· Narrow interests and exceptional abilities. Some children may be able to deliver an in-depth monologue about a topic that holds their interest, even though they may not be able to carry on a two-way conversation about the same topic. Others may have musical talents or an advanced ability to count and do math calculations. Approximately 10 percent of children with ASD show “savant” skills, or extremely high abilities in specific areas, such as memorization, calendar calculation, music, or math.
· Uneven language development. Many children with ASD develop some speech and language skills, but not to a normal level of ability, and their progress is usually uneven. For example, they may develop a strong vocabulary in a particular area of interest very quickly. Many children have good memories for information just heard or seen. Some may be able to read words before age five, but may not comprehend what they have read. They often do not respond to the speech of others and may not respond to their own names. As a result, these children are sometimes mistakenly thought to have a hearing problem.
· Poor nonverbal conversation skills. Children with ASD are often unable to use gestures—such as pointing to an object—to give meaning to their speech. They often avoid eye contact, which can make them seem rude, uninterested, or inattentive. Without meaningful gestures or other nonverbal skills to enhance their oral language skills, many children with ASD become frustrated in their attempts to make their feelings, thoughts, and needs known. They may act out their frustrations through vocal outbursts or other inappropriate behaviors.
Although children with autism spectrum disorder (ASD) often display motor deficits, the nature of these motor deficits remains unspecified. The purpose of this study was to establish a robust motor profile in children with ASD across a wider range of motor skills by using two professionally administered standardized motor assessments alongside a parent report measure to capture a comprehensive view of motor performance compared to a group of neurotypical peers.
Broadly speaking, learning styles can be defined as general approaches to language learning, while learning strategies are specific ways learners choose to cope with language tasks in particular contexts.
Learning strategies are the ways in which students learn, remember information, and study for tests. They refer to the actions and behaviors (The strategies) that depend greatly on their own learning styles.
On the other hand, learning styles refer to the general approaches that students use in acquiring a new language or in learning any other subject.
Each student has his/her own style of learning. As a result, we have different students with different learning styles inside the classroom as shown below:
Visual learners need to see things to fully understand them. They learn best from visual objects such as diagrams, charts, etc. They prefer to write things down.
They learn mainly through listening so they learn best through discussions and talking. They benefit most from reading texts aloud and using a tape recorder.
Learners here learn through using their bodies, hands, and sense of touch. They can use their muscles well so they can be used in playing, tidying, cleaning the board, collecting activity books, etc. They learn best through using their hands making things, fitting things together, or taking them apart so hands-on activities are ideal to help those students learn best.
They prefer to learn in groups or with other people. They have the ability to understand others’ feelings and intentions.
Here, students prefer to work alone and use self-study. They have the ability to understand well their own feelings, strengths, and weaknesses. They tend to write a personal diary, achieve independent projects, discuss feelings about certain topics, express likes, and dislikes, etc.
They prefer using words, both in speech and writing.
They prefer using logic, reasoning, and systems.
Many students use learning strategies automatically without any awareness of them. The role of teachers here is to:
Students use the following learning strategies most often when learning a language:
When they manipulate the language material using indirect ways, e.g. through reasoning, analysis, note-taking, and synthesizing.
When they identify preferences and the need for planning, monitoring mistakes, and evaluating task success.
When they link one item or concept with another but do not necessarily involve deep understanding, e.g. using acronyms, sound similarities, images, keywords.
When they make up for missing knowledge using gestures, miming, or guessing the meaning from the context.
When they manage their emotions by identifying their mood and anxiety level, talking about feelings, rewarding themselves, and using deep breathing or positive self-talk.
When they learn via interaction with others and understand the target culture, e.g. asking questions, asking for clarification, asking for conversation help, talking with a native-speaking partner, and exploring cultural and social norms.
Children and adults with autism spectrum disorders (ASD) are at much greater risk of showing a wide range of challenging behavior (CB) than typically developing people.
These include the reasons for assessment, assessment of topographies, and assessment of function and its implications for treatment. Common problems including aggression, stereotypy, and eating problems in people with ASD are also reviewed. Of most immediate concern are extra-personal maladaptive behaviors, such as aggression and tantrums, because of their negative and sometimes severe consequences for the person and those around them. Intra-personal maladaptive behaviors may also be significant as they may be stigmatizing and may interfere with learning and the expression of adaptive behavior. There are many psychometric measures to assess CB topographies. They can be quick and efficient in the early stages of assessing CB, in screening larger populations, and in periodic screening of individuals, such as during admission to services and annual evaluations. The CB topographies can be readily assessed with screening questionnaires, but these questionnaires are limited in that they do not provide all the information necessary to design an effective intervention plan. Information regarding the establishing operations (Eos), discriminative stimuli, functionally equivalent adaptive and maladaptive behaviors, and contingencies maintaining the CB greatly improve the design of an effective treatment plan. Despite the efficacy of this approach to treatment of CB in people with ASD, certain problems, such as pica, remain more difficult to treat. Additionally, more research involving the dissemination of this technology to routine care providers and practitioners is needed.
5. Tools of Functional Assessment – PEP-R, APEP, ABLLS, TTAP, VABS II
PEP-R
The Psychoeducational Profile Revised (PEP-R) and
now the NEW Psychoeducational Profile (PEP-3): TEACCH Individualized
Psychoeducational Assessment. The PEP-R is a nice assessment and program planning tool for
preschool and gradeschool-aged children with autism. The test covers a variety
of key developmental areas and can help the give one a better picture of the,
sometimes sporadic, developmental patterns of children with autism. The test
items are presented with simple, concrete instructions, and most of the
expected responses are nonverbal.
The PEP-R is the first part of a four volume set, Individualized Assessment and
Treatment for Autistic and Developmentally Disabled Children. The third volume
of this set, Teaching Activities for Autistic Children meshes well with the
PEP-R assessment, providing ideas for teaching skills and behaviors in those
areas where a child may exhibit some deficit.
A description from volume one of the PEP-R:
The PEP-R is an inventory of behaviors and skills designed to identify
uneven and idiosyncratic learning patterns. The test is most appropriately used
with children functioning at of below the preschool range and within the
chronological age range of 6 months to 7 years. If a child is older than 7 but
younger than 12 years, the PEP-R can provide useful information when at least
some developmental skills are at or below the first-grade level. After 12 years
of age, a prevocational evaluation using the Adolescent and Adults
Psychoeducational Profile (AAPEP) (Mesihov, Schopler, Shaffer, & Landrus,
1988) is recommended.
Used as an assessment, the PEP-R provides information on developmental
functioning in
· Imitation
· Perception
· Fine Motor
· Gross Motor
· Eye-Hand Integration
· Cognitive Performance
· Cognitive Verbal areas
The PEP-R also identifies degrees of:
· Behavioral abnormality in Relating
· Behavioral abnormality in Affect (cooperation and human interest)
· Play and Interest in Materials
· Sensory Responses
· Language.
The PEP-R kit consists of a set of toys and learning materials that are
presented to a child within structured play activities. The examiner observes,
evaluates, and records the child's responses during the test. Then, at the end
of the session, the child's scores are distributed among seven Developmental
and four Behavioral areas. The resulting profiles depict a child's relative
strengths and weaknesses in different areas of development and behavior.
Rather than evaluating a child using only Passing or Failing scores, the PEP-R
provides a third and unique score called Emerging. A response scored Emerging
is one that indicates some knowledge of what is required to complete a task,
but not the full understanding or skill necessary to do so successfully. A
child may demonstrate a sense of what a task is about or even partially
complete it, but do so in a peculiar way. These kinds of responses are scored
as Emerging.
APEP
Fiesta Educativa has specifically develop this program with the goal of training parents about the Autism Spectrum Disorder. Even though we are aware of how vast is the information regarding this subject, we have worked really hard to come up with a 16 hour program that covers from the bases of understanding the ASD, to more specific topics such as understanding social, communication and behavioral concerns, available interventions. We also focus on how to maintain an active file on your child to assist in advocacy.
APEP is particularly unique as participants are educated within their own communities. Through this program, parents can foster natural support networks, thus enhancing the communal learning experience. The program has been designed in English and Spanish.
APEP will give you a profound understanding of the Autism Spectrum Disorder .
· The program provides 16 hours of instruction, divided into 4—4 hour session.
· Instruction take place within the community you live.
· The instructors are qualified professional and are Autism expert’s
APEP IS DESIGNED TO:
· Empower parents through education.
· Strengthen regional center relationship and with existing support organizations.
· Promote proactive advocacy to obtain appropriate and realistic services.
· Understand challenges in behavior, communication, socialization; and understand the appropriate and effective interventions to address those challenges.
· Understand what the family can do at home to help their child succeed.
· Teach parents how to maintain an active file by using an “All About Me” notebook.
· Parents will be given a text book Autism A-Z that contains practical solutions to the challenges of Autism
ABLLS
The Assessment of Basic Language and Learning Skills- Revised (The ABLLS-R) is a skills-based system of assessment, curriculum, and tracking system that addresses the basic language and functional skills of an individual with autism and other developmental delays. It is used as a tool to help develop customized curriculums to teach language and other critical skills to children with autism or other developmental disabilities.
The
ABLLS-R focuses on 25 skills in the areas of language, social interaction,
self-help, academic, and motor skills that most typically developing children
need prior to entering kindergarten. Expressive language skills are assessed
using the Verbal Behavior method of behavioral analysis of language using a
system developed by Dr. B.F. Skinner in his book, Verbal Behavior (1957). The
assessment portion of this tool assists in the identification of skills needed
by the child to effectively communicate and learn from everyday experiences.
Results from this assessment are used to identify obstacles that prevent a
child from acquiring new skills. This information is then used to develop a
comprehensive language-based curriculum.
The
original version of the ABLLS was developed by Dr. James W. Partington, Ph.D.,
BCBA- D and Dr. Mark L. Sundberg, Ph.D, BCBA-D. It was revised in 2006 by Dr.
Partington and is currently referred to as ABLLS-R. The revised version incorporates
new task items and provides a specific sequence in the developmental order of
items within the various skill areas. Significant contribution was made by
Denise Senick-Pirri, SLP-CCC in the vocal imitation section. Additional
improvements include a way to associate items with social interaction skills,
motor imitation and other joint attention skills, and to ensure fluency of
acquired skills.
While
ABLLS-R is most commonly used on children with autism and other developmental
disabilities and delays, it can be used for anyone with delayed basic
communication or life skills. The ABLLS-R assessment is conducted through
observing a child’s behavior in each of the 25 skill areas. This is done by the
instructor providing a stimulus to the child to assess skills based upon what a
child does and does not do (assessment of behavior). Input from parents and
other instructors are also taken into consideration.
The ABLLS-R is broken out into two separate books that work in conjunction with each other to accurately assess the child’s skills. The ABLLS-R Protocol is used to assess a child’s performance. The ABLLS-R Guide provides information about the features of the ABLLS-R, how to correctly score items, and how to develop Individualized Education Program (IEP) goals.
TTAP
Ages: Adolescent - adult
Testing Time: 1-½ hours for direct observation or 3-½ hours for 3
scales
Administration: Individual
TEACCH Transition Assessment Profile- Second Edition (TTAP) is an improved revision of the Adolescent and Adult Psychoeducational Profile (AAPEP). This comprehensive test was developed for adolescent and older children with autism spectrum disorders, particularly those with transitional needs. The TTAP is structured to satisfy those provisions in the Individuals with Disabilities Education Act (IDEA) of 1997, which require adolescents to be evaluated and provided with a transition plan by age 14.
Educators, parents, counselors, and care providers can use this powerful tool to assist individuals with autism spectrum disorders to prepare for a successful, semi-independent adult life (i.e., personal development, recreational living, adult integration into employment and residential arrangements, etc.). The TTAP will also help providers identify the individual's principle transition goals, strengths and weaknesses. Second, a "Cumulative Record of Skills" (CRS), along with two data collection forms, provides an efficient method of ongoing assessment in community-based instruction. The TTAP can be used to facilitate educational and transitional planning. Emphasis is on evaluating the six major functional skill areas
1. Vocational Skills
2. Vocational Behavior
3. Independent Functioning
4. Leisure Skills
5. Functional Communication
6. Interpersonal Behavior, within three different contexts:
This indispensable source also features:
1. Assessment for transition
2. Focus on the six major functional areas
3. Assessment in three different environmental contexts
4. A unique scoring system
5. Environmental Accommodation
6. Identification of preferences for individuals with limited communication Skills
VABS II
Vineland Adaptive Behavior Scales, Second Edition
(Vineland-II)
Sara S. Sparrow, Domenic V. Cicchetti & David A. Balla
Ages: Survey Interview Form, Parent/Caregiver Rating Form, Expanded Interview
Form—0 through 90; Teacher Rating Form—3 through 21-11
Administration Time: Survey Interview and Parent/Caregiver Rating Forms 20-60
minutes
Expanded Interview form - 25 to 90
minutes and Teacher Rating form - 20 minutes
Scores/Interpretation: Domain and Adaptive Behavior Composite—Standard scores
(M = 100, SD = 15), percentile ranks, adaptive levels, age equivalents;
Subdomain—V-scale score (M = 15, SD = 3), Adaptive levels, age equivalents;
Survey Interview, Parent/Caregiver Rating Form, Expanded Interview Form—V-scale
score, maladaptive levels for the optional Maladaptive Behavior Index
Benefits
* Addresses today’s special needs populations, such as individuals
with intellectual and developmental disabilities, autism spectrum disorder, and
ADHD
* Updated with new norms, expanded age range, and improved items RTI Tier
Information
* Useful for diagnosis, qualification for special programs, progress
reporting, program and treatment planning, and research
* Offers both respected semi-structured interview format which focuses
discussion and gathers in-depth information, and also offers convenient rating
forms
Covers the full spectrum of adaptive behavior
All Vineland-II forms aid in diagnosing and classifying intellectual and
developmental disabilities and other disorders, such as autism, Asperger
Syndrome, and developmental delays. The scales of the Vineland II were
organized within a three domain structure: Communication, Daily Living, and
Socialization. This structure corresponds to the three broad domains of
adaptive functioning by the American Association of Intellectual and
Developmental Disabilities: Conceptual, Practical, and Social. In addition,
Vineland-II offers a Motor Skills Domain and an optional Maladaptive Behavior
Index to provide more in-depth information about your clients.