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                               Preschool Assessment          abbreviated .pdf version
                 of Developmental Abilities and Disabilities                
           
By   Regilda Anne Romero, Ph.D. and Hannah RaineyShine in School All rights reserved Clinical Psychologyu Associates of North Central Florida,
 
Clinical Psychology Associates of North Central Florida                          CPANCF.COM
2121 NW 40th Terrace Suite B, Gainesville FL  32605                              352-336-2888
Children learn from the moment they are born. Their brains rapidly grow as they constantly change, process experience, interact with the environment, and develop. Children normally meet their early socio-emotional, speech and language, cognitive, and gross motor/movement developmental milestones at a certain ages. Some expected milestones are normally reached as soon as early infancy. Children achieve more complex skills as they grow older and mature.
Parents often have questions about whether or not their baby or child is developing normally.  There has been a great deal of study regarding developmental milestones, which involves a range of ages for which certain skills develop. 
 
The following link allows you to visit the Centers for Disease Control Developmental Milestone Checklist and see what is expected at 5 intervals before age 1 and several subsequent ages: http://www.cdc.gov/ncbddd/actearly/milestones/index.html. The table below presents examples of some of the milestones that are expected at specific ages.
 
 
Age
Socio-emotional
Speech and Language
Cognitive
Gross motor and movement
2 months
Begins to smile
Coos and makes sounds
Pays attention to familiar faces
Holds their head up
1 year
Develops “stranger-danger”
Use simple gestures and try to say one-word exclamations
Examine objects by shaking/banging
Pulls themselves up to stand
3 years
Imitates actions
Converses using 2 to 3 meaningful sentences
Engages in imaginative pretend play
Walks up and down the stairs
5 years
Shows concerns and sympathy
Retells a story using complete thought/sentences
Knows and understands concepts such as money and food
Swings and climbs
 
Toddlers and preschool-aged children normally thrive and learn through their encounters with the environment. Children’s development benefits from proper nutrition, healthcare, an emotionally supportive safe and warm parenting environment, and an environment that provides opportunities for safe interactions and enrichment.  
 
Children who suffer prenatal or perinatal complications, have genetic predispositions to learning disorders, or infants and young children exposed to trauma, neglect, or deprivation may have difficulties.  Unfortunately, delays can be caused by birth trauma, or acquired traumas such as pediatric brain injury.  Some of these may not become apparent until the particular skill areas are supposed to be developed or when they are stressed by demands at later ages or with school.  When delays seem present, parents often worry if this is a normal delay, or something more significant.
 
boys playing lacrosseWhat is Preschool or Early Childhood Assessment? 
 
Definition: A method of examining developmental progress, acquired knowledge, and skills is through Preschool Assessment. Also referred to as early childhood assessment, it is a process of gathering, integrating, and interpreting of information, which includes developmental/medical history, neurobehavioral functions, and observations of children 3 to 5 years of age. Infants and toddlers may also be assessed using age-appropriate testing tools.
 
Since at any given age in preschool, some skills are in development, and some milestones reached, preschool assessment provides a snapshot of the knowledge the child is acquiring as well as evaluating whether expected milestones have been reached.  Such assessments provide essential objective information regarding skills a child is able to do independently and activities the child may need assistance to accomplish. The focus of such assessments is also to identify a child’s particular strengths and weaknesses in the different domains of development.  Assessments help quantify delays, strengths or weaknesses which allows for later objective assessment of progress or effectiveness of any therapeutic or other early childhood interventions.
 
Preschool assessment helps in early identification of toddlers and children who may be at risk for developmental delays or whom may be in need of further referrals for health assessments or other services.  For example, children who are suspected of having Autism Spectrum Disorder, who have suffered anoxia or other brain injury at birth, or those who suffer other neurodevelopment disorders, or those who have medical problems which impact on neurological functioning (i.e., genetic disorder, chronic illness, epilepsy, renal disease, brain tumor, etc.) should be evaluated.  Children who seem to be lagging behind their peers, or siblings at the same age, should also be assessed to allow for early identification and interventions. 
A great deal of progress has been made in the development of preschool and neuropsychological measures of young children.  Far more than downward extensions of tests used for adults, these tests have stimuli and tasks appropriate to present to children at different ages and stages of development.  Traditional measures such as the Halstead-Reitan battery for younger children now have modern counterparts such as the NEPSY-II, the WRAML-2, and other measures which can be combined to accomplish multi-modal comprehensive assessments of children at young ages.
 
Such assessments provide critical information which serves as a starting point for referrals to rule out physical or health causes for delays, provide suggestions for learning strategies and usually serve as a starting point for the establishment of developmentally appropriate instructional programs or the initiation of appropriate pediatric speech and language therapy or pediatric occupational therapy (OT).  Information gathered from a comprehensive psychological preschool assessments also helps establish a baseline to monitor progress, and when coupled with follow-up testing allows for assessment of subsequent development (evaluation of growth other time), trends, and helps in providing an objective independent basis to judge the effectiveness and outcomes of implemented programs and services.
 
What is School Readiness?
 
Toddlers and young children are often evaluated to assess their school or kindergarten readiness. School Readiness traditionally defined as the child’s attainment of a certain set of emotional, behavioral, and cognitive skills needed to learn, work, and function successfully in school (National Association of School Psychologists [NASP]). Different states/school districts have different rules and regulation for school readiness. For more information on Florida’s laws regarding school readiness, please visit: http://www.flsenate.gov/Laws/statutes/2011/0411.01
 
colorful pear sign in vermont  all rights reserved Ernest J. Bordini, Ph.D.What kind of tests do psychologist or pediatric neuropsychologists use for assessment?
 
There are many different tests included in a preschool assessment battery.  These may vary in terms of the breadth of skills measured, and some are designed as general batteries, while others provide more in depth assessment of a particular skill or developmental area.  The number of tests or the length of evaluation is dependent of the reason for referral (please see below).
 
 A comprehensive developmental history is an essential component of psychological, neuropsychological or preschool assessments. This includes information regarding pregnancy and delivery with child, early medical illnesses and problems, family history of medical or psychological problems, etc.  This provides valuable information which may help guide the evaluation in terms or areas to look at more carefully, and what may be expected. This allows the clinician to determine if results fit a particular syndrome or are in line with what parents or teachers observe, whether there are things that may have been missed, or in some cases, whether or not it seems the testing itself may have been “off” due to a child’s “bad day,” poor or variable effort, or other factors which might impact test results.  While test results are helpful at guiding interventions, there is a danger especially at young ages, that simple reliance on a test score without competent clinical assessment, can yield spurious findings and conclusions. Often, to supplement and help confirm the child’s test performance, parents and/or teachers may be asked to complete rating scales.
 
Many of the more commonly used and most sophisticated tests based on large normative samples undergo periodic revision.  For example, our psychologists with more than 25 years of experience will soon be assessing children with the 5th revision of the Wechsler Intelligence Scale for Children (WISC-V) and the soon to be released 4th revision of the Woodcock-Johnson Cognitive and Educational Battery (WJ-IV). A sample of test or test batteries typically given to assess specific skill areas is provided below:
 
Cognitive Functioning (knowing and understanding)
 
Name of Test
Ages
Bailey Scales of Infant Development-III
1-42 months
Bracken Basic Concept Skills- Revised 3rd
2-6 to 7-11
Differential Ability Scales-II
2-6 to 4-11
Kaufman Assessment Battery for Children, 2nd Ed.
2-6 to 8-6
Kaufman Brief Intelligence Test
4-0 to Adult
Mullen Scales of Early Learning
Birth- 68 months
Stanford-Binet, 5th Ed.
2-0 to 23-11
Wechsler Nonverbal Scale of Ability
4-0 to 21-11
Wechsler Preschool and Primary Scale of Intelligence, 4th
2-6 to 7-3
Woodcock Johnson –III, Cognitive
2-0 to adult
 
School Readiness
 
Name of Test
Age
Bracken Basic Concept Scales- 3rd Ed.
3-0 to 6-11
Key Math, Revised
5-0 to 13-11
Test of Early Mathematics Ability, 2nd Ed.
3-0 to 8-11
Test of Reading Ability
3-0 to 9-11
Wechsler Individual Achievement Test, 3rd Ed.
5-0 to 19-11
Woodcock Johnson - III (Achievement)
2-0 to adult
Wide-Range Achievement Test, 3rd Ed.
5-0 to Adult
 
Sensorimotor (including fine motor skills [drawing, writing] and gross motor skills [hopping, jumping, walking])
 
Name of Test
Age
NEPSY-II – selected subtests
3-0 to 16-11
 
Visual-Spatial Processing and Coordination (eye-hand coordination)
 
Name of Test
Age
Beery VMI/VP/MC-6th Ed
3-0 to Adult
Bender-Gestalt Test of VMI
4-0 to 10-11
NEPSY-II – selected subtests
3-0 to 16-11
Purdue Pegboard
2-6 to adult
 
Language Development (expressive and receptive language)
 
Name of Test
Age
Comprehensive Assessment of Spoken Language
2-0 to 21-11
Clinical Evaluation of Language Fundamentals: Pre-2nd
3-0 to 6-11
Expressive/Receptive 1-word Picture Vocabulary
2-0 to 11-11
NEPSY-II – selected subtests
3-0 to 16-11
Preschool Language Scales, 4th edition
Birth to 6-11
Peabody Picture Vocabulary test, 4th Ed
2-6 to adulthood
Test of Language Development
Primary: 4-0 to 8-11
 
Learning and Memory
 
Name of Test
Age
NEPSY-II – selected subtests
3-0 to 16-11
 
Social Perception
 
Name of Test
Age
NEPSY-II – selected subtests
3-0 to 16-11
 
Attention and Executive Functioning
 
Name of Test
Age
Behavior Rating of Everyday Executive Functioning
2-0 to 5-11
NEPSY-II – selected subtests
3-0 to 16-11
 
Adaptive Functioning (daily living skills including self-help and independent skills)
 
Name of Test
Age
Adaptive Behavioral Assessment System, 2nd Ed.
Birth to adulthood
Vineland Adaptive Behavior Scales, 2nd  Ed
Birth to adulthood
 
Emotional and Behavioral Functioning
 
Name of Test
Age
Behavior Assessment System for Children, 2nd Ed.
2-0 to adult
Connor's Teacher Rating Scale, Revised
3-0 to 17-11
Social Skills Rating System
3-0 to 12th Grade
Children's Apperception Test
3-0 to 10-11
 
Obviously, children will not be administered all the tests above.  Assessments can vary in terms of their complexity, scope, and purpose.  Often pediatric neuropsychologists will conduct more comprehensive assessments which cover multiple areas of functioning in some depth.  Pediatric neuropsychologists may also guide more thorough assessments of children with conditions they commonly assess, such as those for autism spectrum disorder, childhood brain injuries, neurodevelopmental disorders, and for children who have medical conditions which impact on neurodevelopment or development in any of the areas of social skills, sensory or motor skills, language, attention, memory, cognitive skills, or emotional functioning.
 
Originally published in the Summer 2014 Edition of Clinical Psychology E-Magazine, and in the articles and archives section of www.cpancf.com
 
See Dr. Romero’s Staff Page for more about Dr. Romero.
 
Edited by Ernest J. Bordini, Ph.D.   7/4/14  all rights reserved.
RELATED ARTICLES AND RESOURCES:
Child Developmental Milestones (Center for Disease Control)
Child Developmental Milestones - Spanish version (Center for Disease Control) 
Autism Spectrum Disorder - Fact Sheet (Center for Disease Control)
 
 
 
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