Includes descriptions and detailed illustrations of normal and atypical variations of prehension. Also includes the Erhardt Developmental Prehension Assessment (EDPA), the EDPA-S, and evaluation reports, treatment notes, and photographs from three case studies.
Abstract A study consisting of three components is reported. During Phase One an extensive literature search led to a compiled set of norms for reflexive and voluntary prehensile development. Phase Two included the clinical use and revision of the resultant Erhardt Developmental Prehension Assessment (EDPA©). Phase Three involved the testing of the EDPA for interrater reliability, which resulted in highly significant intraclass correlations. Single test item correlations were also analyzed to identify items needing clarification or alteration in preparation for final revision of the instrument. A sample application in the clinical field is illustrated by segments of an EDPA used to develop an Individualized Educational Plan, required by Federal Law 94-142 (Education of All Handicapped Children).
Specific Strategies for Gross Motor Assessment There are several reasons for assessing the gross motor competence of young children. The identification of a discrepancy between age-expected performance and actual performance is the first step in determining whether intervention is necessary and is imperative if services are sought under early intervention and preschool legislation. However, the assessment should do more than merely identify disparity. It should provide the evaluation team sufficient information to establish functional goals and objectives to facilitate motor development.
In addition, it should allow one to hypothesize causes for identified motor delays, and it may provide information that will help to explain other areas of delay. Gross motor assessment may occur as part of an interdisciplinary team-based assessment or may occur as a “specialty” evaluation. In the case of the interdisciplinary team, evaluation may be accomplished by a group of professionals, each assuming responsibility for specific areas of function.
Depending on the child’s perceived needs, the evaluation may occur in an arena format, a core format, or with separate appointments by one discipline the home, school, or clinic. We will write a custom essay sample on Assessment tools specifically for you for only $13.90/page Professionals who perform team evaluations often use measures that allow assessment across many domains of functions. Examples of these broad-based assessments that might be used to evaluate young children include: Bayley II (Bayley, 1993) and the Bayley Infant Neurodevelopmental Screener (Aylward, 1995) Battelle Developmental Inventory (Newborg, Stock, Wneck, Guidubaldi, & Svinicki, in press) Infant-Toddler Developmental Assessment (Provence, Erikson, Vater, & Palermi, 1995) Early Intrvention Developmental Profile (Rogers et al., 1981) Hawaii Early Learning Profile (HELP; Furuno et al., 1984). The help is designed for children from 0 to 3 years of age and; the help for Preschoolers Assessment Strands, Charts, and Checklists (VORT Corporation, 1995) were designed for children 3 to 6 years of age. These assessments provide information on a child’s functioning in self-care, gross motor, fine-motor, cognitive, and social and emotional development.
In some settings in which a transdisciplinary approach is used and discipline-free goals are developed, a team-based contextual evaluation may be preferred such as: Transdisciplinary Play-Based Assessment (Linder, 1990). When concerns exist in the gross motor areas, the motor specialist on the team may conduct a more in-depth evaluation. Some assessments designed specifically to measure development of gross and fine motor skills include: Peabody Developmental Motor Scales II (Folio & Fewell, 2000) For children from birth through 5 years. Toddler and Infant Motor Evaluation (Miller & Roid, 2002) Bruininks-Oseretsky Test of Motor Proficiency for Children (Bruininks, 1978) For children who are at least 4 ½ years of age In addition to using assessments that measure gross motor performance, occupational and physical therapists may use standardized and criterion-referenced assessment tools and qualitative measures to assess components of motor skills and sensory processing. There are a number of measures designed primarily to gather information about a child’s ability to process sensory information; these provide supplemental information and do not take the place of an assessment of gross motor performance. The Infant/Toddler Sensory Profile (Dunn, 2002) and the Sensory Profile (Dunn, 1999) For children aged 3 and above.
Use a questionnaire format to provide information about a child’s sensory performance DeGangi-Berk Test of Sensory Integration (DeGangi & Berk, 1983) Designed to measure postural control, bilateral motor integration, and reflex development in children from 3 to 5 years of age The Sensory Integration and Praxis Test (Ayres, 1989). Measures visual tactile, and kinesthetic perception, as well as motor performance in children from 4 to 8 years of age. The results of the gross motor assessment should be considered together with information about the child’s function in other developmental areas, and family information and concerns to develop appropriate intervention plans that consider the whole child. Specific Strategies for Fine Motor Assessment Fine evaluation is often performed by an occupational therapist and includes clinical observations of the degree and distribution of postural tone, symmetry, range of motion existence of primitive reflexes, righting and equilibrium reactions, and quality of movement. The level of mastery and independence in reach, grasp, release, manipulation, bilateral skills, and in-hand manipulation are evaluated during functional activities such as manipulating toys, scissors, or accessing a computer.
The Toddler and Infant Motor Evaluation (Miller & Roid, 1994) A comprehensive standardized assessment to identify quality of movement and motor organization in infants and toddlers. Erhardt Developmental Prehension Assessment (EDPA)-2nd Edition (Erhardt, 1994b) A criterion-referenced test that addresses the presence of primitive reflexes and basic components of prehension, including reach, grasp, release, manipulation, and prewriting for children with developmental disabilities or neurological impairments. Peabody Developmental Motor Scales II (Folio & Fewell, 2000) A standardized, normed, and criterion-referenced test that evaluates both fine and gross motor abilities in children from birth through 5 years of age. Broad-based developmental assessments such as the Hawaii Early Learning Profile (help; Furuno et al., 1997), the help for Preschoolers (VORT Corp., 1995) and the Learning Accomplishment Profile-Diagnostic Edition (LAP-D) (Nehring et al., 1992) include sections on fine motor development.
The LAP-D divides the fine motor section into two subsets: manipulation and writing. Play is a primary occupation of a child and the early intervention professional will evaluate play skills through the use of play assessment tools such as the Test of Playfulness (Bundy, 1997), the Preschool Play Scale (Bledsoe & Shepherd, 1982; Knox, 1997), and the Transdisciplinary Play Based Assessment (Linder, 1993). Specific Strategies for Oral Motor Assessment Oral motor problems are evaluated by occupational therapists or speech-language pathologists who have training in typical or atypical oral motor development. Video-fluoroscopic swallow studies are done in radiology to rule out problems such as aspiration and gastroesophageal reflux. Other critical team members in the evaluation of swallowing disorders include a developmental pediatrician, gastroenterologist, neurologist, otalaryngologist, physical therapist, plastic surgeon, pulmonologist, and radiologist (Arvedson & Lefton-Greif, 1998).
Preassessment information is gathered from medical and nutritional records. An extensive interview is conducted with the primary caregivers about concerns related to their child’s eating abilities. Various assessment tools are available for evaluating oral motor skills including: Clinical Feeding Evaluation of Infants (Wolf & Glass, 1992) Mealtime Assessment Guide and Developmental Pre-feeding Checklist (Morris & Klein, 2000) Pre-Speech Assessment Scale (Morris, 1982) Oral Motor/Feeding Rating Scale (Jelm, 1990).
Specific Strategies for Self-Care Assessment Self-Care Assessment addresses a child’s level of development and independence in self-feeding (finger feeding, use of utensils, use of bottle or cup); dressing (undressing, dressing, fasteners, and directionality); toileting (bowel and bladder control); bathing (washing hands, face and body); grooming (brushing teething, combing hair); and sleeping. Evaluation tools, such as the Hawaii Early Learning Profile (Furuno et al., 1997; Parks, 1995) provide a developmental framework for determining the child’s ability in the self-care domain.
Selected Assessment Tools That Evaluate Self-Care Skills Hawaii Early Learning Profile (HELP) (Furuno et al., 1997) is a curriculum-based, criterion-referenced, interdisciplinary assessment tool. The HELP for infants and toddlers is family centered, covering birth to 3 years of age.
HELP for Preschoolers (Parks, 1995) continues up to age 6. Content of the test includes: a. Gross motor d. Fine motor e.
Social emotional f. Self-help- addresses oral motor development, dressing, independent feeding, sleep patterns and behaviors, grooming and hygiene, toileting, and household independence/responsibility. Results are reported in developmental age levels Battelle Developmental Inventory (BDI) (Newborg, et al., in press) Covers activities of daily living including eating, dressing, toileting, and grooming and it addresses the birth to 8-year population Pediatric Evaluation of Disability Inventory (PEDI) (Hayley et al.,1992) is a structured interview-judgment-based standardized evaluation given to parents or clinicians familiar with the child. It measures three domains (self-care, mobility, and social function) in children with moderate to severe motor impairment between 6 months and 7 years. It also addresses the level of assistance and modifications needed. The self-care domain includes 73 items that include: a. Adaptability to food texture b.
Use of utensils c. Use of drinking containers d. Toothbrushing e.
Hair-brushing f. Hand, body and face washing h. Maneuvering pullover garments, fasteners, pants, shoes and socks i. Toileting and managing bowel and bladder.