February, 18 2016.

By: Shefali Shah

A question I get asked a lot by parents, especially in the early days is “How do I know how my child is doing?” An excellent question indeed!

I generally counter this question with a question of my own, which runs thus: “ Can you tell me a little more about what it is that you mean by ‘how your child is doing’?” I guide the parent to understand that what they really want to know is how their child is doing compared to other children with normal hearing of the same age. A very reasonable concern.

In order to address this parental concern, we must measure and assess our work with babies and young children with hearing loss. Measurement and assessments gives us information on the effectiveness of our intervention service. Even though the choice of assessments may vary from centre to centre, they must measure the development of your child with respect to development in children with normal hearing, of the same age.

These assessments must choose parameters that are

i) Objective

ii) Accurate

iii) Standardised

iv) Normed on a hearing population

v) Administered on an on-going basis

vi) Address our objective

Assessments that fulfil the above criteria can provide the accurate feedback we need to evaluate our work and address the concerns of parents.

Need for Assessment:

Assessments are tools which serve to measure the progress of a child at different stages of the child’s development. Tools by definition must address their pre-selected target.

Why do assessments contribute to the robustness of any intervention? In our clinical practice at Sound Steps, we have found that assessments allow the professional to

i) objectively measure the progress of a child

ii) identify the child’s strengths

iii) identify areas and skills that the child needs more help with

iv) evaluate readiness for later developing skills or learning

v) accurately measure the child’s progress in relation to a corresponding population of children with normal hearing, so as to determine age appropriate development

vi) provide the data needed to determine short-term and long term treatment plans

The purpose of assessments is to use these findings to analyse the child’s current level of functioning and to plan for the next planned period.

Informal Assessments: Parent questionnaires and check-lists provide a means of gathering information about the development of the child. They help collect data based on observation, not performance. It is for this reason that questionnaires and check lists are termed informal assessments. Informal assessments are descriptive in nature; not quantitative. They may contribute to the test protocol for each child but cannot form the basis for evaluation, given their lack of objectivity and measurability.

Formal Assessements: Formal assessments are those which are standardised and rigorously validated. Formal assessments are normed on a large target population, providing reliability to the scores once the assessment is administered.

Every formal assessment has its protocol for how the test is to be administered and how frequently it can be administered. The procedure for administering and scoring the test is stipulated. Most formal assessments specify that they can be re-administered only after 6 to 12 months.

Formal Assessments are age specific. Further, they will specify the developmental area that they assess: auditory comprehension,expressive language,cognition. It is important that as practioners we select our assessments approporiately.


Administering the Clinical Evaluation of Language Fundamentals (CELF)

Readiness for Formal Assessments: It is important that families understand the purpose for which an assessment is being administered. As professionals we need to explain this to families, as we also explain the test procedure, their participation in it and what are permissable responses from them.

The young child must have the necessary attention to be able to complete the assessment. The child’s level of functioning must be one that allows him or her to feel successful about the test that was adminsistered. It must leave the parent feeling confident.

Most importantly, assessments are valuable when analysed for their impact on the child's management. At Sound Steps we discuss test results in detail with families as also how these findings are going to impact the child’s development. We then outline, the steps we will be taking to best address these findings and the approximate period of time we anticipate these issues will take to be so addressed.

Families who are guided to understand the purpose of assessments, are most likely to be able to use them to raise their child, to achieve his or her potential.