ACQ Vol 13 no 2 2011

Assessment

My Top 10 assessment resources (with a paediatric slant) Suze Leitão

A ssessment is such a large part of our clinical practice that we really need to understand what we are doing and why . This will influence how we go about collecting information. Assessment requires us to make an informed judgement for a purpose, based on a sample of behaviour, and is framed by our theoretical knowledge and our understanding of the current evidence. Good assessment practice is functional, adaptive, dimensional, balanced, and grounded in theory. My Top 10 is based on this broad definition. 1 A clear purpose Understanding “why” we assess is critical to helping us decide “what” and “how”. There are many reasons for carrying out assessment, many of which overlap, but it is important to understand the purpose(s) before we start. These can include: • screening • prediction/early identification • diagnosis, classification, and referral/placement • determining eligibility for a service • determining if a “problem” is real • establishing baseline functioning • establishing goals for intervention and approach to therapy • evaluating progress/measuring change in intervention • monitoring recovery, development, degeneration • decision making about discharge. Each of these may require different tools and data collection and will involve the client to different degrees. 2 A good textbook that will stand the test of time and help us make an informed judgment As clinicians we need to be informed. In paediatric assessment this means we need to understand typical developmental norms and trajectories as well as indicators of concern. We also need to understand the theories that underlie these trajectories, and the influences of different cultures.

I draw on three main texts in my paediatric clinical practice and my teaching: • Paul, R. (2007). Language disorders from infancy through adolescence (3rd ed.). Philadelphia, PA: Mosby. This contains a wealth of information on assessment. • Haynes, W. & Pindzola, R. (2008). Diagnosis and evaluation in speech pathology (7th ed.) Boston: Pearson Education. A great resource for clinical problem-solving and decision-making.

Suze Leitão

• Shipley, K., & McAfee, J. (2009). Assessment in

speech-language pathology: A resource manual (4th ed., International Student Edition).

New York: Delmar, Cengage Learning. This contains practical resources galore, many of which are adaptable. 3 A good theory Good assessment is strongly grounded in theory. The underlying assumptions of a theoretical framework will underpin what we choose to assess. Without a set of questions or hypotheses an assessment battery would be little more than a series of tests. Without drawing on theory and evidence, it would also be unethical. The texts mentioned under no. 2 provide some useful information on theories of language development. 4 The normal distribution There is always debate about the advantages and disadvantages of using norm-referenced tests. Standardised tests do have their place in our clinical battery – but should be used and interpreted appropriately. The

Normal, bell-shaped curve

Percentage of cases in 8 portions of the curve Standard deviations Cumulative percentages Percentiles

.13%

2.14%

13.59%

34.13% 34.13%

13.59%

2.14%

.13%

−4σ

−3σ

−2σ

−1σ

0

+1σ

+2σ

+3σ

+4σ

0.1% 2.3% 15.9% 50% 84.1% 97.7% 99.9%

1

5 10 20 30 40 50 60 70 80 90 95 99

94

ACQ Volume 13, Number 2 2011

ACQ uiring Knowledge in Speech, Language and Hearing