Educationally useful assessments for students with severe disabilities Daniel Drevon, Ph.D., LP, NCSP

Learning objectives 1. Introduce the Central Assessment Lending Library. 2. Discuss characteristics of students with severe disabilities. 3. Learn about some challenges involved in psychoeducational assessment of students with severe disabilities. 4. Learn about a framework for assessing strengths and difficulties of individuals with severe disabilities. 5. Review several measures that may be helpful in assessing strengths and difficulties of individuals with severe disabilities Assessment of Functional Living Skills Assessment of Persons with Profound or Severe Impairments, Second Edition Developmental Assessment for Individuals with Severe Disabilities, Third Edition Verbal Behavior Milestones Assessment and Placement Program

Students with severe disabilities Terminology Changes in terminology over time Utility of the label “severe disabilities” Severe disabilities as an umbrella term

Students with severe disabilities Some important characteristics A variety of special education classifications Severe multiple impairment Autism spectrum disorder Cognitive impairment Common characteristics Characteristics impacting assessment and intervention for students with severe disabilities Nonvocal Limited alertness Co-occurring health, physical, or sensory difficulties

Challenges in Psychoeducational Assessment Planning and conducting assessments that are comprehensive multifaceted, fair, valid, and useful Problems with our usual tests given common characteristics of students with severe disabilities However, we can and should plan and conduct assessments that satisfy the above criteria

What are useful assessments? Ethical-legal guidance NASP PPE IDEA Best practice Assessment for eligibility versus assessment for planning instruction/intervention

Framework for assessing students with severe disabilities Consider the following in multidisciplinary assessment: Biobehavioral state/level of arousal Communication skills Preferences for types of stimulation Adaptive behavior Social development Cognitive ability Motor skills

Biobehavioral state What is it? Why is it important to consider? Level of arousal or an indicator of how engaged the student is with the environment Carolina Record of Individual Behavior (Simeonsson et al., 1988) described nine levels of arousal Deep sleep, quiet sleep, active sleep, drowsy, quiet awake, active awake, fussy awake, mild agitation, and uncontrollable agitation Why is it important to consider? Alert state needed for optimal learning Characterized by: Eyes open and focused Response to stimuli Teach when a student is in an alert state

Biobehavioral state (cont.) Variability Note variables that affect state Assessing biobehavioral state Use systematic direct observation Define states Alert Drowsy Active alert Self-stimulating Fussy/agitated Different procedures

Biobehavioral state (cont.) Recommendations Instruction is most likely to be effective when Zoey displays an active- alert state. Data suggest she is most likely to be alert between 9:00- 9:30am when in her wheelchair and Ms. Smith is present. Presenting objects with high-contrast patterns that make noise when activated help maintain alertness. Measuring biobehavioral state over time, i.e., a measure of progress monitoring Biobehavioral state as feedback for service providers

Communication methods Present different types of stimulation (e.g., visual, auditory, tactile) and observe student response Observe behavior prior to presentation and watch for a change in behavior during presentation, e.g., consistent increase or decrease in movement, vocalization, change in EC or facial expression These students may have unique ways of communicating Some obvious (e.g., crying, smiling) Other subtle (e.g., decrease in movement, eye pointing) Critical to recognize student’s signals Responding to student’s messages If a response is not reinforced it will decrease/stop Try imitating student’s response to get back-and-forth play (synchrony)

Determine student preferences Based on student responses, determine which objects, activities, and people student prefers Assessment for Persons Profoundly or Severely Impaired (APPSI) Level of functioning between birth and 8 months Assessments preferences for stimuli, intensity of stimulation needed, and types of responses

Adaptive behavior Norm-referenced options Adaptive Behavior Assessment System, Third Edition Vineland Adaptive Behavior System, Third Edition

Social development Informal measure Matson Evaluation of Social Skills for Individuals with sEvere Retardation (MESSIER)

Cognitive ability Limitations of norm-referenced tests Students with severe multiple impairments were not included in the norm sample Scores do not go low enough Assess few skills relevant for these students Items require enabling behaviors that they student does not posses, e.g., vision when pictures are presented Few appropriate measures because of commercialism

Cognitive ability (cont.) When a norm-referenced cognitive score is needed First choice is a standard score May not go low enough (< 40) Some items may be inappropriate Second choice is an age equivalent May not go low enough Third choice is age referenced items from a norm-referenced test Untimed items that circumvent student’s physical disabilities Age references may help estimate age level Look for patterns in student performance “On the BSID-III and CAS-2, Oliver performed well on items that did not require speech or manipulating small objects through the 30-month-level.”

Cognitive ability (cont.) Considerations for selecting norm-referenced measures Nonvocal measures Standard scores < 40 Age equivalents to ½ student’s chronological age Items that are age-referenced

Nonvocal options with SS < 40 Test Lowest Standard Score DAS-II NV (2-6 to 3-5) 32; no reliability data DAS-II NVR (3-6 to 7-0) 32; reliability too low DAS-II SNV (3-6 to 7-0) 30; acceptable reliability KABC-II 40; reliability too low Leiter-3 M-P-R 11; acceptable reliability WNV 30; reliability too low

Nonvocal options with AE Test Lowest AE Use For Ages: BSID-III 1 month 2-42 months CAS-2 3 months 6-47 months Leiter-3 M-P-R 2-78 months PTONI 28 months 56-84 months SB-V NVI 24 months 48-75 months

Nonvocal options with age-referenced items Test Age Range BSID-III 1-42 months CAS-2 3-47 months M-P-R 1-78 months

Nonvocal options with SS > 40 Test Lowest Standard Score Lowest AE BSID-III 45 1 month CAS-2 55 3 months DTLA-P:3 VR 3-0 PTI-2 PTONI 46-66 2-6 SB-V NVI 42 2-0

Planning instruction (cont.) Developmental inventories Skills based on normal developmental sequences across many areas, e.g., language, adaptive, social/emotional, motor, and sometimes cognitive For example, Brigance, HELP, Carolina Curriculum, AEPS DASH-3 is the only developmental inventory specifically for students with severe impairments Development inventories based on theory and detailed task analysis, for example, VB-MAPP

Planning instruction (cont.) Concerns regarding developmental inventories Score from interview, observation, or direct testing, but no documentation that different methods yield similar results Age references may be based on very dated references that may be obsolete given improvements in education and health care Age levels based on tests with different norm samples; reliability/validity results can be very misleading and confusing Students with severe impairments do not develop skills in the same sequence as their normally developing peers. However, the sequence of skills still useful: skills learned at younger ages are easier to learn. Avoid “reinventing the wheel” by doing a task analysis for skills.

Developmental Assessment of Severe Disabilities, Third Edition (2012) Features Criterion-referenced measure used primarily for planning instruction Items are age referenced Appropriate for students with severe impairments Scoring Based on interview, observation, or completion by someone who knows the student well Scale: 1 = task resistive, 2 = full assistance, 3 = partial assistance, 4 = minimal assistance, 5 = independent performance Developmental Age (DA) for each section is merely an estimate and should be interpreted as such

Developmental Assessment of Severe Disabilities, Third Edition (2012) Social-Emotional scale Assesses feelings, responses, and social skills Examples Language scale Assesses non-symbolic communication, receptive language, expressive language Sensory-Motor scale Assesses reflexes, gross motor skills, sensory, hand skills Activities of Daily Living scale Addresses feeding, toileting, home routines, dressing, and travel and safety Basic Academics scale Requires a developmental level of at least 24 months Preacademics and academics

Developmental Assessment of Severe Disabilities, Third Edition (2012) Strengths Many skills assessed and includes many items appropriate for examinees with severe impairments Use scoring method Multidisciplinary format Concerns No test-retest or inter-rater reliability data References not tied to items or scales and in prior edition 76% were more than 15 years old (most recent was 1997) Age references for this edition are not presented. No associated curriculum

Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) Introduction A criterion-referenced test and progress monitoring system based on a behavioral approach to the assessment of language based on Skinner’s Verbal Behavior (1957) Purpose is to assist in planning instruction, primarily for younger children with DD, but also others with learning/language delays What skills do we need to focus on? What level should we begin at? What are some barriers to learning and language development? Is augmentative communication necessary? What teaching strategies might be most effective? What type of educational placement might work best for a student?

Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) Content Five components: Milestones Assessment 170 measurable learning and language milestones Balanced across three levels (0-18 months, 18-30 months, and 30-48 months) Scored as 0, ½ , 1 Barriers Assessment 24 learning and language acquisition barriers Transition Assessment 18 assessment areas to assist in determining whether a less restrictive educational placement may be appropriate Task Analysis and Skills Tracking Placement and IEP Goals

Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) Content (cont.) Skinner’s analysis of verbal behavior “Verbal behavior” Speaker versus listener Form versus function Elementary verbal operants (Table 1-2) Mand Tact Intraverbal Listener Echoic Imitation Textual Copying-a-text Transcription Milestones Assessment examples of skills

Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) Content (cont.) Barriers Assessment Rating scale of 24 learning and language acquisition barriers Purpose is to identify behaviors that interfere with learning A starting point for conducting further observation or functional behavior assessment Barriers Assessment examples

Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) Evaluation Unique characteristics: Utility in planning instruction and monitoring progress Assists in individualizing curriculum Behavioral approach to the assessment of language Limitations: Age levels are approximate and based on review of developmental checklists and author’s experience No test-retest or inter-rater reliability data