Transdisciplinary Play-Based Assessment II Danielle Nester & Taylor Normand

Key Characteristics Purpose Age Range Birth – 6 years What is it? Occurs in natural environment Play-based & child/family centered Team approach of the parent and skilled professionals (i.e. OT, PT, SLP) Everyone involved in observation, discussion, feedback, and knowledge of their expertise Benefits children that don’t test well with standardized (i.e. ASD, behavioral or emotional problems) or have a language barrier Purpose Used for identifying services, developing interventions, and evaluating progress Provides important info on child’s function through different context Gives an idea where the child is developmentally Assessment is a process, not a tool

Domains & Sub-domains Sensorimotor (7) Social & Emotional (7) Communication (7) Cognitive (7) Gross motor Emotional expression & adaptability Language comprehension & production Attention & memory Motor planning & coordination Emotional & behavioral regulation Pragmatics Problem solving Sensory modulation with emotion, activity level, & attention Sense of self Articulation Social cognition Sensorimotor in daily life and self-care Social interactions Voice & fluency Literacy Vision Hearing Taylor More for each, this is just a few

Testing Procedures Preparing for session After session (Analysis) Child & Family History Questionnaire (CFHQ) Medical, social, & developmental history Family Assessment of Child Functioning (FACF) Daily routines rating form All about me questionnaire Pre-assessment planning meeting During play session Dynamic & flexible Play facilitation, parent facilitation, observation, videotaping After session (Analysis) Family & team perceptions Integration Priorities & needs Resources Recommendations Assessment Report Eligibility Taylor Pre-assessment planning meeting- roles, locations, observation responsibilities, toys/materials, structure observation, questions

Key Characteristics of Play Session Takes ~ 60-90 minutes Can occur in more than 1 session or at more than 1 sites Play facilitator & parent engage child in different interactions and events with any toys/materials Observe what child is able to do and what kind of behavior they exhibit Can sometimes have a video recording Play facilitator integrates developmentally appropriate activities to see skills in domains Observers look for the development guidelines they wish to see Child should interact with family members, a peer, and the facilitator Parents are asked if child’s behavior during assessment was accurate and if there are any skills or behaviors the child normally has Toys- sensory material, manipulatives, construction toys, fine/gross mt, art, books& theme boxes (doctor’s kit, picnic) was accurate and if there are any skills or behaviors the child normally has

Need & Development for Test TPBA is an alternative to traditional, norm-referenced or standardized tests Non-biased to a child’s background, culture/language, or familiarity Functional & dynamic process customizable for different children Results with quantitative AND qualitative as opposed to only statistics and percentiles Not only measures what has been learned, but what CAN be learned Authentic, naturalistic, and motivating assessment for the child, producing a more accurate picture across all domains taylor

Psychometric Properties *All yielded excellent results with 2+ studies Interrater reliability Study that looked at amount of training (in hours) 0.80-1 – excellent results Test-retest reliability Study yielded significant results Construct validity Interdependent relationships within & across domains Criterion validity TPBA-2 was compared to traditional, standardized assessments Results were just as accurate taylor

Test Costs $54.95 $39.95 For 5 packs (50 sheets each) $54.95 $229.95 (CD-ROM) taylor

Example of Test Items http://youtu.be/FCqN3-8_2_w taylor

Scoring: Observation Guidelines - As you would observe the child play, you would circle/highlight/check the items listed in these categories that correspond to the child’s behavior, with any additional observations going in the “Notes” section. - Experienced administrators may choose to collect notes on their own, rather than checking off suggested characteristics

Scoring: Age Table Based on observations, you would review this Age Table to determine the age level that most closely matches the child‘s performance. It may help to circle items that the child can do. If items are circled across multiple age levels, find the child’s age level by finding the mode (determine which age level has the most circled items) For example…. If the child remembers and imitates actions performed by others, particularly with tools or objects, dumps objects out of containers and searches for missing objects, and can combine two or more objects functionally, he/she would be placed in the 10 month age level

Scoring: Observation Summary Percent Delay: If age level < chronological age: 1- (age level/CA) = ___% delay If age level > chronological age: (age level/CA)-1 = ____ % above For each category, you will circle the number that corresponds with the child’s developmental status as observed, using results from the observation sheet Next, consider the child’s performance in relation to same-age peers by comparing the child’s performance with the Age Table Use the Age Table to arrive at the child’s age level for each subcategory, then circle AA (above average), T (typical), W (watch), or C (concern) by calculating the child’s percent delay To calculate chronological age subtract child’s birth date from assessment date and round up or down as appropriate

Scoring Analysis Soon after observation, review: Assessment questions Parent perceptions Team perceptions Summary of skills and contexts for highest skills *A unique property of TPBA-2 is that it not only tells you what a child is doing but how the child acquired the skills and how the child is using the skills (updated 6/12) How does the system link assessment with intervention? Findings from the TPBA-2 assessment are directly incorporated into the TPBI2 intervention process. The intervention team closely reviews findings from TPBA2 and uses these observations as a guide when choosing TPBI2 interventions that address specific areas of concern. The TPBI-2 provides a “planner" of play materials and suggested opportunities, as well as intervention guidelines, to aid in development of individualized programs for children who need extra assistance danielle

Development of Program and Intervention Plans Identification and placement IFSP/IEP development Priorities for intervention Specific developmental objectives Intervention planning within routines and contexts of individual family Resource problem-solving

Area of Occupation Addressed Play participation & exploration: Natural processes such as play result in less inhibited interactions, and consequently higher levels of communication, more exploration, and increased attention and problem-solving ADLs Swallowing/eating Feeding Education participation Social participation with family and peers danielle

Setting Assessment is conducted in the home or a play environment such as a playroom, playground, classroom, or child care setting Natural processes such as play result in less inhibited interactions, and consequently higher levels of communication, more exploration, and increased attention and problem-solving Non-directive, informal, synchronous interactions, rather than question-and-answer formats result in increased initiations and communication on the part of the child danielle

Assessment Approach Arena Convergent assessment model Caregiver observations Professional observations Additional testing if needed Judgment based Ecological (natural play environment) Top down Assessment initially looks at all 4 domains at once Then, once child’s strengths and weaknesses are identified, focus on more specific components danielle

Frame of Reference: Developmental Children normally develop in a sequential way Gains in structure  function  development Physical, sensory, perceptual, cognitive, social, and emotional are all interconnected and affect the whole child Assessment process & intervention involves goals that are child-centered and focus on occupations meaningful to promote optimal participation taylor

Measurement Concerns Subjective Time consuming to analyze Multiple people analyzing Could be a good thing if someone catches your mistake Could be a bad thing if results aren’t consistent with each other danielle

References Bethesda, MD: AOTA Press. Asher, I.E. (Ed.). (2007). Asher’s Occupational Therapy Assessment Tools (3rd ed.). Brookes Publishing Co Home. Retrieved May 28, 2014, from http://www.brookespublishing.com Linder, T. W. (2008). Administration guide for TPBA2 & TPBI2. Baltimore: Paul H. Brookes. Linder, T. W. (2008). Transdisciplinary play-based assessment: a functional approach to working with young children (2nd ed.). Baltimore: Paul H. Brookes Pub. Co.. Linder, T. (2011). Transdisciplinary play-based assessment - 2 [PowerPoint slides]. Retrieved from http://www.sased.org/pages/uploaded_files/SI%202011%20-%20Linder%20TPBA %20no%20pics%20pwr%20pt.ppt