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

2. 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

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

4. 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

5. 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

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

7. 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

8. 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

9. 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

10. 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

11. 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)

12. 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

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

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

15. 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

16. 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.”

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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.

24. 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

25. 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

26. 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

27. 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?

28. 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, months, and 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

29. 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

30. 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

31. 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