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Tanni L Anthony, Ed.S.

Colorado Department of Education, Denver, Colorado, USA

Young children who are deafblind present an interesting paradox when it comes to developmental assessment. Perhaps no other group of children may benefit more from a quality developmental evaluation, while at the same time, no other group of children may be so difficult to assess with an accurate and meaningful outcome.

The developmental impact of both a vision and a hearing loss is considerable to a young child. All aspects of development are influenced. In particular, the skills of spatial orientation and movement skills are affected.

Traditional assessment methodologies and tools are often not helpful with building an accurate picture of the learning style and developmental level of the child with dual sensory loss. The more conventional assessment models support evaluation in a number of environments by a number of professionals who may or may not have communication contact with one another. Parents may or may not be a part of the assessment process in these models.

The result is often a complicated situation of too many people and too little insight on the whole child within the context of the family and home community. This is a scenario that the young child with deafblindness can scarcely afford; good programming and support must begin early for both the child and family.

The assessment process is further complicated by the fact that most developmental assessment protocols were not designed to account for the unique developmental course of the child with vision and hearing loss. A comparative model to children with full sight and hearing is grossly insufficient.

Furthermore, most assessment tools view developmental milestones without regard to their functional relation to the child's environment, nor the qualitative characteristics of the skills; two features of utmost importance to the outcome of the assessment, the child's program.

The Transdisciplinary Play-Based (TDPB) model of assessment embraces two key principles: (a) respect for a team approach including the child's family as team members and (b) recognition of play as a means of gathering important developmental information. While the model was not founded for the exclusive purpose of assessing children with vision and hearing loss, it was designed as an assessment vehicle for children who were not well served within the traditional assessment model (Linder, 1990).

The design of this model invites professionals from all disciplines to work together, with the continual input from the family, to complete an assessment and subsequently build a program for the child. One unique feature of this model is the arena assessment which involves a group observation and assessment opportunity of the child.

Each team member, including the parent(s), is present at the assessment, although only one key person typically facilitates the developmental testing of the child. The role of the facilitator is to follow the child's lead of interest in a manner that supports the display of developmental skills. The team members work to guide the work of the facilitator.

The Colorado Hilton Perkins Project was funded from September 1991 to December of 1994 for the purpose of investigating the use of TDPB model with children with dual sensory loss. Over this period, several adaptations were made to the model to accommodate the unique needs of the young child with vision and hearing loss. These adaptations came over time as the team evolved in their understanding of "what worked" for this population of children.

One significant adaptation was to focus on two primary outcome areas as opposed to all aspects of every specific developmental domain. The areas of (a) communication and (b) orientation and mobility skill development were selected based on community direction. These two areas have also been identified in the literature as key programmatic themes for individuals with deafblindness (Heuber, Glidden Prickett, Rafalowski Welch, 1995).

Each team member contributed their expertise toward these two common themes. As such, a new assessment protocol was developed which included the following orientation and mobility components:

Functional Vision: (a) visual preferences and capabilities concerning light, color, size, and clutter; (b) visually directed purposeful movement; and (c) ability to recognize and use visual clues or landmarks.

Functional Hearing: (a) awareness and discrimination of auditory input; (b) receptive language skills; (c) use of echolocation; and (d) the ability to discriminate, recognize, and use auditory information in everyday situations.

Tactile Responsiveness: (a) responsiveness tactile input (physical guidance vs. self initiated touch) and (b) ability to discriminate tactile input for clues and landmark purposes.

Problem Solving: (a) mastery motivation; (b) object permanence; (c) means end; (d) spatial relations; (e) body image; (f) meaningful use of common objects and tool use (g) imitation (visual and physical); and (h) search patterns and methods of exploration.

Social Emotional: (a) motivating objects for enticement and reinforcement of movement; (b) daily routes for travel that serve a social purpose; (c) social orientation to people; and (d) endurance as it relates to social- emotional relationships.

Self Help: (a) daily routines/routes of travel and (b) orienting self and objects in space for dressing and feeding.

Fine Motor: (a) motor planning body skills in space and related to objects within the environment; (b) tactile and kinesthetic development for being handled; (c) spatial mapping; (d) upper extremity skills; and.(e) grasp and release skills.

Gross Motor: (a) postural tone; (b) voluntary movement; (c) reflexes and involuntary movement upon self- initiated movement; (d) means of independent ambulation; (e) balance and equilibrium reactions; (f) quality of movement indicators; (g) motor skills; (h) adaptive equipment needs; and (i) physical endurance/ fatigue constraints.

Formal O&M: (a) trailing techniques; (b) protective techniques; (c) route travel; (d) sighted guide; and (e) mobility device or cane instruction needs.

The use of the TDPB assessment model was felt to be a viable means of gathering key O&M information for the young child with vision and hearing loss. While project funding has ended, the individual team members continue to use of the TDPB model in their ongoing work with learners who are deafblind.

References

Anthony, T.(1993) Transdisciplinary play-based assessment: communication and orientation and mobility domains for the young child with deafblindness (unpublished document)

Greeley, J. & Anthony, T. (1996) Play interaction with infants and toddlers who are deafblind: setting the stage. Seminars in Hearing 16 (2), 186- 191.

Heuber, H. M., Glidden Prickett, J., Rafalowski Welch, T. (Ed.). (1995) Hand in Hand: Essentials of Communication and Orientation and Mobility for Your Students Who Are Deaf-blind, Volume 1, New York: American Foundation for the Blind.

Linder, T. (1990) Transdisciplinary play-based assessment: a functional approach to working with young children. Baltimore, MD: Brookes.