The Evaluation Process

What is an evaluation?

The purpose of an evaluation is to identify the child’s specific strengths and challenges and to identify the etiology or core underlying root cause of the presenting problem(s). Evaluations are helpful only if they contribute information that will impact the child and family’s ability to more successfully assimilate into everyday routines, activities, and places. An evaluation should…

Provide an objective description of the child's strengths and challenges
Determine eligibility for services through a variety of programs (e.g., early intervention program or public schools)
Aid in the development of a comprehensive intervention plan
Provide a baseline for measuring progress and the effectiveness of the comprehensive intervention plan

Who is involved in the evaluation process?

An interdisciplinary team assessment should be designed to address the presenting concerns raised specific to the individual child. This team should be able to “integrate and synthesize information from numerous disciplines through an interactive, group decision-making process” (Guarlnick, 2000).

When an evaluation is arranged for your child who is suspected of having a communication, learning and social relating disorder, the evaluating team should include the following:

psychologist or developmental specialist
speech pathologist
occupational therapist trained in sensory integration, because so many children with these developmental problems have underlying sensory difficulties.

Depending on your child's age and needs, the evaluation team may also need to include:

physical therapist
social worker
psychiatrist
developmental or behavioral pediatrician
special educator
and/or pediatric neurologist. A pediatric neurologist's evaluation is essential for all children with more severe communication, learning and social relating disorders

This team of professionals representing various disciplines should conduct evaluation of your child’s individual abilities. You, your child's parents, play an important role in the process in relating your observations and understanding of your child to these professionals. You are the resident "expert" on your child because you live with your child 24 hours a day. It is imperative that you work only with professionals who provide respect and recognition to you as the most aware expert concerning your child's developmental progress. If you and these professionals reach different conclusions about your child, it is important that you work together until you all can reach consensus. The idea behind this approach is to get a rich, complete picture of your child's strengths and challenges as a basis for determining, if necessary, how to intervene and treat them.

You want to work with professionals who accept a functional approach to evaluation as a reasonable model to rule out any biological or original traits that might be causing the observed developmental delays.

What should I expect to occur during an evaluation?

Ideally, at least four (4), 45-minute professional evaluation sessions with your child should take place in this evaluation process prior to any diagnosis being made and any treatment or intervention plans being developed. It is useful to assess the child in different environments and on multiple occasions because:

the child's performance may vary depending upon familiarity with the testing environment and examiner
the child's behavior can vary from day to day
possible fatigue factors may affect the child's performance

Evaluations should be individualized to the child by using age-appropriate tests and focusing on the child's unique presenting problems. Additionally, both formal and informal evaluation procedures should be utilized. Be careful to avoid an evaluation process that relies too heavily on formal standardized testing. Many people have difficulty performing upon command for strangers; this is especially true for children with communication, learning and/or social relating difficulties. Finally,evaluations should be conducted in the primary language of the family.
Components of a comprehensive evaluation should include:

An interview with parents to identify their concerns, obtain a history of the child's early development, the child's current level of functioning and family medical history.
Review of the child's records from doctors, teachers, etc..
Observation of the child during informal and unstructured play and during interactions with parents.
Standardized testing of the child's pattern of development in areas of functioning including:

Cognitive level of functioning;
Communication skills, including hearing;
Motor & Physical skills;
Daily living and adaptive skills;
Social, emotional, and behavioral functioning; and
Sensory processing.

What should an evaluation report look like?

When your child's evaluation is completed you should expect to get a packet of reports from the evaluation team that includes:

A description of the concerns you raised regarding your child's developmental issues which were the reason for the evaluation
Developmental history of your child including:

- Pregnancy
- Labor and Delivery & Birth History
- Early Infancy (post hospital discharge until 1 year of age)
- Developmental Milestones Accomplishments
- Medical History

Description of your Child's Activities of Daily Living

- Eating
- Sleeping
- Grooming
- Bathing
- Dressing
- Toilet Training
- Communications
- Social Interactions

Descriptions of your child's strengths and weakness

- Results of the formal evaluations by the:
- Psychologist
- Speech Pathologist
- Occupational Therapist

Conclusions to be drawn from the Evaluations
Recommendations for further evaluations, interventions or treatments
Plan for follow-up

Keep in mind… an evaluation report that does not provide a clear road map is not worth the paper it is written on.