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Children's Medical Services - Special services for children with special needs
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Infant Toddler Development Training
Module 3, Lesson 1

Challenges and Opportunities

There are numerous challenges and opportunities currently facing early intervention personnel as they address the needs of infants and toddlers with disabilities. Many are unique to the identification and development of services for young children. The following highlight the current status of assessment for young children with disabilities and their families:

  1. Baby smilingIt is challenging to assess infants and toddlers due to the fact that this group of children has short attention spans, have limited expressive skills, struggle with separation issues, fatigue easily, adapt slowly to new surroundings, and exhibit a wide range of typical behaviors for their chronological age. (McLean, 2004)
  2. The continuity and stability of the behavior of infants and toddlers varies from hour to hour or day to day. A toddler may display a behavior one minute and not demonstrate the milestone again for several weeks. (Mindes 2003; Overton, 2003)
  3. There are few appropriate instruments for this population. Those that are in use may not be used appropriately. For example, often screening instruments such as the Denver Developmental Screening Test II (DDST-II) are used to define eligibility or as a pre - posttest measurement to define child progress because it yields developmental scores. The DDST-II is a screening instrument and should never be used to determine eligibility or as a form of accountability. In addition the technical data on many of the instruments to determine eligibility is often inadequate. This is sometimes due to the small number in the standardization sample and the reliability of the instrument. Therefore multiple instruments and strategies should be utilized in the decision-making process. Clinical judgment becomes critical throughout the process.
  4. A high priority is placed on family-centered assessment and intervention. Families are vital within the evaluation and assessment process and must be a key member of the team. (McLean 2004) However, it should be noted that many providers have difficulty accepting the role of the family in the evaluation and assessment process.
  5. Assessment should be conducted by a team of personnel including family members. Team members should be knowledgeable about child development, atypical development, and family systems, and share procedures, data and observations to produce a collaborative assessment process and intervention plan. Family members are critical in the process and should participate throughout the assessment process as part of the team. (Mindes, 2003)
  6. There is emphasis placed on assessment in natural environments within everyday routines, activities and places. The child is seen in the context of the familial, cultural and community systems. Each system is changing as the child develops, and assessment personnel must take into account the transaction and reciprocity between the child, the family, the culture and community. Assessment must be conducted and interpreted within the framework of how the child functions within these systems.
  7. The presence of a disability can greatly complicate the assessment process particularly if the child has a motor or sensory impairment. Those involved in the process of gathering information and observing the child will have to make accommodations in order to determine the child's strengths and needs. In addition one has to be observant of the secondary effects of the disability on the functioning of the child. For example, a child with a visual impairment may show delayed motor development as a result of his inability to see the world beyond his blanket or close surroundings. The child with a hearing impairment may use an alternative form of communication which would require the personnel to be knowledgeable about that form of communication. (McLean, 2004).
  8. Father holding baby Evaluation and assessment of children who are from different cultures, and families whose primary language is not English, is particularly challenging. Assessment of English Language Learners (ELLs*) and children from different cultures should focus on observation and more informal procedures. It might also be helpful to compare the ELL who is suspected of having a disability with another child from the same culture and linguistic background to determine if the behaviors are typical. It is also important to determine the child's proficiency in his native language.

*The term English Language Learners (ELL) is used by the Florida Department of Education to describe children for whom English is not their first language.

 

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