Infant Toddler Development Training
Module 3, Lesson 5
Areas Assessed during Motor Assessments
Motor assessment with very young children with disabilities should not be limited to standardized instruments but assess functional motor skills such as patterns of locomotion, the child's ability to move in the environment, to act on their environment and to make meaningful use of information from their environmental interactions (Harris & McEwen, 1996).
Domains of motor assessment include gross motor skills that involve the large muscles of the body and include rolling over, creeping, crawling, walking and running. Functional gross motor skills include transferring from a wheelchair to the floor or toilet. Fine motor skills include the use of small more distal muscles such as the fingers. Fine motor milestones include reaching, grasping, and releasing. Functional fine motor skills include eating, drinking, and picking up small toy pieces. Oral motor skills involve those with the mouth, tongue, teeth, facial and jaw muscles. Milestones in the oral motor area involve sucking, swallowing, biting, and chewing. Functional oral motor skills include eating and talking.
There are many excellent norm referenced instruments that measure motor skills. In the case of a child with motor impairments, it is helpful to get the assistance of a physical or occupational therapist in the evaluation and assessment process.
There currently is less emphasis on the attainment of motor milestones or measurement of muscle tone, strength or balance reactions and more emphasis on functional motor goals within natural environments (Harris & McEwen, 1996).
It is important to "correct for prematurity" in the motor assessment of children who were born less than or equal to 37 weeks gestation (Harris and McEwen). It is also important for caregivers including the parent to adjust their expectations on the child's corrected age rather than chronological age.
Strategies in the Assessment of Social Skills
The development of social skills is a critical domain for infants and toddlers with disabilities. Infants and toddlers with disabilities often experience difficulty interacting with others. A primary focus from birth to 12 months is the child's response to adults. During the second year, the infant expands on his relationships with others, primarily adults and engages in increasingly sophisticated social behavior (Blasco, 2001). According to Blasco, the child's ability to sustain his own wants and needs in order to share with others begins to increase as the child reaches his second birthday. From 24 to 36 months, the focus changes as the child's interest in peers increases (Odum et al 2004).
Social development begins with positive interactions that develop between the infant and caregiver (Blasco). The interactions are reciprocal as the behavior of each member of the dyad influences the other. Failure of either the infant or caregiver to fully participate in early critical interactive interchanges may result in less participation by the other member of the dyad. For some infants and toddlers with disabilities, impairments or delays in development will compromise the quality of interactions.
The primary focus of assessing social competence and social skills of infants and toddlers with disabilities is on the interaction of the child with his caregiver rather than peers. Infants show individual differences in the contribution they bring to the relationship based on factors related to temperament, medical status or disability. It is not until the age of three, that social interactions with peers emerge and become more frequent and complex (Noonan & McCormick, 1993). Assessment of children's social development may occur at the level of individual social behavior, social interactions, or social relationships.
Development of Social Interactions in Infants and Toddlers
|Birth to 2 months
||Infant attends selectivity to faces, smiles, discriminates between self and others, attends to social play
||Smiles in response to stimuli, crying is instrumental, reciprocates with social partners
||Develops social smile, responds differentially to facial expressions
||Shows more interest in objects than people, enjoys parent initiated social play
||Uses adults for social reference, taking cues from their behavior, actively imitates, participates in social games with partner
||Stranger anxiety appears, imitation skills are firmly established, establishes and maintains proximity to caregiver
||Increasing language skills allow parent infant interactions to become increasingly verbal, engages most of the time in solitary activity watching other children, refers to self by name
||Interest in peers increase, sociodramatic play skills become more refined, inclusion of peers in symbolic play, plays simple games
Adapted from Odum, Schertz, Munson and Brown (2004).
Methods for Assessing Social Skills
The assessment of social skills, social interactions and social competence is different than other developmental areas. The use of standardized instruments in this domain is neither appropriate nor available (Odum et al, 2004). Social skills can be most effectively measured in natural environments with familiar adults and peers. Social skills can not be directly assessed in isolation, although social skills can be determined through caregiver interviews.
Assessment of social skills with infants and toddlers rely on observation ideally in natural environments. However, the addition of a strange observer can affect the validity and reliability of the observation. Therefore, observers need time to establish rapport with the child.
It is important to use multiple sources of information and different informants. For example parent ratings and a child care providers ratings may differ. However this discrepancy may provide information about the child's social skills across settings. Assessment of social skills can occur through anecdotal data collection, questionnaires, direct observation, rating scales, interaction scales and checklists which were discussed in Lesson 2 of this module.
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