Interdependence of development

The child is a complete being - not a series of articulated skills, acquisitions, or elements - and the development of each area is dependent on other areas [27]. The child's skill in naming a picture is an indication of sensory, cognitive, and motor abilities, as well as language acquisition. Underlying all of this is the emotional capacity that enables the child to relate to others and to organize his or her world. To consider only one area of development in isolation from the others leaves unrecognized the influence of the other areas and may impede our understanding of the child's abilities and challenges. The child's functional capacities should be examined in a variety of contexts in order to fully comprehend how the child integrates skills into his or her repertoire of behaviours and responses. In-depth examination of a child's skills in a single area of development proceeds from the more complete picture of the child's overall skills and knowledge acquisitions, recognizing the interdependence of the systems in development. Examples of assessment tools that focus on functional capacities in an integrated fashion include the Functional Emotional Assessment System (FEAS) [28], structured and non-structured play observations that are part of the Transdisciplinary Play-Based Assessment (TPBA) [29], and the Infant-Toddler Developmental Assessment (IDA) [30].

TABLE 1. Principles of responsive and developmentally oriented assessment

Source: ref. 26, pp. 17-22.

The TPBA is a comprehensive transdisciplinary approach to developmental assessment that is based on the premise that developmental functions are interdependent and children's development is influenced by a variety of factors. TPBA is a functional approach to the assessment of young children with disabilities or those at risk for developmental delay, which actively involves the child, the child's parents, and other professionals in a natural environment of assessment and intervention. TPBA is organized around the planning of a play session that is based on information about the child's developmental status acquired from the parents. "Toys and materials that are appropriate to the child's level are arranged to entice the child to play using various play strategies and developmental skills. One team member facilitates the child's play to encourage the expression of optimal abilities" [29, p. 4]. Guidelines are provided for observing the cognitive, social-emotional, communication and language, and sensorimotor development of the child. Fundamental to this assessment is the ecobehavioural validity of its methods, materials, and techniques.

Because the assessment is planned with the family, and information is acquired from family members as well as from others who are familiar with the child, the baseline for the assessment is close to the family's experience. Multiple opportunities for the child to interact with new and familiar materials are provided, and many observers are included in the assessment in order to capture as many perspectives as possible. Parents complete a pre-assessment inventory that provides valuable information about the child's developmental level and skills and also assists the team in preparing an environment that will elicit the child's optimal abilities. The assessment itself involves several phases: unstructured facilitation where the examiner follows and expands upon the child's lead; structured facilitation in which the examiner attempts to elicit behaviours that were not spontaneous in the preceding phase; introduction of a peer in order to observe interaction among children; structured and unstructured play between the parents and the child; structured and unstructured motor play; and snack, which allows for screening of oral-motor difficulties as well as social and adaptive development. Throughout the observation period, a staff member discusses with the parent the representativeness of the child's behaviours, some of the professional interpretation of behaviours, and the parent's perception of the child's behaviour. Observers are guided in their observations by questions that address both quantitative and qualitative aspects of the child's behaviour rather than just the presence or absence of behaviour. Once the assessment is complete and the guidelines provided have been reviewed in terms of the child's behaviour and accomplishments, transdisciplinary recommendations are developed and a programme planning meeting is convened to provide additional feedback for the child's parents and others working with the child. This experience is designed to be highly respectful of the child, the child's family, and the culture in which the child is being reared, and focuses on the interdependence of areas of development within the child.