Assessment sequence

Assessments should begin by establishing reliable, working alliances with the significant individuals in the child's life. These individuals hold important information about the child and his or her capacities. Creating a reliable alliance with parents involves the use of sensitive interpersonal communication skills and the development of mutual trust and respect [33]. This calls for sensitive listening skills, responsivity to requests and concerns, openness to the family's interpretations, and honesty in interactions. Mutual respect for the family also involves understanding the family's strengths, challenges, and problem-solving strategies, as well as awareness and communication of the cultural assumptions undergirding assessment and professional recommendations. Hirshberg [34] describes precisely this kind of parent-professional relationship in his description of clinical interviewing. His critical insight is that human connectedness is essential for the process of assessment and intervention. This connectedness occurs at many levels: between parent and child, parent and clinician, and clinician and child.

After this relationship has been established, the assessment should be focused on practical outcomes. Assessment is not an end in itself. Rather, its goal is to obtain useful and accurate information about the child and the child's nurturing environment, including the resources and obstacles inherent in that environment, in order to find or create the most optimal situation for supporting the child in meeting family goals. The validity of an assessment is determined in terms of its application.

Greenspan and Meisels [26, pp. 18-19] translate these ideas into a sequence of assessment as follows:

» Establishing an alliance with the parents, listening to their views of the child's strengths and challenges, and discussing the issues to be explored in the assessment.

» Obtaining a developmental history of the child and an initial picture of the family's experience: although basic information may be readily available, some insights may only emerge over time, as part of an ongoing relationship and working alliance with the parents.» Observing the child in the context of unstructured play with the parent(s) or other familiar caregivers.» If appropriate, observing interaction between the child and a clinician.» Making specific assessments of individual functions in the child, as needed.

» Using a developmental model as a framework for integrating all the data obtained from parents' reports, direct observation, and other sources, and conveying and discussing assessment findings in the context of an alliance with the child's primary caregivers, with the potential for starting an intervention process if needed.