1. Norm-Referenced Tests and Test Scores: What does it all mean?
Steven M. Koch, Ph.D.
Riley Child Development Center
IU School of Medicine - Department of Pediatrics

2. Presentation Goals Recognize areas of assessment
Understand standardized test scores
Learn about the new SSA Test List
Identify resources on specific tests

3. Questions asked and answered today
Why do we assess children?
How do we assess children?
Why do I need to know about the tests?
What do I need to know about the tests?
What are all those scores?
And what do they mean?
Where can I find information on tests?

4. Why do we assess children?
Guide diagnosis
Determine eligibility
SSI
Medicaid waiver
Special education
Monitor progress
Determine treatment approach
Research
Ask audience why we assess?

5. How do we assess children?
Four Pillars of Assessment (Sattler, 2001)
Norm-referenced tests (standardized tests)
Interviews
Observations
Informal assessment procedures
Testing should be fair and culture-free

6. Norm-referenced tests
Provide a degree of quantification of the child’s functioning in a given area
Describes the child’s present functioning in reference to peer group
Identifies strengths and weaknesses in area
Provides a baseline for later testing

7. Interviews Structured interviews Semi-structured interviews
Free flowing interviews

8. Observations Systematic observations / data collection
Frequency counts
Incident logs
Informal observations
Approach towards more difficult tasks
Generate hypotheses

9. Informal Assessment
Non-standardized assessment approaches that test an examiner’s hypothesis
Can further identify particular strengths and weaknesses
Examples of informal assessment procedures
Reading passages
Play-based assessment

10. Fair testing
Fair testing does not mean the same test is administered to all individuals.
The tests selected for each child should address the questions asked, and the areas of concern.
The impact of other skills on performance
should be minimized

11. Why do I need to know about all these tests?

12. Why do I need to know about tests?
Provides an understanding of the tests which are a part of the claimant’s file
Can provide guidance when requesting a CE
How can the CE obtain the needed information to help with the eligibility determination?
What instruments or areas of assessment
would be most helpful as part of the CE?

13. In what areas do we assess children?

14. Areas assessed by norm-referenced instruments
Intelligence / cognition
Social / emotional
Adaptive functioning
Speech
Oral language
Academic
Gross & fine motor
Early childhood / global development
These areas are a breakdown provided by test publishers.

15. Intelligence / Cognition
Definitions (Sattler, 2001)
Higher-level components, which include abstract reasoning, representation, problem solving, and decision making
Overt behavioral manifestations represented by effective or successful responses
Elementary processes, such as perception, sensation and attention
Executive processes
Memory
Ability to learn

16. Intelligence / Cognition
Assessment approaches
Wechsler Intelligence Scale for Children: 4
Wechsler Adult Intelligence Scale: 3
Wide Range Assessment of Memory and Learning: 2
Stanford-Binet Intelligence Scales: 5
Differential Abilities Scale
Bayley Scales of Infant Development: 3
Universal Nonverbal Intelligence Test

17. Social / Emotional Definitions
Assessment of emotional status, impact of mental disorders on functioning, and social interactions and relationships with others
Often viewed as internalizing and externalizing behaviors.

18. Social / Emotional Internalizing Externalizing Other areas
Anxiousness, depressed mood, somatic complaints
Externalizing
Hyperactivity, verbal aggression, physical aggression
Other areas
Social problems, inattention,
thought disturbance

19. Social / Emotional Assessment approaches Mental Status Examination
Child Behavior Checklist
Behavior Assessment System for Children: 2
Behavior Rating Inventory of Executive Function
Revised Children’s Manifest Anxiety Scale
Roberts Apperception Test for Children: 2
Children’s Depression Inventory
Functional Behavior Assessment
Checklists completed by caregiver, teacher, individual
Some are more global, while others are more specific in their focus

20. Adaptive Functioning Definitions
The effectiveness with which individuals meet the standards of personal independence and social responsibility expected of individuals of their age and cultural group (Sattler, 2002).
Multifactorial
Independent functioning, physical development,
economic activity, language development,
numbers & time, (pre)vocational, self-direction,
responsibility, socialization (AAMR)

21. Adaptive Functioning Assessment approaches
Vineland Adaptive Behavior Scales: 2
Scales of Independent Behavior: Revised
Adaptive Behavior Assessment System: 2
Semi-structured interview
Often checklist or interview with caregiver or teacher

22. Speech Definitions Areas of speech disorders
Involves the production of sounds which form words
Areas of speech disorders
Oral-Motor
Apraxia
Articulation
Stuttering / Dysfluency
Phonological disorder
Apraxia of speech (AOS) – It is a neurogenic disorder characterized by sensorimotor problems in positioning and sequentially moving muscles for the independent production of speech. AOS is a disorder of motor programming. Patients with AOS have a number of communication deficits, especially those caused by groping and struggling to speak. It is not caused by muscle weakness or slowness. AOS may be associated with prosodic problems.
Stuttering – a disorder of fluency and rhythm. Stuttering dysfluencies could include repetitions (part and/or whole word), sound prolongations (Mmmmommy), silent prolongations (an articulatory posture held for a duration longer than average but without vocalization), interjections (ex. um), pauses, broken words (ex. Be [pause] fore), incomplete sentences, and circumlocution of a word.
Articulation Disorder - The inability to correctly produce speech sounds (phonemes) because of the imprecise placement, timing, pressure, speed, or flow of movement of the lips, tongue, or throat. With an articulation disorder, there is difficulty producing and using age-appropriate speech sounds.
Phonological Disorder - failure to use speech sounds which are appropriate for the individual's age and dialect. The causes of phonological disorders in children in unknown. There may be a genetic component since a large proportion of children with this problem have relatives with a type of similar disorder. Other risk factors seem to be low socioeconomic status and coming from a large family.
Voice Disorder - A voice is termed "disordered" when the vocal quality of an individual is altered/changed in such a way that it is thought to be abnormal to the listener. The onset and development of these disorders can be "sudden" or "slow." Examples of characteristics of sudden onset may be: trauma, infection, CVA, injurious inhalation, intubation, conversion reaction, or a severe allergic reaction. Degenerative neurologic disease, musculo-skeletal tension, vocal abuse and misuse, growths of folds, gastro-esophageal reflux, and chronic allergies may characterize slow onset.

23. Speech Assessment approaches Goldman-Fristoe Test of Articulation: 2
Khan-Lewis Phonological Analysis: 2
Photo Articulation Test: 3
Stuttering Severity Inventory: 3

24. Oral Language
The use of words and sentences to convey meaning to others. Oral language examines both the production of messages (expressive) and their receipt (receptive).
Basic components
Semantics
Syntax
Morphology
Phonology
Pragmatics

25. Oral Language Assessment approaches Preschool Language Scale: 4
Clinical Evaluation of Language Fundamentals: 4
Receptive-Expressive Emergent Language Scale: 3
Test of Language Development: 3
Peabody Picture Vocabulary Test: 3
Rosetti Infant-Toddler Language Scale
Test of Pragmatic Language
Hawaii Early Learning Profile

26. Academic
Definitions
The skills children learn through direct intervention or instruction (Sattler, 2001)
Commonly assessed skills include
Reading individual words
Reading comprehension
Mathematics
Spelling
Written expression

27. Academic Assessment approaches Wechsler Individual Achievement Test: 2
Woodcock-Johnson Tests of Achievement: 3
Kaufman Test of Educational Achievement: 2
Woodcock Reading Mastery Test: 2
KeyMath: 2
Diagnostic Achievement Battery: 3

28. Gross & Fine Motor Definitions
Gross motor refers to tasks involving the larger muscles of the body, such as the legs and trunk
Fine motor refers to tasks involving the hands and wrists
Visual-motor refers to the integration of visual
and fine motor, such as handwriting
Sensory integration refers to the ability to
regulate sensory input (auditory, visual,
tactile, kinesthetic)

29. Gross & Fine Motor Assessment approaches
Peabody Developmental Motor Scales: 2
Bruininks Oseretsky Test of Motor Proficiency
Beery-Buktenica Test of Visual-Motor Integration: 5
Gross Motor Function Test
The Sensory Profile

30. Early Childhood / Global
Many instruments assessing youth in early childhood examine multiple areas of development, such as cognitive, speech, language, motor, school readiness, etc.
Norm-referenced tests are not always
appropriate for this age, and more
curriculum-based approaches are
utilized

31. Early Childhood / Global
Assessment approaches
Bayley Scales of Infant Development: 3
Assessment, Evaluation & Programming System
Kaufman Survey of Early Academic and Language Skills
Bracken Basic Concept Scale: 2
Hawaii Early Learning Profile
Infant Toddler Social Emotional Assessment
Carolina Curriculum for Infants / Toddlers

32. What scores are provided by tests?

33. Types of scores Raw scores Standard and Scaled Scores
Number of correct responses for a test
May be useful when measuring progress
Standard and Scaled Scores
Normal distribution of raw scores (established
mean and standard deviation)
IQ scores
T-Scores

34. Normal Distribution Curve
Also called the bell curve (due to its shape), or the gaussian curve (after Carl Friederich Gauss)

35. Normal Distribution Curve
Mean () – average score
Standard deviation () – spread of scores

36. Normal Distribution Curve
Population
Mean = 100
SD = 15
Standard deviation

37. Normal Distribution Curve
Population
Mean = 100
SD = 16
Standard deviation

38. Normal Distribution Curve
Population
Mean = 10
SD = 3
Standard deviation

39. Normal Distribution Curve
Population
Mean = 50
SD = 10
Standard deviation

40. Types of scores Age / grade equivalents
Child’s raw score in relation to average score for a given age
Often used with young children, and individuals with developmental delays
Often interpreted incorrectly

41. Age Equivalent 1 == 4 1 == 4
Equal raw scores leads to the same age equivalent score. However, it does NOT mean the same items were correctly answered. The second child answered items that were at a higher developmental
level.

42. Types of scores Percentiles Different than percentages
Provides comparison to peer group
Perform equal to or better than X% of children

43. Normal Distribution Curve
Population
-1 SD = 16%ile
+1 SD = 84%ile
Standard deviation

44. Normal Distribution Curve
Population
-2 SD = 2%ile
+2 SD = 98%ile
Standard deviation

45. When is a score significant?
Generally, when a score is greater than 2 SD (either above or below the mean, the score is significantly different (e.g., an IQ of 70 or lower).
The score can be significant if it is 2SD below OR 2SD above the mean (e.g., T-Scores on
behavior checklists greater than 2SD
above the mean generally indicate an
area of concern.
Standard Scores or Percentiles
Age and grade equivalents are NOT on the normal curve.

46. Where can I find information on tests?

47. Where to get information
Your medical consultants (e.g., psychologists, SLPs)
Sattler, J.M. (2001). Assessment of Children: Cognitive Applications (4th Ed.). La Mesa, CA: Sattler Publisher.
Sattler, J.M. (2002). Assessment of Children: Behavioral and Clinical Applications (4th Ed.). La Mesa, CA: Sattler Publisher.
Buros Institute
Mental Measurements Yearbook
Tests in Print
University libraries (e.g., IUPUI)
SSA Test List

48. SSA Test List Updated list of tests (earlier list developed ca. 1991)
Recently placed on SSA’s intranet
Provides the following information:
List of tests by area
Comprehensive, screening, subarea, special population
Publisher, publication date
Description / Purpose
Standard administration time
Scores (names, types)
How information is obtained
Is currently being updated

49. Where to get information
Test Publishers
Achenbach System of Empirically Based Assessment
American Guidance Service
Psychological Assessment Resources
Psychological Corporation
Riverside Publishing
Western Psychological Services

50. For more information…. Steven M. Koch, Ph.D., HSPP
Psychologist, Interdisciplinary Training Director
Riley Child Development Center
IU School of Medicine – Dept. of Pediatrics
Riley Hospital for Children