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

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

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?

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?

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

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

Interviews Structured interviews Semi-structured interviews Free flowing interviews

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

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

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

Why do I need to know about all these tests?

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?

In what areas do we assess children?

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.

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

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

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.

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

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

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)

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

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.

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

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

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

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

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

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)

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

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

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

What scores are provided by tests?

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

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

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

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

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

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

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

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

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.

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

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

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

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.

Where can I find information on tests?

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

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

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

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 317.274.8167 smkoch@iupui.edu