The Avenues of Learning and the Griffiths Mental Development Scales - The relationship continues Prof Louise Stroud Nelson Mandela Metropolitan University Port Elizabeth South Africa

Babies and young children are exquisitely designed to change and create, to learn and explore, and each one’s web of development is unique.

The Griffiths Story Dr Griffiths designed and created the Griffiths Scales of Mental Development (published 1954). The Griffiths Scales covered first two years of life and assessed development in five areas – Locomotor, Personal-Social, Hearing and Speech, Eye and Hand Co- ordination, and Performance. The Griffiths Extended Scales of Mental Development (developed in the 1960’s ): extended scales and tested children aged two to eight years. Sixth subscale, Practical Reasoning, introduced with the Extended Scales. DR RUTH FLORENCE GRIFFITHS BORN: 2 September 1895 Experienced isolated and troubled childhood Dr Brian Burne: Perhaps these early experiences laid the roots for her later meticulous observation of young children, her love for them and her pleasure in observing their personalities unfold and blossom. BORN: 2 September 1895 Experienced isolated and troubled childhood Dr Brian Burne: Perhaps these early experiences laid the roots for her later meticulous observation of young children, her love for them and her pleasure in observing their personalities unfold and blossom.

The Griffiths Story When Griffiths Scales first introduced, the psychometric conceptions of intelligence. Enormous influence over psychometric measurement for the next three generations. These narrow conceptions included verbal, visual-spatial and mathematical abilities. The Griffiths Scales brought with it an innovative system for developmental assessment, as Dr Griffiths was keenly aware of the importance of interactions between the various avenues of learning. Dr Griffiths advocated a broad-based approach to understanding mental development (i.e., the processes and rates at which growth and maturation of a child’s attributes and abilities takes place). Aware of the importance of social and emotional developmental factors and the interplay between these and mental development.

Dr Griffiths thinking opened doors and her holistic model is illustrated here.

Assessment of Mental Development Assessment of mental development involves comprehensive investigation of child’s abilities, including motor, social and cognitive abilities, by : direct observation; testing ; and reports from caregivers. Rapidly shifting nature of children’s development poses problems for the assessment of young children. Need clinical skills and judgment to differentiate between intellectual and neurophysiological or socio- emotional. Of the various methods for assessing child development, the Griffiths Scales are among those which have been accorded world-wide recognition, especially by paediatricians and psychologists. Not simply a screening test. The Griffiths enables a thorough, holistic, diagnosis through analysis of the development profile. Through periodic re-examinations of children, we can bring to light developmental trends and establish developmental baselines.

Our brain doesn’t finish maturing until the early 30’s. Therefore we must take into account the particular situation of each child in a particular family and consider all his or her physical, social, intellectual, emotional and educational needs in that context We’ve got this whole, huge brain that continues to develop and is constantly moving forward in its development. It’s just like wet cement. What we can do cortically doesn’t come on line fully until the school years, adolescence.

Moving forward Child development and its assessment is a dynamic, moving target. Questions constantly need to be asked in order to have questions answered. It is important to take a fresh look from time to time at the underpinning constructs and variables of measures to ensure that they stay relevant. Each good story has an introduction, body and conclusion. Having completed the introduction to our story, we now turn our attention to the body: the avenues of learning and the current re-standardisation of the Griffiths Mental Development Scales.

The Avenues of Learning & The Re-standardisation of the Griffiths Mental Development Scales (GMDS-ER) July 2010: process of re-standardising the GMDS-ER began. Agreed on by Executive and Research and Re- standardisation Committees of the ARICD: qualitative, exploratory, and descriptive research approach would be adopted in the analysis and implementation of Phase One of the Re-standardisation project.

Phase One Phase One: establish current thinking on child development and its assessment. A thorough systematic review was conducted on the most recent literature and research on child development as well as emerging themes relating to the assessment of children. This information served to establish the emerging themes in thinking regarding ‘avenues of learning’, child development, assessment and child development theories. Questions that guided systematic review: – Based on theory and literature, what should the avenues of learning be? – In designing the test, what other variables should be taken into account in addition to the avenues of learning?’ This enabled research team to measure extent to which Griffiths scales were sufficiently tapping into current key areas in child development and assessment. The exploratory research approach was integral in establishment of a solid theoretical foundation, is needed to underpin and shape the Scales of the future.

The systematic review of available current literature (i.e., from 2001 onwards) revealed: Not much focused research on assessment of children’s development; Thus, very few research questions have been posed to confirm the domains within which children’s development occurs. However, the review revealed: The six developmental areas that underpin the Griffiths Scales (namely, locomotor, personal- social, language, eye and hand co-ordination, performance, and practical reasoning) remain important areas for consideration in the field of child development.

Furthermore, a thematic analysis was conducted on the text, written words, phrases and symbols reflected on the ‘sticky note’ data obtained by the various professionals who attended the Avenues of Learning workshop in London, U.K. in October The four questions posed at the workshop were: 1.What are the ideal components of a developmental test? 2.What are the new knowledges that are not in the current test? 3.What are the new advances/knowledge we do not want? 4.Emotional/social development- what areas would you like included at item level?

The systematic review and ‘sticky note’ data helped to identify and select experts who were visited and interviewed in April The Project Board met beforehand to prepare for the expert interviews. Qualitative interviews were conducted and were intentionally free and led by the specific expert at the time of the interview. Questions related to other assessment measures such as the WISC IV and Bayley Scales were deemed important in order to stay mindful of the modern principles of test development. The Project Board’s thoughts correlated well with the Expert group, including those experts who did not particularly value the Griffiths Scales. Outcome: valuable information obtained as well as suggestions for the enhancement of the Scales. Questions posed to the experts included: establishing why they use the Scales; Why they don’t use the Scales; Whether they have identified key constructs in child development that the Scales are not adequately tapping into; and Important aspects of test development.

Based on all the information obtained, and bearing the ARICD Executive, Research and Re- standardisation Committee’s determinants in mind, it is evident that there is a growing need for the GMDS to become a seamless and continuous test of general development for infants and young children. Also a need for core guiding principles which are underpinned by the philosophy of the GMDS to be highlighted, emphasised, and supported by evidence in directing the next step.

One test cannot measure everything The core of the GMDS should remain the core – in other words, it needs to answer the clinician’s question of “is this child developing like other children?” The underlying theory of the test should remain the structured observation of children The purpose of the GMDS is to measure general development. The breadth of the GMDS remains important. The purpose of the test must be retained but can be adapted by specialists for particular contexts The GMDS must be able to identify the ‘red flags’ of development for further analysis The GMDS must be usable by both the practitioner and the researcher for their respective purposes. Guiding principles identified by the Project Board are as follows:

Guiding principles (cont.) Second order factor analysis: the latest trends need to be unpacked using the general test, by item analysis to get to a range of second order factors – could be developed into useful developmental profiles and supplementary Scales. The strength of the overall validity needs to be established for confident use, both in the clinical setting and research setting. The age range of children currently assessed by the GMDS needs to be clarified.

Phase One continues Having identified guiding principles, the next step in the Re- standardisation Project was to develop a questionnaire to be distributed to Griffiths’ users worldwide. The development of the GMDS questionnaire commenced from July 2011 to date. GMDS questionnaire or practitioner survey: currently being distributed to practitioners and Griffiths users worldwide. Has an important role in establishing with confidence the core guiding principles, grounded on the philosophy of the Scales, to guide and direct the next step in the Re-standardisation process. In addition, information obtained will provide valuable input regarding the merits of the GMDS and to provide suggestions for the enhancement of the GMDS.

In keeping with the qualitative approach, utilising an exploratory- descriptive research method, the team used the open-ended question format in the construction and format of the questions. Open-ended questions have several advantages: – they provide richer and fuller information than fixed questions; – open-ended questions limit the chance of answers being ambiguous since the respondent expresses what he or she thinks and does not have to interpret a statement and then agree or disagree with the statement; – the questioning is more realistic; and it eliminates the frustration a respondent may feel with the constraint imposed by a fixed-choice answer (Coolican, 2004). It is envisaged that by adopting this type of questioning, the responses would enrich the existing ‘thinking’ and knowledge obtained in Phase One.

Based on the information obtained thus far, core guiding principles were identified. Having established these principles, the questionnaire would serve as a measure of confirmation. As such, the team developed open-ended questions around the ten principles first and foremost, as well as developing additional questions to obtain information that would enhance the re-standardisation process, such as merits and limitations of the GMDS.

The development of the questionnaire followed a collaborative process between the members of the Project Board and team from Nelson Mandela Metropolitan University (NMMU). Draft questionnaires were circulated in a round-robin fashion to the members of the Project Board for input and improvements were subsequently made to the questionnaire. It is important to note that the questionnaire consists of two sections: one for current, regular users of the GMDS (Section A), and a second section for practitioners who do not currently use the GMDS (Section B).

Examples of questions posed in Section A include: Why or when do you use the GMDS? Which aspects of the current GMDS do you use most of the time? Which age range of children do you currently find the GMDS to be most useful for? The test must answer the question, “is this child developing as expected or like other children of his/her age?” Please provide comment on this statement. What other suggestions would you like to make for enhancing the GMDS and improving its applicability and use?

Examples of questions posed in Section B include: If you don’t currently use the GMDS, please elaborate as to why not. Do you use a different test of child development in your work? If so, please say which test/s you use, and what you consider to be the merits of the instrument/s you use over the GMDS? Do you think that, in the future, there will be a place in your professional work for developmental testing (as distinct from cognitive or physical testing)? Please elaborate.

In conclusion The relationship between the Avenues of Learning and the Griffiths Mental Development Scales continues through the re-standardisation process and is maintained by the following: The Guiding Principles which have been identified and embraced. Taking note of the things that inform the revision of measures, such as those important discoveries made through ongoing research studies. Some of these findings are captured in the table on the following slide:

Making brave decisions about how much to change in a measure to keep it contemporary. Being mindful of underpinning and emerging constructs such as working memory, attention, processing speed, attachment, emotional development, etc., and being willing to reconceptualise them. Recognising that child development and its assessment is dynamic and deserves proper expression. In conclusion (cont.)

Drawing the story to a close This is a LIVING story. It is a LIVING thing. Clinician’s who make their own rules when they know they are right…clinician’s who get a special pleasure out of doing something well….clinician’s who know there’s more to this whole living thing than meets the eye: they’ll be with us all the way. Others may simply escape into a delightful adventure about freedom and flight. It is not the strongest of the species that survive, nor the most intelligent, but the ones most responsive to change. In the words of Charles Darwin: