Assessment - Process

Jimmy is an 8 year-old boy who resides in Wake County. He has been diagnosed with severe, athetoid cerebral palsy. He uses a wheelchair for mobility, cannot speak or use his arms, and is dependent on others for all self care activities. As is often the case, Jimmy has related highly complex health issues. His family is convinced that he is a smart boy. He laughs at detailed and complex jokes, loves to be read to, and is eager to enter into family conversations.

Jimmy is currently integrated into a regular second grade class with 26 other children and receives speech therapy twice a week for twenty minutes each session. This is a typical commitment of resources for children like Jimmy and it’s not the preference of his teachers and therapists.. His teacher is very frustrated trying to guess what he knows and to be working without a thorough knowledge of his assessed capabilities.

New Voices Assessment Program is a new resource for schools and families! Jimmy is now referred to the interdisciplinary program by his teacher and speech/language pathologist. They believe he has the potential to participate successfully in the classroom, but he currently has no effective means of communication. They do not know how to select a device from the costly options available that will be the best match for his needs and abilities, and they have no experience teaching a child who might use something other than speech as a means to communicate.

The assessment team makes contact with family and school well before the day of his assessment. Jimmy’s school advocate (in his case, the speech/language pathologist) and his family, teacher, classroom aid and occupational therapist have completed a one-of-a kind, computerized, guided questionnaire describing in great detail Jimmy’s needs and abilities. This is a new clinical tool currently being developed by New Voices, and provided to them via a web-based password protected system. This computerized pre-assessment information-gathering tool is the first effort to streamline this complex process.

The assessment team meets to carefully review this information, and determines the key questions and issues that need to be addressed. One member of the team is assigned to serve as Assessment Coordinator for Jimmy. This professional will be the primary contact for the family and school and the lead person throughout the process. The assessment team carefully plans the assessment process to focus specifically on Jimmy’s unique needs and challenges, and strategize ways to maximize his strengths. In some instances, a child may have significant vision, hearing or medical issues. In those cases, the assessment team will call on the participation of a skilled specialist from a list of consultants developed for this purpose. This professional will be integrated into the assessment process.

The assessment team then prepares the assessment room with the necessary specialized equipment, tests and supplies. With permission from the family, the assessment day will be filmed so that the professionals, teachers and family can refer back to the events of the day for purposes of follow-up, education and presentation to the school personnel who were unable to attend in person. Early in the day, team members have discussed the focus and procedures with school and family who have come to participate in the assessment day.

An expert team made up of a speech-language pathologist, literacy specialist, psychologist, occupational and physical therapists engage Jimmy in activities designed to accurately assess his positioning, current communication competencies, adaptive equipment needs, computer access, understanding of language, literacy status, cognitive abilities and related areas. Jimmy’s mom, his teacher and therapist all participate in parts of this assessment to assure that Jimmy’s responses are typical. Jimmy has the opportunity to try out a variety of communication devices selected for him based on his unique configuration of motor, cognitive, communication, vision, and hearing abilities. In some instances, the team will be called upon to build a low-technology system custom designed to the child’s needs.

Equally important, the team gathers information on how he can best access this equipment. Will it be with an adapted splint on his arm? A head-stick pointer? A fine stream light mounted on a head band? A treadle switch accessed by his foot or a sip switch that he accesses by sucking on a straw? The best, most reliable access is maximized in this carefully constructed segment of the assessment process.

The team meets together briefly to summarize their findings, then meets with the family and school personnel to interpret these results and recommendations, answer questions, and provide written guidance on first steps to use the recommended device. During the assessment day the Assessment Supports Coordinator meets with the family to discuss financial issues in order to provide necessary guidance on resource eligibility and access. A critically important service component, the team will assist them in acquiring support to pay for the equipment and services recommended.

Finally, a comprehensive written report is completed that summarizes the information gathered from the family and school, steps in the assessment process, findings, and recommendations in detail. The report will be custom designed for each child and family to assure that it meets all the funding information guidelines required of the sources for which the child is eligible.

Follow up is a key component of the assessment process. The follow-up process is described in advance to the family and school personnel, and a date for the on-site appointment is made at the end of the testing day. Over the next several weeks and months, the school liaison maintains contact to answer questions, monitor progress, assist in equipment access and set-up, and consultation to teachers and related personnel on the best strategies to integrate the communication system into the curriculum. The assessment team continues to serve as a resource for the teacher and related personnel to monitor progress, provide consultation as needed, and support the continued use of the recommended equipment. The assessment is considered complete when children are full, successful participants in their classrooms in regular schools.