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Standardized Tests - a participative workshop Davis, Alexis; Mayson, Tanja; Stewart, Sue Jan 23, 2008

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Standardized Testsa participative workshop Alexis Davis, BScOT Tanja Mayson MSc, BScPT Sue Stewart MRSc, BScPT  Agenda Audio available - BSID-II, PDMS-2, Sensory Profile, MABC-2 No audio - AIM.BOT2, DTVP2, GMFM  Objectives „  „ „  To outline the reasons for using standardized tests To review test terminology To introduce eight different standardized tests „ „  „  To describe when they might be used To describe their psychometric properties  To enable participants to discuss four tests more fully with a clinical expert.  Purpose? „  Why do we use standardized tests? „ „ „  Can all tests predict later function? Can all tests measure change? Need to determine the reason for using the test and then decide which test is best.  Before Selecting a test…. You need to know „ Type of test „ Purpose of the test „ Population it serves „ Time to Complete „ Equipment Needed  Types of Tests „  „  Norm-referenced tests = Compare child with so called “norm” or average of a group of similar children the purpose is to discriminate  Examples??  Types of Tests „  „  Criterion-referenced tests = Compare performance of a child in terms of a set of criterion the purpose is to evaluate  Examples???  Purpose of a test „  Why are you going to use the test? „ „ „ „  Discrimination Prediction Evaluation Planning/Description  Terminology „ „ „ „  Chronological age Corrected age Basal score Ceiling score  Test Scores and Characteristics „ „ „ „ „  Raw score Standard score Percentile Age equivalent Developmental quotient  Reliability „  „  The idea that the test will get the same values if repeated. Actually a very complicated concept and there are many measures to ensure good reliability.  Reliability To be reliable  „ „  „  Provide consistent values with small errors of measurement (Absolute Reliability) Be capable of differentiating between clients with whom the measure is being used (Relative Reliability).  Validity „  „  The idea that the test is actually testing what it says it is. A measure is valid to the extent that it measures what it is intended to measure. Validity implies that a measurement is relatively free from error i.e. a valid test is also reliable.  Characteristics of diagnostic and screening tools „  Sensitivity (80%) „  „  Specificity (90%) „  „  Test’s ability to get a real negative  Positive predictive value „  „  Test’s ability to get a real positive  Estimate that positive result means positive  Negative predictive value „  Estimate that negative result means neagative  How to report findings „  „  Extremely important to think about what the best way to “message” the results of your test. Case example  The Context „  What kinds of things do we need to be cognizant of when using standardized tests?  The Context „  We need to appropriately set the context for the testing situation „  For the child „ „  „  Making them feel comfortable Letting them know what is going on  For the family „  Discussing expectations and reasons for the visit  The Context „  Standardized tests only give us part of the picture  The Context „  Standardized tests only give us part of the picture „ „  The art and the science Clinicians need to use their experience and clinical reasoning to put all of the pieces together.  Difficulties „  How many of us modify the administration of the tests?  Difficulties „  What should you do if you really feel you need to modify a measure?  Tests  The Bayley Scales of Infant Development, 3rd Edition (BSID-III)  BSID-III „  Purpose „  to identify children with developmental delay  BSID-III „  Type „  „  Purpose „  „  Norm-referenced Discrimination, planning  Population „  Children at risk for developmental delay  BSID-III „  Age „  „  Time to Complete „  „  0 – 42 months 50 - 90 minutes  Equipment Needed „  BSID-III kit, table, chair, floor space for motor items, stairs  BSID-III Purpose of revision  „ „ „ „ „  Update the normative data Develop 5 distinct scales Strengthen the psychometric quality Improve the clinical utility  BSID-III Purpose of revision  „ „ „ „ „  Simplify administration Update item administration Update stimulus materials Maintain basic qualities of the Bayley Scales  BSID-III Cognitive subscale Language scale  „ „ „ „  Receptive language subscale Expressive language subscale  Motor scale  „ „ „  Fine motor subscale Gross motor subscale  BSID-III „  Who can administer?  BSID-III „  Standardized Sample  BSID-III „ „ „  Reliability Validity Further considerations  Cases „  „  „  What types of children do you think this test would be most appropriate for? Should it be used for children with cerebral palsy? Down’s syndrome? What is the age span that you think clinically is most appropriate?  The Peabody Developmental Motor Scales, 2nd Ed. (PDMS-2)  PDMS-2 „  Purpose „  „  „ „ „  To estimate a child’s motor performance in comparison to peers To determine discrepancies between gross and fine motor abilities To assist in goal development To evaluate progress To study motor development and ability in children as well as the effectiveness of motor interventions  PDMS-2 „  Type „  „  Purpose „  „  Norm and criterion-Referenced Discrimination, evaluation, planning  Population „  Children suspected of having motor difficulties  PDMS-2 „  Age „  „  Time to Complete „  „  0 – 71 months 45 – 60 minutes for entire test; 20-30 minutes per subscale  Equipment Needed „  Kit, desk, two chairs, stopwatch, manual, and floor space for motor items  PDMS-2 Improvements  „ „ „  „  Updated normative data Normative data that is representative of the US population Stratification by age of normative data  PDMS-2 (improvements) „  „  „  „  Revisions to administration and scoring format Elimination of items criticized in previous edition Revision and reformatting of activity cards into a motor activities program Evaluation of items using conventional and newer statistical analyses to better identify biased items  PDMS-2 (improvements) „  „ „  „  Computed reliability coefficients for subgroups of normative sample Completion of new validity studies Availability of more specific performance levels for the scoring criteria Addition of illustrations to assist with administration  PDMS-2 Gross motor scale  „ „ „ „ „  Reflexes Stationary Locomotion Object manipulation  Fine motor scale  „ „ „  Grasping Visual motor integration  PDMS-2 „  Who can administer?  PDMS-2 „  Standardized Sample  PDMS-2 „ „ „  Reliability Validity Further Considerations  Cases „  „  „  What types of children do you think this test would be most appropriate for? Should it be used for children with cerebral palsy? Down’s syndrome? What is the age span that you think clinically is most appropriate?  The Sensory Profile  The Sensory Profile „  Purpose „  „  „  To evaluate the contributions of sensory processing to a child’s daily functional performance. To determine the child’s tendencies to respond to stimuli. To understand which systems are likely contributing or providing challenges to the child’s performance.  The Sensory Profile „  Type „  „  Purpose „  „  Norm-referenced Discrimination  Population „  Children at risk of sensory processing difficulties  The Sensory Profile „  Age „  „  Time to Complete: „  „  0 to 3 years (Infant/Toddler Sensory Profile), 3 to 10 years (Sensory Profile), 11 years and up (Adolescent/Adult Sensory Profile) 30 minutes for Sensory Profile (10 minutes for Short Sensory Profile); 15 minutes for Infant/Toddler Sensory Profile; 10-15 minutes for Adolescent/Adult Sensory Profile  Equipment Needed „  Questionnaire, manual, score form, pen/pencil  The Sensory Profile 1. 2.  3.  The Sensory Profile (SP) The Infant/toddler Sensory Profile (ITSP) The Adolescent/Adult Sensory Profile (AASP)  The Sensory Profile 1.  The Sensory Profile (SP) 1.  Sensory processing 1.  2.  Modulation 1.  3.  Targets child’s responses to basic sensory processing systems Reflects child’s regulation of neural messages  Behavioral and Emotional Responses 1.  Reflects child’s behavioral outcomes of sensory processing  The Sensory Profile „  Who should administer?  The Sensory Profile „  Standardized Sample „ „ „  SP ITSP AASP  The Sensory Profile „ „ „  Reliability Validity Further Considerations  Cases „  „  „  What types of children do you think this test would be most appropriate for? Should it be used for children with substance exposure? Cerebral palsy? What is the age span that you think clinically is most appropriate?  Movement Assessment Battery for Children (MABC-2)  MABC-2 „  Purpose „ „  „ „  Identification of movement difficulties Clinical exploration and intervention planning Program evaluation Research  MABC-2 „  Type „  „  Purpose „  „  Norm-referenced Discrimination, planning, evaluation  Population „  Children with motor difficulties  MABC-2 „  Age „  „  Time to Complete „  „  3 – 16 years 20 – 40 minutes for test  Equipment Needed „  MABC-2 kit, stopwatch, table, two chairs, floor space for motor items  MABC-2 A revision of test content  „ „ „ „  New plastic materials Improving certain task items Clarifying instructions  A revision of test structure  „ „ „  Extending ages to 3 to 16 years Reduction to three age bands  MABC-2 „  Who can administer?  MABC-2 „  Standardized Sample  MABC-2 „ „ „  Reliability Validity Further Considerations  Cases „  „  What types of children do you think this test would be most appropriate for? What is the age span that you think clinically is most appropriate?  Agenda No audio accompaniment – AIM.BOT2, DTVP2, GMFM „  Alberta Infant Motor Scale (AIMS) „  Purpose is to measure motor development in high risk infants  AIMS „  Type „  „  Purpose „ „  „  Norm referenced Discrimination Evaluation  Population „  At risk infants  AIMS „  Age „  „  Time to complete „  „  0-18 months 20-30 minutes  Equipment needed „  Book, form, pen and observation surface  AIMS „  Overview „ „ „ „ „ „  58 item observational assessment observed or not observed scores are added up higher score means more mature percentiles and age equivalent cut offs?  AIMS „  Who can administer?  AIMS „  Standardized Sample  AIMS „ „ „  Reliability Validity Further considerations  Cases „  What types of children do you think this test would be most appropriate for?  Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) „  The BOT-21 (2005) is a revision of the Bruininks-Oseretsky Test of Motor Proficiency2 (BOTMP) (1978).  BOT2 Purpose  „ „ „  „  „ „  Support diagnoses of motor impairments Screen for motor impairment and determine the need for further assessment or intervention Make placement decisions regarding physical education programs Develop and evaluate motor training programs Assist clinicians and researchers  BOT-2 „  Type: „  „  Purpose: „  „  Norm-referenced Discrimination, planning, evaluation  Population: „  Children at risk for motor impairment  BOT-2 „  Age: „  „  Time to Complete: „  „  4 – 21 years 40 – 60 minutes for complete form; 15 – 20 minutes for short form  Equipment Needed: „  BOT-2 kit, stopwatch, table, two chairs, floor space for motor items  BOT-2 changes „ „ „  „ „ „  Improve functional relevance Expand coverage Improve measurement among 4 and 5 year olds Extend norms through age 21 Improve item presentation Improve quality of kit equipment  BOT-2 „ „  Administration 4 ways to administer  BOT-2 „  Standardized Sample  BOT-2 „ „ „  Reliability Validity Further considerations  Cases „  „  „  What types of children do you think this test would be most appropriate for? Should it be used for children with learning difficulties? What is the age span that you think clinically is most appropriate?  The Developmental Test of Visual Perception, 2nd Edition (DTVP-2)  DVTP-2 Purpose  „ „  „  „  „  Document the presence and degree of visual perceptual or visual-motor difficulties in individual children Identify candidates for referral to intervention programs Verify the effectiveness of intervention programs Serve as a research tool  DVTP-2 „  Type „  „  Purpose „  „  Norm-referenced Discrimination, planning, evaluation  Population „  Children at-risk for visual perceptual or visual-motor difficulties  DVTP-2 „  Age „  „  Time to Complete „  „  4 – 10 years 30 – 60 minutes  Equipment Needed „  DTVP-2 kit, table, chair  DVTP-2 „  The DTVP-21 (1993) is a revised version of the original DTVP2 (1966). „  „  „ „  An increase in reliability of subtests to acceptable levels Evidence for content, criterion-related, and construct validity Completion of factorial analysis Demonstration of an absence of racial, gender, and handedness bias  DVTP-2 „  „  „  Inclusion of a normative sample whose demographic characteristics are similar to the US population Development of two new composite scores (motor-reduced visual perception and visualmotor integration) to assist with diagnosis Expansion of age tested to include 10 year olds  DVTP-2 „  Subtests „ „ „ „ „ „ „ „  Eye-hand coordination Position in space Copying Figure-ground Spatial relations Visual closure Visual-motor speed Form constancy  DVTP-2 „  Administration  DVTP-2 „  Standardization Sample  DVTP-2 „ „ „  Reliability Validity Further considerations  Cases „  „  What types of children do you think this test would be most appropriate for? What is the age span that you think clinically is most appropriate?  The Gross Motor Function Measure (GMFM)  GMFM-88 and GMFM-66 „  Purpose „  to evaluate motor skills in children with cerebral palsy (CP).  GMFM „  Type „  „  Purpose „  „  Criterion-referenced Evaluation  Population „  Children with cerebral palsy (CP)  GMFM „  Age „  „  Time to Complete „  „  5 months to 16 years with motor skills at or below the level of a typical 5 year old. 45 – 60 minutes for GMFM-88; less for GMFM-66  Equipment Needed „  Mat, bench, toys, and access to five stairs  GMFM „  Administration  GMFM „  Standardized Sample  GMFM „  GMFM 66 (advantages) „ „  „  Ordering of items according to difficulty Change to an interval scale which allows for better interpretability Decrease in administration time Use of a computer scoring system  GMFM „  GMFM 66 (disadvantages) „  „ „  Less items in the lower dimensions which may make the GMFM-66 less descriptive for children functioning at lower levels Need for computer and software to score Need to learn to interpret item maps  GMFM „ „ „  Reliability Validity Further Considerations  Cases „  „  „  What types of children do you think this test would be most appropriate for? Should it be used for children with cerebral palsy? Down’s syndrome? What is the age span that you think clinically is most appropriate?  Case Studies  References „  „  http://www.canchild.ca/Portals/0/education_ materials/pdf/ClinicalMeasurement.pdf Clinical Practice Guideline Report of the Recommendations Motor Disorders Assessment and Intervention for Young Children (www.hes.org) NYS Department of Health, Bureau of Early Intervention, Corning Tower Building, Room 287, Empire State Plaza, Albany, New York 12237-0660  

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