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Social-emotional assessment of deaf children : a comparison of two measures Potter, Anne Maree 1982

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SOCIAL-EMOTIONAL ASSESSMENT OF DEAF CHILDREN: A COMPARISON OF TWO MEASURES by ANNE MAREE POTTER .Ed., Tasmanian College of Advanced Education, 1976 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS i n THE FACULTY OF GRADUATE STUDIES Fa c u l t y of Education ( S p e c i a l Education) We accept t h i s t h e s i s as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA Duly 1982 Anne Maree P o t t e r , 1982 In p r e s e n t i n g t h i s t h e s i s i n p a r t i a l f u l f i l m e n t of the requirements f o r an advanced degree at the U n i v e r s i t y o f B r i t i s h Columbia, I agree t h a t the L i b r a r y s h a l l make i t f r e e l y a v a i l a b l e f o r r e f e r e n c e and study. I f u r t h e r agree t h a t p e r m i s s i o n f o r e x t e n s i v e copying o f t h i s t h e s i s f o r s c h o l a r l y purposes may be granted by the head o f my department or by h i s or her r e p r e s e n t a t i v e s . I t i s understood t h a t copying or p u b l i c a t i o n o f t h i s t h e s i s f o r f i n a n c i a l g a i n s h a l l not be allowed without my w r i t t e n p e r m i s s i o n . Department o f The U n i v e r s i t y of B r i t i s h Columbia 1956 Main Mall Vancouver, Canada V6T 1Y3 3E-6 M / f m ABSTRACT The study was designed to permit consideration of two broad issues: (1) the applicability of using a rating scale designed to assess social-emotional functioning in hearing children with a deaf population and; (2) the functioning of a rating scale as a diagnostic instrument for deaf children. To this end, ninety-three,7 to 16 year old deaf children at a school for the deaf were rated by their teachers using two rating scales: an adapted version of Rutter's Children's Behaviour Questionnaire, a screening instrument designed for hearing children; and the Meadow/Kendall Social Emotional Assessment Inventory (SEAI), a scale designed specifically for deaf children and purporting to provide differential diagnostic information on a deaf child's social-emotional functioning. Item behaviour of the two rating instruments and correlations of the scales with each other and with global teacher judgements were analyzed to investigate the applicability of the adapted Rutter scale with a deaf population. Examination of these data showed that, using teacher judge-ment as a validity criterion, the Rutter scale had higher item and test validity than the SEAI. Moreover, correlations between the SEAI and the Rutter questionnaire were moderately high. These results suggest that the adapted Rutter scale is applicable with a deaf population. Intercorrelational analyses between the three scales of the SEAI and the percentage of children identified by each measure as having social-emotional problems were examined to investigate the differential diagnostic functioning of the SEAI. Correlations between the three scales were moderately high. A l l three scales identified nearly one third of the population as having social-emotional problems, while the Rutter scale, designed to "over-identify", identified just over one third. These results c a l l into question the use of the SEAI as anything other than a screening instrument. Finally, additional analyses to examine the r e l i a b i l i t y of the two rating scales and teacher judgement were conducted. A l l three measures had a high r e l i a b i l i t y . i iv TABLE OF CONTENTS Page Abstract i i List of Tables. vi List of Figures v i i i Acknowledgement ix CHAPTER I; THE PROBLEM AND RELATED LITERATURE The Problem 1 Literature Review 4 Conceptual Issues 5 Measurement of Social-Emotional Functioning in Deaf Children 12 Identification and Assessment of Social-Emotional Problems in Deaf Children: The State of the Art 17 Validity and Reliability of Methods Utilizing Teacher's Judgements 27 Summary 32 Research Objectives 33 CHAPTER II: METHODOLOGY Subjects 35 Raters 36 Instrumentation 36 Procedure 4-2 Data Analyses 44-Summary 46 CHAPTER III; RESULTS Item Behavior 4-8 Internal Consistency 52 Discriminant Validity of the SEAI Scales 53 T3 Test-Retest Reliability 55 Distribution of Scores 57 Correlations of TO with Rutter and SEAI Scales 59 Correlations Between SEAI Scales and the Rutter Scale 66 Summary 69 V CHAPTER IV; SUMMARY, DISCUSSION AND RECOMMENDATIONS Page Summary ; 72 Limitations... 75 Discussion 76 ' Recommendations 82 References 85 Appendix A: Measures 92 Appendix B: Supplementary Tables and Figures 98 v i LIST OF TABLES Page Table 1 Summary of data analysis 45 2 Degree to which items differentiate "disturbed behaviour": Rutter and SEAI scales 49 3 Degree to which items correlate with respective scale score: Rutter and SEAI scales 51 4 Degree to which items correlate with teacher judgement: Rutter and SEAI scales 52 5 Hoyt r e l i a b i l i t y coefficients for the SEAI and Rutter scales 53 6 Correlations among SEAI scales 55 7 Percent agreement between Teacher Judgements 1 and 2 56 8 Teachers' ratings of improvement or deterioration in social adjustment, self image and emotional adjustment 57 9 Percentage of children in disturbance categories according to each measure 60 10 Kendall's Tau B correlations between rating scales and global teacher judgement 61 11 Crosstabulation of disturbance categories: T31 and Rutter Scale 62 12 Crosstabulation of disturbance categories: teacher judgement of social adjustment and SEAI 1, Social Adjustment 62 13 Crosstabulation of disturbance categories: teacher judgement of self image and SEAI 2, Self Image 63 14 Crosstabulation of disturbance categories: teacher judgement of emotional adjustment and SEAI 3, Emotional Adjustment 63 15 Crosstabulation of disturbance categories: T32 and combined SEAI scales 64 16 Proportion of false negatives and false positives identified by the SEAI and Rutter scales 65 v i i LIST OF TABLES Page Table 17 Correlations between SEAI scales and Rutter questionnaire 66 18 Crosstabulation of disturbance categories: SEAI 1, Social Adjustment and Rutter Scale.. 67 19 Crosstabulation of disturbance categories: SEAI 2, Self Image and Rutter Scale 68 20 Crosstabulation of disturbance categories: SEAI 3, Emotional Adjustment and Rutter Scale 68 21 Crosstabulation of disturbance categories: combined SEAI and Rutter Scale 69 22 Summary of item analysis data 69 23 Summary of relationships between teacher judgement and rating scales 71 LIST OF FIGURES Page Figure 1 Student P r o f i l e s 5k ix ACKNOWLEDGEMENTS I would like to thank the following people for the contributions they made to this study: Dr. Perry Leslier, Advisor and Chairman of the Thesis Committee for his continuing support and advice throughout the last two years. Dr. Robert Conry, member of the Thesis Committee, not only for his assistance with the analyses, but also for his advice, encouragement and friendship. Dr. David Kendall, member of the Thesis Committee, for his help in this venture and his support during my time at U.B.C. The staff at Oericho H i l l School for the Deaf, for their co-operation. David, for his endless patience and support. Thank you for always "being there". - 1 -CHAPTER I THE PROBLEM AND RELATED LITERATURE THE PROBLEM Since the 1930's, studies of social-emotional adjustment in deaf children have consistently reported that deaf children, as a group, are more egocentric and impulsive and less mature in judgement and social competence than children with normal hearing. Streng and Kirk (1938), Burchard and Myklebust (1942), Avery (1949) and Myklebust (1964) a l l concluded that deaf children are socially immature. Meadow (1980), in reviewing studies of peer interaction, found deaf children to be more aggressive and less co-operative than hearing children. Other studies have pointed out that deaf chidren have more adjustment problems than hearing children (Myklebust, 1964; Pintner, 1933; Springer, 1938). Such characteristics as impulsiveness, egocentricity, r i g i d i t y , suggestibility and immaturity in self awareness have been frequently ascribed to deaf children (Altshuler et a l . , 1976; Craig, 1965; Levine, 1956). Prevalence studies of behavioural/emotional problems in deaf children serve to reinforce the findings cited above. Estimates of the number of emotionally disturbed/behaviour disordered deaf children range from 10.65% (Annual Survey, 1971) to 31.20% (Meadow & Schlesinger, 1971). Although the studies differ in method, population studied and findings, a l l are in agreement that the rate of emotional/behavioural problems is significantly higher among deaf children than among hearing children (Freeman et a l . , 1975; Meadow & Schlesinger, 1971). - 2 -However, as Moores (1978) notes, the situation is not as clear cut as a summary of the literature might suggest. Almost a l l these researchers have fel t obliged to qualify their results. The lack of confidence in the results of these studies appears to be attributable to the questionable r e l i a b i l i t y and validity of the instruments used to assess social-emotional adjustment in deaf children. As early as 1941, Heider and Heider expressed their concern about the practice of testing the deaf on instruments designed to measure adjustment to l i f e circumstances faced by normally hearing individuals. Since then, various writers (DiCarlo & Dolphin, 1952; Grinker, 1969; Stewart, 1974) have suggested that attempts to develop better measuring instruments and effective identification techniques to deal with the social-emotional adjustment of deaf children should emerge as a top priority. Gerweck and Ysseldyke (1975) sum up the concerns of many professionals: The current psychological practices for the assessment of the hearing impaired . . . indicate that the develop-ment and use of appropriate assessment devices for use with the hearing impaired are long overdue, (p. 247). The need for suitable instruments to identify and describe emotionally disturbed/behaviour disordered deaf children is even more apparent when i t is realized that these children are often incorrectly labelled. Simon (In Kahn, 1969), Minski (In Kann, 1969) and Levine (1974) have a l l cited examples of deaf children with severe social-emotional problems who have been "mistakenly tested as retarded" (Levine, 1974, p. 299). As a consequence many deaf children with - 3 -social-emotional problems are excluded from progammes for the deaf and are placed in institutions for the retarded. While concern is being expressed about the "epidemic proportions" of emotional disturbance among deaf children (Naiman, 1973), there is very l i t t l e evidence of appropriate intervention for these children. As Schein (1980) points out, "The l i s t of what is missing for the mental health care of deaf children is as long as the problem is serious" (p. 6). Edelstein (1977), in a national survey conducted in the United States, found only eleven programmes for emotionally disturbed deaf children. This finding is hardly surprising i f we accept that before suitable programmes can be designed for these children, we need to be able effectively to identify and describe them. Attempts to do this have been hampered by the lack of suitable instruments. Despite the questionable or unproven r e l i a b i l i t y and validity of available instruments to assess social-emotional problems in deaf children, a wide variety of measures developed for use with hearing children are frequently used with the deaf. Levine (1974) reporting the findings of a national survey of psychologists providing services to the o hearing impaired in the United States, found that 64% of the respondents routinely used tests designed to assess social-emotional functioning in hearing children. An examination of the literature reveals that projective tests, self report measures, observation techniques, rating scales and teacher judgement have a l l been used to assess the social-emotional status of deaf children. Measures u t i l i z i n g teachers' judgements are one of the more common methods used. Researchers have traditionally relied on - 4 -rating scales to identify deaf children with social-emotional problems (e.g. Hirshoren & Schnittjer, 1979; Rievich & Rothrock, 1972). However, to date, a l l rating scales used with the deaf have been designed for, and standardized on, a hearing population. It has yet to be established that rating scales developed for use with hearing children are applicable with the deaf. Moreover, the function of rating scales used with populations of deaf children has not been addressed. Whether rating scales can be used to identify and/or diagnose emotional disturbance in deaf children has not been investigated. In view of the concerns being expressed over the current status of social-emotional assessment in deaf children and the widespread use of rating scales, i t seems somewhat surprising that this area has received such l i t t l e attention from the researchers. The present study sought to (a) explore the applicability of a rating scale designed for the hearing with a population of deaf students and (b) examine the validity of a rating scale as a diagnostic instrument for assessing the social-emotional problems of deaf children. To this end, the functioning of a rating scale designed specifically for the deaf purporting to provide diagnostic information on a deaf child's social-emotional functioning and a rating scale designed as a screening instrument for a hearing population were examined and compared with each other and with global teacher judgement. LITERATURE REVIEW Selected literature relating to these problems will be reviewed in this chapter. F i r s t , i t seems necessary to c l a r i f y the nature of the - 5 -assessment process and discuss the label "emotionally disturbed." Second, the major problems associated with the assessment of social-emotional functioning in deaf children will be discussed. Thirdly, the available research that pertains to identification and assessment of social-emotional problems in deaf children will be explored in an effort to come to some understanding of the current knowledge and "state of the art" in this f i e l d . Finally, research concerning the validity and r e l i a b i l i t y of rating scales and teacher judgement as an assessment device for social-emotional functioning will be explored. Conceptual Issues The process of labelling (identifying) has become a major issue in - and between - many professional groups. In special education particularly, there is considerable dissatisfaction with current labelling and categorizing practices. Categorical labels have been c r i t i c i z e d on an number of counts: They invite overgeneralization concerning individual children (Reynolds & Balow, 1974). The labelling of an individual as "emotionally disturbed" "behaviour disordered" or "socially maladjusted" can become stigmatic (Furth, 1973). Labels are self-sustaining in that the internal-deviancy connotation of categorical labels sets into action a s e l f - f u l f i l l i n g prophecy. The individual is labelled, then the label is used to explain the origin of the behaviour pattern that is being labelled (Reynolds & Balow, 1974). Traditional categories remove the^"burden of proof" for children's learning from school personnel by providing unalterable conditions of children as reasons for repeated failure (Lily, 1979). - 6 -Once labelled, i t is d i f f i c u l t for a child to "escape" the label and "regain the original status of being normal" (Gardner, 1977). Classification of behaviour problems of children encourages a static view of behaviour (Meadow, 1980). Labels do not present guides to educational treatment (Engel, 1969). The criticism of labelling, and by implication, the assessment process, has been so dominant that some have suggested abolishing them altogether in favour of the more important issue of effective intervention. However, i t is a persuasive contention that a necessary f i r s t step in designing effective intervention is to be able to identify and describe the children requiring special services. In order to understand the nature of this argument, i t is useful to cl a r i f y what is meant by the assessment process and to discuss both the weaknesses and advantages of the label, "emotionally disturbed." The assessment process; Kauffman (1977) has pointed out that, to the uninitiated, assessment means classification - choosing a label or category for a child or the behaviour. In actuality, the label is only one part of the assessment process. This process can be conceptualized as consisting of three major steps; screening, identification and diagnosis. Screening usually involves surveying large groups as a f i r s t stage identification process to detect persons who may have problems. Screening measures usually have lower r e l i a b i l i t y and validity than other measures; they are often designed to overidentify. That i s , in o order to avoid missing too many problems, screening instruments tend to identify individuals who do not have problems (Adelman 1977/78). - 7 -Identifying (that i s , the assignment of a person to a group; labelling or classifying) can be defined as: The process by which person and environmental variables are assessed to determine the existence of a current problem. In general, the purpose of such identification is to provide an opportunity for intervention efforts to modify or ameliorate the problem (Adelman, 1977/78, p. 147) Identification and the assignment of a label is nothing more than a kind of shorthand description which alerts professionals to the need for a closer look at the child. Diagnosis involves "assessing the child's behaviour in order to plan an intervention strategy" (Kauffman, 1977, p. 35). It is the last stage of the assessment process and implies a highly individualized understanding of the child. Diagnosis and identification are not synonomous. Engel (1969) makes this point clear: Classification, or the assignment of a person to a group is indeed part of the diagnostic process. Unfortunately classification is often confused with diagnosis and the diagnostic process comes to a standstill at the point at which the child has been labelled. Since the label brings with i t neither directions for specific interventions nor explanations of the illness, i t is easy to see why those who equate diagnosis with classification soon regard the process as useless from either the educational or psychological point of view (p. 233 - 234). Assessment of social-emotional functioning: One of the most important issues, and perhaps the biggest problem, in this area of assessment concerns the lack of consensus over what to assess. Since there i s no clear definition of mental health, this is hardly surprising. Rutter and his colleagues (1970) observe that mental health - 8 -an invincibly obscure concept which is laden with value judgements and which has thereby proved to be notoriously resistant to attempts to define i t (p. 148). Contributing to the problem is the fact that: The differences between normal and disturbed behaviour is one of degree rather than kind [and that] there are no qualitative norms against which measurement of the disturbed child's behaviour can be judged (Kauffman, 1977, p. 18). Because of this lack of any definitive standard and the fact that measures of social-emotional functioning often attempt to assess supposed internal states or constructs which cannot be directly observed, "we are no longer dealing with behaviours, but interpretation of behaviours" (Salvia & Yssledyke, 1981, p. 430). No matter what techniques are used in making a decision about a child's mental health status, i t is in the final analysis, a subjective judgement based on an adult's expectation of acceptable behaviour. As Haring (1978) points out, "a child is emotionally disturbed when someone in authority so labels him" (p. 125). Judgements about a child's social-emotional functioning are determined by several factors: the social tolerance for particular behaviours, the context within which behaviours are demonstrated, the status of the individual exhibiting the behaviour and the theoretical orientation of the person assessing that behaviour^(Salvia & Ysseldyke, 1981, p. 449). The function of measures assessing the social-emotional adjustment of children i s not clear. There are many measures on the market purporting to either screen, identify or diagnose emotionally disturbed children. Adelman (1977/78) argues that reliable and valid measures for identifying psycho-educational problems do not exist and "are not likely to appear" until the methodological problems which - 9 -produce large numbers of false positive and/or false negative errors are resolved. Kauffman (1977) would agree with this contention: The r e l i a b i l i t y and validity of psychometric tests are simply not adequate for purposes of dividing the disturbed from the nondisturbed (p. 15). If there are no tests to determine accurately whether or not children are disturbed, i t is highly unlikely that many measures exist that can accurately diagnose the problem. Kauffman (1977) believes that formal measures which can be used to assess the child's behaviour in order to plan an intervention strategy do not exist. Adelman (1977/78) warns against the dangers of misusing instruments which are, in actuality, nothing more than screening devices. While some behaviour rating scales claim to diagnose by grouping children's behaviour along some dimension (e.g. The Behaviour Problem Checklist, Walker, 1969; Social-Emotional Assessment Inventory for Deaf Students, Meadow, et a l . , 1980), the validity of these claims has not been established. Definitions of emotionally disturbed deaf children: 1 That there is no generally accepted definition of an emotionally disturbed deaf child is not surprising, given the nature of social-emotional assessment and the problems already discussed. The majority of definitions given to describe deaf children with social-emotional problems generally f a l l into an educational context. This fact too, should not come as any surprise since i t has already been pointed out that the label, ^he terms "emotionally disturbed", "behaviour disordered", "children with social-emotional problems" are used interchangeably throughout this thesis. Although some argue that the terms signify different children (Rutter et a l . , 1970), the terms are recognized by most individuals as a label signifying that the child exhibits some kind of maladjusted behaviour. - 10 -definition or description of an emotionally disturbed child is based on the perspective of the "labeller" and, in the majority of cases, emotionally disturbed deaf children have been identified by teachers or studied within the context of the school setting. Meadow and Schlesinger's (1971) definition is a typical example where emotionally disturbed deaf children are defined as those deaf children who exhibit "behaviour that interferes with learning to a serious extent" (p. 348). Lennan's (1970) definition i s , similarly, general and educational in nature. He describes emotionally disturbed deaf children as those children "whose problems prevent successful performance in a school or class for deaf children as presently organized" (p. 469). A definition with a different orientation is offered by Withrow (1973). He defines an emotionally disturbed deaf child as one who: demonstrates normal or near normal intelligence on performance tests of mental ab i l i t y , demonstrates a functional hearing loss by either conventional or electrophysiological measurements of hearing, f a i l s to develop spontaneous speech and language and also exhibits some of the following characteristics: (1) reacts to aggression toward himself by directing his aggression inwardly by such actions as pulling his own hair, scratching himself, pinching himself, biting himself or withdrawing completely; (2) f a i l s to identify with either his peers or adults; (3) shows obsessions for neatness, order and routine and (4) f a i l s to develop an esoteric gesture system to communicate with his family (p. 352). This definition, however, assumes that emotional disturbance is the province of the intelligent and by i t s very specifity, excludes children who could legitimately be considered emotionally disturbed (e.g. acting-out children). - 11 -Turning to the descriptions of deaf children considered to be behaviour disordered does not provide the needed c l a r i f i c a t i o n . Only a few studies have attempted to describe the actual behaviour of those deaf children identified as disturbed. Reivich and Rothrock (1972) identified five groupings which seemed to reflect the disturbed behaviour of deaf children at a state residential school for the deaf: impulsive, unreflective and uninhibited behaviour; behaviour indicative of personality problems; immature behaviour; isolated behaviour; and behaviour caused by communication problems. Goulder and Trybus (1977) carried out a similar study. They found that deaf children reported by their teachers to be emotionally disturbed/behaviour disordered showed a lower need for achievement, greater aggression, more anxiety and greater degrees of "hostile isolation" than did other deaf children. Other studies have grouped children into commonly used psychiatric classifications of neurotic disorders, anti-social disorders, hyperkinetic disorders and psychosis (Williams, 1970; Goldberg et a l . , 1975). S t i l l others have pointed out that emotionally disturbed deaf children often display autistic like behaviour (Hefferman, 1955; Grinker, 1969). It is apparent that deaf children labelled emotionally disturbed/behaviour disordered display a wide variety of characteristics. Thus i t is d i f f i c u l t to characterize the atypical behaviour which leads a deaf child to be labelled emotionally disturbed or write a definition that encompasses such a diverse range in type and degree of behaviours. Within this context, Lily's (1979) statement is worth noting: - 12 -Perhaps the most important point to be made with regard to behaviour disorders is that i t is not a unitary concept, but rather a term which describes a variety of multi-faceted children (p. 69). Measurement of Social-Emotional Functioning i n Deaf Children Moores (1978) and Levine (1974) have both pointed out that efforts to assess social-emotional functioning of deaf children are at about the same level as the assessment of intelligence in deaf children was 50 years ago. Then, deaf children were given tests designed for hearing children and their poor functioning on them was interpreted to mean that deafness created some kind of mental deficiency. Slowly i t was realized that because of the nature of the tests (e.g. the level of language proficiency required) the deaf were being penalized. Typical results reflected the inappropriateness of tests rather than mass retardation precipated somehow by deafness. The present status of social-emotional assessment of deaf children led Moores (1978) to conclude that: For the most part, inappropriate tests have been administered under unsatisfactory conditions and results have been compared with unrealistic norms (p. 145). and Levine (1976) to state that i t i s : rarely more than lipservice routine in c l i n i c a l practice and a s t a t i s t i c a l exercise in experimental investigation (p. 259). The purpose of this section is to examine the reasons for these claims by discussing the general factors limiting the applicability of most measures of social-emotional adjustment with deaf children. Major concern centres on the appropriateness of using tests and norms developed for a hearing population on a deaf population. Freeman - 13 -(1979) has stated that " i t is necessary to have some norms In mind when asked to evaluate behaviour. Misdiagnosis and mismanagement are, unfortunately, not uncommon when this is lacking" (p. 405). Statements of this nature are not disputed. Most professionals would agree with this. The debate is about which norms should be used. The issue of appropriate norms is a crucial one in the assessment of exceptional children. The debate revolves around whether the social-emotional status of exceptional children should be evaluated in terms of norms for groups of exceptional children or "normal" children. This debate is discussed by Newland (1971). He points out that i f only tests standardized on a normal population are used, the exceptional child stands to suffer by such a comparison. On the other hand, i f only tests standardized on specific exceptional populations are used, there remains the problem of giving a meaningful social perspective to the performance of the exceptional child. The question becomes: Should the child be described as being in the bottom 1% of the general population on a given t r a i t or should he be regarded as doing very well in view of the conditions operating in his case? (Newland, 1971 p. 124). Newland goes on to make the case that the problem does not necessarily need to be one of "an out and out either/or choice" but rather "one of deciding which to use when" (p. 125). For the purposes of labelling and describing a deaf child as disturbed in order to plan a suitable intervention programme, i t seems necessary to base the decisions on norms derived from a deaf population. An examination of the literature reveals that with the exception of a l i t t l e used 1936 self rating scale (Brunschwig Personality - 14 -Inventory for Deaf Children; Brunschwig, 1936) and a recently developed teacher rating scale (Social-Emotional Assessment Inventory for Deaf Students; Meadow et a l . , 1980) no personality or adjustment tests have norms for deaf children. For the last 50 years then, assessment of social-emotional functioning of deaf children has relied on tests designed for, and standardized on, a hearing population. If these tests are to have any validity with a deaf population, they must f u l f i l several basic requirements: 1. The behaviours to be assessed must be within the experience  and competence of the subjects: Recent research has dealt with the deaf child's early environment and has shown that the deaf child, in the majority of cases, experiences a different set of social environmental factors than the hearing child. Researchers have been pointing out that deaf children: are usually restricted in their experiences as a result of care-taking practices within the family; handicapped by the lack of appropriate role models; have impoverished communication with significant others in their environment; and face unrealistic expectations from significant others (Rainer & Altshuler, 1967; Gregory, 1976; Liben, 1978; Meadow, 1976; Mindel & Vernon, 1971; Schlesinger, 1978; Schlesinger & Meadow, 1972). This research is important in any discussion of assessment of social-emotional adjustment in the deaf. It sharply highlights the dubious practice of assessing deaf children with tests designed for a hearing population. Gerweck and Ysseldyke (1975) maintain that instruments which violate any of the basic assumptions underlying psychological assessment are not appropriate. Newland (1971) points out - 15 -that the main assumption underlying psychological assessment i s : that the subjects being tested have been exposed to comparable but not necessarily identical acculturation (p. 118). In this context, Gerweck and Ysseldyke (1975) state that: Any test which has been standarized on subjects who are not hearing-impaired is inappropriate [for use] with hearing-impaired individuals because the acculturation of hearing-impaired individuals is signficantly different from that of non-hearing-impaired individuals. When the norms of one of these devices is used... the child is penalized by his lack of exposure and interaction with his environment through the auditory modality (p. 245). Since the experiences of deaf children are often more limited or, at best, different from hearing children, i t is reasonable to assume that the same questions may not be suitable for both groups. 2. The behaviours being assessed must have the same interpretive  significance: There is a danger in applying the same interpretive labels to certain overt behaviour of deaf and hearing children, i f the behaviour does not have the same significance for both groups. Barker et a l . , (1953) note that in studies which have compared the social-emotional adjustment of deaf and hearing children, this point has generally been ignored. Failure to recognize this point is basically an error of ignoring the context of the behaviour when judging the significance of the behaviour in question. Within this context, many writers have challenged the practice of labelling a deaf child as disturbed on the basis of tests and norms designed for hearing children. They point out that behaviour which in a hearing person would be considered unhealthy, may be normal or healthy in a deaf person (Knapp, 1968; Zeckel, 1953; Levine, 1956). - 16 -It should be emphasized that behaviour which might be considered maladjusted, neurotic or psychotic in one situation might be healthy and r e a l i s t i c in another. For example, people classified as paranoid might have delusions of persecution. They might believe incorrectly that people talk about them or dislike them or are hostile to them. However, for many deaf people such beliefs are not delusions; they reflect reality. In too many cases, deaf persons have faced rejection and hostility from their families . . . People do talk about them - teachers of the deaf seem especially prone to t e l l visitors at length about the limitations of their students in front of the children as though they had no sense of what was occurring . . . (Moores, 1978, p. 145). 3. The language used must be within the comprehension of the  subjects: A futher requirement for the legitimate use of a test with deaf children is that the language used in the test must be within the competence of the deaf. Since deaf children generally have significantly poorer language s k i l l s than hearing children, a test designed for hearing children may be invalid for deaf children. Many professionals have pointed out that reliable personality tests rely on the verbal f a c i l i t y of the subjects (Goulder & Trybus, 1977; Moores, 1978; Myklebust, 1964; Vernon & Brown, 1964). If the language of the test becomes as much, or more, of an issue than the task to be assessed, test validity is severely impaired (Craig, 1965). 4. Effective communication must exist between the examiner and the subject: Newland (1971) asserts that to make psychological testing valid, the tester must: be adequately trained and skilled in the procedures of getting the subject to respond effectively (rapport) and of applying the stimuli . . . (p. 117). - 17 -In testing the deaf, i t is not only the means and clarity of communication by the child to the examiner that is important. Of equal importance is the communication of the examiner to the child. That there may often be some problems in communication between the tester and the subject seems highly probable. Levine (1960) maintains that many of the instruments used to assess deaf children "assume a level of communicative interaction that may not exist between hearing testers and some deaf testees" (p. 51) . Levine's (1974) survey found that 90% of the respondents rated themselves as unable to, or poor in their a b i l i t y to use sign language, although 65% of their clientele was described by the respondents as largely manually orientated. Related to this issue, Levine (1974, 1976) stresses that one of the major d i f f i c u l t i e s in assessing deaf children is the lack of trained professionals knowledgeable of the problems of the deaf. Her 1974 survey showed that 65% of the respondents reported no prior experience with deafness. I d e n t i f i c a t i o n and Assessment o f Social-Emotional Problems i n Deaf Children - The State of the Art The purpose of this section is to review the major techniques which have been used to assess social-emotional functioning in deaf children. The tests will be examined in relation to their functioning with deaf children. The issues discussed in the preceding sections w i l l be illustrated. Projective tests: According to Levine (1974), projective tests are frequently used to assess social-emotional functioning in deaf children. However, the suitability of using such techniques with - 18 -exceptional children has been questioned (Salvia & Ysseldyke, 1978). Two early studies (McAndrew, 1948 and Levine, 1956) which used the Rorschach Ink Blot Test to study the personality characteristics of deaf children serve to illustrate some of the problems encountered when using projective tests with deaf children. Levine (1956) studied 31 normal deaf adolescent g i r l s attending an oral residential school. The results showed a high incidence of egocentric and immature responses (indicating such behaviour as impulsiveness, easy i r r i t a b i l i t y and suggestibility). McAndrew (1948) compared deaf and hearing children matched for age, sex, intelligence and freedom from any kind of mental disorder. On the basis of the test results, McAndrew concluded that the deaf subjects were less mature, more rigid and less able to differentiate than the hearing subjects. These results, however, cannot be quoted with any degree of confidence. Both researchers departed from the standard Rorschach administration procedure which requires verbal responses. Levine relied on sign language and made use of a teacher of the deaf as interpreter. Thus the examiner and the subject used different modes of communication. It has already been pointed out that an important and fundamental consideration in testing deaf subjects is the ease and cla r i t y of communication between the examiner and the subject. This was lacking in Levine's study. Levine noted that her subjects regarded the inquiry with distrust. Given this basic problem In communication and the resultant lack of rapport between the examiner and the child, i t i s unlikely that the testing situation was an optimal one. McAndrew's subjects wrote their responses. Like the Levine study, i t is likely - 19 -that this procedure interfered with rapport between the examiner and the child. Further, as Barker and his colleagues (1953) point out, neither the sign language nor the written language of deaf children are noteably flexible or adapted to conveying the precise nuances on which the Rorschach scoring depends. They conclude that: In view of the variation from standard Rorschach administration procedures that seem necessary when this method is used with the deaf and in view of the restricted l i f e space imposed by deafness, i t is not certain that Rorschach interpretations that appear to hold for normal persons are also appropriate for the deaf (p. 203). Special validation would seem to be needed (p. 203). Unless this special validation is done, i t would seem that the Rorschach can be used only after sophisticated language has been acquired (Myklebust, 1964). Neyhus' study (cited in Meadow, 1980) would seem to support this claim. She found that language f a c i l i t y was directly related to performance on the Rorschach. Sentence completion tests, another projective method, have also been used to look at various aspects of social emotional adjustment in deaf children (Brunschwig, 1936; Pintner & Brunschwig, 1937 reported in Barker et a l . , 1953). It would seem that sentence completion techniques are of limited value because of the language d i f f i c u l t i e s encountered. Meadow (1980) noted that i f the subjects were indeed able to provide adequate sentences, i t was likely that they were either post-lingually deaf or hard-of-hearing. She provided further evidence by citing Titus' study which concluded that sentence completion techniques are unsuitable for e l i c i t i n g data from severely deaf children. Meadow (reported in - 20 -Meadow, 1980) came to the same conclusion when she attempted to develop a sentence completion test in a pilot study concerned with deaf student's self image. In an effort to eliminate language problems, several studies have used relatively non-verbal projective tests such as the Draw-A-Person Test (Vernon & Brown, 1964) and the House-Tree-Person Technique (Buck, 1949). Vernon and Brown (1964) believe that because these require very l i t t l e verbal communication they are probably the most practical projective tests for deaf children. Myklebust (1964) adapted the Draw-A-Person Test in his investigation into the personality development and emotional adjustment of deaf children. He claimed that this technique can be readily used with deaf children above 7 years of age and with most 6 year olds and some 5 year olds. However, G i l l i e s (1968) as part of a larger study of the social-emotional adjustment of deaf children collected drawings of a person from 49 severely deaf, 60 partially hearing and 105 normal hearing children aged between 7 to 15 years of age. From these groups, 24% of the severely deaf children's drawings and 15% of the partially hearing children's drawings had to be eliminated because "their drawings were not suitable for scoring (p. 87). This would throw some doubt on the sui t a b i l i t y of this technique for profoundly deaf children. Self report: A number of earlier studies used this technique to secure data on the deaf child's social-emotional adjustment(Brunschwig, Springer, Springer & Roslow - reported in Barker et a l . , 1953). A more recent study, looking at the applicability of a self rating scale - the California Test of Personality (CTP) - was conducted by Vegely and - 21 -E l l i o t (1968). Since this is one of the few studies directly concerned with whether the adjustment of the deaf child can be measured with the same tools as are used with the hearing child, i t will be examined in some detail. As in other studies, the deaf children obtained scores on the CTP which were consistently lower than the normative group. Vegely and E l l i o t examined the CTP and the deaf children's performance on the CTP to consider to what extent the low scores could be explained as an artifact of the test. It was found that the deaf children circled words (indicating that they did not understand the word) for 25 out of 144 items. Vegely and E l l i o t claimed that the language d i f f i c u l t i e s encountered by these children were concerned largely with word meaning rather than complex sentence structure. In 12 items the majority of the deaf children (over 64%) responded "incorrectly" (according to published norms). It seems likely then, that for 12 items the normative "correct" response can not be considered the correct response for deaf children. Unfortunately, Vegely and E l l i o t do not present these 12 items. It seems important in such a study to provide more detailed information on the performance of individual items. In summary then, 25% of the items on the CTP were not suitable for deaf children; 17% because of language d i f f i c u l t i e s and 8% because the items could not be considered appropriate for deaf children. Given that a quarter of the items were found to be unsitable for deaf children, i t is hard^to understand Vegely and E l l i o t ' s conclusion that "the poor performance of these deaf children on the CTP cannot be - 22 -adequately explained as an artifact of the test" (p. 867). Direct observation techniques: Because of the problems inherent in many of the instruments available for assessing social-emotional problems in deaf children, many clinicians and researchers have relied on observations of the child's behaviour. While this technique eliminates the language d i f f i c u l t i e s encountered in many of the tests, the problem of how to interpret the deaf child's behaviour s t i l l remains. This is especially d i f f i c u l t i f , as has often been the case, deaf children are observed by persons unfamiliar with deafness. Levine's (1974) contention that one of the major problems in the assessment of deaf children is the lack of trained professionals knowledgeable about the deaf is illustrated in Williams' (1970) study. He observed 51 children who were either students in, or applicants to, a special school for emotionally disturbed deaf children in England. He labelled the children according to traditional psychiatric categories such as neurotic , psychotic and anti-social disorders. However, since Williams admits that he "lacked experience of deaf children and had l i t t l e f a c i l i t y with sign language" his assessments must be treated with some skepticism. Hefferman (1955) attempted to examine the "personality, behavioural characteristics, family relations and problems of the deaf child" (p. 271). This was carried out in a two to five hour session with both the mother and child in the researcher's office. The study has obvious methodological limitations, having observed each child only once in a strange setting and then inferring behavioural generalities. Moreover, the mother and investigator "conversed freely" about the child - 23 -in the child's presence, since "the child cannot understand the conversation" (p. 272). This claim is debatable (see Moores, 1978, p. 145). If the child could sense what the conversation was about, it is not surprising that the deaf children in the study displayed "neurotic symptoms." Such a reaction to the situation seems normal and cannot be interpreted as maladjusted in the absence of further validation. There have been other studies which have used observation techniques to assess the social-emotional functioning of deaf children (e.g. Freeman, et al., 1975). Where the child is observed several times in his or her natural environment (either home or school) by trained investigators familiar with deaf children, the observation method can be an effective assessment technique. Rating scales: A large number of studies have investigated the social-emotional functioning of deaf children using rating scales. Freeman (1979) notes that: Because of the difficulty in communication, the studies with the tightest methodology usually involve checklists or questionnaires (p. 407). The first studies investigating the social-emotional adjustment of deaf children commonly used rating scales. Springer, Kirk and Burchard and Myklebust (reported in Barker et al., 1953) all made use of the Haggerty-Olson-Wickman Rating Schedules, a rating scale designed for hearing children. These studies all compared the ratings of a group of deaf children in special schools to the ratings of a control group of hearing children. All showed differences between the two groups, the deaf group generally being less well adjusted and more immature than the hearing. It is probable that the deaf groups' low scores can be explained as an artifact of the rating scale. However, because no item - 24 -data are reported f o r these s t u d i e s , i t i s d i f f i c u l t to come to any conclusions as to the s i g n i f i c a n c e of the f i n d i n g s . The Vineland S o c i a l Maturity Scale ( D o l l , 1965) has been f r e q u e n t l y used i n stu d i e s of s o c i a l development of the deaf since i t was f i r s t designed i n 1935 (Bradway, 1937; Streng & K i r k , 1938; Burchard & Muklebust, 1942; Avery, 1948; Myklebust, 1964; Schlesinger & Meadow, 1972a). R e s u l t s have c o n s i s t e n t l y h i g h l i g h t e d the s o c i a l immaturity of deaf c h i l d r e n . The main question a r i s i n g i n connection with these s t u d i e s con-cerns the a p p l i c a b i l i t y of the t e s t with deaf c h i l d r e n . In t h i s con-t e x t , Bradway's study (reported i n Barker et a l . , 1953) i s worth lo o k i n g at i n some d e t a i l because i t provides an item a n a l y s i s . Bradway looked at the scores of 92, 5 t o 21 year o l d p r e l i n g u a l l y deaf c h i l d r e n attend-ing a r e s i d e n t i a l s c h o o l . He found that t h i s group obtained an average s o c i a l quotient of 80 i n co n t r a s t to 100 f o r the s t a n d a r d i z a t i o n group. Items were analyzed and those on which the subjects showed the gre a t e s t r e t a r d a t i o n were: Item Number Behaviour 53 59 60 61 63 66 73 76 77 78 79 80 84 92 93 Goes about the neighbourhood unattended Plays simple t a b l e games I s t r u s t e d with money Goes to school unattended Uses p e n c i l f o r w r i t i n g T e l l s time to quarter hour Reads on own i n t i t i a t i v e Makes minor purchases Goes about home town f r e e l y Writes o c c a s i o n a l short l e t t e r s Makes telephone c a l l s Does small renumerative work enjoys books, newspapers, magazines Goes to nearby places alone Goes out unsupervised i n daytime (from Barker et a l . , 1953, p. 205) - 25 -Eight of these items are r e l a t e d to language (items 59, 63, 66, 73, 76, 78, 79, 84). Fu r t h e r , Barker et a l . , (1953) point out that eight of the items may be r e l a t e d not to s o c i a l competence per se, but may r e f l e c t the e f f e c t of a r e s i d e n t i a l school regime (items 53, 60, 61, 76, 77, 80, 92, 93). Teacher r a t i n g s c a l e s are f r e q u e n t l y used to assess the s o c i a l - e m o t i o n a l adjustment of deaf c h i l d r e n . Goulder and Trybus (1977), Hirshoren and S c h n i t t j e r (1979) and R e i v i c h and Rothrock (1972) are among those who have used r a t i n g s c a l e s designed f o r hearing c h i l d r e n to assess deaf c h i l d r e n . While r a t i n g s c a l e s e l i m i n a t e the d i f f i c u l t i e s a r i s i n g from deaf c h i l d r e n ' s i n a b i l i t y to understand s p e c i f i c t e s t items because of t h e i r language r e t a r d a t i o n , i t has yet to be e s t a b l i s h e d that r a t i n g s c a l e s designed for the hearing are a p p l i c a b l e f o r the deaf. The r e s u l t s of the s t u d i e s discussed above tend to support the cl a i m that i t i s not always p o s s i b l e to apply the same i n t e r p r e t i v e s i g n i f i c a n c e to behaviours of deaf and hearing c h i l d r e n . F u r t h e r , i t seems that items are not always w i t h i n the experience and competence of the deaf c h i l d r e n . Meadow et a l . (1980) found that 60% of the school personnel i n one school f o r the deaf had r e s e r v a t i o n s about the usefulness of a r a t i n g s c a l e designed f o r hearing c h i l d r e n . They pointed out that some of the items were not a p p l i c a b l e to the deaf, and that items a p p l i c a b l e to the deaf were not inc l u d e d . The s t u d i e s discussed i n t h i s s e c t i o n serve to i l l u s t r a t e the a s s e r t i o n made by Barker and h i s colleagues (1953). In d i s c u s s i n g the d i r e c t i o n research concerned with the assessment of s o c i a l - e m o t i o n a l - 26 -functioning in deaf children must take, Barker and his colleagues insist that, to be of any value "responses to individual items must be discussed" (p. 199). Teacher Judgement; Global teacher judgement, though not a formalized instrument, is another very common method that has been used to identify emotionally disturbed deaf children. Most of the prevalence studies have used this method (Clarke et al., 1977; Evans & Galbraith, 1981; Oensema & Trybus, 1975; Meadow & Schlesinger, 1971; Vernon, 1969). Meadow and Schlesinger (1971) provided some guidelines on which the teachers were to base their judgement. They asked teachers to identify students who were severely disturbed, to the degree that they needed psychiatric help and those who were not as severely disturbed, but who exhibited behaviour which demanded a disproportionate amount of the teacher's time. Specific definitions as to the exact meaning of these two categories was left to the interpretation of the teachers, however some suggestions about the kinds of behaviours which might apply to children in either category were given. Behaviours included being withdrawn from peers, overly dependent, hyperactive, accident prone, overly aggressive and having truancy records, nervous habits such as tics and chronic illnesses without identifiable physical causes (Meadow, 1980). In most studies, definitions of behavioural emotional disorders have not been given to the teachers. Teachers were merely asked to consider whether the child in their opinion, had an emotional/behavioural disorder and the exact meaning of this term was left to the discretion of the teachers. It is presumed that the - 27 -teachers' judgements r e f l e c t an educational o r i e n t a t i o n and i d e n t i f y , i n the main, educationally s i g n i f i c a n t problems. Despite the frequency with which teacher judgements are employed to i d e n t i f y social-emotional problems in deaf c h i l d r e n , only one study d i r e c t l y concerned with the deaf has examined the v a l i d i t y of t h i s method. Goulder and Trybus (1977) asked teachers of 148 hearing impaired c h i l d r e n to describe the classroom behaviour of t h e i r students by means of the School Behaviour C h e c k l i s t . These descriptions were analyzed in terms of whether or not the student was reported to have an emotional/behavioural problem. They found that deaf children reported by t h e i r teachers to be emotionally/behaviourally disturbed were " o v e r a l l more emotionally disabled than hearing impaired children who are not reported as disturbed" (p. 16). They concluded that: The 'emotionally/behaviourally disturbed' lab e l applied by the schools does . . . have s i g n i f i c a n t , substantive meaning. The term i s not randomly or inappropriately applied in general (p. 16). Validity and Reliability of Methods Utilizing Teacher's Judgements The a b i l i t y of teachers to make v a l i d and r e l i a b l e judgements about the behavioural and emotional status of t h e i r students i s an important issue i f either rating scales or teachers' opinions are to be used with any degree of confidence. Since Wickman (1928) f i r s t reported on teacher perception of behavioural problems, there have been numerous studies looking at these issues. The majority of studies suggest that teachers are able to i d e n t i f y emotionally disturbed c h i l d r e n . As Nichol (1980) points out, - 28 -Teachers, by the very nature of their work, are in a commanding position to identify children displaying disturbed or deviant behaviour (p. 245). Rutter (1977) also found that teachers were able to give "quite detailed and accurate information on the child's emotions, behaviour and relationships" (p. 11). Several studies have attempted to validate teacher judgement by comparing teacher judgement with the judgement of others — mainly psychologists and psychiatrists. "Parenthetically, i t should be noted that few have set out to test the validity of these appointed criterion judges" (Rubin & Balow, 1978, p. 103). Bower (1970) found that 87% of a l l children identified by school psychologists as emotionally disturbed were rated by their teachers as among the most poorly adjusted children in their classrooms. Ziv (1970) also found a high correlation between teachers' and psychologist's ranking of children's behaviour problems. Other studies have attempted to validate teacher judgement by correlating this with some objectively scored criterion. Harth and Glavin (1971), for example, asked teachers of 786 10 to 14 year old children to complete a rating sheet noting the children whom they considered to be their five best adjusted and their five poorest adjusted students. No definition of adjustment or emotional disturbance was given. The California Test of Personality (CTP) was then administered to a l l children. It was found that the better adjusted group had a significantly higher mean CTP score than the poorly adjusted. The conclusion was reached that teacher judgements is a valid technique for the identification of emotionally disturbed children. - 29 -Another body of l i t e r a t u r e i s based upon attempts to determine how teachers e x e r c i s e t h e i r judgements i n i d e n t i f y i n g c h i l d r e n as d i s t u r b e d or not d i s t u r b e d . A review by B e i l i n (1959) noted that teachers are most concerned with behaviours that f a c i l i t a t e or i n t e r f e r e with t h e i r i n s t r u c t i o n a l r o l e . Evans and G a l b r a l t h (1981) point out t h a t : The r e a l i t y i s that schools are educational rather than mental health i n s t i t u t i o n s . Their aims, t h e r e f o r e , are academic rather than mental health o r i e n t e d (p. 20). Boomer and King (1980/81) would agree with t h i s . They found that c h i l d r e n i d e n t i f i e d by t h e i r teachers as emotionally d i s t u r b e d d i f f e r e d s i g n i f i c a n t l y from t h e i r "normal" peers i n attending and non-attending behaviours when the teacher was i n s t r u c t i n g , but that when the teacher was engaged i n n o n - i n s t r u c t i o n a l t a s k s , the groups of students were o f f t a s k f o r the same amount of time and s o c i a l i z e d f o r the same amount of time. They concluded that behaviour which i n t e r f e r e d with i n s t r u c t i o n may be a s i g n i f i c a n t f a c t o r i n the i d e n t i f i c a t i o n of emotionally d i s t u r b e d c h i l d r e n by teachers. A major concern i s that teacher r a t i n g s are based upon i n d i v i d u a l teacher's standards of "normal" behaviour. As Rubin and Balow (1978) point out, c h i l d r e n i d e n t i f i e d as d i s t u r b e d may vary depending on the value system of the teacher and the nature of the classroom. A c h i l d with moderate a c t i n g out behaviour i n a classroom of o r d e r l y c h i l d r e n might be i d e n t i f i e d as a behaviour problem, while the same c h i l d i n a s e t t i n g with more aggressive c h i l d r e n might not be so i d e n t i f i e d (Rubin & Balow, 1978, p. 105). Despite these v a l i d concerns, the m a j o r i t y of researchers agree that i f the behaviours to be rated are o p e r a t i o n a l l y defined, s u b j e c t i v i t y i s - 30 -not a major problem ( R u t t e r , 1977; S i e g a l et a l . , 1976). I t has been noted that teachers' judgements are subject to the halo e r r o r ( T i z a r d , 1968). However, Lambert and Bower (1961) noted that a negative r a t i n g f o r a p u p i l i n one area di d not n e c e s s a r i l y r e s u l t i n negative r a t i n g s i n other areas. They found that there was no negative 'halo' e f f e c t operating i n the use of t h i s behaviour' r a t i n g s c a l e f o r an i n d i v i d u a l p u p i l . In many instances an i n d i v i d u a l c h i l d rated n e g a t i v e l y on one item was rated p o s i t i v e l y on other items (p. 18). and concluded t h a t : Teachers e v i d e n t l y are.aware of the f a c t that emotionally handicapped p u p i l s manifest a v a r i e t y of behavioural c h a r a c t e r i s t i c s and are not stereotyped by one type of behaviour or another (p. 18). I t would appear then that teachers' judgements can be used with some confidence. Kauffman (1977) recommends that the teachers' judgements should be used as the basis f o r screening and i d e n t i f y i n g emotionally d i s t u r b e d c h i l d r e n . Despite these f i n d i n g s , the r e l a t i v e s u b j e c t i v i t y of the unstructured statement has led many p r o f e s s i o n a l s to develop and/or use r a t i n g s c a l e s i n an attempt to overcome t h i s problem. Rating s c a l e s attempt to get a p p r a i s a l s on a common set of a t t r i b u t e s f o r a l l r a t e r s and ratees and to have these expressed on a common q u a l i t a t i v e s c a l e (Thorndike & Hagen, 1977, p. 449). The q u a l i t y of a r a t i n g s c a l e depends, i n p a r t , on a number of f a c t o r s : 1. The opportunity of the r a t e r to observe the person ra t e d . 2. The covertness of the t r a i t being rated; r a t i n g s c a l e s w i l l be r e l a t i v e l y u n s a t i s f a c t o r y f o r the in n e r , covert aspects of an i n d i v i d u a l . - 31 -3. The ambiguity of meaning of the dimension being rated. (Thorndike & Hagen, 1977). Various writers have suggested that rating scales may be useful for screening emotionally disturbed/behaviour disordered children i f the factors outlined above are taken into consideration (Kauffmann, 1977; Nelson, 1971). At the same time, most writers have argued that the function of a rating scale is no more than a screening instrument. They do not accurately identify and cannot be used as a diagnostic instrument (e.g. Tizard, 1968). Because of these arguments, i t is necessary to validate rating scales with respect to some particular purpose -screening, identifying or diagnosing. It must be noted that demonstrating the validity of rating scales is a somewhat subjective matter (Kauffman, 1977). There is no definitive criterion that will demonstrate the validity of a measure assessing social-emotional functioning. Instead i t becomes necessary, when looking at such tests, to evaluate them in the light of a series of findings (Kline, 1979). In this regard, Campbell and Fiske (1959) point out that in order to demonstrate construct validity i t is necessary to show not only that a test correlates highly with a criterion with which i t should correlate (convergent validity); but also that i t does not correlate highly with c r i t e r i a from which i t should differ (discriminant v a l i d i t y ) . Studies are needed which use not only convergent validity, but also discriminant validity to validate rating scales. This method is one way of examining the Issue of the applicability of tests designed for the hearing, with a deaf population. According to the literature i t - 32 -would appear that a rating scale designed for deaf children should not correlate highly with one designed for hearing children. Summary The review has shown that: 1. The assessment process can be conceptualized as consisting of three separate stages: screening, identifying and diagnosing. Most techniques used to assess social-emotional functioning in children cannot be used as a diagnostic instrument. 2. Measures to assess emotional disturbance/behavioural disorders in deaf children are commonly used. 3. Most techniques are not applicable with a deaf population due , to the vocabulary and structure of test items, the level of communicative interaction needed between the examiner and the child. 4. Rating scales are frequently used and may be a useful technique with deaf children. They circumvent the problems listed above. There s t i l l remains, however, the problem that items appropriate for hearing children may not be applicable with deaf chidren. 5. While the literature suggests that rating scales may be a useful technique for screening emotional disorders, i t has yet to be established that they f u l f i l l any other function. The general research questions developed in response to these issues are presented in the succeeding section. - 33 -RESEARCH OBJECTIVES This study was designed to permit consideration of two broad issues i d e n t i f i e d through a review of the l i t e r a t u r e as warranting i n v e s t i g a t i o n : 1. The a p p l i c a b i l i t y of using a rating scale designed for hearing c h i l d r e n with a deaf population. 2. The functioning of a rating scale as a diagnostic instrument for deaf c h i l d r e n . In order to consider these two issues, the study investigated the functioning of two teacher rating scales: 1. An adapted version of Rutter's Children's Behaviour Question-naire, a screening Instrument designed for hearing c h i l d r e n . 2. The Meadow/Kendall Social-Emotional Assessment Inventory (SEAI), a rating scale designed s p e c i f i c a l l y for deaf ch i l d r e n which purports to provide information useful i n implementing i n d i v i d u a l i z e d programmes. The functioning of these two scales were examined and compared with each other and teacher judgement as to whether the c h i l d had a s o c i a l -emotional problem. The s p e c i f i c research questions the study attempted to answer are presented below: The a p p l i c a b i l i t y of a rating scale designed for a hearing population  with deaf c h i l d r e n : ( i . e . an adapted version of Rutter's scale) 1. How does item d i f f e r e n t i a t i o n and item v a l i d i t y of the Rutter scale compare with the SEAI (an inventory designed s p e c i f i c a l l y for the deaf)? - 34 -2. Which scale correlates more highly with teacher judgement --the SEAI or the Rutter scale? 3. What is the correlation between the SEAI scales and the Rutter Scale? The functioning of a rating scale as a diagnostic instrument with a deaf  population; (i.e. the SEAI) 1. What is the discriminant validity of the three SEAI scales: Scale 1, Social Adjustment; Scale 2, Self Image and Scale 3, Emotional Adjustment? 2. What percentage of the sample do the SEAI scales and the Rutter scale identify as having social-emotional problems? Because the functioning of the two scales with a deaf population and the r e l i a b i l i t y of teacher judgement have not been reported in the literature, i t was necessary to consider two subsidary questions: 1. What are the r e l i a b i l i t i e s of the SEAI scales and the Rutter scale? 2. Is teacher judgement a reliable method for identifying deaf chidren with social-emotional problems? - 35 -CHAPTER II METHODOLOGY This chapter describes the sample, instrumentation, research procedures and data analysis. Subjects A l l children attending Oericho H i l l School for the Deaf who were between the ages 7 to 16 for the duration of the study were included in this investigation. 93 students were eligible for inclusion. They are described in terms of five variables: Gender: 53 of the subjects (56.99%) were males; 40 (43.01%) were females. Age: Age ranged from 7.4 to 16.11 (on April 1, 1982). Thus a l l children were no younger than 7 at the beginning of the study and no older than 16.11 at the completion of the study. The mean age was 12.11. 44 children (47.3%) were under 13 years of age, while 49 (52.7%) were over 13 years old. Degree of hearing loss: The arithmetic mean of the pure tone thresholds obtained at 500, 1000 and 2000 Hz for the better ear was used to define the degree of hearing loss. Hearing loss categories were grouped using the c r i t e r i a of: Severe: 60 - 90 dB Profound: greater than 90 dB The majority of children in the study (92.5%) were classified as having a profound hearing loss. Ony 7 children (7.5%) had a severe hearing loss. - 36 -Type of hearing loss: With the exception of one child with a mixed hearing loss, a l l of the subjects had a sensori-neural hearing loss (i.e. a hearing impairment caused by damage to, or abnormality of, the cochlea and/or auditory nerve). Residential status: 63 children (67.7%) were day students; 30 (32.3%) were residential. It is important to note that children attending Jericho H i l l School for the Deaf come from a l l over the province of British Columbia. In the majority of cases, alternative educational placements are available in local d i s t r i c t s . Hence, like most schools for the deaf, the population at Jericho H i l l School tends to include deaf children with additional problems which cannot be catered to in their local d i s t r i c t s . Raters Classroom teachers of elementary aged children and home room teachers of secondary aged children (23 teachers in all) were involved in rating the 93 children. The same teacher rated the same child on a l l measures. Information was sought from the teachers concerning how well they knew the child they were rating. Instrumentation Meadow/Kendall Social Emotional Assessment Inventory for Deaf  Students (SEAI): The SEAI i s a behaviour rating scale designed to assess deaf chidren's social-emotional status in the school setting. The author - 37 -describes the tool as one "that can be used to 'flag' a student who needs extra attention in a particular area" and is useful in "implementing an individualized program so that social and emotional areas are emphasized in the curriculum for a child who needs them" (Meadow et a l . , 1980, p. 12). It was designed for deaf students between the ages of 7 to 21. The inventory is comprised of 59 separately considered statements which describe a student's behaviour in school. These are almost equally divided between positive and negative statements. As a result of Meadow's factor analysis, the items were categorized into three separate areas. The emergent factors were labelled as Scale 1, Social Adjustment; Scale 2, Self Image and; Scale 3, Emotional Adjustment. The inventory is designed to be completed by "persons who know deaf children well as a result of intensive contact and repeated opportunities for observation in a variety of settings within the school" (Meadow, et a l . , 1980, p. 8). Evaluators are required to rate each item as i t applies to a paticular student on a four point scale employing the anchors 'very true', 'true', 'false' and 'very false'. Provision is made for a "cannot rate" or "does not apply" response. The responses are translated into numerical scores ranging from the most positive (4) to the most negative responses (1). The construction of the items for the inventory came from three major sources: a rating scale previously used by the author and her colleague in the collection of data from teachers of deaf students (Schlesinger and Meadow, 1972) - 33.90%; as a result of suggestions of persons working in the f i e l d - 33.17%; and from observation based on - 38 -"psychological theory developed in working with deaf individuals (Meadow et a l . , 1980, p. 3) - 32.0%. Over,50% of the items then were constructed by the author based on her theories of deaf children's social and emotional development. Her theories include four major propositions: 1. There is nothing inherent in the condition of deafness that leads inevitably to differences in the social and emotional development of deaf and hearing persons. 2. Deaf persons usually share a different set of experiences from hearing persons which may lead to different patterns of social and emotional adjustment. 3. The most important difference between deaf and hearing individuals is that of language deprivation which leads to faulty communication with significant others. 4. An additional factor in the adjustment of deaf persons is the acceptance (or lack of acceptance) of the deaf individual by significant others. (Meadow et a l . , 1980) The inventory was standardized on 2365 deaf students, 75% coming from residential schools and 25% from day programmes in the Northeast, North Central, South and Southwest of the United States. Three way analyses of variance were performed for each of the three scales. The variables examined were sex (girls vs. boys); type of educational programme (day vs. residential); and age (7-9 vs. 10-12 vs. 13-15 vs. 16-18 vs. 19-21). Significant differences between age levels 7-15 and 16-21 were found for a l l three scales and significant differences between g i r l s and boys were found for scale 1, Social Adjustment and Scale 2, Self Image. No significant differences were found for school setting. Hence norms are provided for younger g i r l s (7-15), younger boys, older g i r l s (16-21) and older boys for Scales 1 and 2 and for younger boys and g i r l s and older boys and g i r l s for Scale 3. - 39 -The inter-item reliabilities of the three scales are reported in the manual: Scale 1, - 0.96; Scale 2-0.94 and Scale 3 - 0.91 (Cronbach's alpha). No other reliability or validity data are reported. Rutter's Children's Behaviour Questionnaire: Rutter's original scale was designed as a screening device to identify hearing children between the ages of 7-13 who may have a psychiatric disorder.^ It was designed in response to the need for a reliable and valid short questionnaire which teachers could complete quickly and which concerned behaviour occurring in a school setting (Rutter, 1967). The scale consists of 26 brief statements concerning the child's behaviour. The teacher is required to check whether the statement 'certainly applies', 'applies somewhat' or 'doesn't apply'. These are given a weighting of 2, 1 and 0 respectively to produce a total score with a range of 0-52. Children with a score of 9 or more (17% of the highest possible score) are designated as showing some disorder. Items were developed to cover "the main common emotional and behavioural problems of chidren as they might be seen in a school setting" (Rutter et al., 1975, p. 495). The items were "tested" on teachers in "several" classes in eight different schools (Rutter, 1967). The teachers were interviewed and asked to outline the behaviours which had led to positive ratings and to describe the behaviours they considered relevant for each item. By this means, T^he term "psychiatric disorder" as used by Rutter is defined as "an abnormality of behaviour, emotions or relationships which is sufficiently marked and sufficiently prolonged to cause handicap to the child himself and/or distress or disturbance in the family or community" (Rutter et al., 1970, p. 149). - 40 -"ambiguous or misunderstood items were revised or omitted [and] items' requiring much inference ... dropped" (Rutter, 1967, p. 2). Rutter (1967) reports on different aspects of the scale: A test-retest reliability coefficient of 0.89 was obtained when teachers rated 80 seven year olds twice, with a two month interval between ratings. Inter-rater reliability was tested by obtaining ratings from four teachers on 70 chidren and comparing them with the ratings of four different teachers two to three months later. A correlation coefficient of 0.72 was obtained. The discriminative power of the scale was tested by comparing the scores of children in the general population with the scores of children attending psychiatric clinics for emotional or behavioural disorders. Approximately 11% of the boys and 3.5% of the girls in the general population obtained scores of 9 or more compared to 80% of the boys and 60% of the girls in the clinic sample. The Isle of Wight Study (Rutter et al., 1970) provides further validity information. Out of 2193 children, the scale identified 157 as being disturbed. Based on a psychiatric interview with the child and parental interviews, 64 of these children were finally diagnosed as disturbed. That is, the proportion of false negatives (children incorrectly identified as disturbed) selected by the scale was 59.2%. Information on the proportion of false negatives (disturbed children not identified) is not available. The scale used in this study was a modified version of Rutter's original scale. 9 of the original items were deleted because they were not considered appropriate for deaf children (e.g. "Has a stutter; "Has other speech difficulty") or have been found to be unrelated to - 41 -emotional disturbance (e.g. "Frequently bites nails;" "Frequently sucks thumb or finger") (Rutter, et a l . , 1970). In addition, four items were added; one relating to communication s k i l l s and three relating to withdrawn behaviour since Rutter's original scale was poorer at identifying withdrawn children than "acting out" children (Rutter, 1967). Thus the modified scale consisted of 21 items which were rated and scored in the same way as the original scale. A total score of 0 -42 was possible. A child was considered to have social-emotional problems i f he/she obtained a score of 8 or more. Copies of both the original and modified version are in Appendix A. Teacher Judgement Measures: Two different approaches to e l i c i t the teacher's opinion of the child's social-emotional status were used in the study. The f i r s t teacher judgement (T3 1) consisted of a single item embedded in the Rutter scale. It was placed at the beginning of the scale so that the items on the Rutter scale would not bias the teacher's judgement. TJ 1, then, was completed at the same time as the Rutter scale. No definition of social-emotional problem was given; nor was a l i s t of behaviours which might be considered indicative of a social-emotional problem supplied. The single item of TJ 1 is presented below: Has a social-emotional problem that demands a disproportionate amount of your time or interferes with the child's functioning. Teachers were required to check whether the item "certainly applies," "applies somewhat" or doesn't apply." The responses were given a rating - 42 -of 2,1 and 0 respectively. The second teacher judgement (TO 2) was designed to e l i c i t the same information (i.e. does the teacher think the child has a social-emotional problem). However, instead of asking a single question, three separate questions were asked relating to the child's social adjustment, self image and emotional adjustment. By doing this, teacher judgement for each area could be compared directly with the three scales of the SEAI. In order to insure that the teachers' judgements and the SEAI scales were measuring the same domains, definitions based on the content of the three SEAI scales were given to the teacher. The teachers rated these three areas using a three point scale of "no problems", "some problems" and "definite problems". These were given a score of 0, 1 and 2 respectively. By totalling the three separate scores, an aggregate score was obtained for a global rating of the child's social emotional status. A copy of this measure can also be found in Appendix A. Procedure 1. In December 1981, a l l teachers at Dericho H i l l School for the Deaf were asked to complete the adapted version of Rutter's Children's Behaviour Questionnaire and the TO 1 for each child in their class. 2. Because the Rutter scale was not originally designed for children over 13 years of age, the scores of children over 13 years of age were examined for inconsistencies compared to teacher judgement. Up to and including children aged 16 years of age differences were not - 43 -apparent. Thus a decision was made to include children aged 7 - 16 in the study. 3. In April 1982, 93 of the original population were selected on the basis of age (7-16) for continued study. At this stage, biodemographic information (age, sex, degree of hearing loss, type of hearing loss and residential status) was collected from school records. This was used to describe the population. 4. In May 1982, the same teacher who had rated the child on the Rutter scale completed the SEAI for each subject in his/her class. 5. One week after the collection of a l l SEAIs, each teacher was asked to complete TO 2 for each child. 6. As the measures were received, they were scored and verified by a second scorer. 7. A l l the data were entered on disk f i l e at the University of British Columbia's computing centre. The f i l e s were checked for consistency with the score sheets and errors corrected. In order to avoid contamination of results, the following procedures were taken: 1. Teachers were informed only that a study looking at the assessment of deaf children's social-emotional functioning was being conducted. Full description of the procedures were not given to the teachers. Hence teachers were not aware until they received the next rating form that they would have more than one scale to complete; nor were they aware that the consistency of their ratings would be examined. 2. Information on scoring procedures was not made available to the teachers. - 44 -Data Analysis Item an a l y s i s ; The LERTAP test analysis package (Nelson, 1974) was used to analyze both the SEAI and the Rutter s c a l e . The information sought from t h i s programme included mean, range, standard deviation, and i n t e r - c o r r e l a t i o n s . This was used to describe the item d i f f e r e n t i a t i o n , item r e l i a b i l i t y and item v a l i d i t y of the scales. R e l i a b i l i t y ; An estimate of the r e l i a b i l i t y indices was obtained for the three SEAI scales and the Rutter questionnaire by computing the i n t e r n a l consistency of the s c a l e . This was computed using Hoyt's analysis of variance a v a i l a b l e from the LERTAP package. Descriminant v a l i d i t y of the SEAI; In order to investigate the c o r r e l a t i o n s between the three SEAI scales, the c o r r e l a t i o n a l analysis s t a t i s t i c a l package for the s o c i a l sciences - SPSS: Version 9 - (Nie et a l . , 1975) was used. Pearson c o e f f i c i e n t s were obtained. Teacher Judgement r e l i a b i l i t y : An i n v e s t i g a t i o n of the consistency between T3 1 and T3 2 was undertaken by c a l c u l a t i n g percent agreement. D i s t r i b u t i o n of scores: The mean, range, frequency and d i s t r i b u t i o n were computed using the SPSS. This information was used to investigate the students' social-emotional status according to the SEAI scales, the Rutter scale and TO 1 and T3 2. Scores were categorized into three groups of low, average and above average and were used to l a b e l children as "disturbed" or "normal". The f u l l procedure for t h i s i s explained i n Chapter I I I . Test v a l i d i t y : Concurrent c r i t e r i o n - r e l a t e d v a l i d i t y of the SEAI and the Rutter scale was examined by c o r r e l a t i n g scores from these two - 45 -measures with teacher judgement. The crosstabs option of the SPSS was used to obtain Kendall's Tau B c o r r e l a t i o n c o - e f f i c i e n t s and to compute crosstabulation t a b l e s . The same procedure was followed to examine the c o r r e l a t i o n between the SEAI and the Rutter questionnaire. Table 1 summarizes the data analysis. Table 1 Summary of Data Analysis Description Test R e l i a b i l i t y : An i n v e s t i g a t i o n of students' scores on the 3 SEAI scales and the Rutter scale. Teacher Judgement  R e l i a b i l i t y : An i n v e s t i g a t i o n of the consistency between TJ 1 and TJ 2. Test V a l i d i t y : An i n v e s t i g a t i o n of the c o r r e l a t i o n s between the 3 SEAI scales. An i n v e s t i g a t i o n of students' social-emot-i o n a l status as deter-mined by a l l measures. An i n v e s t i g a t i o n of how well performance on the SEAI and Rutter scale agrees with teacher judgement. Procedure Item analysis (LERTAP) Percent agreement. Pearson c o r r e l a t i o n (SPSS:version 9) crosstabs option of SPSS: version 9 Output Item behaviour: discrim-i n a t i o n , r e l i a b i l i t y , v a l i d i t y . Internal consistency. Test-retest r e l i a b i l i t y Discriminant v a l i d i t y of The SEAI sc a l e s . Concurrent c r i t e r i o n -r elated v a l i d i t y of SEAI and Rutter. SPSS:version 9 Percentage of "disturbed" c h i l d r e n i d e n t i f i e d . An i n v e s t i g a t i o n of the c o r r e l a t i o n between SEAI and Rutter. crosstabs option of Discriminant v a l i d i t y of SPSS:version 9 The Rutter scale. - 46 -Summary 23 teachers completed two rating scales for 93 deaf c h i l d r e n aged between the ages of 7 - 16 at Oericho H i l l School for the Deaf. At or near the time of the administration of the two rating scales, teachers also completed teacher judgement measures. The two rating scales - the Meadow/Kendall Social-Emotional Assessment Inventory for Deaf Students and the adapted version of Rutter's Children's Behaviour Questionnaire are described in t h i s chapter. Data were entered into computer disk f i l e s and analysis were effected in f i v e stages: item analysis discriminant v a l i d i t y percent agreement d i s t r i b u t i o n of scores c o r r e l a t i o n a l analysis Results are described in the succeeding chapter. - 47 -CHAPTER III  RESULTS This chapter presents d e s c r i p t i v e data and the r e s u l t s of the s t a t i s t i c a l analysis of the data relevant to the questions under inves t i g a t i o n in t h i s study. Various aspects of the functioning of the d i f f e r e n t measures were examined: 1. Item behaviour of the three SEAI scales and the Rutter scale in terms of item d i f f e r e n t i a t i o n , r e l i a b i l i t y and v a l i d i t y . 2. Internal consistency of the three SEAI scales and the Rutter scale. 3. Discriminant v a l i d i t y of the SEAI sc a l e s . 4. Test-retest r e l i a b i l i t y of teacher judgement. 5. D i s t r i b u t i o n of scores and number of c h i l d r e n i d e n t i f i e d as "disturbed" by a l l measures. Relationships between the measures were examined by: 1. Comparing the percentage of children i d e n t i f i e d as "disturbed" by each measure. 2. Comparing the c o r r e l a t i o n s of teacher judgement with the Rutter scale and the SEAI scales. 3. Comparing the c o r r e l a t i o n between the Rutter scale and the SEAI sc a l e s . Rating scales for 93 c h i l d r e n were included in the a n a l y s i s . A 100% return rate was obtained for three of the four measures (T3 1, Rutter's Children's Behaviour Questionaire and the SEAI).'' T3 2 had a return rate of 99%. 1 Scale 1, S o c i a l Adjustment could not be included in the analyses for one c h i l d because of the high number of "cannot rate" or "doesn't apply" responses. - 48 -In 52 cases (55.92%) the c h i l d being rated was known "very well"; 36 (38.71%) - "moderately well" and; 5 (5.37%) - "not w e l l " . An inspection of these f i v e cases revealed that the teacher was s t i l l consistent in his or her ratings of the c h i l d (see Appendix B, Table A). Thus these f i v e cases were included in the a n a l y s i s . Item Behaviour An item analysis was performed for the three scales of the SEAI and the Rutter questionnaire. Tables B through E in Appendix B provide item analysis information for each of these scales. Items were examined in terms of t h e i r a b i l i t y to d i f f e r e n t i a t e "disturbed" vs. "non-disturbed" behaviour, t h e i r r e l i a b i l i t y ( c o r r e l a t i o n between item reponse and scale score) and t h e i r v a l i d i t y ( c o r r e l a t i o n between item response and the c r i t e r i o n measure of teacher judgement). Item d i f f e r e n t i a t i o n : The item analysis provided the percentage of subjects scoring 1 or 2 on the four scales ( v i z . SEAI scales 1, S o c i a l Adjustment; 2, S e l f Image; 3, Emotional Adjustment and the Rutter s c a l e ) . These scores indicated that the "maladjusted behaviour" in question was present to either a lesser or greater degree. A l l items that had not more than 25% of the population scoring 1 or 2 can be considered to d i f f e r e n t i a t e "disturbed" from "non-disturbed" behaviour.^ Table 2 provides information concerning the degree to which items within each scale d i f f e r e n t i a t e d disturbed from non-disturbed behaviour. 2Although t h i s 25% c r i t e r i o n i s somewhat a r b i t r a r y , i t has been used as a c r i t e r i o n for item s e l e c t i o n in some personality measurers (Nunnally, 1967) and can thus be considered a useful "rule of thumb". - 49 -TABLE 2 Degree to which items d i f f e r e n t i a t e "disturbed behaviour": Rutter and SEAI scales SEAI Scales - Rutter Soc. Adj. S e l f . Img. Emot. Adj. Scale Percentage of items which i d e n t i f y 15% of population as ex-h i b i t i n g "disturbed behaviour." Percentage of items which i d e n t i f y 16-25% of population as ex-h i b i t i n g "disturbed behaviour." Percentage of items which i d e n t i f y 26-35% of population as ex-h i b i t i n g "disturbed behaviour." Percentage of items which i d e n t i f y over 35% of population as exhi b i t i n g "disturbed Behaviour." 13.04 30.43 34.78 30.43 43.48 30.43 8.70 8.71 53.85 19.05 38.46 23.81 7.69 28.57 0.0 28.57 As can be seen i n Table 2, Scale 3, Emotional Adjustment appears to d i f f e r e n t i a t e "disturbed" from "non-disturbed" behaviour best with 92.31% of the items i d e n t i f y i n g no more than 25% of the population. Item d i f f e r e n t i a t i o n i n Scale 1, S o c i a l Adjustment has the lowest d i f f e r e n t i a t i o n . Only 47.82% of the items i d e n t i f i e d 25% or less of the population as e x h i b i t i n g "disturbed" behaviour. Of some in t e r e s t are the items in which nearly half of the children in the sample received a rating of 1 or 2: - 50 -Denies own misbehaviour (may also blame others for own misdeeds). (Item 59; Scale 1, S o c i a l Adjustment). Acts without thinking. Impulsive. Doesn't consider or doesn't care about the consequences. (Item 55; Scale 1, S o c i a l Adjustment). Other student's look to t h i s c h i l d as leader. (Item 49; Scale 2, S e l f Image). Very r e s t l e s s . Often running about or jumping up and down. Hardly ever s t i l l . (Item 2, Rutter s c a l e ) . Has poor concentration or short attention span. (Item 13, Rutter s c a l e ) . Tables B to E in Appendix B provide further information on i n d i v i d u a l items. The majority of items in Scale 2, S e l f Image can be considered to d i f f e r e n t i a t e "disturbed" from "non-disturbed" behaviours. 60.86% of the items i d e n t i f i e d 25% or less of the population as e x h i b i t i n g disturbed behaviour. However, as can be seen from Table C in Appendix B, 15 to 20% of the responses on three items were a "cannot rate" or "does not apply" r a t i n g . These three items were: I d e n t i f i e s with (e.g. shows excited recognition of) a stranger or v i s i t o r who wears a hearing aid (Item 26; Scale 2, S e l f Image). Shows excited, p o s i t i v e responses to stranger who i s using signs (Item 38; Scale 2, Self Image). Demonstrates acceptance/pride in own s o c i a l group membership ( i . e . r a c i a l / e t h n i c / l i n g u i s t i c / r e l i g i o u s i d e n t i t y ) (Item 56; Scale 2, S e l f Image). Item r e l i a b i l i t y : The p o i n t - b i s e r i a l c o r r e l a t i o n between item response and t h e i r respective t o t a l scale score was computed for each of the SEAI scales and the Rutter questionnaire. Table 3 summarizes t h i s - 51 -information by providing the percentage of items within each scale with c o r r e l a t i o n s of < .35, .35 - .50, .51 - .65 and .66 - 80. TABLE 3 Degree to which items c o r r e l a t e with respective scale score: Rutter and SEAI scales. Range of Pbis Scale Pbis < .35 .35 - .50 .51 - .65 > .65 Soc. Adj. 0.0 13.04 30.43 56.53 S e l f Img. 13.04 26.09 39.13 21 .74 Emot. Adj. 7.69 69.23 23.08 0.0 Rutter 4.29 19.05 42.85 23.81 Inspection of the p o i n t - b i s e r i a l s for each item on a l l four measures (see Tables B - E, Appendix B) revealed that a l l items were p o s i t i v e l y related to the t o t a l scale score with a c o r r e l a t i o n of greater than .35 for the majority of items. As can be seen from Table 3, the three SEAI scales and the Rutter questionnaire had c o r r e l a t i o n s of greater than .35 for 100%, 86.96%, 92.31% and 95.71% of the items r e s p e c t i v e l y . Item v a l i d i t y : Teacher judgement was used as the c r i t e r i o n measure in an attempt to examine the degree to which the item responses related to the subjects' actual social-emotional status. Correlations between item response and teachers' ratings of s o c i a l adjustment for Scale 1, S o c i a l Adjustment; teachers' ratings of s e l f image for Scale 2, S e l f Image; teachers' ratings of emotional adjustment for Scale 3, Emotional Adjustment; and teachers' global ratings of s o c i a l emotional - 52 -status (T3 1) for the Rutter scale were computed. Table 4 provides the percentage of items within each scale which correlated 0.0-.20, .21-.40, .41-.60 with teacher judgement. TABLE 4 Degree to which items c o r r e l a t e with teacher judgement: Rutter and SEAI scales Scale item/Teacher Judgement 0.0 < r < 0.20 0.21 < r < 0.40 0.41 < r < 0.61 Soc. Adj. 8.70 73.91 17.39 Se l f Img. 13.04 52.18 34.78 Emot. Adj. 23.08 61.54 15.38 Rutter 9.52 28.58 61.90 As shown in Table 4, c o r r e l a t i o n s did not exceed .60 for any item. With the exception of the items in the Rutter scale, most of the items had a c o r r e l a t i o n with teacher judgement of less than .40. Internal Consistency The i n t e r n a l consistencies of the three SEAI scales and the Rutter scale were computed using the Hoyt r e l i a b i l i t y c o e f f i c i e n t . The re s u l t s are presented in Table 5. - 53 -TABLE 5 Hoyt r e l i a b i l i t y c o e f f i c i e n t for the SEAI and Rutter scales. Scale Hoyt r e l i a b i l i t y c o e f f i c i e n t Soc. Adj. .95 S e l f Img. .90 Emot. Adj. .81 Rutter .91 Discriminant Validity of the SEAI Scales To examine the extent to which the three scales of the SEAI measure three separate dimensions, 13 subjects were randomly selected from each of three groups - below average (combined SEAI score i s lower than P30); average (combined SEAI score i s between P30 and P60 and; above average (combined SEAI score i s greater than P60). The mean percentile rank for each of these groups in each scale was c a l c u l a t e d and plotted on a p r o f i l e . Figure 1 provides t h i s information and shows that subjects in each group score around the same l e v e l across the three scales. - 54 -FIGURE 1 Student P r o f i l e s P e r c e n t i l e Rank 100 80 60 40 20 S o c . A d j , S e l f Image. Emot. A d j . SEAI S c a l e s B e l o w a v e r a g e g roup A v e r a g e g roup Above a v e r a g e g roup In addition, Pearson's c o r r e l a t i o n s between scales were computed and corrections for attentuation c a l c u l a t e d . Table 6 shows the c o r r e l a t i o n c o e f f i c i e n t s between the three scales, the r e l i a b i l i t y c o e f f i c i e n t of each scale and the corrected c o r r e l a t i o n c o e f f i c e n t . - 55 TABLE 6 Correlations among SEAI s c a l e s 1 SEAI Scales Soc. Adj. S e l f . Img. Emot. Adj. Soc. Adj. 95 58 72 Se l f Img. 5k 90 62 Emot. Adj. 63 53 81_ ^diagonal entries are scale r e l i a b i l i t i e s ; e n t r i e s above the diagonal are corrected for attenuation, while those below the diagonal are uncorrected. Decimals are omitted. As shown in Table 6, the c o r r e l a t i o n s are r e l a t i v e l y high. Teacher Judgement Test-Retest R e l i a b i l i t y Owing to the time lapse between the c o l l e c t i o n of the two teacher judgement measures (4 months), t e s t - r e t e s t r e l i a b i l i t y was examined in terms of percent agreement to accomodate change over time in children's behaviour. The second teacher judgement (TO 2) enquired whether the teacher thought the c h i l d ' s behaviour had changed since the f i r s t teacher judgement (T3 1) and in what d i r e c t i o n . It was therefore possible to take t h i s into account when c a l c u l a t i n g percent agreement. For example, i f a c h i l d had o r i g i n a l l y obtained a rating of " d e f i n i t e problems" on the f i r s t measure and a "some problems" rating on the second, but the teacher had indicated that the c h i l d ' s behaviour had improved, the two ratings were judged to be in agreement with each other. Conversely, i f a c h i l d had obtained a rating of "some problems" on TO 1, "no problems" on 13 2 and the teacher had indicated that the - 56 -c h i l d ' s behaviour had deteriorated or had remained constant, t h i s was rated as a disagreement. In t h i s way, the teacher ratings for each c h i l d were judged and d i s t r i b u t e d across c e l l s of a cross-tabulation t a b l e . Table 7 provides t h i s information and shows that a 75% agreement rate was reached. I t can also be seen from Table 7 that over half of the disagreement occurred i n the cases where the teacher had ranked a c h i l d as having "no problems" on TO 1 and as having "some problems" in T3 2. TABLE 7 Percent Agreement Between Teacher Judgements 1 and 2 Teacher Judgement 2 Above Average Average Below Average Above Average 38.04 (n=35) 3.26 (n=3) 1.09 (n=1) Agreement 0.0 15.22 (n=14) 2.17 (n=2) Disagreement Teacher Judgement 1 3.26 (n=3) 11.96 (n=11) 0.0 Agreement Average 1.09 (n=1) 0.0 1.09 (n=1) Disagreement Below Average 0.0 10.87 (n=10) 6.52 (n=6) Agreement 2.17 (n=2) 3.26 (n=3) 0.0 Disagreement It i s i n t e r e s t i n g to note that the teachers perceived a change i n - 57 -behaviour in 35.5% of the c h i l d r e n . Table 8 shows the number of children who, according to the teacher, either improved or deteriorated in the three areas of s o c i a l adjustment, s e l f image and emotional adjustment. TABLE 8 Teacher's ratings of improvement or de t e r i o r a t i o n i n s o c i a l adjustment, s e l f image and emotional adjustment S o c i a l S e l f Emotional Adjustment Image Adjustment Improvement 26 24 20 Deterioration D i s t r i b u t i o n of Scores The scores of the three SEAI scales, the Rutter questionnaire and the two measures of teacher judgement were c l a s s i f i e d into three categories - below average, average and above average. Children in the category 'below average' were l a b e l l e d "disturbed" and children in the 'average' and 'above average' categories as "normal". The numbers i d e n t i f i e d by each measure in the three categories were t a l l i e d . C r i t e r i a for the grouping of the scores into these three categories i s outlined below: - 58 -Rutter scale: According to Rutter (1967) a score of 17% or more of the possible t o t a l score indicates that the c h i l d has some p s y c h i a t r i c problems. Using t h i s c r i t e r i o n , however, over 61% of the sample would be considered to have some p s y c h i a t r i c problems. A c u t - o f f point of a score of 8 (or 38% of the possible t o t a l score) was used in t h i s study. Thus a score of 8 or more was translated to mean that the c h i l d had d e f i n i t e problems in his/her social-emotional functioning and could be l a b e l l e d as "disturbed". Children with scores below 8 were considered normal. The scores below 8 were broken down into two categories: 0-3 (above average) and 4-7 (average). SEAI scales: Since a raw score for each of the thre scales can have a d i f f e r e n t meaning depending on the age and sex of the subject and the number of items checked, i t was necessary to follow Meadow's procedure of converting a l l scores into p e r c e n t i l e ranks. Using appropriate age and sex information, the scaled scores for each c h i l d were converted to p e r c e n t i l e ranks according to the norms published in the manual. Although Meadow does not e x p l i c i t l y state what perc e n t i l e rank i s to be considered i n d i c a t i v e of social-emotional problems, the p r o f i l e form published i n the Inventory suggests that scores of less than P30 are below average, P30 - P60, average and greater than P60 above average. These c r i t e r i o n were used. SEAI scales - combined: Although Meadow does not suggest that a combined score be calculated, i t was considered advantagious to do so in the l i g h t of the findings c i t e d previously concerning the possible non-discriminantory nature of the three scales. Thus the p e r c e n t i l e ranks for the three scales were summed and divided by three and the SEAI was treated as one s c a l e . In order to maintain consistency with the procedure followed in grouping the c h i l d r e n into categories in the three separate scales, a combined perce n t i l e ranking of less than P30 was considered i n d i c a t i v e of 'disturbed' behaviour, while P30 - P60 and greater were considered to be average and above average. T3 1: Since t h i s was a single item asking teachers to rate whether the c h i l d d e f i n i t e l y had a problem, had somewhat of a problem or had no problem, i t was a straight-forward procedure to group these ratings into the three categories. - 59 -5. TJ 2: The responses to the three items were summed giving a possible range of 0 - 6. A score of 0 was considered to place a c h i l d in the above average category, 1-3 average and 4-6, below average. Figures A through G in Appendix B show the d i s t r i b u t i o n of scores for the seven measures. Table 9 summarizes the information in these figures by giving the percentage of c h i l d r e n in each category for each measure. As shown in Table 9, TO 2 i d e n t i f i e d the least number of c h i l d r e n as being disturbed (13.04%). This figure i s markedly lower than the number of c h i l d r e n i d e n t i f i e d by TJ 1 (22.58%). T3 2 i d e n t i f i e d 43.48% as being average, whereas T3 1 i d e n t i f i e d only 18.25% and placed more chi l d r e n i n the above average category (59.14%). The Rutter scale i d e n t i f i e d the most children as being disturbed. Nearly as many ch i l d r e n were i d e n t i f i e d as having social-emotional problems (37.63%) as children who were considered to have no problems (38.71%). The three SEAI scales varied in the number of children they i d e n t i f i e d as being disturbed. Scale 1, S o c i a l Adjustment with 33.70% of the children scoring below the P30 rank i d e n t i f i e d the most and Scale 3, Emotional Adjustment, the least with 24.74%. The percentage of children i d e n t i f i e d as being disturbed was much lower when the scores for the three SEAI scales were combined (17.20%). Co r r e l a t i o n s o f Teacher Judgement with the Rutter and SEAI Scales Because of the skewed d i s t r i b u t i o n s of the Rutter and teacher judgement measures, i t was not appropriate to compute Pearson r c o r r e l a t i o n s . Instead, a c o r r e l a t i o n c o e f f i c i e n t using Kendall's Tau B TABLE 9 Percentage of Children in Disturbance Categories According to Each Measure Adapted Rutter Scale Teacher Judgement 1 Teacher Judgement 2 SEAI Scales Combined SEAI Soc. Adj. Self Img. Emot. Ad j . Above Average 38.71 (n=36) 59.14 (n=55) 43.48 (n=40) 42.39 (n=39) 31.18 (n=29) 37.63 (n=35) 35.49 (n=33) Average 23.66 (n=22) 18.28 (n=17) 43.48 (n=40) 23.91 (n=22) 38.71 (n=36) 37.63 (n=35) 47.31 (n=44) Below Average 37.63 (n=35) 22.58 (n=21) 13.04 (n=12) 33.70 (n=31) 30.11 (n=28) 24.74 (n=23) 17.20 (n=16) n=93 n=92 n=92 n=92 n=93 n=93 n=93 - 61 -(Nie et a l . , 1975) was computed and corrected for attenuation. Owing to the time difference between the c o l l e c t i o n of the Rutter and SEAI scales, the Rutter scale was correlated with T3 1 and the SEAI scales with the corresponding items of T3 2. The r e s u l t s are presented in Table 10. The cross tabulations corresponding to these c o r r e l a t i o n s are reported in Tables 11 through 15. TABLE 10 Kendall's Tau B c o r r e l a t i o n s between rating scales and global teacher judgement. Scale Rutter Scale Scale 1, Soc. Adj. Scale 2, Self Img. Scale 3, Emot Adj. Combined SEAI Correlated With TO 1 Teacher judgement of soc. adj. Teacher judgement of Se l f image Teacher judgement of emot. adj. TO 2 Kendalls Tau B Corrected for Computed Attenuation 0.67** 0.42** 0.41** 0.25* 0.39** 0.70 0.43 0.43 0.28 0.39 **p < .001 *p .001 - 62 -TABLE 11 Crosstabulation of disturbance categories: TO 1 and Rutter Scale.* Rutter Scale Above average Teacher Oudgement 1 Average Below average Above average 36.6 (n=34) 2.2 (n=2) 0.0 (n=0) Average 16.1 (n=15) 7.5 (n=7) 0.0 (n=0) Below average 6.5 8.6 22.6 *Tau B = 0.67 p < .001 Tau B corrected for attenuation = 0.70 TABLE 12 Crosstabulation of disturbance categories: teacher judgement of s o c i a l adjustment and SEAI 1, So c i a l Adjustment.* SEAI 1, Soc. Adj. Teacher Oudgement of Soc i a l Above average Average Adjustment Below average Above average 30.8 (n=28) 9.9 (n=9) 1.1 (n=1) Average 17.6 (n=16) 6.6 (n=6) 0.0 (n=0) Below average 7.7 (n=7) 18.7 (n=17) 7.7 (n=7) Tau B = 0.42 p < .001 Tau B corrected for attenuation = 0.43 - 63 -TABLE 13 Crosstabulation of disturbance categories: teacher judgement of s e l f image and SEAI 2, S e l f Image.* Teacher Judgement of Self Image SEAI 2, Self Image Above average Average Below average Above average 25.0 (n=23) 4.3 (n=4) 1.1 (n=1) Average 22.8 (n=21) 13.0 (n=12) 3.3 (n=3) Below average 7.6 (n=7) 15.2 (n=14) 7.6 (n=7) Tau B = .41 p. < .001 Tau B corrected for attenuation = .43 TABLE 14 Crosstabulation of disturbance categories: teacher judgement of emotional adjustment and Scale 3, Emotional Adjustment.* Teacher Judgement of Emotional Adjustment SEAI 3, Emot. Adj. Above average Average Below average Above average 30.4 5.4 1.1 (n=28) (n=5) (n=1) Average 18.5 17.4 5.4 (n=17) (n=17) (n=5) Below average 14.1 5.4 5.4 Tau B = .25 p. .001 Tau B corrected for attenuation = .28 - 64 -TABLE 15 Crosstabulation of disturbance categories: TO 2 and combined SEAI scales* Teacher Oudgement 2 Combined SEAI Above average Average Below average Above average 25.0 7.6 2.2 (n=23) (n=7) (n=2) Average 14.1 29.3 4.3 (n=13) (n=27) (n=4) Below average 4.3 6.5 6.5 (n=4) (n=6) (n=6) Tau B = 0.39 p. < .001 The c o r r e l a t i o n between the adapted Rutter scale and TO 1 was much higher than any of the c o r r e l a t i o n s obtained for the SEAI scales. In order to insure that the high c o r r e l a t i o n of teacher judgement with the Rutter scale was not due to the d i f f e r e n t format of teacher judgement, addit i o n a l analyses was undertaken c o r r e l a t i n g the Rutter scale with TO 2. The c o r r e l a t i o n c o - e f f i c i e n t obtained was s t i l l higher than any obtained for the SEAI scales (.60 p < .001). As shown i n both Table 10 and the cross tabulations (Tables 11 -15), the highest c o r r e l a t i o n i s between TO 1 and the Rutter scale (.70). The lowest c o r r e l a t i o n occurred between teacher judgement of emotional adjustment and Scale 3, Emotional Adjustment (.35). It has already been shown that the teachers' judgements i d e n t i f i e d fewer ch i l d r e n as having social-emotional problems than - 65 -ei t h e r the SEAI of Rutter scales (see Table 9). The crosstabulations also show t h i s . Teachers co n s i s t e n t l y ranked the c h i l d ' s problems as less severe than the SEAI or the Rutter scales. Using teacher judgement as a v a l i d i t y c r i t e r i o n , i t i s possible to estimate the proportion of f a l s e p o s i t i v e s and f a l s e negatives selected by the SEAI and Rutter scales. The cases in which the c h i l d had been rated as below average according to a scale, but above average according to the teacher were defined as f a l s e p o s i t i v e s . Conversely, a c h i l d with d e f i n i t e problems ( i . e . in the category "below average") according to the teacher, but an above average rating according to the scale was defined as a f a l s e negative. Table 16 provides t h i s information. TABLE 16 Proportion of f a l s e negatives and f a l s e p o s i t i v e s i d e n t i f i e d by the SEAI and Rutter scales. %False Negatives %False P o s i t i v e s Soc. Adj. 1.1 14.1 Self Img. 1.1 7.6 Emotional Adjustment 1.1 7.7 Rutter 0.0 6.5 SEAI combined 2.2 4.3 As shown in Table 16, the percentage of f a l s e negatives picked by any scale i s small. That i s , the scales are missing very few children that the teachers judge to have social-emotional problems. The percentage of f a l s e p o s i t i v e s i d e n t i f i e d by the scales i s higher and - 66 -range from 4.3% (Combined SEAI) to a high of 14.1% (Scale 1, Soc i a l Adjustment). Correlations between the SEAI Scales and the Rutter Questionnaire As with the teacher judgement and scale c o r r e l a t i o n s , crosstabulations and Kendall's Tau B were used to examine the c o r r e l a t i o n s between the Rutter scale and the SEAI scales.3 Table 17 provides the c o r r e l a t i o n c o e f f i c i e n t s obtained, and corrected for attenuation. TABLE 17 Correlations between SEAI scales and Rutter questionnaire. SEAI Scales Kendalls Computed Tau B Corrected for attenuation Scale 1, Soc. Adj. 0.42** 0.46 Scale 2, S e l f Img. 0.52** 0.55 Scale 3, Emot. Adj. 0.30* 0.35 Combined SEAI 0.51** 0.53 ** p < .001 * p .001 When corrected for attenuation c o r r e l a t i o n s ranged from a low of .35 for Scale 3, Emotional Adjustment to .72 for the Scale 2, S e l f ^Because of the four month time difference between the administration of the two measurers, preliminary analysis was ca r r i e d out using Pearson r c o r r e l a t i o n s only on the cases where teachers had indicated that no change in behaviour had occurred (n=60). No appreciable d i f f e r e n c e was found (see Table E in Appendix B); hence a l l subjects were included in the a n a l y s i s . - 67 -Image. Further information i s provided in Tables 18 through 21 which give the crosstabulations for each of the three SEAI scales and the Combined SEAI rating with the Rutter scale. As shown i n these tables, there does not appear to be any consistent pattern in the way the scales rated the c h i l d r e n . The Rutter scale did not consistently rank the c h i l d ' s problem as either more or less severe than the SEAI sc a l e s . TABLE 18 Crosstabulation of disturbance categories: SEAI 1, S o c i a l Adjustment and Rutter Scale* SEAI, Soc i a l Adjustment Rutter Scale Above Average Average Above Average Above Average 26.1 (n=24) 9.8 (n=9) 3.3 (n=3) Average 7.6 (n=7) 7.6 (n=7) 8.7 (n=8) Below Average 8.7 (n=8) 6.5 (n=6) 21.7 (n=20) *Tau B = .42 p < .001 Tau B corrected for attenuation = .46 - 68 -TABLE 19 Cross tabulation of disturbance categories: SEAI 2, Self Image and Rutter Scale* SEAI 2, Self Image Rutter Scale Above Average Average Below Average Above Average 22.6 (n=21) 12.9 (n=12) 3.2 (n=3) Average 6.5 (n=6) 10.8 (n=10) 6.5 (n=6) Below Average 2.2 (n=2) 15.1 (n=14) 20.4 (n=19)-*Tau B = .50 p < .001 Tau B corrected for attenuation = .55 TABLE 20 Cross SEAI 3, tabulation of disturbance categories: Emotional Adjustment and Rutter Scale* SEAI 3, Emotional Adjustment Rutter Scale Above Average Average Below Average Above Average 23.7 (n=22) 8.6 (n=8) 6.5 (n=6) Average 6.5 (n=6) 11 .8 (n=11) 5.4 (n=5) Below Average 7.5 (n=7) 17.2 (n=16) 12.9 (n=9) *Tau B = .30 p .001 Tau B corrected for attenuation = .35 - 69 -Table 21 Cross tabulation of disturbance categories: Combined SEAI and Rutter Scale* Combined SEAI Rutter Scale Above Average Average Below Average Above 26.9 10.8 1.1 Average (n=25) (n=10) (n=1) Average 4.3 16.1 3.2 (n=4) (n=15) (n=3) Below 4.3 20.4 12.9 Average (n=4) (n=19) (n=12) *Tau B = .51 p < .001 Tau B corrected for attenuation = .53 Summary of Results The following i s a summary of the r e s u l t s reported in t h i s chapter. Item behaviour: Table 22 summarizes the information obtained from an item analysis of the three SEAI scales and the Rutter s c a l e . TABLE 22 Summary of Item Analysis Data Soc Adj. S e l f Img. Emot Adj. Rutter Item D i f f e r e n t i a t i o n : % items i d e n t i f y i n g no 47.82 60.86 92.31 42.86 more than 25% of pop. Item R e l i a b i l i t y : % items c o r r e l a t i n g to 100.00 86.96 92.31 85.71 t o t a l score > 0.35 Item V a l i d i t y : % items c o r r e l a t i n g to 17.39 34.78 15.38 61.90 teacher judgement > 0.40 - 70 -Internal consistency: Kline (1979) points out that most psychometric texts argue that the i n t e r n a l consistency of a test i s s a t i s f a c t o r y when i t i s around the .7 f i g u r e . The three SEAI scales and the Rutter scale were well above t h i s with r e l i a b i l i t y c o e f f i c i e n t s of .95, .90, .81 and .91. Discriminant v a l i d i t y of the SEAI: The three scales c o r r e l a t e d with each other .58 (Scale 1 and Scale 2), .72 (Scale 1 and Scale 3) and .62 (Scale 2 and Scale 3). In addition, the p r o f i l e s obtained were f a i r l y f l a t . Teacher judgement t e s t - r e t e s t r e l i a b i l i t y : A 75% agreement rate was found between the two teacher judgement measures. Percentage i d e n t i f i e d as having s o c i a l emotional problems: The d i s t r i b u t i o n of scores d i f f e r e d for each measure. The Rutter scale i d e n t i f i e d the largest percentage (37.63%) as having social-emotional problems. The three SEAI scales i d e n t i f i e d , i n order, 33.70%, 30.11% and 24.74%. When the three SEAI scales were combined, however, 17.20% were i d e n t i f i e d . Correlations with teacher judgement: Table 23 summarizes the findings concerning the r e l a t i o n s h i p s between teacher judgement and the two rating scales. - 71 -TABLE 23 Summary of r e l a t i o n s h i p between teacher judgement and rating scales SEAI Scales Soc. Self Emot. Rutter Adj. Img. Adj. Comb. Corre l a t i o n with teacher judgement (Kendall's Tau B) % f a l s e negatives, using teacher judgement as v a l i d i t y c r i t e r i o n % f a l s e p o s i t i v e s , using teacher judgement as v a l i d i t y c r i t e r i o n Correlations between SEAI and Rutter scales: Correlations were moderately high between the Rutter scale and SEAI 1, S o c i a l Adjustment (.72) and SEAI 2, S e l f Image (.55) SEAI 3, Emotional Adjustment i s the only SEAI scale that can be considered to have a low c o r r e l a t i o n with the Rutter scale (.35). Conclusions derived from these r e s u l t s are discussed in the following chapter. 0.43 0.43 0.28 0.39 0.70 1.1 1.1 1.1 2.2 0.0 14.1 7.6 7.7 4.3 6.5 - 72 -CHAPTER IV  SUMMARY, DISCUSSION AND RECOMMENDATIONS This chapter discusses the major conclusions derived from the study. To provide a context for t h i s discussion and to f a c i l i t a t e i n t e r p r e t a t i o n . o f r e s u l t s , a summary of the background, procedures and r e s u l t s and a description of the major l i m i t a t i o n s of the study have been included. The discussion i n t e r p r e t s the r e s u l t s and o f f e r s conclusions related to the research questions posed in Chapter I I . F i n a l l y , recommendations for future research are included. Summary Background: A review of the l i t e r a t u r e revealed that professionals perceive serious d e f i c i e n c i e s in the current measuring instruments used to assess social-emotional functioning in deaf c h i l d r e n . Most techniques in current use are not applicable with a deaf population because of the vocabulary and structure of test items and the l e v e l of communicative i n t e r a c t i o n needed between the examiner and the c h i l d . Teacher ratings may be a useful technique since t h i s method circumvents these problems. However, with the exception of the newly developed SEAI, a l l rating scales used with the deaf have been designed f o r , and standardized on, a hearing population. The d i f f e r e n t e x p e r i e n t i a l background of most deaf children and the danger in applying the same i n t e r p r e t i v e l a b e l s to c e r t a i n overt behaviour of deaf and hearing c h i l d r e n , c a l l into question the p r a c t i c e of using, with the deaf, tests designed for the hearing. - 73 -Moreover, the purpose of using teacher rating scales with a deaf population has not been c l a r i f i e d . Many professionals contend that r a t i n g scales function only as screening devices and can do no more than i d e n t i f y children who may have a problem. Examination of the research showed that while teacher rating scales have been frequently used to assess the social-emotional functioning of deaf c h i l d r e n , no studies have investigated the two issues outlined above. In response to these issues, the study sought information concerning the functioning of, and r e l a t i o n s h i p between, two teacher rating scales designed to assess social-emotional adjustment in c h i l d r e n . The two instruments were: 1. An adapted version of the Rutter Children's Behaviour Questionnaire, a screening instrument designed for hearing c h i l d r e n . 2. The Meadow/Kendall Social-Emotional Assessment Inventory, an instrument purporting to have a diagnostic function and designed s p e c i f i c a l l y for deaf c h i l d r e n . Method: 23 teachers of 93, 7 to 16 year old deaf children at one p r o v i n c i a l school for the deaf completed the two rating scales during a four month period. At the time of administration of the two scales, teachers' opinions of the c h i l d ' s social-emotional status were sought. The following analysis were undertaken: 1. Item analysis using LERTAP to examine the item behaviour and i n t e r n a l consistency of the three SEAI scales and the Rutter questionnaire. 2. C o r r e l a t i o n a l analysis using the SPSS to investigate the discriminant v a l i d i t y of the SEAI scales. 3. Percent agreement between the two teacher judgements to investigate the t e s t - r e t e s t r e l i a b i l i t y of teacher judgement. - 74 -4. Frequency d i s t r i b u t i o n s using the SPSS to examine the d i s t r i b u t i o n of scores of the measures. 5. The crosstab option of the SPSS to investigate the extent to which the SEAI scales and the Rutter scale correlated with teacher judgement and the c o r r e l a t i o n between the SEAI scales and the Rutter questionnaire. Results: The r e s u l t s were reported and summarized in Chapter III i n the order of the analyses undertaken. Rather than repeat t h i s summary, an integration of the findings w i l l be provided within the context of the three categories of research questions asked. 1. The subsidiary questions r e l a t i n g to the r e l i a b i l i t y of the scales and teacher judgement: The three scales of the SEAI and the Rutter questionnaire a l l demonstrated high i n t e r n a l consistency. A 75% agreement rate was found between the two teacher judgements, in d i c a t i n g that the teachers in t h i s study were consistent in the ratings of the c h i l d r e n in t h e i r c l a s s . 2. The a p p l i c a b i l i t y of the adapted Rutter scale with a deaf population: The r e s u l t s tend to indicate that the Rutter Children's Behaviour Questionnaire can be used with a deaf population. Using teacher judgement as a concurrent v a l i d i t y c r i t e r i o n , a c o r r e l a t i o n c o - e f f i c i e n t of .67 was obtained (Kendall's Tau B). This c o r r e l a t i o n was much higher than any obtained for the three SEAI scales. The r e s u l t s of the item analysis for the Rutter scale were somewhat ambiguous. Item v a l i d i t y , using teacher judgement as the external c r i t e r i o n , was r e l a t i v e l y high, with 61.90% of the items obtaining a c o r r e l a t i o n of .40 to .60. Item d i f f e r e n t i a t i o n , however, was low. Only 42.86% of the items i d e n t i f i e d 25% or less of the - 75 -population as exhibiting disturbed behaviour. C o r r e l a t i o n a l analysis of the SEAI and the Rutter scale was used to examine the discriminant v a l i d i t y of the Rutter scale compared to the SEAI. Correlation c o e f f i c i e n t s of .46 for Scale 1, S o c i a l Adjustment; .55 for Scale 2, Self Image; and .35 for Scale 3, Emotional Adjustment were obtained. A c o e f f i c i e n t of .53 was reached when the three scales were combined. 3. The v a l i d i t y of the SEAI as a diagnostic instrument: Correlations between the three scales were r e l a t i v e l y high. In addition, the scores of 39 children on the three scales were plotted^ The r e s u l t i n g p r o f i l e s tended to be f l a t . The percentage of the sample i d e n t i f i e d as disturbed by the three SEAI scales were compared with the percentage i d e n t i f i e d by the Rutter s c a l e . A l l four scales i d e n t i f i e d approximately one t h i r d of the sample as having social-emotional problems. Using teacher judgement as the v a l i d i t y c r i t e r i o n , i t was observed that a l l scales tended to over i d e n t i f y . The three SEAI scales, noteably Scale 1, So c i a l Adjustment, produced more f a l s e p o s i t i v e s than the Rutter scale. On the basis of these fi n d i n g s , i t i s not possible to state with any c e r t a i n t y that the SEAI i s functioning as a diagnostic instrument. Li m i t a t i o n s Three features of the sample r e s t r i c t generalization of the r e s u l t s : 1. The subjects in t h i s school a l l attended one p r o v i n c i a l school for the deaf. To what extent these findings would be duplicated in another school for the deaf or in other types of educational settings i s not known. - 76 -2. The sample consisted of a r e l a t i v e l y homogeneous group of deaf c h i l d r e n i n terms of degree and type of hearing l o s s . The r e s u l t s , then, may not apply to deaf c h i l d r e n who do not have a profound, sensory-neural hearing l o s s . 3. The r e l a t i v e l y small sample s i z e did not permit independent analyses of secondary and elementary students. Teachers of elementary children have more intensive contact with t h e i r students than secondary teachers. It i s possible then, that d i f f e r e n t findings would be obtained for these two groups. Other l i m i t a t i o n s which af f e c t the int e r p r e t a t i o n s of the res u l t s are: 1. The assumption that teachers' judgements are a v a l i d technique for i d e n t i f y i n g deaf children with social-emotional problems. While the l i t e r a t u r e tends to support t h i s assumption, no attempt was made in t h i s study to validate teachers' judgements. 2. The ar b i t r a r y c r i t e r i a used to group the scores, and hence the ch i l d r e n , into categories of above average, average and below average. Some kind of c l a s s i f i c a t i o n was necessary in order to compare the child r e n i d e n t i f i e d by the various measures as disturbed. However, i t i s recognized that d i f f e r e n t c r i t e r i a for grouping the scores could have resulted i n d i f f e r e n t f i n d i n g s . 3. The adaptation of the Rutter s c a l e . It was considered necessary to shorten the Rutter scale and to delete the items which were obviously not applicable to deaf children i n order to ensure teacher co-operation. However, by doing t h i s , i t i s recognized that the scale i s no longer the o r i g i n a l one designed for hearing c h i l d r e n . Discussion The i n t e r p r e t a t i o n and discussion of r e s u l t s are presented below. The r e l i a b i l i t y of teacher judgement: The re s u l t s suggest that teacher judgement i s a r e l i a b l e method for i d e n t i f y i n g emotionally disturbed deaf c h i l d r e n . This was considered an important finding of the study. It has already been pointed out in Chapter I that methods using a global teacher judgement to i d e n t i f y emotionally disturbed deaf - 77 -c h i l d r e n are common despite the lack of information concerning the r e l i a b i l i t y of t h i s method. This study found teachers' judgements to be consistent over a four month period. These findings suggest that confidence can be placed in teacher judgement as a r e l i a b l e technique for i d e n t i f y i n g deaf children with social-emotional problem. Some comments on the method used to obtain t h i s result are i n order at t h i s stage. F i r s t l y , by allowing teachers to i d e n t i f y children whose behaviour had either improved or deteriorated and taking t h i s into account in the c a l c u l a t i o n of the percent agreement, i t was possible to obtain a more accurate r e s u l t . Secondly, t h i s method allowed a count of the number of children whose behaviour, according to the teachers, had changed. The-finding that the teachers perceived a change in approximately 30% of the sample would tend to in v a l i d a t e claims that raters have a fixed idea of an in d i v i d u a l which i s res i s t a n t to change. At the same time, i t must be noted that most of the children's behaviour was rated as improving. The o p o s s i b i l i t y that teachers have a vested i n t e r e s t in proving t h e i r e f f o r t s to be j u s t i f i e d cannot be discounted. An equally v a l i d i n t e r -pretation i s that the programmes used by the teachers are e f f e c t i v e in helping social-emotional adjustment. L a s t l y , the d i f f e r e n t formats of the two teacher judgements need to be discussed. T3 1 asked teachers to rate each c h i l d ' s s o c i a l -emotional status on a 3 point scale. Itconsisted of only one item and did not give a d e f i n i t i o n of social-emotional functioning. T3 2, on the other hand, categorized "social-emotional functioning" into three areas: s o c i a l adjustment; s e l f image, and emotional adjustment. T3 2 also gave - 78 -examples of behaviour which could be considered i n d i c a t i v e of emotional disturbance. Nunally (1974) has demonstrated that increasing the number of items in a test provides a more r e l i a b l e and more discriminating measure. Further, Thorndike and Hagen (1977) have pointed out that the quality of ratings i s improved i f operational d e f i n i t i o n s are given to lessen ambiguity. It i s probable then that T3 2 was a more discriminating measure than T3 1. This could explain why T3 2 i d e n t i f i e d fewer children as disturbed than T3 1. The highest disagreement occurred in the cases where the teachers had rated a c h i l d to have "no problems" (above average) in T3 1, but "some problems" (average) in T3 2. The a p p l i c a b i l i t y of the adapted Rutter's Children's Questionnaire with  a deaf population: The r e s u l t s of the analyses undertaken to examine t h i s issue suggest that the adapted Rutter scale i s applicable with a deaf population. Correlations with the SEAI scales were moderately high, suggesting that both scales r e s u l t in the i d e n t i f i c a t i o n of the same i n d i v i d u a l s as "disturbed". It would appear that, according to the teachers, items used on the Rutter scale have the same i n t e r p r e t i v e s i g n i f i c a n c e for the deaf as for the hearing. Items on the Rutter questionnnaire correlated more highly with teacher judgement than items on the SEAI scales which were designed s p e c i f i c a l l y for the deaf. Moreover, the Rutter scale and teacher judgement converged on the i d e n t i f i c a t i o n of the same chi l d r e n as being disturbed more often than did any of the SEAI scales and teacher judgement. - 79 -The higher c o r r e l a t i o n s between teacher judgement and the Rutter scale cannot be attributed to the d i f f e r e n t formats of the two teacher judgements. Additional analyses which correlated T3 2 with a l l scales including the Rutter scale shows that the Rutter questionnaire s t i l l had the highest c o r r e l a t i o n with teacher judgement. Two in t e r p r e t a t i o n s for the high c o r r e l a t i o n s between the Rutter scale and teacher judgement are offered: F i r s t , i t may be that emotionally disturbed deaf children display the same behaviour as emotionally disturbed hearing children and that i f the language problems encountered in many tests can be overcome, measuring instruments designed to assess social-emotional functioning in hearing children are also applicable with a deaf population. While such an i n t e r p r e t a t i o n i s not supported by the l i t e r a t u r e , t h i s i s because very few studies have actually described emotionally disturbed deaf children and t h e i r behavioural c h a r a c t e r i s t i c s . A l t e r n a t i v e l y , i t i s possible that behaviour i n d i c a t i v e of emotional disturbance in deaf children i s d i f f e r e n t from that of hearing c h i l d r e n , but that teachers judge deaf children's behaviour according to standards set for hearing c h i l d r e n . This i n t e r p r e t a t i o n cannot be resolved u n t i l d e s c r i p t i v e studies on the actual behaviour of deaf c h i l d r e n perceived by t h e i r teachers to be emotionally disturbed are conducted. One fi n d i n g which appears to refute the conclusion that the Rutter scale i s applicable with a deaf population i s that which showed item d i f f e r e n t i a t i o n to be poorest on the Rutter scale. Over half of the items i d e n t i f i e d more than 25% of the sample as ex h i b i t i n g disturbed behaviour. - 80 -One approach to defining emotional disturbance i s to equate "deviant" behaviour with i t s r a r i t y (Rutter et a l . , 1970). That i s , ch i l d r e n are considered "disturbed" i f they exhibit behaviours which are known to be unusual i n children of the same age. Using a s t a t i s t i c a l approach to define emotional disturbance, i t can be argued that behaviours which the majority (or at least half) of the population e x h i b i t , cannot be considered i n d i c a t i v e of emotional disturbance. An examination of the items in which the lowest d i f f e r e n t i a t i o n occurred provides an a l t e r n a t i v e explanation. Items with the lowest d i f f e r e n t i a t i o n concerned aggressive and impulsive behavioural c h a r a c t e r i s t i c s . Studies have consistently shown that these t r a i t s are more common in deaf c h i l d r e n than hearing c h i l d r e n . This might mean that an aggressive deaf c h i l d i s not unusual or "disturbed". At'the same time, though, aggressive and impulsive behaviours are s t i l l considered, by the majority of teachers, to be undesirable regardless of the number of children who might possess these t r a i t s . It has already been pointed out that demonstrating the v a l i d i t y of tests assessing social-emotional constructs i s not a simple procedure since there i s no one v a l i d i t y figure that can be obtained for a t e s t . Some r e l a t i v e l y rigorous methods for t e s t i n g v a l i d i t y do e x i s t . C o r r e l a t i n g the measure in question with other well established tests of the same domain i s one way to demonstrate v a l i d i t y . Obviously, t h i s method can only be used where another well accepted measure exi s t s ( K l i n e , 1979). - 81 -This method i s of l i m i t e d value for i n v e s t i g a t i n g the v a l i d i t y of t e s t s designed to assess the social-emotional functioning of deaf c h i l d r e n since a well accepted measure does not e x i s t . Instead i t was necessary to have the children rated for social-emotional status, using several such i n d i c a t o r s , and compare ratings and scores. Using t h i s method, the study has shown that the Rutter scale i s applicable with a deaf population. The diagnostic functioning of the SEAI: No reported studies have examined the diagnostic functioning of the SEAI. Aside from the inventory's obvious appeal of being designed s p e c i f i c a l l y for deaf c h i l d r e n , the inventory i s designed as a diagnostic instrument in that i t can be used to " ' f l a g ' a student who needs extra attention in a p a r t i c u l a r area" (Meadow et a l . , 1980, p. 12). Some aspects of the functioning of the SEAI with a sample of 7 to 16 year olds in a school for the deaf have already been mentioned in the previous section. A l l three scales of the SEAI had a low c o r r e l a t i o n with teacher judgement. Only Scale 3, Emotional Adjustment had good item d i f f e r e n t i a t i o n . O v e r a l l , none of the three scales performed any better than the Rutter Questionnaire, a screening instrument designed for hearing c h i l d r e n . This finding i s s u r p r i s i n g in view of the l i t e r a t u r e which suggests that an instrument designed s p e c i f i c a l l y for the deaf should be superior to instruments designed for the hearing, when used with a deaf population. The SEAI scales i d e n t i f i e d nearly as many children as "disturbed" as did the Rutter scale. Further, using teacher judgement as a v a l i d i t y c r i t e r i o n , i t was found that a l l scales tended to over i d e n t i f y , that i s - 82 -a l l the scales selected more f a l s e p o s i t i v e s than f a l s e negatives. These r e s u l t s suggest that the SEAI i s performing as a screening instrument. I n t e r c o r r e l a t i o n s between the three scales were r e l a t i v e l y high, showing that the scales are i d e n t i f y i n g the same children as "disturbed." This finding can be interpreted to mean that s o c i a l adjustment, s e l f image and emotional adjustment are highly interdependent. Such an i n t e r p r e t a t i o n i s c e r t a i n l y supported by the l i t e r a t u r e . A l t e r n a t i v e l y , i t may be that the three SEAI scales are measuring one underlying f a c t o r . E i t h e r i n t e r p r e t a t i o n suggests that the SEAI cannot provide diagnostic d i f f e r e n t i a t i o n on a c h i l d ' s social-emotional status. Further research i s needed on t h i s issue, since the number of cases in the present study would not support the required factor a n a l y s i s . The r e s u l t s of t h i s study, suggest that i t may be unnecessary to use three separate scales. Recommendations Future research: Several areas of research a r i s i n g d i r e c t l y from the present study are worthy of future i n v e s t i g a t i o n . The two d i f f e r e n t formats of teacher judgement used in t h i s study have been discussed. It was suggested that TO 2 may be a more discriminating measure than T3 1. Research into the r e l a t i v e effectiveness of d i f f e r e n t formats of teacher judgement would be de s i r a b l e . Although the findings of t h i s study c a l l into question the use of the SEAI as a diagnostic instrument, further studies are needed to - 83 -resolve t h i s issue. A related p o s s i b i l i t y in which further investiga-ti o n could prove valuable, i s that the SEAI might function more e f f e c t i v e l y as a screening or i d e n t i f i c a t i o n instrument i f the three scales are combined and treated as one. F i n a l l y and most importantly, i t seems necessary to take a broader view of the research needed with emotionally disturbed deaf c h i l d r e n . The e n t i r e area of assessment of emotionally disturbed deaf c h i l d r e n requires substantial development i n terms of the value of various methods of assessment, the r e l a t i v e effectiveness of d i f f e r e n t i d e n t i f i c a t i o n techniques and the development of e f f e c t i v e diagnostic techniques. Before t h i s can be done, however, des c r i p t i v e studies based on intensive observation of deaf children in both home and school settings are needed. U n t i l behavioural c h a r a c t e r i s t i c s associated with emotionally disturbed deaf children are s p e c i f i e d , assessment w i l l continue to be inadequate and subjective. , C l i n i c a l p r a c t i c e : It i s recommended that u n t i l further research i s conducted, use of the SEAI should be limited to screening purposes. The SEAI i s able to i d e n t i f y deaf children who may be emotionally disturbed but does not appear to o f f e r information on an i n d i v i d u a l ' s social-emotional functioning which could be used in planning an intervention strategy. Further, the r e s u l t s of t h i s study suggest that, with few modifications, the Rutter scale can be used to assess s o c i a l -emotional functioning of profoundly deaf c h i l d r e n . At t h i s stage i t would appear that assessment techniques to i d e n t i f y and diagnose deaf c h i l d r e n with social-emotional problems should focus on d e s c r i p t i v e , observational methods. By doing t h i s , the - 84 -basis for persuasive v a l i d a t i o n studies for instruments l i k e the SEAI w i l l have been established. - 85 -REFERENCES Adelman, H. Predicting psycho-educational problems in childhood. Behavioral Disorders, 1977/78, 2> 148-159. A l t s h u l e r , K. 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New 3ersey: P r e n t i c e - H a l l , Inc., 1971. Nichol, H. Survey of classroom teachers of children aged 5-14 years in Vancouver C i t y . B r i t i s h Columbian Journal of Special Education, 1980, 4, 245-261. Nie, H., H u l l , C , Jenkins, 3., Steinbrenner, K., & Brent, D. S t a t i s t i c a l package for the s o c i a l sciences. (2nd ed.). New York: McGraw H i l l , 1975. Nunnally, J. Psychometric Theory. New York: McGraw-Hill Book Co., 1967. P h i l l i p s , L., Draguns, J., & B a r t l e t t , D. C l a s s i f i c a t i o n of behavior disorders. In N. Hobbs (Ed.), Issues in the c l a s s i f i c a t i o n of  chi l d r e n (Vo. 1). San Francisco: Jossey-Bass Pub., 1975. Pintner, R. Emotional s t a b i l i t y of the hard of hearing. Journal of  Genetic Psychology, 1933, 43, 293-311. Pintner, R., & Brunschwig, L. Some personality adjustments of deaf children in r e l a t i o n to two d i f f e r e n t f a c t o r s . Journal of Genetic  Psychology, 1936, 49, 377-388. Prugh, D., Engel, M., & More, W. Emotional disturbance in c h i l d r e n . In N. Hobbs (Ed.), op. c i t . Rainer, 3., & Al t s h u l e r , K. (Eds.) Psychiatry and the deaf. Washington, D.C: U.S. Department of Health, Education & Welfare, 1967. Reivich, R., & Rothrock, I. Behavior problems of deaf children and adolescents: A f a c t o r - a n a l y t i c study. Journal of Speech and Hearing  Research, 1972, 15, 93-104. Reynolds, M., & Balow, B. Categories and variables in s p e c i a l education. Exceptional Children, 1974, 38, 357-366. Robinson, L. Sound minds in a soundless world. Washington, D.C: U.S. Department of Health, Education & Welfare, 1978. - 90 -Rubin, R., & Balow, B. Prevalence of teacher i d e n t i f i e d behavior problems: A lo n g i t u d i n a l study. Exceptional Children, 1978, 45, 102-111. Rutter, M. A children's behavior questionnaire for completion by teachers: Preliminary f i n d i n g s . Journal of Child Psychology and  Psychiatry, 1967, 8_, 1-11. 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Child Development, 1970, 41_, 871-879. - 92 -APPENDIX A: MEASURES - 93 -Rutter's Children's Behaviour Questionnaire To be completed by teachers Below are a se r i e s of descriptions of behavior often shown by chidren. Af t e r each statement are three columns: 'Doesn't apply', 'Applies Somewhat', and 'Certainly Applies'. I f the c h i l d d e f i n i t e l y shows the behavior described by the statement place a cross in the box under 'Certainly applies'. I f the c h i l d shows the behavior described by the statement but to a lesser degree or les s often place a cross i n the box under 'Applies somewhat'. I f , as far as you are aware, the c h i l d does not show the behavior place a cross in the box under 'Doesn't apply'. Please put ONE cross against EACH statement. Thank you. Doesn't Applies Cert a i n l y apply somewhat applies 1. Very r e s t l e s s . Often running about or jumping up and down. Hardly ever s t i l l . ( ) ( ) ( ) 2. Truants from school. ( ) ( ) ( ) 3. Squirmy, fidgety c h i l d . ( ) ( ) ( ) 4. Often destroys own or others' belongings. ( ) ( ) ( ) 5. Frequently f i g h t s with other c h i l d r e n ( ) ( ) ( ) 6. Not much l i k e d by other c h i l d r e n . ( ) ( ) ( ) 7. Often worried, worries about many things. ( ) ( ) ( ) 8. Tends to do things on his own-rather s o l i t a r y . ( ) ( ) ( ) 9. I r r i t a b l e . Is quick to ' f l y of the handle'. ( ) ( ) ( ) 10. Often appears miserable, unhappy, t e a r f u l or d i s t r e s s e d . ( ) ( ) ( ) 11. Has twitches, mannerisms or t i c s of the face or body. ( ) ( ) ( ) 12. Frequently sucks thumb or fi n g e r . ( ) ( ) ( ) - 94 -cont'd Please put ONE cross against EACH statement. Thank you. 13. Frequently bites n a i l s or f i n g e r s . 14. Tends to be absent from school for t r i v i a l reasons. 15. Is often disobedient. 16. Has poor concentration or short attention span. 17. Tends to be f e a r f u l or a f r a i d of new things or new s i t u a t i o n s . 18. Fussy or over-particular c h i l d . 19. Often t e l l s l i e s . 20. Has stolen things on one or more occasions. 21. Has wet or s o i l e d s e l f at school t h i s year. 22. Often complains of pains or aches. 23. Has had tears on a r r i v a l at school or has refused to come into the building t h i s year. 24. Has a st u t t e r or stammer. 25. Has other speech d i f f i c u l t y . 26. B u l l i e s other children. Doesn't apply ( Applies Certainly somewhat applies ( ) Are there any other problems of behaviour? Signature: Mr/Mrs/Miss ) How well do you know t h i s child? Very Well ( ) Moderately well ( ) Not very well ( ) THANK YOU VERY MUCH FOR YOUR HELP - 95 -Adapted Rutter's Children's Behaviour Questionnaire Below are a se r i e s of descriptions of behavior often shown by chidren. After each statement are three columns. I f the c h i l d d e f i n i t e l y shows the behavior described by the statement place a cross i n the box under 'Certainly applies'. I f the c h i l d shows the behavior described by the statement but to a lesser degree or less often place a cross in the box under 'Applies somewhat'. I f , as far as you are' aware, the c h i l d does not show the behavior place a cross in the box under 'Doesn't apply'. Please put ONE cross against each statement. Doesn't Applies Cert a i n l y apply somewhat applies 1 . Has a social-emotional problem that demands a disproportionate amount of your time or i n t e r f e r e s with c h i l d ' s functioning. ( ) ( ) ( ) 2. Very r e s t l e s s . Often running about or jumping up and down. Hardly ever s t i l l . ( ) ( ) ( ) 3. Often destroys own or others' belongings. ( ) ( ) ( ) k. Frequently f i g h t s with other c h i l d r e n . ( ) ( ) ( ) 5. Not much l i k e d by other c h i l d r e n . ( ) ( ) ( ) 6. Tends to do things on his/her own; rather s o l i t a r y . ( ) ( ) ( ) 7. Often appears miserable, unhappy, t e a r f u l or di s t r e s s e d . ( ) ( ) ( ) 8. I r r i t a b l e . Is quick to ' f l y of the handle'. ( ) ( ) ( ) 9. Has twitches, mannerisms or t i c s of the face or body. ( ) ( ) ( ) 10. Engages in behavior considered to be bizarre or strange. ( ) ( ) ( ) 11. Tends to be absent from school for t r i v i a l reasons. ( ) ( ) ( ) - 96 -Cont'd Please put ONE cross against each statement, Doesn't Applies Certain apply somewhat applie 12. Is often disobedient. 13. Has poor concentration or short attention span. 14. Tends to be f e a r f u l or a f r a i d of new things or new s i t u a t i o n s . 15. Fussy of over p a r t i c u l a r . 16. I n s i s t s on r e p i t i t i o n of usual routine. 17. Has stolen things. 18. Has wet or s o i l e d s e l f at school. 19. Often complains of pains or aches. 20. Has cr i e d on a r r i v a l at school or has refused to come into the school b u i l d i n g . 21. In comparison with other deaf c h i l d r e n , communication s k i l l s are poor. 22. Is i n d i f f e r e n t to or ignores other c h i l d r e n . How well do you know th i s c h i l d ? ( ) Very well, ( ) Moderately well. ( ) not w e l l . - 97 -Teacher Oudgement, 2 Name: (to be erased) ID # No Some D e f i n i t e Problem Problem Problem 3. S o c i a l adjustment: e.g. Displays an ( ) ( ) ( ) in t e r e s t in and s k i l l s of, i n t e r a c t i n g with both children and adults in work and play s i t u a t i o n s . Is w i l l i n g to give and take in interpersonal s i t u a t i o n s . Shows conformity to basic s o c i a l norms of behaviour. P o s i t i v e self-image: eg. Has a r e a l - ( ) ( ) ( ) i s t i c perception of s e l f ; i s able to recognize his/her l i m i t a t i o n s as well as strengths. Shows confidence in his/her a b i l i t y to communicate with both deaf and hearing ch i l d r e n and adults. Dis-plays s e l f - r e l i a n c e and confidence i n his/her a b i l i t y to handle school-related -work. Emotional adjustment: eg. Demonstrates ( ) ( ) ( ) adequate s k i l l s necessary for handling s t r e s s f u l s i t u a t i o n s , making decisions, etc. Does not demonstrate obsessive behaviour or symptoms of physical i l l -ness with no apparent medical basis. Has there been any change in these three areas of the c h i l d ' s functioning over the l a s t four months? 1. S o c i a l adjustment: 2. Self-image: 3. Emotional adjustment: No ( ) ( ) ( ) Yes ( ) ( ) ( ) If yes, has the c h i l d ' s behaviour deteriorated improved ( ) ( ) ( ) ( ) ( ) ( ) - 98 -APPENDIX B: SUPPLEMENTARY TABLES AND FIGURES - 99 -TABLE A Percent agreement between T31 and T32 for the 5 cases where the rater did not know the c h i l d w ell. Teacher Judgement 2 No Problems Some Problems De f i n i t e Problems Teacher Judgement 1 No Problems Agreement Disagreement Qrtmp 111 1 Agreement Problems Disagreement D e f i n i t e Problems 1 Agreement Disagreement - 100 -TABLE B Item Analysis Information for Scale 1, So c i a l Adjustment Item X SD r scale 1 P r t j soc. adj. 1. Obeys the rules; follows i n s t r u c t i o n s or requests from adults i n authority 3.11 0.84 0.73 13.0 0.26 2. Kind and considerate 3.01 0.97 0.77 14.0 0.43 5. Aggressive. Behavior may includ f i g h t i n g , scratching, b i t i n g other students and/or kicking or h i t t i n g animals 2.99 0.98 0.76 31.2 0.39 9. Has generally acceptable emotional responses. Rages (tantrums) or violent outbursts occur only after extreme provocation i f at a l l 2.77 1.07 0.41 32.2 0.31 11. Accepts some delay of g r a t i f i c a -t i o n . (Does not expect instant s a t i s f a c t i o n of every need, whim or desire) 2.97 0.83 0.42 22.6 0.11 14. Teases or annoys or pesters students 2.84 1.09 0.55 35.5 0.22 17. Takes r e s p o n s i b i l i t y for f a i r share of tasks (e.g. helps to clean up after a project i s finished) 3.05 0.91 0.61 19.4 0.28 20. Performs cooperativly in group of peers. Contributes to cohesion rather than to c o n f l i c t 2.93 0.86 0.76 22.6 0.43 23. Happy, cheerful, pleasant, easy-going 3.06 0.84 0.65 19.3 0.39 27. Engages in destructive behavior (e.g. breaking objects, defacing walls or f u r n i t u r e , scattering things in disarray) 3.44 0.87 0.74 11.8 0.34 - 101 -Table B (contd.) Item Analysis Information for Scale 1, Soc i a l Adjustment Item X SD r scale 1 P r t j soc. adj. 29. Trustworthy, dependable, 2.92 0.98 0.77 25.9 0.45 r e l i a b l e 32. Misbehavior not deterred by 2.99 1.04 0.58 28.0 0.29 r e s t r i c t i o n s or by threat of punishment 35. F a i l s to accept c r i t i c i s m , 2.88 0.99 0.69 33.3 0.36 e s p e c i a l l y i f i t i s expressed as d i s c i p l i n e or r e s t r i c t i o n 37. Demands attention. Must be 2.85 1.14 0.58 32.2 0.23 center of everything. (May i n s i s t on being f i r s t in l i n e , or leader, or captain) 40. Seems to understand the feeli n g s 2.72 1.11 0.60 22.6 0.46 of others; demonstrates empathy 43. Responds poorly to losing in 2.83 0.98 0.77 32.6 0.37 games or f a i l i n g to achieve in c l a s s 45. Accepts differences in other 2.92 1.14 0.71 17.3 0.36 people; doesn't tease or exclude peers on basis of r a c i a l d i fferences or physical handi-caps 46. Has habits, mannerisms or t r a i t s 3.13 0.98 0.76 20.4 0.36 considered to be rude or s o c i a l l y unacceptable (e.g. picks nose, makes obscene/ sexual references) 48. Doesn't try to copy classmates' 3.00 1.01 0.61 31.2 0.10 work nor take things belonging to others 51. Generous. Shares with others 3.03 0.91 0.71 20.5 0.37 - 102 -Table B (cont'd.) Item Analysis Information for Scale 1, So c i a l Adjustment Item X SD r scale 1 P r t j soc. adj. 52. Demands attention and help constantly. Takes disporpor-tionate share of teacher's time 2.67 1.08 0.47 32.3 0.21 55. Acts without thinking. Impulsive. Doesn't consider or doesn't care about consequences 2.61 1.05 0.69 40.9 0.38 59. Denies own misbehavior (may also blame others for own misdeeds 2.66 1.12 0.79 46.2 0.37 - 103 -TABLE C Item Analysis Information for Scale 2, Self Image Relates well to peers and i s accepted by them Distinguishes between fact and f i c t i o n r e a l and imaginary events and/or people, (e.g. understands that "Superman" does not r e a l l y exist) 7. Takes pride i n physical appearance/personal attractiveness: feels at least moderately pretty or handsome 12. Isolated. Has few or no f r i e n d s . May be considered "withdrawn" 15. Shows i n i t i a t i v e in completion of assignments; motivated to f i n i s h work 16. Tr i e s to communicate with others (both deaf and hearing) by any means necessary: ( s i g n s ) , speech, writing, pantomine 19. S e l f - r e l i a n t . Not overly dependent on others for help 24. Gives up quickly, f a i l Expects to 26. I d e n t i f i e s with (e.g. shows excited recognition of) a stranger or v i s i t o r who wears a hearing aid 28. Relates well to adults (both men and women) 2.95 3.15 2.97 2.97 2.89 3.20 2.93 2.83 2.20 2.98 SD 0.94 1.02 1.07 1.05 0.97 0.83 0.88 0.95 1.43 1.17 r scale 1 0.62 0.62 0.50 0.47 0.63 0.67 0.55 0.44 0.21 0.56 25.7 8.7 17.2 28.0 29.0 12.9 24.8 29.2 30.1 15.1 r t j soc. adj, 0.58 0.43 0.25 0.36 0.53 0.28 0.40 0.58 0.08 0.23 - 104 -Table C (cont'd) Item Analysis Information for Scale 2, Self Image X SD r scale 1 P r t j soc. adj. 33. Creative. Shows imagination i n school work, in lei s u r e / p l a y a c t i v i t i e s 2.95 0.92 0.56 25.9 0.50 34. Lethargic. Lacks energy. Always t i r e d 3.04 0.92 0.50 •22.6 0.26 38. Shows excited, p o s i t i v e responses to stranger who i s using signs 2.53 1.31 0.30 24.8 0.02 41. Tr i e s to understand the communication of others by any means offered l i s t e n i n g , l i p r e a d i n g , signing, writing, gestures 3.07 0.80 0.72 12.9 0.42 42. Curious. Eager to lean new things. Likes new experiences 3.17 0.92 0.69 17.2 0.48 44. Daydreams. Tunes out events in immediate environment 2.71 1.10 0.62 35.5 0.36 47. P a r t i c i p a t e s in classroom or group a c t i v i t i e s ; volunteers answers, o f f e r s opinions in discussions ,3.16 0.91 0.74 12.9 0.35 49. Other students look to t h i s student as a leader 2.24 1.08 0.61 58.1 0.39 50. Demonstrates a sense of humor or wit (e.g. can appreciate funny s i t u a t i o n s or jokes at own expense) 3.11 0.90 0.68 14.0 0.40 - 105 -TABLE C Item Analysis Information for Scale 2, Self Image X SD r scale 1 P r t j soc. adj. 53. P a r t i c i p a t e s well in organized play or games (takes role of leader or follower, plays to completion; follows rules) 2.90 1.13 0.65 19.4 0.42 54. Is w i l l i n g to interact with hearing people ( i . e . does not refuse to interact with peers or adults who have normal hearing) 3.01 1.03 0.43 8.6 0.20 56. Demonstrate acceptance/pride in own group membership ( i . e . r a c i a l / e t h n i c / l i n g u i s t i c / r e l i g i ous i d e n t i t y ) 2.47 1.44 0.27 14.0 0.27 57. Avoids communicating through speech. Seems embarrassed to use voice 2.87 1.11 0.36 29.1 0.27 - 106 -TABLE D Item Analysis Information for Scale 3, Emotional Adjustment X SD r scale 1 P r t j soc. adj. 6. Demonstrates negative f e e l i n g s about physical size and/or strength 3.03 1.05 0.43 9.7 0.30 8. Engages in behavior considered by most teachers and students to be bizarre or strange (e.g. t a l k i n g or signing to s e l f , rocking, staring at l i g h t s for long periods, twi r l i n g ) 3.42 0.86 0.52 14.0 0.41 10. Has many fears. Overly and u n r e a l i s t i c a l l y concerned with danger, storms, injury, death 3.24 0.96 0.55 8.6 0.35 13. Lacks competence with t o o l s , u t e n s i l s or equipment even though there i s no apparent physical basis for lack of s k i l l 3.02 1.21 0.41 15.1 0.37 18. I n s i s t s on r e p e t i t i o n of usual routines. Changes in sched-ules, habits, routine arrange-ments e l i c i t extreme (negative responses) 2.71 0.92 0.45 30.1 0.24 21. Overly concerned with c l e a n l i -ness. (May wash hands con-st a n t l y or be unable to t o l e r -ate specks of dust or d i r t ) 3.10 1.07 0.38 5.4 0.18 22. Shows great concern or preoccu-pation with minute d e t a i l s (e.g. may i n s i s t on perfection in writing or drawing) 2.81 1.12 0.22 24.7 0.02 25. Complains of physical ailments that have no apparent medical basis (e.g. headaches, stomaches, etc.) 3.21 0.99 0.45 14.0 0.39 - 107 -Table D (cont'd) Item Analysis Information for Scale 3, Emotional Adjustment X SD r scale 1 P r t j soc. adj. 30. Nervous. Anxious. Worries about many commonplace events 3.11 0.89 0.58 17.3 0.45 31. Demonstrates negative attitudes towards sign language (refuses to sign, pretends not to under stand others' signing) 3.55 1.04 0.42 2.2 0.22 36. Demonstrates negative f e e l i n g s about own motor s k i l l s , d e x t e r i t y , or v i s i b l e handicaps 3.11 1.03 0.46 19.4 0.34 39. Has many accidents or mishaps r e s u l t i n g in breakage of objects or i n j u r i e s requiring f i r s t a i d . 3.42 0.83 0.50 7.5 0.36 58. Displays twitches, mannerisms, t i c s of face or body. 3.31 0.91 0.50 15.1 0.34 - 108 -TABLE E Item Analysis Information for Rutter Scale X SD r scale 1 P r t j soc. adj. 2. Very r e s t l e s s . Often running about or jumping up and down. Hardly ever s t i l l . 1.57 0.74 0.59 42.0 0.45 3. Often destroys own or others' property 1.28 0.56 0.67 22.6 0.62 4. Frequently f i g h t s with other c h i l d r e n 1.44 0.68 0.63 35.5 0.57 5. Not much l i k e d by other ch i l d r e n 1.39 0.66 0.77 29.1 0.60 6. Tends to do things on his/her own; rather s o l i t a r y 1.47 0.68 0.63 36.4 0.52 7. Often appears miserable, unhappy, t e a r f u l or distressed 1.35 0.60 0.59 29.1 0.48 8. I r r i t a b l e . Is quick to ' f l y o f f the handle 1 1.54 0.80 0.54 36.6 0.54 9. Has twitches, mannerisms or t i c s of the face or body 1.30 0.62 0.65 23.6 0.51 10. Engages in behavior considered to be bizarre or strange 1.23 0.59 0.71 16.1 0.45 11. Tends to be absent from school for t r i v i a l reasons 1.07 0.38 0.26 7.6 0.17 12. Is often disobedient 1.32 0.61 0.55 26.9 0.56 13. Has poor concentration or short attention span 1.60 0.77 0.66 45.1 0.60 14. Tends to be f e a r f u l or a f r a i d of new things or new si t u a t i o n s 1.35 0.69 0.52 25.9 0.36 - 109 -Table E (cont'd) Item Analysis Information for Rutter Scale X SD r scale 1 P r t j soc. adj. 15. Fussy or over p a r t i c u l a r 1.33 0.65 0.43 25.8 0.37 16. I n s i s t s on r e p e t i t i o n of usual routine 1.48 0.75 0.71 35.5 0.53 17. Has stolen things 1.32 0.68 0.49 22.6 ' 0.37 18. Has wet or s o i l e d s e l f at school 1.05 0.34 0.33 4.4 0.11 19. Often complains of pains or aches 1.19 0.52 0.40 16.1 0.32 20. Has c r i e d on a r r i v a l at school or has refused to come into the school building 1.01 0.18 0.35 2.2 0.24 21 . In comparison with other deaf c h i l d r e n , communication s k i l l s are poor 1.46 0.79 0.53 30.8 0.56 22. Is i n d i f f e r e n t to or ignores other children 1.14 0.48 0.41 10.8 0.27 FIGURE A D i s t r i b u t i o n of raw scores for Rutter scale Number I d e n t i f i e d 6 »8 I I above average average r l TTTi rrr h n below average 10 12 14 16 18 20 22 24 26 28 30 32 Raw Score Rutter sca le FIGURE B Number ified Ident 22 20 v 18 16 1A 12 10) 8 6 Distribution of percentile rank for Scale 1, Social Adjustment 10 t 20 below average 30 , I I 40 50 average 60 I 70 80 I I above average FIGURE C D i s t r i b u t i o n of perc e n t i l e rank for Scale 2, Self Image Number i d e n t i f i e d 14 12 10 6 4 10 20 30 40 50 60 70 80 90 I ' ^ P e r c e n t i l e below average average above average FIGURE D Number I d e n t i f i e d 12 D i s t r i b u t i o n of per c e n t i l e rank for Scale 3, Emotional Adjustment 10J 8 hi 10 20 30 below average 40 50 average 60 I 70 80 I I above average 90 I Percentile FIGURE E D i s t r i b u t i o n of scores TJ 1 Number I d e n t i f i e d 60 ' k 55 40 • 20 17 21 10 0 1 2 FIGURE F D i s t r i b u t i o n of scale f o r TJ 2 Number Id e n t i f i e d 40 40 i 20 12 12 10 4 4 4 I I , 1 * TJ 2 scores FIGURE G D i s t r i b u t i o n of Combined Percentiles for SEAI Number I d e n t i f i e d 12, a 6 4 2 - r -80 10 20 30 40 50 60 70 90 Combined SEAI Perce n t i l e s (Averaged) 

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