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Flashcards in Developmental Examination and Evaluation Deck (49):

Therapists can gather a plethora of information about the child through clinical observations, often during the ________

interview process.

  • Responses to the environment and you
  • General movement abilities
  • Position transitions
  • Ability to communicate, make needs known and follow directions****


Age-equivalent scores may be especially useful with ___________________children for whom it may be impossible to derive a meaningful developmental index

developmentally delayed children 

Age-equivalent scores are easy for parents to understand, but they must be interpreted carefully because they can be misleading.


Criterion-referenced tests are used to measure a person's (child) mastery of a set of _______

behavioral objectives

  • Items usually have a direct relationship to functional tasks


The criterion-referenced test is one in which scores are interpreted on the basis of absolute criteria. They are designed to provide information on how


children perform on a specific task. 

  • Such tests are usually developed by the teacher or researcher and can be used for research involving a com- parison of groups, just as norm-referenced tests are used.


Norm-referenced or standardized tests use normative values as standards for interpreting individual test scores. The purpose of standardized tests is to make a comparison between a particular child and...

the “norm” or “average” of a group of children

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The percentile score indicates the number of children of the same age or grade level (or whatever is used for a source of comparison) who would be expected to score lower than the child tested. For example, a child who scores in the 75th percentile on a norm-referenced test...

has done better than 75% of the children in the norm group.


A raw score is the total of _________that are passed or correct on a particular test.

individual items

  • On many tests, this will require establishing a basal and ceiling level of performance. The number of items required to achieve a basal or ceiling level varies from one test to another.
  • Basal level: item preceding the earliest failed item.
    • for PDMS-II, it is passing 3 items in a row going backward.
  • Ceiling: Item representing the most difficult
    • for PDMS-II it is failing 3 items in a row.


Reliability refers to consistency or _______ between measurements in a series


  • Types of reliability include interobserver and test–retest.
  • Simply stated, this type of reliability determines whether the same or similar scores are achieved when the test is repeated under identical conditions.


There are two types of criterion-related validity:

  • Concurrent validity relates the performance on the test to performance on another well-known and accepted test that measures the same knowledge or behavior.

  • Predictive validity means that the child’s performance on the test predicts some actual behavior.


Sensitivity can be defined as the ability of a test to identify correctly those who

actually have a disorder.

High sensitivity results in few false-negative scores.


Specificity refers to the ability of the test to identify correctly those who

 do not have the disorder.

High specificity results in few false-positive scores.


Professionals watch as children interact
with selected play materials often with other children. Materials are arranged to allow
observation of the areas or skills to assess:

Play Based Assessment 


  • Multiple members of the team, professionals and parents observe the child at the same time. 
  • Each records information related to their area of practice. 
  • Can be done via video, one way mirrors:

Arena Assesment


Standard error of measurement (SEM) is a measure of reliability that indicates the...

precision of an individual test score.

  • The SEM gives an estimate of the margin of error associated with a particular test score and is related to the probability of observing a score at a given interval.
  • The SEM can be used to develop confidence intervals for interpreting the accuracy of a test score.


Tests for the neonate:

  • NBAS or Brazelton (Behavioral Assessment Scale)
  • Infanib


Neonatal Behavioral Assessment Scale (NBAS or Brazelton):

  • Neonate: 37-48 weeks gestational age
  • Criterion referenced 
  • Assess response to environment:
    • 2 parts: reflexes, and environment (cudle)



  • Neonates: Up to 18 month, including pre-terms
  • Simple to do: Incorpartes french angles
  • Predictive and diagnostic.
  • Test for tone.



  • done at 1, 5, 10 minutes after birth
  • scored 0 - 10: the higher the healthier
  • HR, RR, muscle tone, color, response to catheter in nostril


Neonate score an Apgar 4/10 at 10 minutes:

may need suport in NICU


What test could you give to a baby that is at 26 weeks of gestation?



Which 2 neonatal test assess muscle tone?

Apgar and Infanib


Does the NBAS asess muscle tone?

no, behavioral assesment


Which neaonate tests would most useful in a early intervention or home setting?

Infanib:  simple to do, score and learn.


What type os tests would you use to see if the baby needs a more serious evaluation and are intended to differentiate between those who are “typically developing” and those who are not?

Screening tests


Most common screening tests:

  • Bayley Infant Neurodevelopmental Screener (BINS)
  • Denver Developmental Screening Test II (DDST): most common
  • Ages and Stages Questionnaire


Selection of appropriate tests and measures for the examination depends on the purpose of the assessment. Kirshner and Guyatt describe three purposes of assessment:

  1. Evaluative measures are used to determine change over time or change as the result of intervention

  2. Predictive measures are used to help identify children who will have delays in the future or to predict the outcome of the delay

  3. Discriminative measures are used to distinguish between children who have a delay , impairment, functional limitation, or atypical development and those who do not.7,8 

    Determining the most appropriate developmental test for the physical therapy examination is a key component of a valid developmental assessment.


 Therapists must also give careful consideration to the setting and timing of assessment:


  • Timing:  nap and meal times, “best” times of day, school and class schedules, when parents are available
  • Setting: clinical (sometimes fear inducing), home, school
  • Distance: If family has long commute to medical center, impact of multiple evals on one day


This test for the neonate is not performed by physical therapists. It assess how healthy the baby is:



_________________is a screening tool designed to identify infants and young children who are at risk for developmental and neurodevelopmental delay. It is mainly used in settings where high-risk infants are followed up, such as a developmental follow-up clinics or large-volume clinical and research programs.

The Bayley Infant Neurodevelopmental Screener (BINS)


criterion referenced tests


W-weefim, H -help, E-eidp, N-nbas


norm-referenced test are standarized or not?

always standarized

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criterion referenced test are usually standarized or not?

May be standardized or not


The ________quantitatively assesses motor development and is used to identify infants who might benefit from early intervention services. It assesses the postural control and alignment needed for age-appropriate functional activities involving movement in early infancy , including changing positions and moving against the force of gravity , adjusting to handling, self- comforting, and orienting the head and body for looking, listening, and interacting with caregivers.

Test of Infant Motor Performance (TIMP)


The _______has excellent test–retest and rater reliabilities and is designed specifically to assess infants born preterm and those at risk for poor motor outcome based on perinatal medical conditions

Test of Infant Motor Performance (TIMP)



Which screening test is valid for children  4 months to 5 years,  measures communication, fine motor , Gross Motor, Problem Solving, Personal Social
and is practical, is quick and easy to use, inexpensive, encourages parent participation?

Ages and Stages Questionnaire


Due to the age specifications of this test, its clinical utility is limited to settings such as special care nurseries, developmental follow-up clinics, or early intervention services.

Test of Infant Motor Performance (TIMP)


The _________is an observational assessment scale constructed to measure gross motor maturation in infants from birth through independent walking.

Alberta Infant Motor Scale (AIMS)


The test includes 58 items organized into four  positions: prone, supine, sitting, and standing. 



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The _______provides the ability to detect, as early as possible, any deviations from the norm, thereby permitting early intervention to remediate or minimize the effects of dysfunction. Use of percentile ranking should be done with caution because a small change in raw score can result in a large change in percentile ranking

Alberta Infant Motor Scale (AIMS)


True or false: the Alberta Infant Motor Scale (AIMS)
is not a diagnostic test,


implications of lower percentile rankings (10%) are not definitive, and the examiner's clinical judgment is required for decisions related to ongoing monitoring, referral for further diagnostic workup, and/or recommendations for intervention for motor delay


Purposes of evaluation:

  • Information gathering
  • Screening
  • Determining a diagnosis
  • Eligibility determination
  • Treatment planning (plan of care)
    • Prescriptive examination
  • Outcome measurement
    • Monitor progress
    • achievement of goals


Bayley Infant Neurodevelopmental Screener (BINS) 

age range and population:

  • 2-24 months 
  • Low, Medium or High Risk  for neurological impairment or developmental delay


Comprehensive test list (3):

(Examines the whole child across all DOMAINS of development, including language, personal-social, fine motor, gross  motor, self-help and cognitive development)

  1. Bayley Scale of Infant Development (BSID-III): 1-42 mo
  2. Hawaii Early Learning Profile (HELP): 0-3, 3-6 yr
  3. Early Intervention Developmental Profile (EIDP): birth to 36 mo


Developmental areas assessed by comprehensive tests include ____(5)___, complying with Part C of Individuals with Disabilities Education Act (IDEA) regulations for service eligibility for early intervention and special education services.

  1. physical,
  2. cognitive,
  3. communication,
  4. social-emotional, and
  5. adaptive language


____________________ is a comprehensive clinical assessment of functional capabilities as well as performance in children between the ages of 6 months and 7.5 years.

The Pediatric Evaluation of Disability Inventory (PEDI)

The PEDI is intended to be used as an instrument to detect functional deficits or delays, as an evaluative instrument to monitor progress in pediatric rehabilitation programs, and/or as an outcome measure for program evaluation, either in pediatric rehabilitation setting or in an educational setting.


PEDI has three domains

  1. Self care domain
  2. Mobility domain
  3. Social function domain



  •  Functional capability test
  • non-disabled children 6 months to 8 years, disabled up to 12 
  • Acute care setting


Functional assessments give pediatric physical therapists information on how a child's disability or movement disorder impacts task requirements of daily-life routines.


Pediatric Evaluation of Disability Inventory (PEDI)


Naturalistic Observation:



  • PT observes child in their environment doing what they usually do in that setting,  without handling the child
  • In a clinical setting a waiting room may be a good spot to observe
  • Then therapist gradually begins to interact with the child