Tag Archives: Dynamic Assessment

Attachment to our clients makes diagnosis more difficult

There’s nothing like getting a huge hug from a 3-year-old speech therapy client: what a way to tell me he enjoys therapy!

The affection goes both ways: we grow attached to our clients. We notice progress, point it out to families, and celebrate with them. When we work with families for long enough, we meet new siblings, hear about first days at school, and get invited home to birthday parties and for tea!

Clouding my judgement

But is it possible for therapists to get too attached? I’m trying to make a tricky differential diagnosis and reflecting on whether my affection for this little chap is muddling me up. Am I observing his skills through rose tinted glasses? Placing more of an emphasis on things he can do while skimming over things he can’t?

I’m trying to clarify my thinking by making objective observations: noting down what I see without interpretation. I’m comparing these observations to what I expect from a child his age, as well as his clinical presentation from a year ago. I’m reviewing how he responded to different types of therapy and attempting Dynamic Assessment. I’m also planning to observe him at nursery, to see how he responds to other adults. I’ll figure it out!

Do you form close bonds with particular clients? Do you think it supports therapy outcomes? Or do you have to focus on being impartial?

Dynamic Assessment: Mediation, Metacognition and Maximum performance

I recently attended a Psychology ‘Special Interest Group’ event about Dynamic Assessment. Ruth Deutsch and Natalie Hasson led an engaging session covering the what, why, and how of Dynamic Assessment, as well as its relevance and application to Speech and Language Therapy. Here is an overview of the session and some of my thoughts.

What is Dynamic Assessment?

Vygotsky (1978) believed that the difference between a child’s performance when he works alone and his performance when he collaborates with an adult reflects his ‘zone of proximal development’ or developmental potential. Dynamic Assessment is based on this theme, aiming to assess potential for learning rather than a ‘snapshot’ of a child’s performance in a particular situation on a particular day, as measured by conventional tests.

Why use Dynamic Assessment?

I sometimes complete my set of standardised or formal assessments and end up thinking, ‘now what?’ Dynamic Assessment can highlight which cognitive processes need to be targeted, describe useful mediation techniques, and indicate next steps of learning.

Natalie suggested Dynamic Assessment may be useful for:

  • differentiating between children with Specific Language Impairment and those with low language levels due to English as an Additional Language.
  • finding out the modifiability of clients to plan effective intervention.
  • standardising ways of measuring how responsive an individual is to language learning.
  • identifying which types of intervention will benefit particular individuals.

Dynamic Assessment in action

Ruth and Natalie showed video clips which demonstrated Dynamic Assessment in action. The clips were a great learning tool; making the idea of mediation much more concrete for me. Ruth explained some techniques of mediational teaching, such as focussing on processes rather than responses, and the development of principles of learning, e.g. ‘when I take my time I can complete the task.’

Mediation can take place before, within, or after a task. There is an emphasis on metacognition (“awareness and understanding of one’s own thought processes” — Oxford American Dictionary); in the video clips the adults asked questions such as, “how did you know?” and, “how did you work it out?” Ruth advised that during mediation the adult shouldn’t over-assist, because this takes away a learning opportunity. The adult should begin with the lowest level of assistance, such as encouraging the child to identify the problem, and then help the child work out their own way of approaching the task.

For more information about Dynamic Assessment try: Hasson, N. and Joffe, V. 2007 ‘The Case for Dynamic Assessment in speech and language therapy‘, Child Language Teaching and Therapy, 23(1), 9-25.

What next?

So, if I want to see what my clients’ maximum performance is, how can I use these ideas in my assessments? Well, I can’t use mediation techniques on standardised assessments, because the mediation will make any re-testing with the same assessment unreliable. I talked to Natalie briefly about using the Renfrew Action Picture Test (RAPT). I think that if I could develop five more RAPTs (sets of ten pictures and questions) I would have enough material for the intervention (or mediation phase) and the re-assessment phase. Developing five RAPTs seems both feasible and a mammoth task, depending on which day I think about it!

In the meantime, it occurred to me that perhaps I could use the picture and question scenarios from the Language for Thinking program. There are 50 scenarios with questions at three levels; plenty to use for assessment, mediation and re-assessment.

Fancy collaborating on some new RAPT style assessments? Used the principles of Dynamic Assessment with under 5s? Please leave a comment, I’d love to hear from you!