3 Types of Evaluations and What They Tell Us about Your Child’s Development

When you have concerns about your child’s development, you want answers.  You might choose to have a screening completed to briefly assess your child’s development. If concerns are noted following the screening, a formal evaluation will help answer your questions.

During the evaluation, the pediatric professional will ask questions about your child’s birth history, health history, daily activities, current skills and challenges. There are several types of evaluation protocols available, but most often therapists combine evaluation tools to gather more information and to look at your child as a whole.

The 3 most common types of evaluation tools used by therapists include:

1. Clinical Observations – Therapists will observe your child as he or she plays with toys and interacts with others.  These observations tell therapists about your child’s play skills and social interactions.

2. Questionnaires and Checklists – These tools are used to gather more detailed information.  Parents may be the ones to complete these forms or therapists may go through the questions with the parents during the evaluation.

3. Standardized Testing – Most therapists will also use a standardized test to assess your child’s development.  These standardized tests are administered and scored in a consistent manner by all therapists.  The results of the standardized tests show a relative degree of validity and reliability – which means that if others administer the same test to your child, they would get about the same score.  The scores gathered from these tests are based on score samples of typically developing peers.

So, what exactly are therapists looking for when they assess your child?  This all depends on their specialty area and your concerns.

Physical Therapy:  The PT (physical therapist) will look at your child’s ability to use their large muscle groups, aka “gross motor skills.”  They assess your child’s ability to move and explore their environment.  They also look at their balance and coordination, body awareness, range of motion, strength, endurance, etc.

Occupational Therapy:  The OT (occupational therapist) will assess your child’s small muscle groups, aka “fine motor skills.”  They will also look at your child’s sensory processing skills, motor coordination, visual and perceptual skills, self-help, feeding skills and handwriting.

Speech Therapy:  The SLP (speech-language pathologist) will assess your child’s ability to communicate.  They will look at your child’s understanding of language (receptive language skills), their ability to express themselves (expressive language skills) and how they produce specific sounds (articulation).  They SLP will also look at the way your child moves and coordinates the muscles in and around their mouth in order to produce sounds and chew and swallow food.

Developmental Therapy:  The DT (developmental specialist) will assess your child’s overall development. They also look at their social interactions, play skills, classroom interactions and cognitive skills.

After the evaluation is complete, the results will tell us which skills are missing and what, if any, further recommendations and referrals are needed.

If you have questions about the evaluation process or the results of the evaluation, please talk to your child’s therapist.  It’s important for you to understand exactly what is being assessed and what the results mean.

Now It’s Your Turn:  Has your child had a formal evaluation?  If so, what did your think about the evaluation process?                                                                                                                                                                          

3 Benefits of Developmental Screenings

It is perfectly normal for parents to have concerns about their child’s development.  Many parents, especially first time parents, may be unaware of “typical” child development milestones.  These milestones are important guidelines used to monitor and measure a child’s development, especially during the critical time for learning – birth to 5 years of age.

The American Academy of Pediatrics (AAP) recommends “regular, universal developmental screenings of infants and toddlers by pediatric healthcare providers at 9, 18 and 30 months of age.”  These are standardized screenings that typically take about 15 – 20 minutes to complete and provide an overall snapshot of your child’s development. They are important for 3 reasons:

1.  Identify Areas of Concern:  These screenings look at all areas of development – including gross and fine motor skills, communication and language, cognitive skills, self-help skills, etc.  Screenings can be completed by your child’s pediatrician, but your child’s daycare, preschool, therapy center or other community organization may also be able to provide a screening for your child if you have concerns about a specific area of development.

2.  Monitor Growth and Development:  By completing screenings at regular intervals (9, 18 and 30 months), the pediatric professional is able to monitor your child’s development to make sure that they are continuing to gain new skills.

3.  Make Referrals for Services:  While screenings alone cannot diagnose a problem or indicate if a child needs therapy, if concerns are noted in any area, referrals can be made in a timely manner.  These referrals could be to your state’s Early Intervention system, specific therapy or education centers, other community programs, etc.

If you have concerns about your child’s development, it’s important for you to talk with your child’s pediatrician.  Always trust your parental instincts and remember that you are the expert on your child.  Tell the pediatric professional your concerns and ask for a screening to be completed if one isn’t offered.

Now It’s Your Turn:  Have you found developmental screenings to be beneficial for you and your child?

Cues to Learning

Therapists and teachers implement a variety of strategies and techniques to help children learn.  You may be using these techniques already and not even know it. Here are a few ways you can cue your child to help them learn new skills:

Physical Cues:  These cues are provided when the adult physically assists the child to complete a task.  There is a range of physical cues from indirect to direct:

  1. Pointing (indirect) – We see this cue when the adult points to where the child needs to go or points to redirect the child’s attention back to the task at hand.
  2. Physical Gestures (indirect) – These cues are used when an adult touches the child’s arm or hand to remind them to complete an activity.  Or, when the adult nods or taps on a toy to redirect their attention.
  3. Physical Assistance (direct) – This occurs with the therapist provides direct physical assistance to move the child to complete an activity.  This includes hand-over-hand assistance to pick up objects, put a puzzle piece on a puzzle, etc.

Visual Cues:  These cues are provided when the adult provides a visual (pictures, signs, symbols, etc) to alert the child on how to respond.   Examples of visual cues would be using signs to tell a child to “stop,” using a visual schedule to assist the child with completing an activity, using a visual board for “first” and “then,” etc.

Verbal Cues:
  These cues occur when the adult provides information verbally and directly to the child.  Examples would include specific instructions about a task (e.g. “put the block in”), how to produce a specific speech sounds, information about a person, place or thing, etc.

You might see your child’s therapists combining these cues together to help you child learn a new skill. The most important thing to remember is to be patient.  Children learn at different rates. What one child does at 18 months of age, another child will do at 24 months.  If you have concerns about your child’s development, please talk to your child’s pediatrician and/or therapist.


Now It’s Your Turn:  What new skills has your child learned lately?

Why We Love Shape Sorters

The Shape Sorter is a classic toy that has been around for generations.  Many of us grew up with the toy in the picture – the cubed shape sorter.  Nothing fancy, just a box to put shaped blocks in.  But what this toy teaches your child is amazing!

1).  Problem Solving Skills – Children learn trial and error by attempting to match the shapes in the correct place. If the square doesn’t fit in the diamond shaped hole, you try another one – and another one. You keep trying until you get it right.

2).  Fine Motor Skills – Placing blocks in a container is a fundamental fine motor skill for children to learn.  The way in which a child picks up the block (raking it with their palm, using their fingers, etc) tells a lot about their fine motor development.  Some shape sorters require the shapes to match up exactly right – which uses a lot of fine motor manipulation and coordination.

3).  Language Learning – Shape sorters provide great language stimulation.  When your child plays with you and a shape sorter, they are hearing and learning about colors, shapes, sizes, etc.  These toys provide huge opportunities for vocabulary growth and development.

4).  Requesting and Naming – These toys typically come with several blocks. This is a great opportunity to have them request “more” by signing or vocalizing.  If you’re working on producing 2 word phrases, they can request “more please, more circle, more block, etc.”  As they get older, they can request “I want block” or “I want blue block, etc.”

5).  Cognitive Skills – Shape sorters come in many different styles, colors, shapes and sizes.  For younger children, they typically have only 3 or 4 shapes (circle, triangle, square, star, etc).  As they get older, the shapes become more advanced (hexagon, octagon, etc).  Children are learning early math and geometry skills when they understand the size and shape of objects.

As you can see, shape sorters are wonderful toys for children.  Take a few minutes to play with your child and you can see all these wonderful skills taking shape.