A new way of assessing mental ability and potential
What has been lacking is a test method that is relatively free of the biases inherent in conventional testing and is a good predictor of mental capabilities. The Zelazo Information Processing Procedures, (Zelazo IPP™), in conjunction with Free Play & Parent-Child Interaction Session allows the psychologist to make a differential diagnosis. A direct probe of the child's "central processing ability" allows the examiner to bypass the confoundings of the traditional tests and identify those children who have the potential to overcome their expressive delays.
The Zelazo IPP™ Laboratory enables the professional to assess the mental development of infants and children from 3 to 42 months. The methodology is based on the STANDARD - TRANSFORMATION - RETURN (STR) paradigm, an information processing approach. The STR procedure relies on the administration of various sequential dynamic stimuli, and measures mental encoding and the development of mental representations by evaluating elicited responses to a series of visual and auditory sequences.
Monitoring and recording of instantaneous heart rate through an electrocardiograph monitor and the recording of behavioural responses such as durations of smiles, vocalizations, eye movements, and measures of attention, are used to measure information processing abilities. The data are then computer analyzed and compared (scored) relative to a sample of typically developing children. The speed with which a child forms mental representations of external events is a more accurate or valid indicator of current intellectual ability.
The development of talking does not come easily to all children. Many factors can influence the acquisition of expressive language, including biological conditions such as cerebral palsy or Down's Syndrome and experiential factors such as non compliant behaviour.
There is a body of sound evidence that indicates that developmentally delayed children do not catch up spontaneously. Children who do not acquire language, generally do not interact socially in a "normal" manner. They fall further and further behind their peers, and with the passing of time, the likelihood of catching up is reduced further.
Even for those children with known biological conditions, such as cerebral palsy, it is extremely helpful to be able to determine the child's level of mental development independent of delayed expressive development such as talking.
The importance of an early assessment of mental capability and potential
An early differential diagnosis, which includes an accurate indication of mental ability independent of the degree of delayed expressive development, is critical for proper intervention at the appropriate time. Intervention that may be appropriate for an 8-month-old is too simple for a child who can process information at the 24-month level. Such mismatched intervention not only would be useless but would further compound the child's problems. A differential diagnosis is an extremely important first step; appropriate practical treatment is the next step. Treatment protocols have been developed and used extensively to benefit children with various diagnoses.
Behavioural assessment
In addition to the "conventional" tests and the Zelazo IPP™, it is important to assess the child's social, familial, and play behaviours. These behaviours are assessed during laboratory based sessions of free and instructional play. The child and his or her parent are observed in several sessions of free play as well as during more structured "teaching" sessions.
Research has shown that during periods of increased external (parental) demands, children may have difficulty in self-regulating their emotional and stress coping systems. As demands are made of the child their intolerance for even moderately stressful situations results in a decrease of appropriate behaviour and an increase in avoidance strategies, including disengagement, resistant non-compliance, and tantrums. Age appropriate learning and development is compromised by these behaviours. Essential to an intervention plan is the functional analysis of these behaviours.
Follow-up measures of treatment efficacy
Yearly re-evaluations that include measures of visual and auditory information processing ability, functional and symbolic play, language development, and conventional tests of intelligence, measure each child's progress objectively and guide future therapeutic goals.
In cases where children display age-appropriate information processing ability despite seriously delayed development, we provide parent-implemented therapeutic intervention. Our initial objectives are to foster compliant behaviour and stimulate talking and appropriate object use. These are essential for stimulating appropriate cognitive development and social behaviour. Only then do we attempt integration of children into normal pre-school, kindergarten or first grade, depending on rate of progress and age. A key role is then conferred on a school liaison professional who trains and directs the transition to a new setting that may sometimes include a school aide, co-ordinates the principal players and ensures a smooth transition to a classroom with typically developing children.