Team Congruence in Developmental Diagnosis and Intervention: Comparing Clinical Judgment and Child Performance Measures

Abstract

Accurate assessment of the developmental capabilities of young multihandicapped children presents a frustrating dilemma for school psychologists. Recent early intervention research suggests that interdisciplinary, multidimensional assessment procedures are the most effective modes for monitoring developmental status and progress with such children. Moreover, team assessment practices which blend child performance and clinical judgment data have been offered as remedies to the dilemma. Yet, little formal clinical research has focused on the efficacy of these practices. This study addressed the issue of congruence and consistency among multiple team estimates of child functioning (i.e., multiple scales, multiple sources). A sample of multihandicapped infants and preschool children (N=54) was assessed by an interdisciplinary developmental diagnostic team (i.e., 7 professionals and 54 mothers) using a battery of 5 developmental/behavioral scales: Bayley Scales of Infant Development (BSID); Gesell Developmental Schedules (GDS); Early Intervention Developmental Profile (EIDP); Perceptions of Developmental Skills (PODS); and The Developmental Profile (DP). Team assessments of child status and progress over a 12-month period during early intervention revealed strong evidence of team congruence in diagnosis. Data analysis revealed consistency among multiple clinical judgment and child performance estimates. Mothers were observed to overestimate developmental skills but were very consistent with the team and sensitive to subtle changes in behavioral style. Guidelines for designing team developmental diagnostic batteries are discussed.