Strategies for Evaluating Communication Development in Infants

Abstract

Assessment of the at-risk infant's developmental status requires the cooperative efforts of a team of specialists. No team member can function optimally in isolation. The speech-language clinician's assessment protocol necessarily overlaps and complements that of other professionals. Team members, including the infant's parents, cooperate to develop a comprehensive, transdisciplinary habilitative plan to guide clinicians and family members in devising natural, functional, child-centered activities. Such activities will integrate therapeutic strategies to enhance development across communicative, cognitive, motor, and emotional areas. The speech-language clinician's initial role in the assessment/habilitation process is to provide the team with a quantitative and qualitative description of the infant's communication development. The latter will provide the focus for this article. Dunst (1980) argues that obtaining a valid qualitative assessment is the most important aspect in the clinical process. It also is the most difficult. Obtaining a comprehensive description of the child's development requires the use of a sophisticated instrument. The clinician must become that instrument. The effective clinician must have a well founded knowledge of the language-learning system, experience in observing and describing communicative behaviors and the ability to develop hypotheses. He needs the flexibility to change ideas and procedures as indicated and sufficient confidence to work independently or to be able to ask for support as needed (Siegel, 1975). The clinician's perspective should acknowledge that the infant's developing skills for adaptive interactions with people and objects emerge in a set order, with the time of emergence of any specific skill being jointly influenced by internal mechanisms and environmental circumstances (Dunst, 1980; Fisher and Corrigan, 1980; Richards, 1978; Seibert and Oiler, 1981). The clinician's perspective considers personality variables which, in unnatural environments, may adversely affect the infant's learning style. It acknowledges that each infant has a unique history of interactions with the world and that this history provides the infant with a variety of strategies to use in active problem-solving situations and in the development of communication. Since the clinician is concerned with the evalution of handicapped or at-risk infants, the assessment protocol should evolve from a broad definition of communication which will provide a multitude of entry points for habilitation. Thus, any behavior of the infant should be viewed as occurring on a continuum from least