the WISC-V

Understanding the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V)

In the world of psychological assessment, the Wechsler Intelligence Scales are considered to be the gold standard measures of intellectual functioning.  The assessments represent over 70 years of research and subsequent revisions that reflect advancements in neurodevelopmental and neurocognitive research, psychology, technology, and changes in population. (Wechsler, 2014).

The Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V):

One of the most commonly used assessments for school-aged children is the Wechslerchilds-brain-Portrait Intelligence Scale for Children, Fifth Edition (WISC-V). The assessment generates five composite score indices:

  • Verbal Comprehension (VCI)
  • Visual Spatial Index (VSI)
  • Fluid Reasoning Index (FRI)
  • Working Memory Index (WMI)
  • Processing Speed Index (PSI)

Together, a Full Scale Intelligent Quotient (FSIQ) is developed.  When large discrepancies are identified between the indices which comprise a child’s FSIQ, alternative scores can be calculated to best capture a child’s cognitive profile.  Alternative scores may be considered when deficits in language, attention, or motivation appear to have negatively impacted a child’s overall performance. Through the analysis of the general and specific domains of cognitive functioning, clinicians are better able to make informed decisions regarding diagnostic conceptualization and treatment recommendations.

WISC-V Composite Score Indices:

  • VCI: The VCI measures verbal reasoning, understanding, concept formation, in addition to a child’s fund of knowledge and crystallized intelligence.  Crystallized intelligence is the knowledge a child has acquired over his or her lifespan through experiences and learning.  The core subtests which comprise the VCI require youth to define pictures or vocabulary words, and describe how words are conceptually related.  Children with expressive and/or receptive language deficits often exhibit poorer performance on the VCI.  Studies have also indicated that a child’s vocabulary knowledge is related to the development of reading abilities, and as such, weaker performance on tasks involving vocabulary may signal an academic area of difficulty.
  • VSI:  The VSI measures a child’s nonverbal reasoning and concept formation, visual perception and organization, visual-motor coordination, ability to analyze and synthesize abstract information, and distinguish figure-ground in visual stimuli.  Specifically, the core subtests of the VSI require that a child use mental rotation and visualization in order to build a geometric design to match a model with and without the presence of blocks.  Children with visual-spatial deficits may exhibit difficulty on tasks involving mathematics, building a model from an instruction sheet, or differentiating visual stimuli and figure ground on a computer screen.
  • FRI: The FRI assesses a child’s quantitative reasoning, classification and spatial ability, knowledge of part to whole relationships.  It also evaluates a child’s fluid reasoning abilities, which is the ability to solve novel problems independent of previous knowledge.    The core tasks which make up the FRI require that a child choose an option to complete an incomplete matrix or series, and view a scale with missing weight(s) in order to select an option that would keep the scale balanced.  A child with fluid reasoning deficits may have difficulty understanding relationships between concepts, and as such, may generalize concepts learned.  They may also struggle when asked to solve a problem after the content has changed, or when question is expressed differently from how a child was taught (e.g., setting up a math problem by using information in a word problem).  Difficulties with inductive reasoning can also manifest as challenges identifying an underlying rule or procedure.
  • WMI: The WMI evaluates a child’s ability to sustain auditory attention, concentrate, and exert mental control.  Children are asked to repeat numbers read aloud by the evaluator in a particular order, and have memory for pictures previously presented.  Deficits in working memory often suggest that children will require repetition when learning new information, as they exhibit difficulties taking information in short-term memory, manipulating it, and producing a response at a level comparable to their same age peers.  It is also not uncommon for youth with self-regulatory challenges, as observed in Attention-Deficit/Hyperactivity Disorder (ADHD) to present with difficulties in working memory and processing speed (noted below).
  • PSI: The PSI estimates how quickly and accurately a child is able to process information. Youth are asked to engage in tasks involving motor coordination, visual processing, and search skills under time constraints.  Assuming processing speed difficulties are not related to delays in visual-motor functioning, weaker performance on the tasks which comprise the core subtests of the PSI indicate that a child will require additional time to process information and complete their work.  In the academic context, school-based accommodations may include allowing a child to take unfinished assignments home, focusing on the quality of work over quantity, shortening tasks, and allowing extended time.

In summary, IQ is more than one aspect of functioning and encapsulates several factors described above.  As a result, it is often more helpful to assess the indices which comprise a child’s FSIQ separately in order to best inform treatment and intervention.

Neuropsychology testing IL
NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!


using stairs to assess functional strength

How to Use a Staricase to Assess Functional Strength

We as physical therapist use functional measures of strength to assess strength in a child. Parents can use these same measures to assess whether their child is on track with gross motor skills, or to see if there is an underlying weakness. I have broken down the milestones for stair ascent and descent during the first 4 years of life, along with possible weaknesses and impairments associated with delayed skill.

Functional Strength Assessment Using a Staircase:

  • 18 months – Children should be able to walk up and down 1 set of stairs in home or at the park, How to Use Stairs to Assess Functional Strengthusing one railing or one hand held assistance, and demonstrating any type of form. Children will usually place both feet on each step at this phase. Be aware of children who always lead with the same foot; this may be a sign of opposite side weakness. Delays to this milestone may indicate core weakness, lower extremity weakness, or balance impairments.
  • 2 years – As children continue to practice this skill and strengthening their legs, their stair skills dramatically improve. First children will begin testing their stair skills by carrying objects up or down stairs and taking steps without holding onto the railing or holding a hand. Initially, they will place both feet on each step. By 2½ years old, children will begin using a more mature reciprocal form (one foot on each step), when going up stairs while using one handrail. Delays to reciprocal gait while going up stairs usually indicates weakness in the leg that does not step up.
  • 3 years – A 3-year old should be able to ascend 1 set of stairs demonstrating reciprocal gait, without handrail support. This milestone may be delayed due to short stature, and subsequent shortened tibia length (shin bones) which make it harder to reach the stairs, but will be achieved prior to their 4th birthday. Delays to reciprocal gait without handrail support indicates lower extremity weakness in non-leading leg.
  • <4 years – Prior to their 4th birthday, children should have mastered stairs. This includes walking up a set of stairs using reciprocal stepping, both with and without handrail use, as well as walking down a set of stairs using reciprocal stepping, both with and without handrail use. While handrail use will be dependent on situation, reciprocal gait will be the norm, used regardless. Delays to reciprocal gait while going down stairs may indicate eccentric weakness of quadriceps (inability to control limb with slow descent), impaired single limb balance, or core weakness.

Any child over the age of 4 who is unable to walk up and down 1 set of stairs without support, demonstrating a mature one-foot-one-each –step form, should come into NSPT for a free physical therapy screen to assess leg strength and balance.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

interpreting neuropsychological testing

A Guide To Understanding Neuropsychological Test Results

When a child comes in for a neuropsychological evaluation, it can provide an opportunity to gain a larger picture of how he learns and if support is needed in and outside of the classroom. The results from the evaluation can then help parents and teachers alike to better support the child’s learning. After a day of testing, there are a lot of numbers and verbiage that may seem overwhelming and difficult to understand… what does it all mean?! Here is a guide to understanding these sometimes complex neuropsychological test results.

Most psychological tests are reported with standard scores and percentiles. This number is representative of how the child scored in comparison to a representative sample of same-age peers. This group is the “norm” group.

Standard Scores

Standard Score: Based on scale with the average score of 100.interpreting neuropsychological tests

“Typical” limits of functioning:

  • Above Average: 110-119
  • Average is considered: 90-109
  • Low Average: 80-89

68% of the general population will perform within these limits

There are generally many small tests (subtests) that make up a larger area of functioning like Working Memory (aka short-term memory), for example. When the scores of all the subtests are combined you get a composite score, which is reported as a Standard Score. These composite scores tend to be a little more reliable than the individual scores on their own…

Why may you ask?  Attention, fine motor skills, alertness, distractibility, anxiety, etc.  can all play a role in a child’s performance.

All of these observations are taken into account when interpreting the child’s results.

 Percentiles

Percentiles: These often go hand in hand with the standard scores. If a child earned a standard score of 100, then they performed at the 50th percentile. If you took stats, this may ring a bell, if not, here’s another way to think about it..

-“Danny did as well or better than 50% of the his same-age peers”

Typical areas looked at during an evaluation:

Your child’s cognitive functioning =

  • Memory
  • Verbal Comprehension
  • Fluid Reasoning: ability to think logically & problem solve in new situations
  • Visual Spatial skills: ability to visualize things in your head
  • Processing Speed: how quickly a child can perform on an “easy” or over-learned activity

Your child’s academic functioning =

  • Reading
  • Writing
  • Math

If the child has attention, language, social or emotional concerns, different types of tests are administered to supplement the evaluation and is tailored to the parents’ concerns and child’s needs.


Neuropsychology testing IL
NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

when will my child be done with speech language therapy

When Will My Child Be Done With Speech-Language Therapy?

Society as a whole is goal-oriented; as human beings we want to have a plan for the future. The unknown is anxiety-provoking, and people want straight answers. Therefore it is no surprise that a common question when a child is first recommended for speech-language therapy is how long will my child need speech-language therapy? The tough answer to this challenging question is there is no scientific way to determine a child’s timeline for speech-language therapy. However, there are a several components to speech-language therapy that can facilitate greater progress in therapy, possibly resulting in faster discharge.

These Components Will Help Determine How Long a Child Will Need Speech-Language Therapy:

  • Early identification is a key component for success in intervention. It is highly recognized that when speech and language disorders when will my child be done with speech language therapyare identified and treated as early as possible, there is a better prognosis. Developmental milestones can be helpful in identifying children who may be in need of speech-language intervention.
  • With any speech-language disorder there is a spectrum of severity that can occur. Often with a more severe speech-language disorder, therapy will be more intensive and may require a longer treatment period. Looking at the percentile ranking of your child’s score on a standardized test is helpful at determining where your child’s skills are in relation to the typical population.
  • There are several components of a therapy plan which can affect the rate of progress. Receiving consistent and frequent therapy can both positively impact a child’s progress. The greater amount of time a child is spent working on a skill, the faster that skill is likely to improve. Additionally, completing home programs or home activities given by your child’s therapist will facilitate carryover of the child’s targeted skills into other environments.
  • Lastly, every child is different in their areas of need for speech-language therapy. Therefore, each child’s therapy approach will be unique to him or her. A child’s diagnosis will ultimately affect what skills will be targeted and how many target areas there will be. Concomitant issues may also affect a child’s therapeutic approach, resulting in additional goal areas to target through therapy. The presence of multiple diagnoses does not necessarily mean slow progress, but may correlate with the reality that there may be more goals to be met before discharge.

This list is by no means all-encompassing of components which could facilitate faster progress in speech-language therapy. Overall, it is important that the child, family and clinician become a team to target that child’s speech and language needs. Then as a team, goals can be addressed positively in a variety of environments and communication situations.

Click here for more help understanding a speech-language evaluation.






neuropsychological testing at north shore pediatric therapy

Diagnosing Your Child on the Autism Spectrum: Fact or Fiction?

Many times parents fear an autism diagnosis because they do not want a stigma for their child. However, it is important to understand that an appropriate diagnosis is the first piece of the puzzle. For those brave souls who don’t stop until they have the correct answer, the payoff is worth the effort and pain. A good diagnosis and evaluation should serve as a means of identifying appropriate and practical recommendations as well as a basis for progress monitoring from the intervention. At North Shore Pediatric Therapy’s Neuropsychological Center in Illinois, we utilize clinical testing to help identify the most appropriate diagnosis.

The Autism Testing Process at NSPT-Diagnosing Your Child:

Neuropsychological testing is an empirically supported way of assessing a child’s cognitive, academic, and social-neuropsychological testing at north shore pediatric therapyemotional functioning. The evaluation occurs over three days with an intake session, the actual testing day, and the feedback session.

  • Intake: The intake session is when the parents and child attend a formal meeting to discuss concerns. It is important that child attends the session as the neuropsychologist would want to attain some basic information regarding the child’s verbal functioning, social skills, and attentional regulation. Parents understandably do not want to speak in front of their child about concerns they have. We understand that and will ensure our best that the child is in a separate room when parents are talking about specific concerns.
  • Testing: The testing session consists of ascertaining information from a variety of resources including parents, teachers, outside practitioners (any therapist working with the child or family), behavioral observations, as well as the child’s performance on a variety of assessment measures. Testing is intensive and lasts upwards of four to five hours. The focus is to provide quantified information regarding the child’s functioning across a variety of domains and also to look for consistent patterns across performance.
  • Feedback: The feedback session is the most important aspect of the evaluation. This is the meeting in which the parents are provided information regarding the diagnosis that is given as well as what the next steps are to ensure that the child is able to progress to his or her potential. Read here for more on what to expect after neuropsychological testing.
  • Follow-up: The next step is for the neurologist to re-evaluate the child in six month’s to one years time (depending on the intervention that was prescribed) in order to monitor progress the interventions and to help progress monitor if additional supports or services are needed.

Be a Smart Detective When Seeking an Autism Diagnosis for Your Child:

For those parents with the courage to dive into discovering the diagnosis behind your child’s challenges, I say kudos to you! Those parents are the real child-advocates. Kick start your child’s success with a deep dive into your child’s diagnosis by seeking a neuropsychologist. I, Dr. Greg Stasi along with my colleague Dr. Amy Wolok provide in depth Autism Spectrum testing at our Neuropsychology Center in Chicago, IL. Our Center works alongside the many other therapists at North Shore Pediatric Therapy’s Glenview, Highland Park, Bucktown, Evanston and Lincolnwood Clinics to provide a comprehensive team all working together to help your child reach his or her potential. The neuropsychological evaluation is designed to help identify what specific strengths and weaknesses a child is exhibiting which leads to the best diagnosis and most importantly the most efficacious intervention.

how to understand a speech language evaluation

Understanding a Speech Language Evaluation

Taking your child in for a speech-language evaluation and receiving the initial report can be a confusing and overwhelming process. As a parent or caregiver, you are entering a new health care field, which comes with new terminology and jargon. In order to best understand your child’s needs, it is helpful to have a good foundation of what speech-language pathology is. Here are eight terms that you will likely come across when reading your child’s report or when talking with your child’s speech-language pathologist. Reference this list to get the most out of the information that you are given from your speech-language pathologist.

8 Terms to Know to Understand a Speech Language Evaluation:

1. Language is the system that you use to communicate your thoughts and feelings. The use of language can happen through several differenthow to understand a speech language evaluation modalities, using your voice, writing, or gesturing. There are three main components of language: Receptive Language, Expressive Language, and Pragmatics.

2. Receptive Language refers to your ability to understand language. Activities where you use your receptive language are when you follow directions, listen to a story, or when categorizing/grouping items. Learn about receptive language delay here.

3. Expressive Language refers to your ability to use language through speaking or writing. Activities where you use your expressive language include when you tell a story, answer a question or describe an item. Learn about expressive language disorder here.

4. Pragmatics is the last component of language and includes the social rules of communicating or how language is used within certain situations. An example of a pragmatic language skill is your ability to greet an unfamiliar person and learn their name.

5. Speech can also be thought of as vocal communication. It is the ability of the human voice to create a variety of sounds to form the words and sentences that we use when communicating. Speech itself is only a series of sounds, it is the language system that it is used with that gives your speech meaning.

Click here to learn more about the difference between speech and language.

6. Standardized Tests are used during speech and language evaluations due to the standard procedures laid out for the administration and scoring of these tests. The standardization of these tests eliminate environmental and clinician factors that could influence a child’s performance.

After standardized testing is completed a child will receive various scores. Two important scores to pay attention to are: Standard Score and Percentile Ranking.

7. Standard Score is calculated by standardizing a child’s raw score based on indicated method for that test. When standardizing a raw score, the child’s gender and age are often taken into account. Once a score has been standardized it can be compared to the continuum of scores of the typical population.

8. Percentile Rank also compares a standard score to the typical population by identifying the percentage of people who received the same or lower score than your own. For example, receiving a percentile ranking of 50 indicated that 50% of people who also took the same standardized test received the same score or a score lower than your own score.

The results from standardized and informal testing will guide your child’s speech-language pathologist recommendations for services. If services are warranted, these test scores and observations are used to identify areas of need and the child’s therapeutic goals. Every 3 to 6 months, re-evaluations are completed to assess your child’s progress through therapy.



Dyslexia

Identifying Dyslexia: Will My Child Grow Out of This?

Reading problems tend to be pretty common, so it’s interesting to learn that Dyslexia is often missed! Although care must be taken before jumping into an evaluation and diagnosis, reading difficulties may not be temporary (as we often hope they are). Children may not grow out of these struggles, and in fact, these difficulties will continue to persist until something is done! Missing the warning signs can lead from the 5 year-old who can’t quite learn her letters to the 6 year-old who can’t match sounds to letters to the 13 year-old who shies away from reading aloud in class…(Overcoming Dyslexia, 2003)

Here is where you come in! Parents, we need your feedback and detective skills.

When Dyslexia is suspected, here are some clues to look for:Dyslexia

Signs of Dyslexia in the Preschool Years:

  • Difficulty with common nursery rhymes like “Humpty Dumpty”
  • Doesn’t know the letters in his own name
  • Mispronounces words and persistent baby talk
  • Difficulty learning and remembering names of letters

Signs of Dyslexia in Kindergarten- 1st Grade:

  • Unable to understand that words come apart : (i.e. Cowboy becomes Cow-boy)
  • Difficulty linking sounds with letters : b makes a “ba” sound
  • Difficulty reading common one syllable words: “cat, bat, hop”
  • Parent or siblings have a history of reading difficulties
  • Avoids reading time or outwardly states that reading is hard

Signs of Dyslexia in 2nd Grade & Up:

  • Mispronounces words that are complicated or unfamiliar
  • Leaves out parts of words or confusing parts : amulium instead of aluminum
  • Difficulty finding words and confusing words that sound alike: tornado & volcano
  • Difficulty remembering phone numbers, names, dates, lists
  • Lots of “um’s” and pauses while speaking
  • Taking out/missing parts of words when reading
  • Extreme difficulty of learning a foreign language
  • Difficulty with spelling and word problems

Strengths of children with Dyslexia (hint, hint: they have lots of them!)

  • A great imagination
  • Good at building models
  • Higher maturity level
  • A great listening vocabulary
  • Able to understand well what is read TO him
  • Ability to understand & read high level words in areas of extreme interest (i.e. he loves dinosaurs and can a read a highly sophisticated book on the topic – due to practicing and seeing the words multiple times)

A diagnosis can come at any point in a person’s life from pre-school through adulthood! Don’t be afraid to reach out to your child’s teacher or therapist if you suspect Dyslexia. Help is only an evaluation away!

P.S. check out: Overcoming Dyselexia by Dr. Sally Shaywitz…great read!

North Shore Pediatric Therapy offers the Orton Gillingham reading program to help children with Dyslexia break the reading code. Read here about the benefits of Orton Gillingham reading therapy.

 

receptive language delay

A Guide to Receptive Language Delay

Receptive language is the ability to understand verbal (spoken) and nonverbal (written, gestural) language. Receptive language includes skills such as following directions, understanding gestures, identifying vocabulary and basic concepts, and answering questions. Are you wondering if your child’s receptive language skills are developmentally appropriate? Read on for a guide to receptive language delays.

Refer to this guide of common receptive language developmental milestones:

 

Age Milestones
0-3 months Turns to a familiar voice, smiles in response to voice
4-6 months Searches for sound sources, responds to ‘no’, shows interest in music and toys
7-12 months Responds to name, begins to respond to requests, understands 3-50 words
1-2 years Follows simple commands, points to pictures in books when named, points to a few body parts
2-3 years Follows 2-step commands, understands in/on/under/stop/go
3-4 years Understands simple ‘what’, ‘who’, ‘where’ questions
4-5 years Answers simple questions about stories

 

 There are multiple causes for difficulties with receptive language. Some of them include:

  •              Additional developmental disorders or delays
  •              Hearing loss
  •              Lack of exposure to language
  •              Intellectual disabilities
  •              Unknown origin

Here are some ideas to foster receptive language development at home:receptive language delay

  1. Label Objects: Name and point to objects when reading books and during daily routines such as meals, baths, and bedtime. Modeling the words helps to increase a child’s vocabulary.
  2. Simplify your Language: Use simple words and short word combinations. Instead of saying, “Oh, look at the car go!” say “Car go!” Rather than asking “Do you want more apple juice?” say “more juice?” This limits the amount of information the child needs to process in order to understand the message.
  3. Provide Cues: Give the child visual and/or gestural cues when communicating with the child. A visual cue could be a real or pictured object. A gestural cue could be pointing, turning, or gazing towards an object. They aid in improving receptive language because they provide additional information that is processed differently than verbal language. They also help the child pair meaning with verbal words.
  4. Give Directions: Practice following directions by making them fun. Give directions such as “Go find daddy”, “jump up and down”, and “clap your hands”. Provide a model for the child if needed.
  5. Check for Understanding: Be sure the child understands the direction, question, or information by having them repeat what they heard. Provide the child a repetition and/or re-word parts of the message using fewer words and simple, familiar language.

Wondering about red flags for a receptive language delay? Click here to learn more.



Reference: Paul, Rhea. (2007). Language Disorders from Infancy through Adolescence. St Louis, MO: Mosby Elsevier.

why I love being a pediatric physical therapist

The Top 5 Reasons Why I Love Being a Pediatric Physical Therapist

October is National Physical Therapy Month and an important time of the year to promote physical therapy as a profession. There are many areas physical therapists can specialize in: orthopedics, neurology, pediatrics, women’s health, sports, cardiovascular and pulmonary physical therapy, and geriatrics. So why did I choose to specialize in children’s physical therapy?

These are the top 5 reasons I love being a pediatric physical therapist:

  1. I sing, I dance, and I laugh, daily. Being a pediatric physical therapist is as much about creativity as clinicalwhy I love being a pediatric physical therapist competency. We have to use our knowledge of human movement and development to detect early health and mobility problems in infants, children, and adolescents with a variety of injuries, disorders, and diseases. But at the same time, we have to make exercises and the whole therapy process FUN! I spend a majority of my work day dancing, singing, and jumping right along with my clients. Studies have shown that the simple act of smiling can bring about happiness. I can definitely attest to that!
  2. I don’t have to choose. Being a specialist in the field of physical therapy means clinicians must focus on specific body systems or medical diagnoses. For example, orthopedic specialists often diagnose and treat disorders of the musculoskeletal system, and neurological specialists often concentrate on neurological conditions such as brain injury, spinal cord injury, or Parkinson’s. Meanwhile, so much goes into a child’s development that pediatric physical therapists don’t have to choose. We often work with musculoskeletal injuries, neurological insults, as well as cardiopulmonary abnormalities during development. In planning and carrying out treatment for a variety of conditions such as cerebral palsy, adolescent sports injuries, and cystic fibrosis, we don’t have to choose between different systems of the body.
  3. I am still learning. Every stage of children’s development, from the typical and atypical to the cognitive and physical, fascinates me. What is awesome about being a specialist in children’s development is that I have to be constantly up to date on the latest research on children. With the advances in modern medicine come a new assortment of complications and need for therapeutic interventions. In working alongside other pediatric healthcare professionals such as behavioral analysts, speech therapists, pediatricians, neuropsychologists, and occupational therapists, I gain invaluable insight into every aspect of the development of children. Every age, diagnosis, and milestone presents another learning opportunity.
  4. I am proud of what I do. There are certainly days when the most that I accomplish is a pile of paperwork. Yet rarely is there a day where I feel like I wasted my time. Sure, I get my share of crying babies, screaming toddlers, temperamental teenagers, and challenging parents. But at the end of the day, the frustrating parts of my work are always completely washed away when I see the excited faces of first time walkers, proud parents, and supportive coworkers. The fact that my work directly contributed to these newfound skills in others makes me take pride in what I do.
  5. I am proud of what others do. Children are an exceptionally inspiring clientele to work with. In this setting, every milestone feels like it deserves a standing ovation. Behind every first step and every new skill, is the hard work of the parents and children I work with. Exercising IS hard. The recovery process is sometimes a slow one. With kids, no small victory goes unnoticed. I have witnessed many children’s first steps, and I was right next to their parents beaming with pride. You know that feeling when you learned to ride a bicycle for the first time without training wheels? I get to see kids and parents experiencing something like that, every day.

Being a pediatric physical therapist means I encourage children to move, to grow, and to become independent. Really, they make my job easy, because they motivate me too.

Are you interested in becoming a pediatric physical therapist? Click here to learn more about our Physical Therapy Student Fieldwork Program.

Bayley II

Understanding Physical Therapy Outcome Measurements: The Bayley Scales of Infant Development

The Bayley Scales of Infant Development was revised in 1993 and is now known as The Bayley II. This assessment measures not just fine and gross motor skills (such as the PDMS-II), but also monitors mental and cognitive performance as well. The Bayley II is a comprehensive and reliable tool used to measure skills and behavior in children from 0 to 3 years.

The motor portion of the test looks at both fine and gross motor skills, including manipulatory skills, large muscle Bayley IIcoordination, dynamic movement, postural imitation, and stereognosis. The test is used to detect developmental delay and to monitor a child’s developmental progress. The items are arranged by degree of difficulty and uses a pass/fail system for scoring. So how is this test different from the other exams we use to monitor children birth to 3 years old?

Advantages and Limitations of the Bayley II:

Advantages of the Bayley II:

  • Most widely used tool to determine developmental level of infants
  • Most widely utilized assessment in infant research
  • Comprehensive psychometric properties
  • Standardized on a nationally representative sample
  • Takes 20-60 minutes to complete

Limitations of the Bayley II:

  • No sub-scores for individual tests to quantify specific strengths and needs
  • A credit/no credit binary scoring system does not allow a child to be credited for emerging tasks
  • Cognitive items depend on fine motor performance
  • Quality of movement is hard to assess
  • Limited reliability and validity

Physical therapists mostly use the motor subset of the Bayley Scale, assessing gross and fine motor development, and skill acquisition. The Bayley II has been norm-referenced, and proven to be reliable and valid. It is relatively easy to administer and has been helpful in research and physical monitoring related to children with suspected delay.

Does your infant or toddler have special needs? Or do you have more questions about the physical development of your preschooler? Come to see one of our specialists!