Psychological and Developmental Assessment: Children with Disabilities and Chronic Conditions.

This book is a ‘must read’ for child psychiatrists, developmental pediatricians and clinicians who work with children with disabilities. The editors Rune J. Simeonsson and Susan L. Rosenthal have proven that scholarly books can offer practical dimensions. This book has contributions from the fields of school psychology, pediatrics, human development, neuropsychology, rehabilitation counseling, pediatric psychology and psychiatry. One can confidently say that the majority of contributors are from various fields of psychology as the format of chapters is quite uniform and the whole book is laid out in an orderly categorical fashion. The book is divided into four main parts. The first part addresses dimensions and issues in clinical assessment of children with disabilities. I was extremely impressed with the stepladder approach in planning an evaluation. The authors teach, through a clinical vignette, how to construct an intervention model. The steps they ask you to consider are precisely what we do in our clinical practice; however, these interventions are aimed at a chronically disabled child (medical or neurological/psychological). For example, consider these simple steps in an intervention plan for a 4-year-old with fragile X syndrome, an example cited by the authors: Specify goals/objectives for the child Prioritize goals by weighting scales Project a scale of worst to best outcomes for each goal. Define child’s present status on each side. Carry out program for specified duration. Identify follow up status on each side. Calculate initial and follow up GAS scores (Goal Attainment Scaling) We could use this approach to planning whether working with children who require educational interventions or who are being assessed self-injurious behavior. The second part is as informative as it addresses the general assessment issues of children suffering from chronic disabilities. The chapters on qualitative and quantitative developmental assessments are absolutely invaluable. I never thought I would enjoy reading Piaget’s theory so much. The authors included a well-defined and well-formulated description of different psychometric measures of cognition used in early childhood. The measures are described according to the age of the child and whether they are useful with developmentally delayed children. For example, Miller Assessment for Preschoolers (Miller, 1982) is said to be more appropriate for preschoolers with perceptual or language problems and coloured Progressive Matrices (Raven, 1991b) are more applicable for children with a hearing impairment. This chapter also offers an eco-behavioural approach in clinical assessment that accounts for the child’s experiences within the environment ranging from the molecular (interactional or instrumental variables) to the molar (broad variables such as gender, disability, socioeconomic status) dimensions. The family assessment includes important indices such as family culture, family interactions and the role of significant others. Part three describes specialized measures and strategies for unique clinical situations and specialized populations such as maltreated young children, infants, children with motor impairments, deaf, visually impaired and children with autism. The outstanding contribution in this section is the chapter on assessment of children with chronic illness, my favorite, as it covers common scenarios child psychiatrists face during the consultation-liaison process. While reviewing various assessment strategies for children with chronic respiratory illnesses (asthma), genetic diseases, and juvenile rheumatoid arthritis, particular emphasis is placed on the study of two dimensions of cognitive domain in these children: the child’s understanding of concepts related to illness and health and the child’s knowledge of his own condition. It is important to note that the chapter on developmental measures for children with neurological dysfunction emphasized that clinicians could still accomplish a reasonable assessment in his/her office that would be as valuable as several batteries of neuropsychological tests. The last chapter describes ethical and legal issues involved in assessment of children with special needs. Although legal issues described are not very applicable to Canadian practitioners, the guidelines for making ethical assessment decisions are. This is a book one would like to refer to from time to time when working with children with disabilities. The book has contributed richly to fields of psychology and developmental processes of young children. In my opinion, it has the potential of becoming an authoritative text.