Cognitive Assessment of Children Who Are Deafblind: Perspectives and Suggestions for Assessments

Abstract

The overall goal of a cognitive assessment is to improve communication, learning, and quality of life for a child who is deafblind. This article will give a brief description and perspective on different evaluation approaches as a basis for reliable cognitive assessments and offer suggestions on how to improve the quality of a cognitive assessment in our clinical practice. The assessor should be aware of the limitations of norm-referenced tests if standardized normative measures are applied to evaluate the cognitive functions of a child who is deafblind. However, if engaging a child with deafblindness in a standardized normative assessment, special considerations and assessment concessions would be required. Furthermore, key issues on how to improve the quality of a cognitive assessment by affording multiple assessment pathways for cognitive assessments will be addressed. Particular attention is given to the following assessment approaches: multi-method, multi-informant assessment, ecological assessment, and dynamic assessment. The use of multiple assessment pathways is necessary to reveal the genuine cognitive abilities and potentials of a child with deafblindness.

The Ethical Debate About the Neuropsychological Assessment of Young People With Visual Impairments

“…Using neurocognitive test norms with people who have visual impairments may be biased and, therefore, violate an underlying tenet of assessment (Lund et al, 2014). Normative samples are predicated upon strict, standardized administration protocols to minimize inter-rater bias, but their utility for the assessment of children with visual impairments is limited (Minks et al, 2020; Nicholas, 2020). Adaptations to test administration, including magnification of materials and additional time allowance, deviates from the standardized protocol rendering the results not strictly comparable to the normative group.…”

“…In this situation, a clinician needs more information, particularly from teachers who are likely to have observed a child engaging in visual tasks at school (Loftin, 1997). Multi-informant reports of function contribute much assessment of children with visual impairments (Nicholas, 2020). Including other forms of hypothesis testing of in-home or school-based functional skills provides additional collateral information to assist in interpreting test results (Sechrest, 2005).…”