Qualitative Approaches

A Qualitative Approach uses informal procedures and methods to document complex and holistic behaviors of a child engaged in naturally occurring activities such as playtime, eating dinner, or taking a walk outside. Evaluation and assessment tools are used to collect information from structured and unstructured observations of a child across multiple environments at different times.  These tools include rating scales, checklist, anecdotal notes, photographs, video and audiotapes, verbatim accounts of behavior, and work sampling.

Examples are:

• Natural Observation occurs in situations within the family, culture, and community that can be either structured or unstructured, depending on the desired information. This type of observation analyzes why and how a child engages in specific situations, and views a child’s interactions and behaviors from a holistic perspective that collects information across multiple domains of development.  Natural observation also provides important information about how a child engages in activities in familiar settings with familiar adults.  It can involve parents in active roles, as desired, in their child’s evaluation and assessment. Finally, natural observation helps identify functional outcomes for children and select meaningful family supports/services to promote a child’s participation the home and community.

Al was two years old and had a great sense of humor.  His cerebral palsy and arthrogryposis severely limited all his movement, including using his mouth and throat muscles to eat and talk, but he had a smile and facial expressions that communicated a lot to his family.  The service coordinator presented Al’s parents’ request to the evaluation team.  They had requested  that the team focus on Al’s strengths and needs as well as on finding ways for him to play by himself and with his older brother (not on learning to walk and talk).  A physical therapist and educator conducted Al’s multidisciplinary assessment by listening to Al’s parents tell them what sparked his interest, strategies that have worked, and what was not working.  Together they analyzed his movements and began plans to adapt his current toys and introduce electronically activated ones.

• Play-based assessment brings together parents and a team of various professionals as applicable, providing the opportunity to evaluate young children in a natural environment of structured and unstructured play.  Play-based assessment allows the content, sequence, and personnel involved in the assessment to be altered depending on the needs of the individual child.  Initially, parents are asked to play with the child and another person on the assessment team. Once the child becomes comfortable, the parents bow out.  This allows the professionals to observe, assess, and take data on the child’s performance and to talk with parents to gather additional information about the child’s development.  Play-based assessment results provide a complete picture of a child, including strengths and areas of need.  This type of assessment recognizes the importance of play as a natural context for development, acknowledging the expertise and contributions of both parents and a variety of professionals.  These professionals, members of the assessment team, assume the following roles:

• Play facilitator who interacts with the child
• Parent facilitator who interacts with the parent/s
• Observers
• Video camera operator

​Three year old Jerrell had suspected delays in language and cognitive development.  His parents were concerned that he was having trouble expressing himself and did not prefer to play with other children.  Therefore, a speech-language pathologist, an early childhood special educator, and a behavioral specialist made up the assessment team.  Jerrell and his mother were brought into the assessment room which had a variety of toys for him to play with.  One team member played with Jerrell and his mother while the other two team members observed and completed their assessments.  Jerrell’s mother then left the play situation once he was comfortable so that she could talk and share information with a team member about Jerrell’s behavior and skills at home.  Team members alternated playing with Jerrell, observing and completing their assessments, and eliciting information from his mother.  During the entire process, a staff member was taking video of Jerrell playing and interacting so that team members could refer to it later.  Jerrell and his mother enjoyed their experience, and assessment results were shared with his mother at a later meeting.  Jerrell’s mother expressed her appreciation for the efforts the team made to really get to know her child.

• Informed Clinical Opinion is a critical assessment component, particularly when standardized measures are unavailable or inappropriate for a given age or developmental area.
  • Always includes a discussion with families members and caregivers
  • Involves observation of a child in a familiar setting
  • Requires appropriate training and experience with evaluation and assessment, and sensitivity to a family’s culture.