10 Tips for Play-Based Evaluation in Preschoolers

It’s the first day of summer vacation and I’m celebrating this break! Over the school year I completed over 100 different evaluations. I work on a play-based evaluation team. Here are a few quick tips to help you if you’re starting a new assignment next year!

10. Develop a system to get referral information.  There will be a lot of things are that not in your control when you’re evaluating a preschooler. Those three year olds will give you a run for your money! It is hard! I work on a transdisciplinary team for evaluation. My school psychologist gives me a quick overview of the child’s areas of concern a basic summary of parent concerns. This helps me pick the best tools to complete my evaluation. Will I need cause/effect toys or more open-ended toys? Formal assessments? AAC devices?

9. Set the environment to your advantage. No matter where you do your evaluation (classroom, therapy office, etc.), you should think about how you want to set up the room. Will you have all the materials viewable from the start? Will you hide some toys in a bin or cabinet and slowly introduce them? There isn’t a right or wrong answer to this questions. I prefer to have several toys out so I can watch how the kids interact with them. Which ones are they drawn too (cause/effect, legos, kitchen?) and if they stay in a space for a while or move around quickly. I keep other toys out of site until we’re working more intentionally to elicit certain skills.

8. Make a judgement about tests. After watching a child play for a few minutes I make my best judgement about the area of concern. If it’s phonology and language, I doubt most children can sit for standardized assessments in both. I look for the primary area of concern and try to pick an assessment that I can get a standard score with. The PLS-5 has a nice mix of both “book work” (labeling/pointing) and play. If the child is more like a 4 or 5 year old, I might use the CELF-P2. If the child has significant delays or very poor engagement/attention, I often complete the REEL (parent interview). If possible I give a phonology assessment but at the minimum I take a language sample and note which processes are present.

7. Utilize parent interview. I just mentioned using the REEL assessment. Even if I don’t use this assessment, I always do an extensive parent interview.  I interview before during and after the actual time I spend with the children. I start by asking their primary concerns and how the child communicates at home (words, signs, gestures, contact gestures, tantrums, etc.). I focus on the functions of language in addition to their vocabulary, MLU, and speech intellgibility. During the assessment, I often check in with parents. I ask if a skill/activity is similar at home. For example “Does he always drool when he’s playing?” “I hear him jabbering to himself while he plays, is that what he does at home? He’s grabbing my hand but he isn’t looking at me. Is that what he does at home?” After the evaluation, I always ask parents if there was something I didn’t ask that they are noticing or are worried about.

6. Go deeper. Ask your question and then a follow up. Many parents aren’t sure how to tease out the skill you’re trying to identify. Example:

Clinician: “Does your child notice when other people are upset or sad?”  Parent: “Yes”

Clinician: “Tell me about a time recently when you’ve observed that.” Parent: “Whenever her sister cries, she covers her ears and runs in the other room. She doesn’t like when other people are upset.”

Clinician: “She really has a reaction to that noise! I noticed today she covers her ears when she hears a noise. I’m wondering if that is related to how her body interprets loud noises in her sensory system. Does she ever come over to someone who is sad and try to comfort them?” Parent: “No, she only reacts to the noise of crying loudly. If someone is mad or upset but quiet, she doesn’t notice.”

The answers parents gave initially and the answered teased out by further questioning are very different!

5. Use examples to help parents. I usually ask a question and follow it up with an example. For instance, “Does your child understand positional concepts like under, behind, and next to? If you said, the ball went behind the couch, would he know where to look?”

4. Use forms that make your life easier. I do about 100 initial evaluations per year in addition to my caseload for therapy. It’s a lot and  the only way to do it efficiently is with forms that work for me. I use a play-based observation form to take my language sample, make observations, and note important case history information. I use a check-box version that let’s me see that the things I should be looking for. During the evaluation, I go ahead and write notes about what the goals/objectives should be. This helps save me time when I go to write the IEP later. You can find more information about my forms in my shop.

3. Go with the flow. Nothing is less predictable that a toddler. Just be prepared that everything might go out the window. That’s ok. Let the child lead and keep him engaged with you. Everything else depends on that engagement with you!

2. Think outside the speech bubble. The best thing about working on a transdisciplinary team is having those discussions around the conference room table. What’s causing this child’s behavior problems? Is it that he can’t communicate? Is it sensory? Is it both? Working on a team helps me identify that there might be multiple things impacting a child.

1. Provide feedback to parents in a positive and meaningful way. Sometimes we have to deliver bad news. Telling a parent that their child best fits the educational category of Autism is a really hard thing. I focus on giving as many positive statements as I can about his/her communication abilities. I also focus on a positive future. Be understanding, be empathetic, and be positive about the wonderful experience the child will have at preschool. Most importantly, give parents something they can do starting that day to make a difference for their child. I use these parent handouts from for early intervention and my Learning through Play parent handouts every week.

Happy Evaluating! Leave a comment if you have some more advice! I’d love to hear it!