The Developmental Profile As an Assessment Tool for Support Workers

The Developmental Profile as an assessment tool for support workers Jette Ehrlich ([email protected])

In our work at Tanne, a swiss foundation for deafblind people, we experience the imoprtance of communication every day. Communication is may be the most important ability for everyone. So for deafblind people. But congenitally deafblind people got an enormous amount of challenges to cope with, in order to be able to communicate. Due to the loss of seeing and hearing and an intellectual disability in addition, perhaps also a bodily disability, the cognitive functions which are needed for communication do not develop in the same way as they normally should.

Co-Creating Communication In Tanne we use the Co-Creating Communication Approach (CCC) of Nafstad & Rødbroe (1999) as the main guideline for basic communication intervention. The CCC is based on the assumption that the communication development of deafblind people is based on the same principles as that of non-handicapped persons but due to the disabilities happening in a different manner and speed. It is thus based on general theories out of the developmental psychology like those of Bowlby (attachment), George H. Mead (symbolic interactionism), Sameroff &McKenzie (transactional model), Vygotsky, Bronfenbrenner & Ceci (Ecological Systems Theory), Stern, Marková (dialogicality) or Aitken & Trevarthen. All of them talk about cognitive abilities which are needed for communication and how they develop. In a short discription the CCC emanates on the following development: Within social interaction between two partners (which means being together, experiencing something together, playing together and sharing emotions), who co-regulate proximity and distance in a dialogical way and who are in interaction with their environment (exploration), the partners learn. Important presuppositions for communication are developing. Those are e.g. reciprocity, dialogicality, joint attention, theory of mind, intersubjectivity or intentionality. This process presumes an emotional bonding between the interaction partners and leads to co-constructed communication. The CCC-Model of Nafstad&Rodbroe, 1999

In communication intervention we try to create as much as possible learning chances for the deafblind people by co- creating emotional loaded social interaction and exploration within daily routines. With that we want to strengthen the suppositional cognitive abilities. In order to do so we need to assess and to observe those cognitive abilities. And this is a difficult issue. Nafstad & Rødbroe invented a tool for that purpose: the Developmental Profile. The Developmental Profile (Nafstad&Rodbroe, 1999)

The Developmental Profile as a baseline assessment During my studies in the international master`s programme „Communication and Congenital Deafblindness“, which is organised by DbI`s European Communication Network and the University of Groningen in The Netherlands, I investigated the use of the Developmental Profile as a baseline assessment of Karl, an adult who is deafblind, intellectual disabled and living in a residential home group in Tanne (Ehrlich, 2007). I filmed sequences of social interaction between him and me and analysed those videos with the Developmental Profile, in order to assess his cognitive and communicative abilities. The aim was to find an assessment tool which is easy to accomplish by support workers of Karl, which leads to suggestions for intervention within a specialised education approach and which is made for adults with deafblindness and intellectual disability. The results showed that it is possible to find information about present cognitive and communicative functions in the video sequences. The Developmental Profile is accomplishable with congenitally deafblind adults. But also a lot of difficulties occurred: The Profile was not easy enough to handle because the profile- cues were difficult to understand. The assessor needed to have comprehensive theoretical knowledge about the Co-Creating Communication Approach in order to understand the Profile. The next point is the amount of time it needed to do the assessment. A lot of video-material had to be produced, watched and interpreted. The best video sequences and the cues had to be found. Support workers normally do not have that much time. Within the analysis there is also the risk of overinterpretation. It became clear that knowledge about the person in focus and team work is very helpful for the assessment which emphasizes the purpose to let the support workers be the assessors. The last important founding was that an assessment of cognitive capacities with the Developmental Profile is at the same time an assessment of the quality of interaction between the person in focus and one interaction partner. The results are dependant on the situation and the interaction partner which is involved in the analysis. Thus standardization and comparability are not given. So in the end certain suggestions for an adaption of the Developmental Profile arised. In order to make the assessment possible in the practice of Tanne a paraphrasing of the profile cues into clear and easy assessment questions which contain examples of observable behaviour seemed to be needed. In addition we needed brief theoretical instructions for the support workers. The third aim was to include the life experiences of adults in the interpretation of the results somehow. The problem of standardization and comparability seemed not to be of primary importance for our daily practice.

Tanne means „fir“ and is a swiss foundation for deafblind people. It is the only centre for deafblind and dual-sensory- impaired, multiple disabled children and adults in the german speaking part of Switzerland and is based in Langnau – a small town near Zürich. The services include amongst others early education, school, educational advancement, living support and engagement for adults, various therapies, consultance and further eduaction for professionals. Tanne got involved with this specific target group for 40 years and takes care of 55 people today (www.tanne.ch).

Staff development at Tanne With the masters thesis as a fundament I firstly wanted to convey the theoretical knowledge of CCC to the Tanne staff in order to make them aware of the cognitive functions which are needed to communicate and to build the basis for introducing an assessment. The aim was to give them a helpful and efficient tool to assess communicative and cognitive capacities within daily life and with video analysis and a questionnaire. So together with collegues I arranged 3 staff education days where the CCC theory was explained, videos of social interaction were filmed and analysed with the help of a questionnaire which was based on the Developmental Profile. In the evaluation of those days it became clear that most of the staff members experienced that the CCC principles are helpful for communication intervention and important for their daily work. So I was convinced that the CCC was the right background for an assessment tool. About the video analysis with the questionnaire 44% said that they could find indicators for social-cognitive and communicative capacities of the deafblind person. 33% could find them in parts. 23% didn`t find them. 91% of the evaluating staff members wanted to use video analysis in their daily practice in the future. The results of the survey showed that an assessment on the basis of the Developmental Profile could be useful for practice and seemed to be needed by the staff members. With the help of the cognition network, especially Anne Nafstad and Flemming Ask Larsen, I again refined the assessment questions which are based on the Developmental Profile cues and created a new assessment guideline for video analysis including observation questions and brief theoretical background information. During the year 2009 six support workers in Tanne will try to make an assessment of the communication development of a deafblind person with the purpose of communication intervention based on the principles of CCC. The use of the assessment guideline will be evaluated.

Cognition network The CCC and the Developmental Profile are properbly used in many different institutions in different countries. It can be assumed that Tanne is not the only deafblind service who tries to find a way how to assess cognitive capacities. The CCC seems to be a good framework to develop an assessment as long as the focus lies on communication, which is often the focus in deafblind education. In order to develop a tool which is useful in practice it is very helpful to colaborate by exchanging experiences. Within the cognition network at least 5 persons met who all want to adapt and refine the Developmental Profile. Luckily the two authors of the Profile Anne Nafstad and Inger Rødbroe are part of this little working group.