Article summary with Assessment for Intervention: a practice-based model by Pameijer - 2016

What is this article about?

In this article, an assessment model used for assessing children’s special educational needs, is discussed. This model is called the Assessment for Intervention (AFI) or the Needs Based Assessment (NBA). This model is used to give recommendations for interventions which are evidence-based (science-based). In this article, the seven principles of this model and the five stages of it are described. Lastly, the successes, problems, and questions related to this model are discussed.

What is the AFI?

The AFI can be used to make recommendations. For example, how can we improve a problematic situation and achieve certain goals? Often, in real-life, there is a lot of diagnostic information about a child, but practical recommendations are lacking. In these cases, the AFI can be used. By using the AFI, a school psychologist goes through a certain decision-making process, through different stages. First, the psychologist analyses the questions of the teacher, the school-counsellor, and the parent and child. These questions, together with the psychologist’s own questions, are the basis the assessment. These questions will be answered.

The process is as follows. First, the psychologist analyses the child’s learning capabilities and behaviour problems in the context of the classroom. Then, he or she looks for possible explanations. He or she generates hypotheses, and tests these hypotheses in a scientific way. Then, he or she comes up with recommendations using the AFI. These recommendations have to be accepted by the teachers, child, and parents. In this way, personalised interventions can be created.

What is assessment?

Assessment can be divided into two domains: the assessment process (generating and testing hypotheses, integrating information, making decisions) and the assessment methods (the tests, surveys, interviews, and observations that are used). The AFI emphasizes the assessment process. For the AFI to be effective, the teachers, parents, and child should also be involved in the process.

The AFI has been used for more than 20 years in the Netherlands and Belgium, in both regular as well as special educational settings.

What are recent developments in assessments?

Over the last years, there have been six developments into the AFI.

1. There is Assessment for Improvement. This refers to that assessment is effective when it improves teacher’s instructions, and student learning. The support that children with special needs receive may also be beneficial to other students, which is called ´essential for one, beneficial for all’.
2. Assessment should focus on the needs of the student, and not solely on the disorder.
3. Assessment should focus on solutions and empowerment of clients.
4. Increasing the therapeutic value of assessment makes it more functional: the client should be involved right from the beginning.
5. Children should participate in the assessment process, regardless of their age. Their opinion should be taken seriously.
6. The assessment process should be evidence-based. The assessment should include an accurate formulation of the student and the school and home environment. These descriptions are the basis of interventions: these interventions will be tailored to the specific needs of the children/students.

What are the seven principles of the AFI?

Based on systematic reviews on assessments, there seem to be certain criteria/standards for the quality. For the AFI, there are seven characteristics that make it a good assessment method. Each criteria will be discussed.

Goal-directed and functional assessment

The AFI is goal-directed, and it is aimed at recommendations which are both meaningful and useful for clients and beneficial to the child. The goal of the AFI is to provide effective interventions. To reach this goal, many steps are involved. All relevant persons are involved in the process, and the client is also involved on a high level. In this first principle, only functional information is collected (so what do we NEED to know, instead of what is NICE to know). To collect only functional information, the psychologist uses an if-then reasoning:  “If we know…, then the intervention….”. Also, during the assessment, the student’s situation becomes clearer. Then, during the process, a ‘change-oriented hypotheses’ can be tested: if the student, teacher, or parents change their behavior, can this help to reach a specific goal? Lastly, this principle also refers to that the AFI is aimed at improving a problematic situation. So, it focuses only on variables that can be changed and tries to do this by using interventions.

The transactional perspective

The AFI offers a transactional perspective on development and does not only focus on the child, but also on teachers’ strategies and on parental support. This transactional perspective states that children develop through continuous interaction with their educational and home environment. These interactions are ‘transactional’. This means that children’s behavior evoke reactions from their parents, teachers, and peers. These reactions also influence the children’s behavior. For example, a teacher influences a student (motivates the student to read). If the child starts to read, then the teacher feels successful: he or she was able to get the student to read. So, the relationship between the child and the teacher is bidirectional: the teacher influences the student, and the student influences the teacher. This works the same for parents. This principle is also useful to avoid blaming the child, the teacher, or the parents. Instead, questions such as: “What is going well? And what should be changed?” are asked. So, the teacher and parents think about what they could change and the child thinks about what he or she should change.

Special needs of the child

The AFI focuses on educational needs: what does this child need to achieve a specific goal? So, this moves the focus from ‘what does the child have? (ADHD, dyslexia)’ to ‘what does the student need?’. So, the first question is: ‘which SMARTI goals are we pursuing?’. Then, ‘which approach does this student need to reach these goals?’. The school-psychologist also focuses on the home environment of the child, because this environment is also of big importance on the child’s educational performance. Then, the psychologist discusses with the parents what they are already doing well (‘goodness of fit’), what is missing (‘poorness of fit’), and how feasible it is to offer these extras. 

Support needs of teachers and parents

The AFI also focuses on the needs of teachers and parents, because they are important factors in the education of children. It seems that 20% of student’s academic achievement is determined by the school, and 80% is determined by variables of the child and his home environment. The 20% mostly includes teachers’ behaviors. When they have the right teaching-strategies, this impacts the student’s academic achievement in a positive way. However, in the other 80%, parents are involved. Coming back to teachers, it seems that effective teachers do not treat all students the same: they use different approaches with different students. Also, the relationship between the teacher and the student is of high importance. A positive relationship leads to better behavior in the classroom, and a negative relationship can lead to antisocial or withdrawn behavior in students. Therefore, the AFI also focuses on the relationship between teachers and students.

Protective factors and strengths

The AFI does not only focus on risk factors, but also on protective factors of the child, school, and parents. Because, every child, no matter how severe their problems are, also have positive aspects in their behavior. So, the school-psychologist, using AFI, also focuses on what are the student’s talents and interests, what are positive exceptions (so when does the child display desired behavior), and so forth. So, even though the psychologist focuses on problems and concerns of the client, he or she also takes positive aspects into the assessment report. Positive aspects can be having an easy temperament, high intelligence, strong emotion-regulation, an internal locus of control, and strong coping skills. Other positive aspects are a warm relationship with the teacher and/or the parents, a safe neighbourhood, a supportive school team or a supportive family network. These positive factors are protective factors: they protect children from risk factors. The school-psychologist therefore tries to determine the degree to which the student has these protective factors. Then, he or she tries to find ways to reinforce these factors, and/or use them in the intervention. Also, it is important to mention to the client the positive aspects. This can make the client feel better, and can also contribute to a positive relationship between the child and the teacher. Also, by determining the amount of positive factors in a student’s life, it is possible to get an overview of how severe the problems are. The fewer positive factors, the more severe a situation. It can also tell something about a diagnosis. For example, if a child is very empathic, this makes it improbable that the student has an autism spectrum disorder (ASD).

An overview of risk factors, protective factors, and the interaction between these provide a ‘case formulation’. Using this information, the gap between recommendations and interventions can be bridged. For example, if a student is really interested in bears, this information could be used to make a biology class more meaningful. 

Collaborative partnerships

The assessor works in a collaborative partnership with the teacher, child, and parents. This is an essential characteristic of professional practice and makes assessments more valid and leads to more effective recommendations. It is important to involve clients, because they often know what the possibilities for change are. Therefore, the AFI includes all students, their teachers, and their parents into the assessment process. The AFI is also transparent. This means that students can share their opinions, and teachers also. This makes the AFI more effective, because it has been shown that teachers often have a hard time implementing recommendations in their classroom (because of too little time, or because they do not like the recommendations). Therefore, by collaborating with the teacher, this problem can be solved: the recommendations can be matched to the teacher’s preferences. However, to effectively cooperate, the assessor should have a professional, warm, empathic, sincere, and respectful attitude. Also, he or she should be eloquent: communication skills are key, such as meta-communication. To be an effective communicator, the school-psychologist should be open about his or her intentions, the questions that he or she asks and the things that he or she discusses. He or she should also evaluate the discussion, and ask whether all parties feel like the goals are reached.

A systematic and transparent assessment process

The AFI follows a systematic and transparent process with five cohesive stages. Assessment is defined as ‘a process of hypothesis testing designed to answer clients’ questions and to solve their problems’. However, to make this process as effective as possible, this process should be systematic and consistent. It should also be transparent to colleagues and clients. In the AFI, this is done. The AFI progresses five stages. Each stage has its own steps. In these stages, the mentioned principles are used.

What are the five stages of the AFI?

The five stages in AFI are closely linked, through a cyclical process and a systematic feedback loop.

Stage 1: The Intake

In the first stage, the intake, the goal is to collect information. This information is the basis for the strategy that is chosen: which stages will we go through to answer the questions? Another goal of an intake is also to achieve compatibility with the school, the child, and the parents, so to create a stable partnership. The intake has six steps:

1. Preparation: who will be present during the first meeting, and who are these people?
2. Reasons for assessments, questions, aims, expectations and requests: what are the questions? What are the problems?
3. Overview: what is the client’s formulation of the problem, and what does the child feel is positive in their educational and home environment?
4. Relevant past history: this includes anamnestic information, previous activities and effects, so: what worked and what did not work?
5. Attributions, goals, and solutions: what could explain the situation according to the child, teacher, counsellor and parents? What are the goals? What are possible solutions?
6. Conclusion: this includes all the questions by the client and the school-psychologist, the further appointments, and evaluation (is all relevant information collected?).

Stage 2: Strategy

In this stage, it is decided how will be proceeded. For example, will the process include Stage 3, or is it possible to move directly to Stage 4? To answer this question, four different questions have to be answered:

1. What is known already?
2. Is it needed to know more?
3. If the process involves stage 3, what information is needed?
4. What is the conclusion of the strategy? Will the process involve stage 3?

During assessment, often more information is collected than wat is required. This information can not always be used. Therefore, the information gathering process should be goal-directed. The collection of information only has the goal to yield recommendations. Therefore, the information collection follows the ‘if-then’ principle. So, before a question is asked, first this if-then is answered. So, if we know…, then we can recommend…, however if we don’t know…., then we cannot yet recommend… This is a form of goal-directed information collection. In this stage, the goodness of fit question is also answered: to what degree is the approach tuned to the student’s needs? This is called compatibility: the approach and recommendations should fit the capabilities of the student.

Stage 3: Investigation

In this stage, data is collected in six steps:

1. Operationalize the concepts in the questions;
2. Choose the appropriate tools and instruments;
3. Formulate testing criteria: when do we accept, and when do we reject the hypothesis?;
4. Consult the clients: can they participate as co-researchers?;
5. Gather the data that is necessary for testing the hypotheses;
6. Interpret the data and answer the questions.

The a priori hypotheses and questions determine which information needs to be gathered. To gather information, one can use tests and questionnaires, but also interviews. Also, the teacher may be observed. The suggestion is to use only valid and reliable instruments. So, the context is also important in AFI: the school-psychologist or the assessor examines the child in his natural environment. This makes the data more ecologically valid, and this data can be used to come up with specific, fit interventions.

Stage 4: Integration and needs assessment

So, Stage 3 provided answers to questions that were important to investigate. In the fourth stage, these answers are transformed to fit the personal theories of the child, teacher, and parents. So, the information is summarized and integrated into a ‘case-formulation’. Therefore, this stage is also called the ‘pre-treatment’ stage. This stage is the stage in which the assessment turns into the intervention. It includes five steps, namely:

1. Transactional case formulation: how can the situation be understood?
2. What do we need or want to change, and what can we change?;
3. What does the child need to achieve these goals? What do the teachers and parents need?;
4. Recommendations based on the needs;
5. Estimation of the most appropriate recommendation (intervention).

Stage 5: Recommendations

This is the last stage, and when this stage is reached, the process has been going on for a while. It is known what key problems are, and what the optimal recommendations are. Also, the teacher, child, and parents have been involved in the assessment process. Therefore, in this last stage, the clients are informed about the outcomes. The aims of this stage are to answer the client’s questions, to objectify goals (how can we determine that a goal has been achieved?), these specific goals will be matched to specific needs, and clients will be supported in choosing the intervention that has the highest chance on success. Thus, all parties discuss, question each other, and listen. The result of this stage is a tailored intervention. This last stage contains five steps, namely:

1. Preparation: what are the goals of this meeting and who should participate?;
2. Discussion of the case formulation: do clients recognise this formulation? To what extent do they agree or perceive the situation differently?;
3. Discussion of the goals, needs, and recommendations, supported by arguments. So, it is determined whether the clients have additional ideas, solutions or arguments;
4. Clients choose one (or more) of the suggested recommendations/intervention;
5. Conclusions, evaluations, and appointments.

So, the main goal of this last stage is to arrive at a feasible intervention, which is supported by all relevant parties (students, teachers, parents). For the process to be successful, the parties should all be willing to ‘start tomorrow’.

How is the AFI evaluated?

In the Netherlands, an evaluation study was conducted. There were 102 schools involved, and twenty schools were chosen. These schools participated in a three year pilot study which implemented AFI to assess the needs of children with learning and/or behavior problems.

In this evaluation study, there were multiple questions, such as:

• Are the principles of AFI implemented as intended?
• Are the aims of AFI achieved? So, does the assessment offer a better understanding of the student and the support he needs? Does assessment generate recommendations for teachers and parents? And, are teachers able to apply the recommendations in their classroom?

Method

The assessors were educational psychologists, school-psychologists, and school-coaches. They were trained in the use of the AFI. Three weeks after the assessment was completed, a digital questionnaire was sent to the teachers, counsellors, parents, and assessors.

Results

The first question: ‘Are the principles of AFI implemented as intended?’ was answered in a positive way. So, yes, the teachers, counsellors, parents, and assessors all felt as if the principles of the AFI were implemented as prescribed. The other question, related to whether the aims of the AFI are achieved, was also answered in a positive way. So, the assessment provided most teachers and counsellors with more insight into the child’s situation than they had before the assessment. For parents, this was less true. However, the parents already knew the child before the assessment, so this finding makes sense. Teachers also stated that they feel more capable in teaching the child. Two out of three teachers reported that they were able to implement the recommendations in their classroom.

What can be concluded?

The five stages of the AFI made it easy to use; all professionals had a shared language. Also, everyone who was an important factor in the education of the child, was involved. This makes it optimal for the child. Further, the assessment provided schools and parents with a perspective on how they can further collaborate and come to an agreement in the interest of the child. Also, the counsellors, teachers, and parents valued their partnership and the communication with the assessors. Their questions were the basis for the assessment, so the outcomes were meaningful for them. Lastly, teachers and parents really seemed to like the process as in the AFI. Even though this process requires a  lot of time and effort, most teachers found it to be worth the time and effort.

Some points from improvement resulting from this evaluation are that the case formulation should be explained to the parents. The information should be meaningful to them. Also, parents should be complimented on the positive aspects of their home environment. By doing this, parents will be more motivated to continue to do so.

The five stages of the AFI can support school-psychologists in their work. The checklists can guide them through the stages, and can provide them feedback. The AFI also promotes communication between professionals. For teachers and parents, it is nice that the AFI is transparent. There are however some challenges. For example, it seems difficult to only ‘assess what is needed’ so, only gather information about what is needed. Also, sometimes different opinions can clash. For example, the school might feel as if it is unnecessary to investigate the classroom, while the school-psychologist can feel as if this is really important. Or, parents might want their child to be diagnosed as ‘dyslexic’, while the school- psychologist does not agree.

Another difficulty refers to the AFI-report. There is a specific format for this report, but the content is not standard. The content is namely very client-specific; it contains questions and answers for specific clients. However, it might be difficult to only report questions and answers. Also, translating jargon into common language can also be difficult and time-consuming. It might also be hard for school-psychologists to describe the quality of the teacher’s strategies and the parental support, without being rude.