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A Framework for Understanding Young Children with Severe Multiple Disabilities: The Van Dijk Approach to Assessment

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Abstract

This article describes a framework for assessing young children with severe multiple disabilities that was developed by Dr. Jan van Dijk and colleagues in the Netherlands. The assessment is guided by the lead of the child as it looks at the underlying processes of learning including biobehavioral state, orienting response, learning channels, approach–withdrawal, memory, interactions, communication, and problem solving. Through the use of two case studies, each of the learning processes is described along with suggestions for assessment and intervention. A sample protocol with observations, child strengths and needs, and suggestions for intervention is included.
... According to Grove, Bunning, Porter, and Olsson (1999), communication is about two or more people working together and coordinating their actions in an ongoing response to each other and the context (Bunning, 2009). Communication partners thus play an essential role in enhancing or hindering children's communicative development by facilitating or reinforcing communicative behavior, or failing to recognize that a communicative attempt has occurred (Greathead et al., 2016;Nelson, van Dijk, McDonnell, & Thompson, 2002). The latter may lead to frustrating communicative attempts and ceasing endeavors to communicate on the children's side as well as on the partners' side (Greathead et al., 2016;Grove et al., 1999;Halle, Brady, & Drasgow, 2004). ...
... Examples of associated specific codes are expressing discomfort, protest, etc. (general code: negative code for sign of functionality), and attention drawing, showing affection, etc. (general code: positive code for sign of functionality). Because these behaviors are more recognizable for communication partners, they are more likely to generate a response and therefore facilitate the emergence of intentional communication (Greathead et al., 2016;Nelson et al., 2002;Prizant & Wetherby, 1987 ; 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 836 837 838 839 840 841 842 843 844 845 846 847 848 849 850 851 852 853 854 855 856 857 858 859 860 861 862 863 864 865 866 867 868 869 870 871 872 873 874 875 876 877 878 879 880 881 882 883 884 885 886 887 888 889 890 891 892 893 894 895 896 897 898 899 900 901 902 903 904 905 906 907 908 909 910 911 912 913 914 915 916 917 918 919 920 921 922 923 924 925 926 927 928 Wong & Kasari, 2012). Signs of emerging intentionality (3.5) contains the specific codes for behaviors that show a certain character, such as goal-directedness, persistence, and turn taking (general code: code for intentionality), which might provide evidence of emerging intentionality (Bruce & Vargas, 2007;Prizant & Wetherby, 1987;Vandereet, Maes, Lembrechts, & Zink, 2010). ...
Article
The aim of this study was to develop a coding scheme that enables researchers and practitioners to conduct a detailed analysis of the communicative behavior of young children with significant cognitive and motor developmental delays. Currently, there is a paucity of methods to do conduct such an analysis. For the study, video observations of three different scenarios from 38 children with significant cognitive and motor developmental delays aged between 12 and 54 months, were used. Findings from the video observations served as the primary means for development of the coding scheme, which comprises three main categories - context, partner behavior, and individual behavior - and several subcategories. The coding scheme was used to document the early expressive communicative behavior of persons with significant cognitive and motor developmental delays in a detailed manner. This fine-grained information is necessary to differentiate children based on their communicative abilities, to monitor their communicative development longitudinally, and to inform person-centered communicative interventions.
... Since ASD is defined by a common set of behaviors, it is best represented as a single diagnostic category that is tailored upon the individual's clinical presentation including clinical characteristics and associated features [120]. Assessing ASD in blind and visually impaired children is a very delicate process in which most of the common methods used to score autistic behavior, including several items linked to vision [121,122] are applied. Therefore, in clinical practice, these standard assessment tools may not be appropriate for specific VI populations [123]. ...
... Hoevenaars-van den Boom and colleagues [123] aimed to identify ASD-specific behaviors in deaf-mute people. For this purpose, authors have developed the "observation of characteristics of ASD in persons with deaf-blindness (O-ADB)", an originally semi-standardized observation tool based on the Autism Diagnostic Observation Schedule [124], the Autism Screening Instrument for Educational Planning [35], the Autism Diagnostic Interview Revised [125], and on the Van Dijk Approach to Assessment [121]. ...
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There remains great interest in understanding the relationship between visual impairment (VI) and autism spectrum disorder (ASD) due to the extraordinarily high prevalence of ASD in blind and visually impaired children. The broad variability across individuals and assessment methodologies have made it difficult to understand whether autistic-like symptoms shown by some children with VI might reflect the influence of the visual deficit, or represent a primary neurodevelopmental condition that occurs independently of the VI itself. In the absence of a valid methodology adapted for the visually impaired population, diagnosis of ASD in children with VI is often based on non-objective clinical impression, with inconclusive prevalence data. In this review, we discuss the current state of knowledge and suggest directions for future research.
... The van Dijk approach to assessment and communication intervention has been adopted internationally and is intended to support the development of presymbolic to early linguistic communicators. Van Dijk's approach emphasizes the establishment of trust, responsiveness to the child's communicative attempts, sharing of emotional states, communicating using the child's expressive forms, building different types of conversations based on the child's interests, coactive techniques (including coactive movement routines), sequential memory strategies, the use of drawings, and the achievement of symbolic understanding and expression [123][124][125][126]. Early conversations are sensitive to the child's emotional state and need for safety, focus on the child's preferred topics, integrate the use of movement and objects, and establish turn taking [125,127]. ...
... The van Dijk approach to assessment and communication intervention has been adopted internationally and is intended to support the development of presymbolic to early linguistic communicators. Van Dijk's approach emphasizes the establishment of trust, responsiveness to the child's communicative attempts, sharing of emotional states, communicating using the child's expressive forms, building different types of conversations based on the child's interests, coactive techniques (including coactive movement routines), sequential memory strategies, the use of drawings, and the achievement of symbolic understanding and expression [123][124][125][126]. Early conversations are sensitive to the child's emotional state and need for safety, focus on the child's preferred topics, integrate the use of movement and objects, and establish turn taking [125,127]. ...
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