General Guidelines for using the DISC and DPSOVERVIEWINTRODUCING THE CONCEPT OF "DEVELOPMENTAL SCREENING" TO THE PARENT OR GUARDIAN:Explain to the parent or guardian, using a vocabulary that will be clearly understood, the following points: "The DPS or DISC are "developmental screening tools" and not IQ tests; the results will show their child's strengths and weaknesses so that I can given you some ideas on what you can do at home to assist in your child's development. I will start by giving your child some fairly easy items and then the items will get harder. I have to keep giving items until your child starts to have some difficulty. Don't assume that because I am trying to get your child to do a certain task, that he/she should be able to complete the task. You are welcome to stay and watch but please sit behind your child and try not to say anything unless I look to you for some direction or some information. If you feel that your child would cooperate better without you in the room, you can make the decision to leave the room. We will have plenty of time, after I complete the screening, to discuss your child's performance and any questions you may have. At times your child might not be interested in completing the task we are working on. If this happens, I will return to the task later during the screening session. If your child gets too tired or loses interest, we will take a break or we can complete the screening at another time. When I finish the screening and review the results with you, it is important for you to evaluate how "accurate" these results are in your opinion. When observing your child's performance, I would be quite interested in hearing, at the end of the session, whether you feel your child performed as he would "normally" on a day-to-day basis. I would also be very interested in hearing whether you have an concerns about whether your child is developing "normally" in comparison to other children of the same age". (This question is critical as parent responses indicating a concern have, in the past, correlated significantly with documented delays). Thus, as the DPS and DISC manuals indicate, parent's or even teacher's concerns should supersede "average" results on either the DPS or DISC and the child should be referred for follow-up assessment. AGE CALCULATIONIf you know the child's birth date, calculate their "age in months" before you begin the screening session. Refer to the DPS or DISC Manual for instructions on how to calculate the "age in months". Do not correct for prematurity when calculating the age in months. However, you can easily calculate and track the difference in a child's developmental level using both the "chronological" and the "corrected" age levels. For example, if a child is 12 months but was born 2 months premature, on the DPS, simply start screening at the "corrected" age in months (10 months) and give the corresponding 12 items plus the extra two items that would be given if the child were 12 months. Then calculate two scores based on each set of 12 items; for 10 months; items from 10 months to 20 months and for 12 months items from 12 months to 23 months to generate two separate scores out of 12. On the DISC, the corrected age will make less of a difference on the particular sample of items administered, since the items administered are based on reaching a basal and ceiling. Also, when interpreting DISC results using the norm tables or interpretive tables, the corrected age will most often not chance the "age grouping" in which the child falls. However, when plotting the child's eight DISC scale scores on the Approximate Age Equivalent Profile Sheet, you can draw horizontal lines corresponding to both the "corrected" and "uncorrected" ages and visually see the difference in approximate developmental age on each DISC scale.
ADMINISTRATION HIGHLIGHTSOn both the DPS and the DISC, calculate the child's "age in months" and begin your screening at the corresponding item on the DPS, administer this item plus the next eleven items for a total of 12 items on the DISC, establish a basal (all items passed in an age grouping of items) before proceeding. Keep going lower on the scale until you reach this basal then continue your screening until you reach a ceiling (all items "missed or failed" in an age grouping). Sit beside the child (on the side corresponding to his/her preferred hand) so that demonstrations (e.g. drawing for the Fine Motor scale) will be in a direction corresponding to the child's preferred hand. Before starting the screening, remove the containers from the kit that correspond to the child's age; set these materials on a chair beside you, away from the child to avoid distraction. If the child refuses to complete any item, leave it and return to it at least two more times during the screening before marking it as a missed or failed item. If the child appears tired or really uncooperative, stop the screening and give the child a break or, in consultation with parent or guardian, continue at another time or day. Always provide consistent positive feedback to the child regardless of the quality of their performance, e.g. "Well done", "You're doing a great job", or "Great work". If siblings are around, it is acceptable to allow them to do some of the tasks with the child e.g. fine motor or gross motor tasks however, language or attention and memory tasks must be completed with the child alone. On the DISC, the order that the scales are organized in the record form seems to suit most children:
Before moving on to the next item, always make sure that the child feels good about his/her performance on the item just completed after a reasonable amount of time, and after all demonstrations and trials have been completed and the items has been recorded as "missed or failed", if the child is having difficulty completing the item, adjust the item so that the child feels they have accomplished the task, e.g. "stringing the beads": hold the bead for the child and allow him/her to place the string through the bead then say "Well done!" Be careful of the amount of "prompting" offered: on the Fine Motor and Gross Motor scales, unlimited prompting is allowed; however on other scales such as the Language and Attention & Memory Scales, the examiner must be careful not to provide any clues that would invalidate the item; for example, on the Visual Attention & Memory Scale, when showing the child the red circle from the form board, the examiner says "See this"...then hides the shape and says "Now where is it?" The examiner cannot say "See this red circle" or allow the child to describe the shape or the nature of the task changes to measure both verbal and auditory attention and memory. This whole issue can be reinforced through reference to the DISC Skill Bases Manual which describes the nature of each skill that is evaluated by the DISC (available on request from the authors). Record all observational information on the DISC record form especially all verbalizations made by the child; several of the Expressive Language items can be credited if observed any time during the screening session so recording is critical and can save testing time; this recording can also he used to evaluate how the "quality of the child's performance" changes from one test session to another. Make sure you record the amount of time the child takes to complete any of the "timed tasks" on the Fine Motor scale. Recording of time can also be recorded for Self Help items for children with severe delays a "reasonable amount of time" is considered acceptable but severely delayed children do not meet this criterion; however, recording the time they do take can allow for monitoring not only the number of items mastered, but the "increase in quality of their performance" over time. The DPS and DISC are "standardized screening tools" and standard administration instructions and materials should be used; however, in some cases, deviations are necessary: sometimes substitute toys elicit the desired response or modifications have to be made related to culture or physical disability; these modifications are acceptable as they will still yield valuable information; the critical point is that any modifications to the instructions or test materials must be clearly listed and discussed in the DISC summary report. Record all observations and summaries on the back section of both the DPS and DISC; the DISC does not specifically measure behaviour but the last page of the record form allows the examiner to record any notable behaviours for inclusion in the DISC summary report. The DISC also does not measure articulation; the Receptive and Expressive Language scales of the DISC measure language and speech "development" rather than "articulation"; thus a child's score could fall within the "Average" range in these areas but a Speech and Language referral is still warranted based on observed difficulties with articulation. Make sure that you take advantage of the Linkage Cues in the Instruction Manual under " NOTE:" which should speed up your screening. Also make sure you read the "COMMENT:" for items in the Instruction Manual which assist in the accurate administration of each item. Try to administer or observe information for all DISC items; however, some items, especially on the Expressive Language, Self Help and Social scales can be credited based on report from a parent or guardian. For items where report from the parent, teacher or guardian is accepted (indicated by "REPORT ACCEPTED"), do not ask leading questions e.g. for Self Help, some items require information about feeding, dressing and toileting; rather than asking "Does your child put on his socks by himself?", say "Let's discuss your child's dressing skills: What clothes can he take off by himself and what clothes can he put on by himself?"; the reliability of parental responses to leading questions is much lower than when they are asked more open-ended questions; most parents assume that if we ask them if their child can put on socks by herself, that their child should be able to perform this skill. Several items include comments to the effect that the required skills "can be observed at any time during the screening session". This means that the child's response does not have to occur on demand but can occur at any time that you are working with the child and administering the DPS or DISC.
SCORINGDISC Preschool Screen (DPS): the DPS score is out of 12 for each child; remember to refer to the DPS manual for the correction factor to apply if the child is over 50 months. A score of six or below indicates the need for follow-up with the complete DISC. Diagnostic Inventory for Screening Children (DISC): the DISC score is out of 27 on each DISC scale; there are several ways of representing the results: DISC Interpretive Summary Sheet:
(A: Average, P: Possible Delay, D: Probable Delay) DISC Approximate Age Equivalent Sheet:
DISC Item Performance Summary Sheet:
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