ERIC EJ1137411: Adaptation of a Developmental Test to Accommodate Young Children with Low Vision

2017·0.16 MB·English

by  ERIC

Adaptation of a Developmental
Test to Accommodate Young
Children with Low Vision
Viviana Ferreira and Cristina P. Albuquerque
Structured abstract: Introduction: This study analyzed the effects of accommo­
dations for children with low vision in the Griffiths Mental Development
Scales–Extended Revised (GMDS-ER). Methods: The sample comprised 25
children with low vision and chronological ages between 28 and 76 months.
There were two assessment phases: in the first, the Griffiths Scales were admin­
istered according to the procedures described in the manual; about two to four
weeks later, a second assessment was performed with the same instrument that
had been adapted for low vision. Results: The results indicated that there were
some favorable differences in the use of item accommodations for children with
low vision, including statistically significant improvements of scores in sub-
scales A, locomotor; C, language; and E, performance, as well as in the full scale.
All children, except one, increased their full scale score; in the subscales, the
number of children that increased their scores varied. The combination of
different types of accommodations (materials, administration conditions, and
success criteria) generated the best results. Still, many children increased their
scores with only accommodations to materials (for instance, enhancement of
contours and greater visual contrast). Discussion: The results demonstrated the
importance of adapting developmental standardized tests for children with low
vision. Future studies should increase the sample size and control variables related
to type of visual impairment. Implications for practitioners: Test developers and test
users should consider accommodations for young children with low vision. That
way, the developmental level could be described more precisely and intervention
could be better adjusted to each child’s abilities. Furthermore, a more accurate
developmental assessment of effective child’s competencies and difficulties may be
useful in terms of eligibility criteria for special education services.
W
hen children have a specific sensory Hence, it is very important to assess their
disability such as visual impairment, they development regularly. Furthermore, the
may have more difficulties exploring and assessment of a child’s development is a
understanding the (visual) world around crucial step for the design of an interven­
them and may, therefore, be at greater risk tion plan, so it should accurately reveal
of developmental delays (Warren, 1994). the child’s strengths and difficulties. For
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©2017 AFB, All Rights Reserved Journal of Visual Impairment & Blindness, March-April 2017
children with visual impairments, this as­ as the Reynell-Zinkin Scales (Reynell,
sumption is no exception. 1979) and the Oregon Project for Pre­
When information is necessary about a school Children who are Blind or Visu­
child’s level of development in relation to ally Impaired (Andersen, Boigon, Davis,
peers, professionals often use individual­ & deWaard, 2007), and that were de­
ized, standardized, and norm-referenced signed for children with this particular
developmental assessment instruments. type of impairment. These instruments,
These instruments are designed for chil­ however, were originally developed in Eng­
dren with typical development, and, as a lish and are not always available in other
result, the materials, procedures, and in­ languages and contexts, such as in the case
structions do not take into account the of Portugal. Another solution is to adapt an
specificities of some populations, such as existing and psychometrically robust instru­
children with low vision. There is, there­ ment that has been designed for the gen­
fore, no guarantee that a developmental eral child population. Accommodations
assessment conducted with a child who has of materials, response possibilities, and
low vision reflects his or her actual skills, procedures may minimize the influence of
since changing the procedures, instructions, a disability without changing what the
and materials of a particular standardized test assesses. As accommodations main­
instrument is not recommended. tain the item content, norm tables would
Unless accommodations are made in as­ still be applicable, thus allowing the com­
sessment tests, however, assessment prac­ parison of the test scores of children with
tices pose the risk of treating children with and without disabilities (Visser, Ruiter,
disabilities unfairly (Salvia, Ysseldyke, & van der Meulen, Ruijssenaars, & Tim-
Bolt, 2013). Children with disabilities may merman, 2013, 2014).
have difficulties on tests if the items are Although there is a recognized need in
very difficult or impossible to understand the literature for assessment instruments
due to their disabilities (for example, tests in that are specifically adapted to children with
print or tests with images, lots of visual visual impairments, there is little empirical
information, and low contrast may be con­ research that has demonstrated the reliabil­
sidered inappropriate for students with se­ ity and validity of adapted tests for a given
vere visual impairments). In addition, country or that has analyzed the effect of
children with disabilities may also expe­ such adaptations. For instance, a recent re­
rience difficulties when trying to carry out view analyzed contemporary, widely used,
the tasks required by the test, and their and standardized instruments for the devel­
disability can limit their own ability to opmental assessment of children aged 0–4
respond or renders responses impossible years, and concluded that for children with
(for example, to fit board pieces in a short visual impairments no suitable instrument
period of time or to walk down stairs with was available (Visser, Ruiter, van der Meu­
one foot on each step, without being al­ len, Ruijssenaars, & Timmerman, 2012).
lowed to hold the handrail, may be difficult And only three studies (Ruiter, Nakken,
for a young child with visual impairment). Janssen, Meulen, & Looijestijn, 2011; Vis­
There are tests that take into account ser et al., 2013, 2014) were found that ac­
the specificity of visual impairment such commodated the procedures, instructions,
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Journal of Visual Impairment & Blindness, March-April 2017 ©2017 AFB, All Rights Reserved
and materials of a standardized develop­ Greece—Giagazoglou et al., 2006). The
mental test, namely the Bayley Scales, for GMDS-ER 2– 8 assesses the areas of cog­
the assessment of children with low vision. nition, language, fine and gross motor
More specifically, the main accommoda­ development, and social-emotional devel­
tions made in these studies included: the opment. Regarding the scales’ psycho­
extension of time limits so that the child metric properties, it has been demon­
with low vision had enough time to visually strated that they have construct validity
and tactually explore materials; the intro­ across cultures and over time (Luiz et al.,
duction of more color and contrast in the 2001: Reyes et al., 2010), and there is
materials (such as vivid and bright colors other favorable evidence of their validity
against a black background); placing ob­ and accuracy (Ferreira et al., 2007a,
jects and pictures closer to the child; the 2007b; Griffiths, 1984). In Portugal, the
consideration of the child’s position in the GMDS-ER is one of the few standardized
room (with their back to the window); developmental assessment instruments
the lighting in the room; and the additional available, and is also one of the most used
verbal prompting from the test administra­ with young children.
tor or parental figure during motor activi­ The GMDS-ER has not been adapted
ties. The accommodations were evaluated for children with low vision in any coun­
positively by test administrators and proved try. In the current study, the GMDS-ER
to be beneficial for some of the children was adapted to assure its suitability for
with visual impairments or motor impair­ use with children with low vision and, in
ments who participated in the studies particular, to enhance the children’s op­
(Ruiter et al., 2011; Visser et al., 2013, portunities to show their skills. Items
2014). Nevertheless, only one of those had were accommodated in terms of materi­
a sample totally comprised of children with als, administration conditions, and suc­
low vision (Ruiter et al., 2011); the other cess criteria in order to minimize the
studies included children with motor im­ influence of visual impairments in the
pairments (Visser et al., 2013, 2014), visual children’s performance. The item time
impairments (Visser et al., 2013), and both limits were also extended because chil­
visual and motor impairments (Visser et al., dren with visual impairments generally
2013, 2014). need more time to complete the tasks.
In this context, the present study takes Thus, this study has the following purposes:
as its starting point the Portuguese
version of the Griffiths Mental Develop­ 1. To determine whether children with
ment Scales–Extended Revised: 2 to 8 low vision would perform differently
years (GMDS-ER 2– 8) (Ferreira, Carval­ in each subscale of the GMDS-ER
ha˜o, Gil, Ulrich, & Fernandes, 2007a, with and without accommodations and
2007b). This instrument was created by to define what types of accommoda­
Griffiths (1984) in the United Kingdom, tions were more and less effective. Re­
but it is widely used in Portugal as well as sults will be analyzed quantitatively
in other countries (such as South Africa— and qualitatively.
Luiz, Foxcroft, & Stewart, 2001; the 2. To obtain information concerning the
Philippines—Reyes et al., 2010; and development of Portuguese young
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©2017 AFB, All Rights Reserved Journal of Visual Impairment & Blindness, March-April 2017
children with low vision. The research timing ensured that the children with low
available about the development of vision had the time they needed for ex­
children with visual impairments is ploring the materials and completing the
restricted, mainly to North America tasks. In short, this procedure seemed un­
(Celeste, 2006, 2007; Hatton, Bailey, likely to affect children’s scores.
Burchinal, & Ferrel, 1997; Lewis &
Iselin, 2002) and focused on blindness PARTICIPANTS
(Brambring, 2001, 2006, 2007; Ce­ The sample comprised children moni­
leste, 2006, 2007; Warren, 1994). tored by the Support Centre to Early In­
tervention in Visual Impairment (Centro
Methods de Apoio a` Intervenc¸a˜o Precoce na Defi­
STUDY DESIGN cieˆncia Visual [CAIPDV]), a part of the
National Association of Early Interven­
This study used a within-subject design
tion (Associac¸a˜o Nacional de Intervenc¸a˜o
and included, first, the administration of
Precoce [ANIP]). The CAIPDV monitors
the GMDS-ER 2– 8 to children with low
visually impaired children from birth to
vision according to the procedures de­
age 6 years who live in the center of
scribed in the manual (standard version).
Portugal. The criteria for sample selection
Next, the authors identified the accommo­
were: age (between 2 and 6 years); the
dations that were to be introduced into
type of visual impairment, including only
several items that might reduce the im­
low vision due to “potentially simple”
pact of the visual impairment on the chil­
congenital peripheral visual pathologies
dren’s performance, in the various devel­
(cerebral visual etiologies were exclud­
opmental areas assessed. Two to four
ed); and a severe level of visual impair­
weeks later (M = 22.2 days; SD = 4.1
ment, that is, form (spatial) vision or
days; Min. = 16 days; Max. = 34 days),
awareness of visual targets that do not
a second assessment was performed with
reflect light. These criteria are consistent
the same instrument, now adapted for low
with the ones proposed by Sonksen and
vision (the accommodated version).
Dale (2002) concerning the categoriza­
At the second assessment, only those
tion of children with visual impairments
items that the child had previously failed
who participate in developmental studies,
and those that required timing were ad­
as well as with the need to control for
ministered. This procedure was imple­ confounding variables.
mented for the following reasons: to re­ Thus, the sample included 25 children
duce the GMDS-ER 2– 8 administration with low vision, of which 18 were boys
time, which is usually long, since it in­ and 7 were girls, aged between 28 and 76
cludes six subscales and a maximum of months (M = 56 months, SD = 15.3). To
228 items; and to avoid fatigue in the grade the level of visual impairment, the
children since they were being retested Near Detection Vision Scale was applied
shortly after having completed the first (Sonksen & Dale, 2002).
assessment. Loss of acquired skills was This is a 0-to-9–point functional scale
not expected. In addition, the decision to that grades degrees of impairment and
re-administer all the items that required levels of vision lower than the limits of
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Journal of Visual Impairment & Blindness, March-April 2017 ©2017 AFB, All Rights Reserved
other scales—Snellen size 60 at 1 meter into account the main occupation, job sit­
(about 3.3 feet), logMAR 1.8 at 1 meter, uation, and school level of the child’s
grating acuity 0.18 cycles/degree at 38 parents or caregivers. The information
centimeters (about 15 inches)—and is was collected by interviewing the chil­
used with children who have already been dren’s parents (usually the mother). The
identified as having visual impairments. parents of all children participating in the
A functional scale seems essential for study gave their informed consent.
preschool children with visual impair­
ments whose visual acuity cannot be re­ INSTRUMENT
corded using optotypes. The Near Detec­ The GMDS-ER 2–8 consists of six sub-
tion Vision Scale assesses fixation or scales: A, locomotor, which measures
tracking of stationary or moving targets gross motor skills, including balance,
(easily performed by typically sighted chil­ coordination, and movement control; B,
dren); 0 points corresponds to sunlight per­ personal-social, measuring the proficiency
ception (profound visual impairment) and 2 of the child’s autonomy in daily activities,
or more points to form vision (severe visual as well as the ability to interact with peers;
impairment) (Sonksen & Dale, 2002). Ap­ C, language, which assesses receptive and
proximately 96% of the children obtained a expressive language; D, eye and hand
score of 9 points (fixation on a stable object coordination, measuring the child’s fine
of 0.12 centimeters [0.05 inches] diameter), motor skills, manual dexterity, and visual-
and 4% of the children had a score of 8 motor skills; E, performance, which
points (fixation on a stable object of 0.25 assesses visual-spatial skills, including
centimeters [0.1 inches] diameter). Both ob­ speed of working and precision; and F,
jects were presented at 30 cm [11.8 inches] practical reasoning, which measures the
distance and contrasted against a dark-green child’s ability to solve practical problems,
cloth on a table surface. Hence, the sample sort sequences, and understand basic
included children with severe visual impair­ mathematical concepts and moral issues
ments and, therefore, form (spatial) vision, (such as understanding right and wrong).
since all children achieved scores equal to It is possible to calculate scores for each
or higher than 2 points. Furthermore, the of these subscales and for the full scale,
severe visual impairment had very diverse which encompasses all subscales.
causes, with high myopia (n = 7), nystag­
mus (n = 3), ocular albinism (n = 3), and Griffiths Mental Development Scales
glaucoma (n = 3) being the most frequent —Accommodated Version
pathologies. The first step in the process of adapting
Approximately 56% of the children be­ the GMDS-ER for children with low vi­
longed to a low socioeconomic level, sion was to research the accommodations
24% to a medium one, and 20% to a high performed in other studies reported in the
one. Socioeconomic level was determined literature (Ruiter et al., 2011; Visser et al.,
according to a classification system cre­ 2013, 2014). In addition, all GMDS-ER
ated and used with the Portuguese popu­ 2– 8 items were explored to assess which
lation in the national standardization of accommodations would be necessary. Ob­
tests (Simo˜es, 2000). This system takes servations of how each child performed the
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©2017 AFB, All Rights Reserved Journal of Visual Impairment & Blindness, March-April 2017
tasks proposed in the first assessment (with­ instance, the child may not see how the
out accommodations) also provided clues examiner had cut a piece of paper with
on the accommodations necessary. The scissors), so if the child failed the item,
long experience of the first author in work­ the visual demonstration was replaced by
ing with children with low vision was also a demonstration with the physical assis­
a factor taken into account when defining tance of the examiner (by the examiner
the accommodations necessary for each holding the paper and giving the scissors
item. The accommodations were also de­ to the child). After the demonstration, the
veloped in close cooperation with assess­ child performed the task by herself.
ment experts and practitioners working The accommodations related to success
with children with visual impairments. criteria involved determining a perfor­
Accommodations were made to the ma­ mance conducted with a little assistance
terials, administration conditions, and suc­ (such as holding the handrail while going
cess criteria (response and time). These ac­ up stairs) as successful. These accommo­
commodations included the enhancement dations were used with a small number of
of contours (such as images using a black items of the locomotor subscale: while
marker); image magnification (for in­ going up or down stairs the child could
stance, block patterns or images); the use hold the handrail; while running up or
of the reading stand; isolation of visual down stairs the child could also hold the
stimulus (for instance, for copying figures handrail; the child could ride a bicycle or
or for describing a big image); and con­ a tricycle in the presence of an adult or in
trast enhancement (such as the use of familiar places. These accommodations
yellow cubes instead of brown ones, pro­ were intended to ensure that the children
viding greater contrast with the black with low vision could show their skills
box). with safety.
The accommodations to administration The accommodated items were orga­
conditions comprised better lighting in nized into three mutually exclusive cate­
the work area; the substitution of the man­ gories: items included in category 1 that
datory visual demonstration of the task required accommodation of the materials
(such as cutting with scissors) as it was or administration conditions; category 2
performed by the examiner, by having the included the items requiring accommoda­
examiner and child performing the task tion of the success criteria; and category 3
together; and the tactile exploration of the comprised those items that required two
material before performing the task (for or more of the aforementioned accommo­
example, puzzle pieces, blocks, or boxes). dations, particularly in terms of materials,
These accommodations took place, mainly, administration conditions, and success
in items that required eye and hand coor­ criteria. In the specific case of this cate­
dination. Visual demonstration of the task gory, accommodations could also include
is mandatory in several items of the extension of time limits, which we de­
GMDS-ER, so the examiner demon­ cided to extend by one-third, as proposed
strated the task before asking the child to by Ruiter et al. (2011).
perform it. This procedure could be inac­ The largest number of accommoda­
cessible to a child with low vision (for tions occurred in motor or visual-motor
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Journal of Visual Impairment & Blindness, March-April 2017 ©2017 AFB, All Rights Reserved
Table 1
Raw scores and developmental ages in the standard and accommodated versions.
Developmental
Raw scores ages
Subscales M SD ta/Wb M SD ta/W b
A. Locomotor 57.74 21.68 -3.12*a 49.08 17.14 -3.08*a
A. Locomotor, with accommodations 58.70 21.63 49.94 17.27
B. Personal-social 63.81 18.20 -1.00b 53.18 15.61 -1.00b
B. Personal-social, with accommodations 63.89 18.21 53.26 15.61
C. Language 62.23 23.19 -2.82*a 50.80 18.73 -2.85*a
C. Language, with accommodations 63.91 22.71 51.94 18.34
D. Eye-hand coordination 56.15 22.30 -2.90*a 49.64 16.29 -1.87a
D. Eye-hand coordination, with accommodations 57.24 22.45 50.78 17.35
E. Performance 56.50 20.68 -8.44*a 52.42 24.83 -3.83*b
E. Performance, with accommodations 64.49 21.99 61.84 26.18
F. Practical reasoning 57.36 23.03 -1.45a 47.82 15.29 -1.45a
F. Practical reasoning, with accommodations 57.52 23.02 47.94 15.27
Full scale 58.90 20.42 -7.49*a 50.04 16.63 -5.99*a
Full scale, with accommodations 61.09 20.63 52.40 17.67
* p < .05.

a Paired samples t test.

b Wilcoxon signed-ranks test.

subscales, specifically in the locomotor (22 the second administration. The items ad­
items accommodated), eye and hand coordi­ ministered (previously failed and those
nation (27 items accommodated), and perfor­ that required timing) were scored again.
mance (38 items accommodated) subscales. Table 1 shows the raw scores and devel­
Of a total of 228 items, 108 items were opmental ages obtained.
accommodated as follows: 68 items with The raw scores and developmental ages
category-1 accommodations; 7 items with of each of the subscales and of the full
category-2 accommodations; and 33 items scale (see Table 1) with and without ac­
with category-3 accommodations. commodations for low vision indicated
the existence of differences between the
Results standard and the accommodated versions.
Preliminary data analysis indicated three This was evident in the means, which
outliers in developmental ages (one in were slightly higher for the accommo­
subscale D with accommodations; one in dated version, especially in subscale E
subscale F; and one in subscale F with (performance), which displayed the larg­
accommodations). These extreme values est differences.
were Winsorized (Wilcox, 2005). In order to test these differences, the
Developmental ages were derived distribution of all the variables was ex­
through reference tables of the normative amined with the Shapiro-Wilk test, which
sample. Concerning the accommodated is considered suitable for small samples
version, all the items passed on the first (Field, 2000). All the variables showed a
administration were scored as passed on normal distribution (p > 0.05), except the
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©2017 AFB, All Rights Reserved Journal of Visual Impairment & Blindness, March-April 2017
Table 2
Score increases from the first to the second assessment.
Category
accommodations
Score
Subscale 1 2 3 increase n %
A. Locomotor (38 items) 15 7 0 Yes 9 36
No 16 64
B. Personal-social (38 items) 5 0 0 Yes 1 4
No 24 96
C. Language (38 items) 7 0 0 Yes 9 36
No 16 64
D. Eye-hand coordination (38 items) 26 0 1 Yes 8 32
No 17 68
E. Performance (38 items) 6 0 32 Yes 22 88
No 3 12
F. Practical reasoning (38 items) 9 0 0 Yes 2 8
No 23 92
Full scale 68 7 33 Yes 24 96
No 1 4
following ones: raw scores of subscale B and the full scale, Table 2 shows that the
with (p = .004) and without (p = .006) scores of 96% of the children increased
accommodations; developmental ages of on the full scale. Analyzing each of the
subscale B with (p = .014) and without subscales separately, the greatest number
(p = .019) accommodations; and devel­ of children (88%) increased their score in
opmental ages of subscale E with (p = subscale E (performance). By contrast,
.005) and without (p = .005) accommo­ subscale B (personal-social) and subscale F
dations. Data were compared with the (practical reasoning) were those in which
paired samples t test when the distribu­ the greatest number of children (96% and
tions were normal, and with the Wilcoxon 92%, respectively) maintained their original
signed-ranks test when the distributions scores. These scores are consistent with the
were not normal. There were significant number of items accommodated in each of
differences (p < .05) in the raw scores the subscales. All items of subscale E were
and developmental ages in subscale D accommodated, while only five and nine
(eye and hand coordination) between the items were accommodated in subscales B
standard and the accommodated versions. and F, respectively.
In addition, at both the raw score and In regard to the accommodation cate­
developmental age levels, there were sig­ gories, the score increase was higher in
nificant differences in subscale A (loco­ items with category-3 accommodations
motor), subscale C (language), subscale E (88% of the sample), followed by cate­
(performance), and the full scale. gory 1 (56% of the sample), and category
Regarding the score increase from the 2 (20% of the sample). Table 3 shows the
first to the second assessment, in terms of number of children who increased their
the raw scores in each of the subscales score per accommodation category.
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Journal of Visual Impairment & Blindness, March-April 2017 ©2017 AFB, All Rights Reserved
Table 3
Number of children who increased their score according to accommodation category.
Items of Items of Items of
category 1 category 2 category 3
Children who n % n % n %
Did not increase their score 11 44 20 80 3 12
Increased their score by 1 point 5 20 5 20 0 —
Increased their score by 2 points 4 16 0 — 2 8
Increased their score by 3 points 1 4 0 — 4 16
Increased their score by 4 points 1 4 0 — 5 20
Increased their score by 5 points 1 4 0 — 6 24
Increased their score by 6 points 0 — 0 — 1 4
Increased their score by 7 points 2 8 0 — 2 8
Increased their score by 8 points 0 — 0 — 1 4
Increased their score by 9 points 0 — 0 — 1 4
Total 25 100 25 100 25 100
A wide variability in individual perfor­ provement in one or more of the accom­
mances was observed for each of the modations categories.
accommodation categories when analyz­
ing each participant separately. In partic­ Discussion
ular, the scores of participants 2, 11, and EFFECTS OF THE ACCOMMODATIONS
18 did not improve or improved only —QUANTITATIVE ANALYSIS
slightly, and improvements were most ev­
The main objective of this study was to
ident in the scores of participants 3, 9, 10,
determine what adaptations should be in­
12, 13, 15, 22, and 24 (see Table 4). The
troduced to the GMDS-ER and to analyze
remaining participants showed some im-
the effect of item accommodations on the
performance of children with low vision.
Table 4 Significant differences were found in
Variability in individual performances. the raw scores and developmental ages
Score increase
between the standard and the accommo­
dated versions in subscales A (locomo­
Participants Category 1 Category 2 Category 3

tor), C (language) and E (performance),
2 0 0 0
as well as in the full scale. By analyzing
3 1 1 6
the differences between the standard and
9 7 0 5
10 5 0 5 the accommodated versions, both in raw
11 1 0 2 scores and developmental ages, it was
12 7 0 9
possible to verify that in subscale E (per­
13 2 0 7
formance), there was an increase of ap­
15 0 1 7
18 1 0 0 proximately nine months in developmen­
22 4 0 8 tal age, equivalent to 8 raw score points,
24 1 0 5
and that the full scale score increased by
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©2017 AFB, All Rights Reserved Journal of Visual Impairment & Blindness, March-April 2017
a few months. It should be noted that als (category 1), which means that these
between the administration of the stan­ accommodations may be sufficient for
dard and accommodated versions only children with low vision to perform bet­
two to four weeks had elapsed. Regarding ter in accordance with their effective
the score increases from the original ver­ abilities.
sion to the accommodated version, all
children except one increased their EFFECTS OF THE ACCOMMODATIONS
scores. In each of the subscales, the num­ —QUALITATIVE ANALYSIS
ber of children with increased scores In regard to the score increases in each
varied. item’s accommodation category, the anal­
It is interesting to note that it is in sub- ysis of the individual performance of each
scale E (performance) that the most signif­ of the participants revealed a wide vari­
icant differences were found. This subscale ability that is important to explore (see
had the largest number of items with ac­ Table 4). Participants 2, 11, and 18 did
commodations, especially category-3 ac­ not show improvements, while subjects 3,
commodations, and was the most effective 9, 10, 12, 13, 15, 22, and 24 did show
in terms of the score increases of the clear improvements. By analyzing the in­
participants. dividual characteristics of each child, it is
A lack of effectiveness in score increases possible to propose some explanations for
in items with category-2 accommodations these results.
(success criteria) was observed. A possible Participants 2 and 11, in the assessment
explanation is that there were only seven with the original scales, already revealed
items with category-2 accommodations, a developmental age within what would
mainly in subscale A (locomotor). More­ be expected for their age, and they had
over, taking into account the qualitative ob­ difficulties in seeing faraway objects.
servations made during the assessments, if Thus, without any concerns about their
the child had difficulty performing a certain development and because their type of
task in the first assessment, having changed vision impairment did not greatly inter­
only the success criteria did not seem to fere in the performance of the assessment
have an effect on the score (for example, in tasks, it was somewhat expected that the
items related to stairs, the accommodation accommodations would have no effect on
introduced was the permission to hold the their scores. The contrary was observed
handrail; if the child had difficulty going up for participant 18, who was also near­
and down stairs, holding the handrail did sighted but for whom the assessment with
not eliminate this difficulty, although it may the original scales revealed a develop­
have minimized it). mental delay. Hence, the fact that the
The combination of different types of accommodations did not have a signifi­
accommodations (materials, administra­ cant effect on the performance of this
tion conditions, success criteria, and ex­ child may be explained by the existence
tension of time limits)—that is, category of developmental, rather than visual,
3— generated the best results. Nonethe­ impairments.
less, many subjects increased their scores Participants 9, 10, and 12 reached
only with accommodations of the materi­ higher scores on items with category-1
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Journal of Visual Impairment & Blindness, March-April 2017 ©2017 AFB, All Rights Reserved