Dynamic assessment of learning processes using Feuerstein’s LPAD: an paradigmatic innovation to plan inclusive educational intervention for children with special educational needs1
Jo Lebeer MD PhD2
Problems with life-long testing
Children with special educational needs are habitually tested all their lives. Life-long testing seems to prevail to life-long learning. On the basis of test results, decisions are made as to special needs provisions, support provision, curricula, therapy, work, income, etc. Tests start early in life as soon as there is a suspicion of deviating from the norm. Tests may be mainly oriented to diagnosis (medical underlying etiology), functioning (developmental profile, neuropsychological functioning), to learning performance (academic achievement).
The impact of testing is huge, and not always to the benefit of the child. In a survey done in 6 European Countries (Birta-Szekely & Demeter, 2009), by the Daffodil projectgroup, the obvious beneficial effects. such as a recognition of the child’s problem and a benefit in terms of financial or human support, are often outweighed by harmful effects on the child’s educational future. The shadow of a diagnostic, functional and learning testing is that labels often create educational low expectations, which might in themselves generate a self-fulfilling prophecy. This process has been described already years ago by Rosenthal e.a. in their famous Pygmalion papers.
It has not reduced testing practice: standardized testing remains standard practice in school psychological services, academic psychology and at school, as it was found out in our previous report. Although few people seem to be happy with it: teachers report they don’t know what to do, they don’t get educational advice out of them. Parents are ambiguous: happy when the report yields support and recognition, but they complain because the doors close to full inclusion and challenging education. The only ones who seem to be satisfied with standard test practice are the test sellers, scientists and applying professionals. The users are unhappy. Children are excluded from further education when test results turn out low; and many times, in countries where inclusive education is not yet a right, children are referred to special schools where they remain the rest of their school career. In this way, standard tests are a frequent source of discrimination.
A question is: is this a problem of the tests, or of interpretation and resulting measures, or of organisation, i.e. the link between assessment and intervention.
This is the purpose of the Daffodil project.
Criticisms to psychometric and achievement testing
Criticisms have been formulated against standardized psychometric test practice already more than 90 years (for an overwied see Dias, ) An extensive criticism about the origin, use and misuse of specifically IQ measurement has been published by Stephen J. Gould in “The Mismeasure of Man”. His book met a lot of resistance by proponents of “classic” psychometric testing. Feuerstein et al (1979), the ‘founders” of dynamic assessment, also published a thorough critique. What are the fundamental objections against psychometric testing?
Not oriented to learning/ static
Because tests are meant to measure performance, they need to conform to the principles of measurement, which is standardization. Tests are standardized in the way they are applied as well as in their interpretation . In the name of equal treatment, the questions and instructions must be the same for everyone. This is the case for achievement as well as psychometric tests. One must ask therefore what is the problem with standardization? The most fundamental criticism is that psychometric tests are not valid to tell something about learning.
André Rey stated, already in the thirties of the 20th century, that IQ tests suppose they measure learning and they make predictions about learning,but there is no learning involved: if one wants to measure learning, one has at least to try to teach something, so look at the responses to learning.
Prejudice against disadvantaged people
There is a growing awareness that individual, standardized forms of testing disadvantage learners with special educational needs as well as learners from different cultures or disadvantaged backgrounds. Clear correlations are known to exist between ethnic background, socio-economic status, IQ and low school and economic performance. These have been brought together in the controversial “Bell curve” (Murray & Hernnstein, 1994) and amply criticized e.g. by Gould and many other people. IQ tests are culturally biased, unfair to individuals with a cultural background which is different from the “typical” white, Western, well-off children. In itself this standardization is not a problem, but its purpose has to be understood well and that isn’t always the case. Standardization is allright when the purpose is measurement and comparison within a population. But when the purpose is to understand functioning and, based on this, to formulate guidance, then standardization is of little use. Children who are low- or high functioning are always disadvantaged by any normated system.
Locating the problem in the individual
Another problem is that tests are always linked to individual performance, as if performance is a trait of the pupil. When a child does not learn well, the usual question is to ask “what’s wrong with the child?”, followed by a battery of tests.
Although it may add to understanding a learning problem of a child, by looking at underlying difficulties in functioning, it is a narrow perspective to locate the problems mainly or only within the chld.
It is common sense that any learning is highly contingent on a number of other factors, such as motivation, attention, physical well-being, selfperception and context. A standardized test does not take any of these into account, whereas in a typical classroom these factors become highly relevant. No current test takes a teachers’, parents’ or psychologist teaching style, or child’s background into account, while nevertheless making important projections about a child’s future functioning. Or, if such tests exist at all, they are not used at all, according to our research.
Rarely one would find a school which would evaluate a learners’ cooperation capacities, or dealing with diversity capacities. Yet it is the ability to cooperate jointly to a common goal, work in an interdisciplinary way, and with a diversity of people, which is a competence that is most needed in adult life. Most school and university exams are individual testings. The underlying philosophy is a competitive school or learning model. This is incompatible with an inclusive model. So here we are facing a fundamental philosophical contradiction, having however, huge practical consequences.
Similarly, in the end-evaluation of a student, the teacher’s influence is not taken into account, yet he or she might have had a decisive influence on the acquisition of a student’s competence. When the question is whether an individual masters a certain individual competence, e.g. to be able to drive a car, this should be teacher-independent. But when the question is to know why a child does not function and how it may function, one certainly needs to take the teacher into account.
The assumptions underlying test habits are based on an individual model of disability and learning, as if disability and learning are situated only within the child.
Static & deterministic conception of cognitive functioning
Standardized tests are based on the assumptions that:
a child’s performance is largely determined by child’s underlying learning characteristics.
These learning characteristics are seen as relatively stable in time
and mainly determined by biological factors
taken together, these are described as “intelligence”, a trait of the individual.
In psychology, this is referred to as “factor g”.
The correlation between intelligence and school achievement may seem rather strong (0,71) but the point is that 50% of the variance is not explained (Tzuriel).
The concept of static testing rests on the assumption of a nativistic, static and deterministic concept of learning and intelligence.
A static interpretation is given to test results
Standardized test results are plotted against a normative distribution curve, hence the results are always inter-individual comparative. Raw scores are compared to a scale of performance by age-related peers, and the performance is calculated as a fraction. This is the basis of IQ, DQ, and even academic performance and other tests. Of course, psychologists are well aware of this, but the public (parents, teachers) isn’t. Results are not always communicated in this way. An IQ of 50, objectively speaking, is “high”, because people with IQ level are capable of many things. But when a teachers knows that the child has an IQ of 50, immediately a system of beliefs starts to take hold of the mind.
For educational purposes, i.e. when the question is to know how to advance children in their learning, this is of little use. Yet the results, if they are interpreted in a static way, may create negative self-fulfilling properties. The same line of thinking operates in school achievement tests. Millions of children are subjected a few times a year to reading tests. What is the use in telling a teacher or a parent that the child’s reading performance is lagging 4 months behind, or language development is retarded with 2 years? In itself, it need not be harmful. The teacher can become aware and take necessary steps. But if testing results in a list of deficiencies – be it cognitive, motor, learning, etc. – the risk is that this negatively affects perception by others and self-perception, leading to blocking instead of activation.
Making tests is fine, as long as the results serve to give feedback how to correct or do better. Essential is to give feedback in a positive way, mediating feelings of competence, in order to increase motivation. When this is neglected, test results lead to a lack of feelings of competence. Perhaps it is more customary that teachers give feedback to tests, more than putting red marks with every mistake. But it is far from systematically done. Everyone learns by errors. Correcting erros in a reflective way is a very useful learning opportunity. In psychometric testing, this kind of feedback is not allowed, as it is supposed to interfere with objectivity.
A supplementary consequence, in those countries where inclusive education is an option and not a right, is that in many situations, “bad outcome” results in referral to special schools, hence in exclusion. Hence, the real problem with testing is the perspective that is adopted by those who interpret the testing, i.e. what kind of underlying view they have on a child’s learning potential and modifiability.
All these criticisms, however, have not prevented psychometric assessment to continue to blossom worldwide, to be taught at our universities as a first choice and sometimes only valid evaluation system, and to influence strongly a child’s educational career and future adult life.
Alternatives to the testing paradigm
In order to respond to these criticisms, a number of alternatives have been formulated.
the European Agency for Development of Special Needs in Education published a manifesto “the Inclusive Assessment” with recommendations to individualize assessment according to the specific functional problems and educational needs of the child. These recommendation mainly focus on the issue of school achievement testing.
Another alternative is the framework of thinking offered by the World Health Orgnisation ‘s International Classification of Functioning, Disability and Health (ICF), which wants us to think about 5 domains: organic impairment, impairment in activity, impairment in participation, external and personal factors. A learning difficuly may thus be regarded from a biological or brain perspective, but this does not tell the whole story, as one must also look at the other domains in order to understand why a child does (or does not) function. This is a step forward, as for the first time in history, context is taken into account as an equal factor in understanding disability. However the ICF only gives a framework and classification; how functions are assessed and interpreted is another matter .The ICF is too young to have generated already workable methods.
The system of needs-based assessment (Pameijer, Vandeveire) shifts the prior emphasis on static psychometric assessment of individual properties to the assessment of educational needs. It de-emphasizes IQ t ogive it but a small place within the whole picture. Observation, dialogue with child, teacher and parents, assessment within the curriculum, are all equally valid sources of information. The goal of needs-based assessment shifts from testing to assessment over time, also to look at effectiveness of intervention.
Dynamic assessment (DA) designates a heterogenic group of approaches, which have in common that they assess responses to learning (Sternberg & Grigorenko). The principle is based on a test-intervention-retest model. Feuerstein (1979) can be regarded as a pioneer in the development of dynamic assessment. His LPAD (formerly called Learning Potential Assessment Device, now Learning Propensity Assessment) has become a source of inspiration for the development of other dynamic approaches (Haywood, Tzuriel, Lidz). Parallel to Feuerstein, Learning tests have been developed in other countries (Campione & Brown, Budoff, Hamers, Goetke, Hessels, Wiedl…), which aim to give learning tests more psychometric properties (validity and reliability) and make them also suitable for standardization and quantitative analysis. Hamers & Ruijssenaars’ Learning Test for Ethnic Minorities as well as Feuerstein’s LPAD and derived batteries are reportedly not so much culturally biased as is the case with IQ. Some of the newer approaches have been developed to assess cognitive functioning within the curriculum, using curricular subjects (Resing, Lidz). These will be discussed elsewhere.
In this article we will focus on Feuerstein’s LPAD model, because it is the basis of many other dynamic assessment systems, yet it differs from them in principles, objectives, methods, interpretation of data and recommendations. The LPAD is a radical departure from the classic testing paradigm: all the “rules” are broken. It represents a paradigmatic shift. In this article we will present its characteristics, some research data, and discuss weaknesses and strenghts
Principles & practice of Feuerstein’s LPAD
The Learning Potential Assessment Device (LPAD) battery was created by Feuerstein e.a. during the 50ties of the 20th century, as a response to a growing frustration in using psychometric testing for disadvantaged children. Historically, André Rey, a collaborator of Piaget at the University of Geneva, gave the first ideas. While Feuerstein was working with André Rey in post World War II refugee camps in Marocco and the South of France, they came across many children who performed low on classic psychometric testing, but who were intuitively believed to have more potential. Feuerstein & Rey introduced, after observing a baseline performance, a learning phase, where by the tester intervenes with the learner to teach principles, strategies, vocabulary and problem solution, in a mediating way. They observed that the performance afterwards was revealing their “true potential” and gave a better basis to make recommendations for teachers and parents and design educational interventions. Years later, after many other dynamic assessment methods have followed, Feuerstein changed the name to Learning Propensity Assessment Device, being well aware of the danger of using the concept “potential”. If a test pretends to measure potential, it can easily be misused and exclude again a number of children who would have a measured “low potential”.
Dynamic nature of LPAD
Feuerstein’s LPAD can be considered “dynamic” in various meanings.
It is dynamic in the sense that the underlying model of intelligence – the theory of Structural Cognitive Modifiability - is a dynamic one (as opposed to the static concept of “g” as an immutable characteristic of the individual). Feuerstein’s sees modifiability of the individual as characteristically human, whereby the construction of higher cognitive functions, cognitive tools and – operations is contingent on the adequate building of mediated learning experiences. Mediated learning experience is the way in which adults mediate the world to their offspring; it is the process of cultural intergenerational transmission. It is the very process of change.
It is dynamic in its choice of instruments. Although the test battery is composed of 14 instruments, not every individual is given the same set. The choice is made in function of the child’s individuality, particular needs. Modalities (visual, auditive, motor) may vary. The level of difficulty may also vary. Instruments may be chosen outside the specific LPAD battery, if they are more suitable for the purpose.
It is dynamic in its way of application. The essential characteristic of LPAD is that the examiner, after having established a “baseline” to find out how the child operates without interference, tries to teach something to the child: to mediate concepts, strategies, searching behaviours, language, planning, etc. This in function of the deficiencies or difficulties the examines did observe in the primary “pre-test” performance. This teaching takes place in a highly mediating way, according to the criteria of mediated learning experience. The degree of mediation also varies according to the needs. Mediation is never standardized. Feuerstein did not want to follow critics who wanted to make dynamic assessment more acceptable to “scientific” proponents of psychometrics by e.g. prescribing and quantifying the “prompts” or help that is given during the learning phase, as is done e.g. in the “Gutke” way or Wiedl. In the LPAD the kind of mediation that is needed to solve a problem, is written down and serves as a source for recommendations.
LPAD is also dynamic in the way it is interpretated and recommendations are given. Recommendations are always given taking the specific learning styles, difficulties and changes, as well as the need for mediation into account. Because these vary widely, recommendations vary widely, as opposed to usually very meagre recommendations at the end of a psychological report.
The dynamic nature of LPAD is also reflected in its goals: basically LPAD is an evaluation of the learner’s modifiability and his learning processes.
Objectives of the LPAD
The LPAD is interested in signs of change and modifiability in four domains: basic cognitive functions, mental operations, affective/motivational characteristics, and learning efficiency.
Evaluating basic cognitive functions
Based on empirical, clinical evidence, Feuerstein elaborated a list of 28 cognitive functions, roughly divided in a temporal sequence of input functions (gathering information), elaboration and output functions (expressing the found solutions). In the input phase, the basic functions are: focalised perception, systematic search, labels for discriminating objects, and their characteristics, precision, conservation of constancies while some characteristics change and combining two sources of information. The elaboration phase starts with accurate problem perception and problem definition, retrieving relevant information, compare the data with each other and with what is known, relating the data, giving logical evidence, making hypotheses and inferences, testing hypotheses, determining a framework, planning and summative behaviour. Finally, in the output, it is observed how much the learner can refrain from acting impulsively, is able to transport the data visually, use accurate vocabulary, project virtual relationships, express himself in a non-egocentric way, and use precision.
Evaluating mental operations
Evaluating affective and motivational factors
regulation of behaviour
reaction to mediation of challenge
feelings of competence
individuation and differentiation
need of mastery
need of independent work
looking for complexity
looking for novelty
awareness of own change
internal" locus of control”
reaction to criticisms
fear of failure
Evaluating learning efficiency
automatisation and habit formation
autonomous self- regulation
Evaluating transfer capability
LPAD basic questions about change
The basic questions in LPAD are:
Where: in what context can we see change?
What is needed to be changed?
What can be changed?
How can the change be implemented
All these observations taken together leads to a profile of modifiability. This is a largely qualitative summary of all these factors, with some attempt to quantification in “low to high”.
Establish a relationship
The first step in LPAD assessment is to establish a working relationship, a friendly, welcoming atmosphere, where a child feels at ease. Therefore, it is very important to communicate beforehand to the parents that we are not going to test the child, but we are going to explore, to find out how he learns. There will be play activities and works.
If the child knows he is going to be tested, that creates already a stressful situation. Usually, the LPAD comes “at the end of the road”, when lots of tests have already been done; so the child has already accumulated negative experiences. Also parents might enter the room with a load of negative experiences and stress, and this is picked up by the child.
In principle, in the LPAD it is recommended to incorporate the parents into the process, by letting them be present during the assessment sessions. This has a very important educative role, in order to convey to them what is mediation, to show them so that they can see the changes for themselves, and the kind of mediation that is needed to lead to change. Because the goal of assessment is to create change, and change starts by shifting your belief system and the way you behave towards a child. A concerned parent might interfere in a negative way, by stressing the child too much. Just a wink of the eye, a sigh or a remark might be seen by the child and it is already blocked, because it knows. Yet this is important information, as these habits have to change if the child has to change. The LPAD examiner therefore simultaneously observes the child as well as the parents. The examiner has to establish a relationship with the parents who are present as well: comfort them, teach them how to respond, withold them from interefering too much when necessary.
It might be important to observe parents teaching something to the child. Whether one starts with it or does it later, depends on the careful observation and judgement of the examiner. For e.g. with a child with serious autistic behaviour, who reacts to strangers with resistance, it is very recommendable to use enough time to just play and observe natural behaviour, until the child is familiar with the presence of the examiner. This might include a phase to go along with the child’s interests for a while, and then gradually, introduce something new.
A particular case: working with children with autism
Doing assessment with “autistic” children is an art and skill in itself and asks a lot of creativity. It is a stand-alone book. We may start “on the floor” (as in Greenspan’s “floortime” sessions), playing together, trying to enter the child’s world, until playing together is fun and the child shows that it accepts the examiner as a partner. We don’t “push” a test under the child’s nose like that. A child with autism who e.g. has discovered in the waiting room a set of toy cars, might want to bring them into the room. The first time, it might be needed, as a compromise, to let them do so. Because the child becomes easily obsessed, the tendency is to remain with this object of obsession. Then it demands a lot of creative thinking how to replace the obsession by something the examiner wants, e.g. draw a parking lot and park the car. Autistic children are particularly sensitive to attempts to change them , they are very resistant to change. One of the most extreme examples was an 11-year old boy with hemiplegia, cognitive and social impairments, who was performing low in an inclusive school, barely able to read and write. He was really addicted to his game-boy; it took 3 days to get rid of it and make the child cooperate. We started by reversing roles, by letting the child show the game-boy to the examiner; this helped a while, but the child wanted to remain in control. Direct authority or forbidding made the child very resistant. In the end we succeeded in a paradoxical, indirect way, by stopping every attempt to “evaluate” the child or making him feel he was being evaluated, but by just playing with mother, his sister and other students with a ball and after a minute he wanted to join. He was not so autistic at all; he had just taken control of a difficult situation, and his game boy addiction was the only way to survive. It took an LPAD of 4 weeks to basically change this behaviour. After a while, the game boy was left home and was not needed any more, and not even a source of conflict, which it had been for years. LPAD sessions in this way, with some children, become therapy sessions, play-therapy, or natural observation. Needless to say, this is totally different from assessing IQ or even functional assessment. It can be understood why functional assessment of children with autistic spectrum is mostly underscoring their true potential, because classic, static functional assessment does not invest the necessary time to explore possitibilities of change.
In any case the examiner in any LPAD has a dual role: an observer as well as a partner. LPAD is much more a dialogue than a monologue (figure 1).
figure 1 The paradigm of testing, left, a monologue with nature, versus the paradigm of LPAD, a dialogue (drawing A. Marin)
The next step, before doing any instruments, is getting to know the child better. It is important to find out first about the child’s interests and strenghts, how he perceives himself. This can be done, if possible, in the form of an interview. When the child is capable of writing, the child may be asked to write down his name, address, birth date, family composition, school, hobbies, preferences, what his dreams are, etc. It is also a way to already assess a number of abilities, and whether the child’s reciprocates the examiners’ requests, also important information.
Establishing baseline performance
Next, we start with presenting the child with some task.
The procedure usually follows a test-learning-retest model, but not always. It depends on the anticipated level of frustration the child can tolerate. It may be necessary to immediately start with mediation. The “test” phase consists in letting the child become familiar with the task, to let him explore and see what the child is able to do without interference, in an autonomous way. This is the baseline level. In our research we found that baseline levels - as expected – are compatible with the child’s performance on IQ or DQ tests.
Then we start to mediate the child. The examiner might start to elicit reflective thinking by asking questions, such as “what do you think you have to do? How do you think you will go about?” ; orient focussing “what do you see”, give labels, ask for precision, give feedback, subjective feedback (“this is really great what you have done! ) as well as objective feedback (“you looked carefully and you waited before drawing this line, great!” ;”first look, then do”); teach some rules of generalisations. There is a variety of possibilities. In its most intensive form, mediation consists in modelling and showing an example.
An example is given below of the kind of mediation which is given in the Human Figure Drawing test. The example is drawn from an LPAD done with a 14-year old girl with a diagnosis of autistic spectrum disorder (PDD-NOS) with severe language and cognitive impairment. She hardly speaks, uses only 1 word sentences to answer, has a poor understanding of language, is able to count until 20; she also has motor coordination and balance problems. Her spontaneous drawing of a child (figure 2) is very poor (head and feet). If one would stop here, one would have to infer that she has a mental age of about 3 years.
figure 2 Human Figure Drawing pre-test. P., 14 years old. Diagnosis: PDD-NOS During the mediation phase, we drew a model, while continuously verbalizing what we did and were planning planning to do, in the form of questions.
planning (“what are we going to draw first? The head? O.K.)
modelling: first the examiner draws, then the child is invited to imitate
teaching vocabulary: naming the body parts
compare with reality (visual transport)
name the position, e.g. in the middle/ on top of, left, right
compare relative size
count the number of fingers and toes, arms etc
name the number of fingers without counting again
refraining from impulsivity
In this way, she was able to draw a recognizable, fully shaped human figure (figure 3). When asked to draw it the week thereafter, she had remembered how to do it. The problem with her was that she did not have representation, nor a vocabulary, nor a strategy for planning, comparing, locating, etc. All a deficiency of basic cognitive functions, which was modifiable through mediated learning experience.
figure 3, Human Figure Drawing post-mediation-test. P., 14 years old. Diagnosis: PDD-NOS The information from the mediation phase is the most crucial part of the LPAD, because it is this information which is going to be useful at home and at school. This information is not available in static testing. In the case just described, because the inference had been made, on the basis of IQ and DQ testing, of a mental age of 3, the educative programme was comparatively low and she was expected to do little. This changed following LPAD indications.
The mediation phase is based on Feuerstein’s description of 12 mediating criteria. It has to be learned during training, not in theory, but in practice. Mediating during an LPAD is a skill as well as an art and requires a lot of energy and inventivity.
With higher functioning individuals, mediation does not need to be so intensive. One always starts “at the greatest distance” of mediation, by asking the least possible; never giving the answer, but eliciting reflection.
Choice of instruments
Feuerstein e.a. use partly existing tests, which are well known and are normated, such as Raven’s progressive matrices (which in its static version is a relatively culture-free test correlating well with IQ) and Rey-Osterrieth’s Complex figure test (widely used in neuropsychological testing); but do it in a 3 or 5-phase way. Sometimes they adapt existing tests, such as the Rey’s verbal memory test, which is also widely used in neuropsychology; but Feuerstein changed the words and added a 16th, in order to allow the child to use categorization as a mnemonic technique.
Overview of utilized LPAD instruments
Test for visual- constructive organisation and planning & memory
Table 1 Tests used in the LPAD battery of Feuerstein
The kind of test chosen depends on the child’s level, motivation, difficulties. There is a logic in the choice of tests, in as much as diffent domains are covered, different modalities, operations, functions, degrees of abstraction and complexity. These are called “parameters of the cognitive map”.
Test instruments developped by David Tzuriel have been inspired by the original Feuerstein LPAD battery, and have been amply researched for their validity and reliability to demonstrate modifiability.
Indications for LPAD
The LPAD started for low-functioning school-aged children. Later it appeared to be suitable for other target groups, using similar or different sets of instruments.
Because of its in-built capacity of variating the instruments according to complexity, content, etc. ,the LPAD has a wide range of application.
It has been reported to be useful in general for children and adults with reduced learning performance, regardless of cause, degree and etiology. Low functioning individuals with a low IQ, or underachieving learners with a normal IQ, or even gifted underachievers. The “regular” battery of LPAD instruments can be used from the age of 6 years and upwards, unto low performing adults. Some of the “highest” instruments are quite challenging, even for “normally” functioning adults. In order to respond to a growing need to have instruments suitable for lower functioning individuals, an LPAD-basic battery has been developed ( Feuerstein, e.a. 2002). This may be used in individuals with a “mental age” 4- 7, including low functioning adolescents and adults. For children who are lower functioning than a mental age of 4, the LPAD-basic battery is not suitable, but the LPAD paradigm and modifiability profile can be used with more concrete play or assessments materials in a dynamic way.
Implementing an active modifying environment & educational intervention plan
Retrospective study LPAD in B/NL/IT
We will briefly report the use of LPAD in a “clinical-educational” context in a population of children and adults with various cognitive and learning impairments
During 1998-2008, 486 people have been assessed with LPAD in different clinico-educational contexts: the Feuerstein Centre in Amsterdam, a private clinic in Antwerp, two rehabilitation clinics in Italy and a school in France. Most of these children and adults (age range 3-60 years; mean age 11,4 years; SD = 5,92) were either self-referred or by their parents; a minority by other professionals. The reason for referral , as reported by parents, was low school performance, low functioning, disappointment with IQ or DQ tests, the need for a second opinion in diagnosis, a need to find out the child’s potential to change and to learn, the need to have suggestions as to how to enhance autonomy, cognitive functioning and how to handle a child’s behaviour or contact problems.
The diagnostic spectrum (or “impairments” in ICF language) (figure ) consisted in a majority of cognitive retardation due to a genetic or unknown origin (almost 50%; 22% of them having Down syndrome) and children with a diagnosis of autistic spectrum (20%), cerebral palsy (7,8%), gifted underachievers with high IQ (5%), children with a main problem of dysphasia (5,14%). The IQ range aried from 30 to 150. 63,7 % were male.
figure 4 Diagnostic spectrum of an self-referred LPAD population of 486 people in Belgium, Netherlands, France & Italy
We start the assesment procedure with a thorough interview with the parents in the presence of the child and without the child, while the child is playing or doing some other activity. Then, after a few weeks, the proper assessment is started according to the methodology outlined above, in sessions varying between 1 to 3 hours. The total duration of this phase varied between 6 to 15 hours, with a mean of 9,5 h. The child is evaluated in a room with the examiner, usually in the presence of its parents or another person who is accompaying him. Also some sessions are tried in the absence of parents. Then an extensive report is written describing the child’s history, functional impairments, activities, participatory activities, school achievements and the work with the instruments. For each instrumental activity, a baseline is described, followed by the kind and degree of mediation to obtain a higher performance, followed by post-mediation performance. Scores are given in pre- and post-test format wherever possible and appropriate. But the main description is a qualitative one. Conclusion are given in terms of the modifiability profile (see above). Recommendations are written for the domain of academic learning, cognitive activation, behaviour management, general environmental organisation and life management, therapies and need for assistance. Finally, the report also mentions specific and general mediation actions to be taken. This report is first discussed with the parents, before it goes to others. Parents (or with older individuals, the assessed person himself) are the owners of their report and decide with whom they want to share it, but it is encouraged to share it with all the people dealing with the special individual. Many times a home and/or school visit is done to observe the child as well as to communicate assessment results and discuss an intervention plan.
As a result of the LPAD process, an activation plan is set into motion, in order to create an active modifying environment. This may consist in changing school (from a special to an inclusive school, or going to a more welcoming school which is willing to work with the child in a more active way) , or working with the present school’s team to improve activation and participation. The child also starts to work in weekly cognitive activation and mediated learning sessions, usually with Feuerstein’s Instrumental Enrichment programme, or similar educative games, remediation materials or art activities (music, painting, sculpturing). These sessions are coached by different staff than the LPAD examiner. Parents are often present during these activities, similarly as during the assessment phase, with a teaching goal, in order to model mediation and ensure that this is transferred to the home situation. A intervention lasts at least a year, and often 2-3 years.
Parents invariably reported that the LPAD had changed their view on the child in a more positive way; it increased their feeling of competence in parenting, it gave them concrete goals and suggestions how to work with the child and how to mediate at home. They also reported that the LPAD report was radically different from all the previous reports they had been given, in the sense that it was the first time they received a positive report which was more than a list of deficiencies. They also appreciated the fact that now the child’s modifiability was demonstrated “black-on-white”, in writing.
A frequent problem is the gap between the LPAD’s message of modifiability and what the schools do with it. Especially the special schools tend to stay within their “old way of believing and doing”. Parents experience a hard time to change beliefs of others. Implementation of a programme is much better when schools request regular guidance on the basis of LPAD report and are open to suggestions.
From the clinical experience with LPAD, it becomes clear that LPAd is a valid tool to reveal a child’s hidden capacities and modifiability, to shift the child’s, his parents’ and his teachers’ perspective on its educability, to design a challenging educative intervention plan
Scientific validity & reliability
But it is still scarcely used
ref IACEP articles
LPAD reflects the mediator’s ability and not the child’s potential
Addiction to prediction
Choosing the right kind of evaluation methods
to do a selection of the best
to evaluate competence, actual performance
to have an objective system of comparison
to do scientific population based comparison studies
to find out about learning potential
to explore underlying problems
to explore the link between cognitive, emotional, motivational and other factors
to explore the influence of context, attitude, way of interacting
to find out about how an individual functions in regular & optimal conditions,
to find out the kind of support that is needed to make the individual function
Practical problems with feasibility
Modifications needed to LPAD
Missing domains Tests are too visual
Complete it with developmental modifiability profiles
Quantification of modifiability
Quantification of mediation
How the child functions in his natural environment
How the child learns within the curriculum
Measurement of mediation needed?
Measurement of change in cognitive functioning?
Validity of instruments
LPAD radically differs from testing
LPAD has ecological validity
Non-deterministic, as the behaviour of complex systems
1 Text presented at the Daffodil Expert Meeting in Szeged & Budapest on 1 & 2/12/2009
2 Coordinator of Daffodil Project, Dynamic Assessment of Functioning for Development towards Inclusive Learning
Produced with the financial support of the European Commission’s Life Long Learning Programme – Project DAFFODIL 2008-2010