Purpose
Inside HELP is a comprehensive administration and reference guide to be used in conjunction with all the HELP (Hawaii Early Learning Profile, Birth-3) curriculum and assessment materials: the HELP Strands, HELP Checklist, HELP Charts, HELP Activity Guide, HELP at Home, HELP When the Parent has Disabilities, and the HELP Family-Centered Interview.
Inside HELP is intended to maximize the use of HELP as a curriculum-based assessment. It includes clear definitions, flexible contextually-based assessment guidelines, and credit criteria for each of the 685 developmental skills and behaviors appearing in all the HELP products (Birth-3). In addition, it provides guidelines for understanding and interpreting the child's skills and behaviors in the context of his caregiving relationships and environments, and recognizes families as central to the assessment process. As a curriculum-based assessment, HELP is directly linked with parent and professional curriculum activities and strategies to help promote the child's development and positive parent-child interactions.
Objectives of Inside HELP
Using Inside HELP with the HELP Strands, Charts, or Checklist will facilitate the professional's efforts to:
Identify and report qualitative descriptions of the child's developmental skills and behaviors along multiple lines of development
Determine approximate developmental levels within and between major domains of development
Identify strengths and needs within and between major domains of development
Interpret how one area of development may be influencing another area of development
Conduct a family-directed assessment of family concerns, priorities and resources as they relate to the development of their child;
Recognize factors in the child's physical environment that support development
Recognize caregiver interactions that support and facilitate the child's development
Develop child and family outcome statements with the family that are meaningful and functional to the child and family.
Designed to support Infant and Toddler Legislation (IDEA)
Professionals who work within early intervention programs will find Inside HELP especially valuable because it addresses many of the requirements for multidisciplinary, family-centered assessment as required under Part C, Individuals with Disabilities Education Act.
Guiding Principles
The development and intended use of Inside HELP is based upon the following guiding principles:
Curriculum assessment is a multidimensional ongoing process
Curriculum assessment should go beyond evaluation and observation of a child's skills and behaviors;
Curriculum assessment should be family-centered
The curriculum assessment process should be pleasurable and meaningful for infants and families
Disabilities should not interfere with a true assessment of a child's abilities;
Assessment should be logically linked to intervention.
Issues Regarding Density and Multiple Lines of Development
One of the most unique features of HELP - applauded by both parents and professionals - is its density: the high number of quality, specific skills. No other currently available birth-to-three curriculum includes as many developmental skills and behaviors and intervention strategies as the HELP. This density provides families and clinicians considerable choice in the process of assessment and curriculum planning, and facilitates monitoring of the child's progress in small incremental steps.
The density and comprehensiveness of Inside HELP can appear overwhelming to the new user. Remember, however, that Inside HELP is intended to be an administration and reference guide. As such it is intended to be used as a resource for the professional to refer to on an "as needed basis" for clarification of specific skills when using HELP products, and for review or expansion of knowledge and skills in early childhood development and assessment. As you become familiar with the HELP skills and format of Inside HELP, the comprehensiveness and ease of use as a reference tool will become more apparent.
One final caution that cannot be overemphasized: Although the HELP is formatted along multiple lines of development through the use of developmental domains and strands, no domain, strand or skill can be understood in isolation of other areas of development or in isolation of the environment. Separating development into domains and strands can be helpful for understanding and pinpointing underlying areas of strengths and needs, but children should never be viewed in separate, fragmented or isolated areas of development. The challenge for the clinician is to analyze the mutual impact and interplay of these multiple lines of development and then integrate findings with the family to determine integrated intervention strategies and functional outcomes. Inside HELP stresses the importance of interdependence and interrelatedness between and within domains, strands, and the
environment.
History of HELP
The original HELP materials, the Hawaii Early Learning Profile (HELP) Charts and HELP Activity Guide, were developed by the multidisciplinary pediatric team of Setsu Furuno, Ph.D., Katherine A. O'Reilly, R.P.T., M.P.H., Carol M. Hosaka, M.A., Takayo T. Inatsuka, O.T.R., Toney L. Allman M.A., and Barbara Zeisloft M.S.,Sp., through a federal demonstration and training project, the Enrichment Project for Handicapped Infants, from 1971 to 1979. This project was conducted under the auspices of the School of Public Health, University of Hawaii, and was funded by the Bureau of the Education of the Handicapped.
Six-hundred and eighty-five (685) developmental skills and behaviors were selected by the multidisciplinary team from numerous available growth-and-development scales and standardized tests. The age ranges provided for the skills on the Charts and in the Activity Guide were "based on a synthesis of research and project data." There was "not always agreement in growth and development literature as to when a skill begins," and thus "age ranges" in months for when a skill typically emerges was included rather than one specific "month" level.
These 685 developmental skills provided the framework for developing curriculum activities for the HELP Activity Guide and HELP Charts within the six traditional domains: Cognition, Language, Gross Motor, Fine Motor, Social-Emotional and Self Help. All skills are not necessarily critical to the child's development, but were included because of their teachability and amenability to intervention.
The HELP Charts and HELP Activity Guide were field-tested by numerous programs for infants and toddlers with disabilities. The materials were also used and reviewed by programs in 35 states and 7 different countries for additional feedback.
Since the HELP Activity Guide and HELP Charts, additional HELP materials have been developed to meet the growing field of early intervention: HELP at Home, HELP When the Parent has Disabilities, HELP Checklist, the HELP Family-Centered Interview, and the HELP Strands. Each of these derivatives build upon and are cross-referenced to the 685 core HELP skills and behaviors.
Development of Inside HELP
Inside HELP was developed to provide: (1) flexible, clear, and valid
definitions, (2) credit criteria, and (3) assessment procedures for each of the 685 core HELP skills and behaviors. This manual is intended to promote consistency and a common framework of reference among multidisciplinary professionals using HELP as a curriculum assessment for planning comprehensive programs for infants and toddlers with special needs and their families. This manual is not intended to provide standardized evaluation, or diagnosis.
The definitions, credit criteria, and assessment guidelines were derived from a variety of growth and development scales, standardized norm-referenced tests, infant curriculums, and extensive early intervention research papers, articles, and texts listed under References at the end of this manual. The guidelines presented in each strand "Preface" (e.g., Family Friendly definitions, Parent Questions, Transactional Assessment, etc.), were drawn from infant and family literature as well as from experience and collaboration with families and professional colleagues.
A core interdisciplinary team of pediatric therapists who work in the Prince William County Parent Infant Education Program contributed to the search of the literature process and development of this manual. A vision specialist who works with the Virginia Department for the Visually Handicapped provided her expertise and research in developing the adaptations for the visually impaired. When definitions, credit criteria and assessment guidelines were vague or unclear in the literature, the team, in concurrence with at least two additional professionals from the applicable discipline, developed clarification and criteria through clinical judgment and experience. Each of the contributors to this work has a Masters degree and a minimum of 10 years of experience in the field. The pediatric physical and occupational therapists are NDT certified and have training and experience in sensory integration principles. The final draft was sent to four outside experts in the field for final critique and review.
Purpose of the HELP Strands
The HELP Strands is a curriculum-based developmental assessment booklet for direct use with individual children. It covers the same core 685 skills and six traditional developmental domains included in the original HELP materials, but it has been structured like Inside HELP to provide a more precise framework for assessment and planning - the traditional HELP domains have been divided into 58 developmentally sequenced conceptual strands. Each strand includes HELP skills which focus upon a specific underlying key concept and are hierarchical in nature; i.e., one skill leads to or builds the foundation for the next skill. Developmental levels, strengths, and needs within each domain can thus be more easily identified for curriculum assessment and
individualized planning.
Skills listed on traditional developmental checklists and standardized tests, although generally listed in a developmental order according to age, are not generally hierarchical. For example, if a child "passes" one skill it does not necessarily mean that he is ready to learn the next skill. Conversely, if a child "fails" an item, this does not mean that he cannot accomplish or is not ready to learn a skill placed higher on the continuum. Without careful item analysis, it can be difficult to identify strengths and needs within a major area of development and difficult to identify "next steps" for planning. The HELP Strands were developed to address this need and to provide an additional option to the clinician for assessment and monitoring.
Features of the HELP Strands
Regulatory/Sensory Organization (0.0) is a new section that has been added to the framework of the HELP Strands. It includes pertinent HELP skills selected from all domains which tap the child's self-regulation capacities (i.e., sleep cycles, regulation of moods, attention, and consolability), and, the child's capacities to perceive and organize various sensory experiences (i.e., sights, sounds, touch, taste, smell, vestibular [body movement through space and head position] and proprioception [awareness of body position in space])
Condensed definitions are included directly on the HELP Strands assessment form for quick reference..
Some of the original HELP skills age ranges and wording have been updated to reflect current literature (these updates are are listed in Inside HELP, Appendix A and B.)
Completely cross-indexed: Each skill in the HELP Strands has the same skill identification number used in all of the HELP products. This allows for easy cross reference and linkage between all HELP materials (birth-3).
Development of the HELP Strands
The development and restructuring of the 685 core HELP skills into the HELP Strand format began in 1988. The first step included analyzing each of the HELP skills for its underlying concept regardless of the domain in which it was originally placed. This process was completed through clinical judgment, review of the early intervention literature, and collaboration with an interdisciplinary team of pediatric therapists and infant specialists. The skills were then sorted into respective multiple conceptual strands within the traditional six major domains and sequentially ordered by age. Several skills included more than one underlying concept and were thus placed in more than one strand.
Initial drafts of the HELP Strands (with definitions) were then developed and field-tested during the following three years with more that 200 infants and toddlers enrolled in the Prince William County, Parent Infant Education Program located in Manassas, Virginia. The infants and toddlers were aged birth (adjusted age for prematurity) to 35 months and were enrolled in ongoing early intervention services because of developmental delays, atypical development, and/or disabilities. Program staff conducting the curriculum assessments were experienced and licensed pediatric speech, occupational and physical therapists, and infant educators.
The primary purpose of field testing was to test the adequacy of the initial sequencing of skills within strands based on a hierarchical structure. If a child "failed" more than two items in a row but then passed a higher item in spite of assessment adaptations for disabilities, the relevant skill items were more closely scrutinized. In some cases, the skill ended up "fitting" better conceptually and sequentially in another strand. In other cases, by the nature of the several-month age range span in which the skill typically emerges, the skill had simply been misplaced in the sequence. In some cases, through a search of more recent literature, it became evident that the age range references listed in the original HELP Charts needed to be revised, either to a higher or lower range. Some skills within strands such as 1-5 "Spatial Relationships," and 0.0 "Regulatory/Sensory Organization," although conceptually related, were not expected to have complete sequentiality because they include more than one underlying concept. This is noted when applicable in the applicable strand prefaces.
This ongoing process of refinement and reordering of skills within and between strands continued until the strands were considered as sequential and as hierarchical in nature as possible. The final HELP Strands were then reviewed by outside experts in the field for final
confirmation.
Approximate Developmental Levels (see IDEA, Part C)
The HELP assessments, including the HELP Strands, are not norm-referenced or standardized, and will not yield a single age level or score. The major purpose of HELP as a curriculum assessment is to identify curriculum outcomes, goals, strategies and activities.
The HELP Strands can, however, be used to provide approximate or estimated developmental levels within and between areas of development, document that a child is not displaying skills and behaviors expected for his age, provide meaningful descriptions of a child's skills and behavior, and document when skills and behaviors are of poor quality, atypical, or dysfunctional.
Editorial and Formatting Notes
Skill ID#: As noted, specific identification #'s have been assigned to each of the HELP skills. This numbering system is consistent across all the HELP products to facilitate quick cross-referencing between products. This numbering system was developed with the first HELP materials, i.e., HELP Charts and HELP Activity Guide according to major domains, e.g., 1.0 Cognitive, includes skills 1.01, 1.02, 1.03, etc. The HELP skill ID#'s were originally (1979) assigned based upon the skill's placement on the HELP Charts, but the numbers do not necessarily reflect sequentiality. Skills within strands are in sequential order, and thus do not always appear in numerical order within a strand. A cross-reference index of the numerical order of skill ID#'s is on pages 376-379. If you are using the HELP Charts or HELP Checklist, pages 376-379 are intended to act as a quick reference for finding the page in Inside HELP for each of the skills.
Since there are no neutral words to designate male and female children, we were faced with the long standing editorial "she/he" issue. To avoid redundancy and confusion, all children are referred to as "he" throughout this manual. No gender bias is intended.
