Assessment of students with

complex communication needs

Practice guide for psychologists
Supplement to the Program for Students with Disabilities
Professional guidelines
Version 1.0 September 2018
This publication was produced by the Cerebral Palsy Education Centre Inc. and the Department of Education
and Training to provide guidance for psychologists conducting cognitive assessments for the purposes of
establishing eligibility for the Program for Students with Disabilities.

© State of Victoria (Department of Education and Training) 2019

These professional guidelines are provided under a Creative Commons Attribution 4.0 International licence. You are free to re-use
the work under that licence, on the condition that you credit the State of Victoria (Department of Education and Training), indicate if
changes were made and comply with the other licence terms, see: Creative Commons Attribution 4.0 International
The licence does not apply to:
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• content supplied by third parties.
Copyright queries may be directed to copyright@edumail.vic.gov.au
CONTENTS
1. Introduction .......................................................................................................................... 4
2. Principles of Cognitive Assessment ...................................................................................... 4
3. Purpose of this Practice Guide ............................................................................................. 5
4. What are “Complex Communication Needs”? ....................................................................... 5
5. What is Augmentative and Alternative Communication (AAC)? ............................................ 6
6. Planning For Assessment ..................................................................................................... 6
Steps in the development of an assessment plan ................................................................ 6
7. Assessment Considerations for Students with Complex Communication Needs .................. 8
Determining the student’s ability to manage the language demands of the assessment
process ............................................................................................................................... 9
Considering the language requirements of the assessment process ................................. 10
Determining the student’s ability to manage the motor demands of the assessment process
.......................................................................................................................................... 12
What are the ways a student may access his/her AAC system? ........................................ 15
Additional assessment challenges specific to students using AAC .................................... 16
8. The Assessment Process ................................................................................................... 16
9. Interpreting Assessment Findings ...................................................................................... 18
10. Reporting Assessment Findings ......................................................................................... 19
11. Summary ............................................................................................................................ 20
Appendix 1: Alternative Standardised Tests for Students with CCN ........................................... 21
Appendix 2: Students with CCN and Additional Challenges ....................................................... 22
ATTACHMENT A: Understanding the Student with Sensory Processing Challenges ................. 23
ATTACHMENT B: Understanding the Student with Motor Challenges ....................................... 25
ATTACHMENT C: Understanding the Student with Hearing Impairment .................................... 28
ATTACHMENT D: Understanding the Student with Vision Impairment ...................................... 29
ATTACHMENT E: Understanding the Student who is Deaf-Blind ............................................... 30
References ................................................................................................................................ 31

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1. INTRODUCTION
Students with Complex Communication Needs (CCN) including physical, language or sensory difficulties may
be referred by schools for cognitive assessment.
The purpose of this assessment may be to:
 Gather information about the student’s current learning needs and future potential for learning to make
informed decisions for personalised learning and support planning.
 Assist the school/ family/ carers to understand the student’s current abilities, their potential for learning
and longer-term educational needs.
 Determine eligibility and access to resources, e.g. Program for Students with Disabilities eligibility.

2. PRINCIPLES OF COGNITIVE ASSESSMENT

Diagnosis of an intellectual disability can have a significant and lifelong impact upon the student and his/her
family. “Diagnosis and classification of a child should not be based solely on results from a single test. A
diagnostic assessment should integrate information from observations, different assessment modalities, and
a battery of relevant tests as well as multiple informants.” (WISC-V Technical and Interpretive Manual, 2014).
When assessing students who have significant physical, language or sensory difficulties, it is important not to
attribute the assessment results solely to low cognitive ability, when in fact low performance may be attributable
to the student’s physical, language, or sensory difficulties.
The resource, Practice Guide for the assessment of school age students in educational settings (October
2014) prepared by the Australian Psychological Society and Speech Pathology Australia, sets out best practice
principles for professionals conducting assessments with school age students in educational contexts. In
particular, Principles 29 to 35 of this resource address the assessment of students with special needs and
these principles should be considered by psychologists conducting assessments with students who have CCN.

Assessment of students with special needs (APS, 2014)

Principle 29: Practitioners take account of the possible effect of factors that may impact on the assessment
process, including language, cultural background and disability.
Principle 30: Practitioners understand the use of reasonable test accommodations.
Principle 31: Practitioners consider whether accommodations are required for an assessment, the suitability
of available accommodations to increase access to a testing opportunity, or the availability of an alternative
test that would not require accommodations to be made.
Principle 32: Practitioners apply accommodations only when it is necessary to provide more equitable access
and not when this will lead to an advantage for the student over other students.
Principle 33: Practitioners consider the extent to which an accommodation may impact on the construct being
measured and document this in the report.
Principle 34: Where there are no reasonable options for test accommodations to enable fair and valid access
for the student, practitioners make clear the limitations of the testing process used.
Principle 35: Practitioners recognise that modifications to a test will preclude the interpretation of the results
with reference to standardised procedures and test norms.

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3. PURPOSE OF THIS PRACTICE GUIDE
The Department provides professionals assessing students for establishing eligibility for the Program for
Students with Disabilities with professional guidelines to assist in conducting and reporting upon such
assessments. The Intellectual Disability Program for Students with Disabilities Professional Guidelines were
revised in 2017, to include a supplement (Cognitive Assessment of Students with Complex Communication
Needs) to assist psychologists in assessing students who are nonverbal, or have minimal speech.
This practice guide is intended to enhance advice and support currently available to psychologists in the
Program for Students with Disabilities Professional Guidelines and the relevant test administration manuals.
The practice guide aims to assist psychologists to develop the most appropriate assessment plan, taking into
account the student’s CCN.
It is intended to assist psychologists in determining whether:
 standardised administration of one of the recommended tests is a fair and appropriate method of
determining a student’s cognitive ability.
 modifications and accommodations to standardised administration are required.
 standardised cognitive assessment administration, even with significant modifications or
accommodations, is appropriate or possible.
 the student’s communication needs are such that an alternative assessment tool is required to
understand or evaluate the student’s cognitive ability.
The Guide has been developed to support psychologists who work with students who have CCN, and may
use augmentative and alternative communication (AAC).

4. WHAT ARE “COMPLEX COMMUNICATION NEEDS”?

The term Complex Communication Needs (CCN) describes the needs of a person unable to use speech to
efficiently and effectively meet their communication needs¹. Students with CCN may have motor and/or
sensory and/or perceptual impairments in addition to significant speech impairments (Beukelman & Miranda,
2005).
CCN may be associated with developmental or acquired disabilities. Some examples of primary diagnoses of
people with CCN include: Childhood Apraxia of Speech, Autism Spectrum Disorder (ASD), Cerebral Palsy
(CP), deaf-blindness, hearing impairments, traumatic brain injury, Global Developmental Delay (GDD),
diagnoses of genetic origin and social-behavioural challenges. Appendix 2 provides information about some
additional challenges encountered by students with CCN.

In all cognitive assessments, regardless of the primary diagnosis, an interaction between the assessor and
student is taking place.
Psychologists need to consider:
(1) the student’s understanding of the modality used by the assessor when delivering test instructions

and
(2) the expressive modality (speech, pictographs, sign/gesture, other movement) used by the student to
respond.

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5. WHAT IS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION (AAC)?
The term ‘augmentative’ in this context means supplemental or additional to speech. Augmentative techniques
(e.g. gestures, facial expressions, objects, picture symbols and spelling) are commonly used when
communicating and interacting with others. The use of the term ‘alternative’ acknowledges that there are some
individuals whose speech is sufficiently impaired that they rely completely on strategies, systems, and
techniques which do not augment speech but are alternatives to speech (Speech Pathology Australia 2012,
p.6). AAC systems include:
 Aided AAC: refers to when an external item is used to aid communication (e.g. communication
boards, books, speech generating device, computer, mobile phone, and tablet).
 Unaided AAC: refers to communication techniques that do not require the use of an external aid. The
student uses whatever is available to them generally using their own body. Examples of unaided AAC
include using eye gaze, facial expression, body language, gesture, and manual sign.
The goal of AAC is to enable the student to efficiently and effectively engage in a variety of interactions and
participate in activities.

6. PLANNING FOR ASSESSMENT

Students who have significant language, physical, or sensory difficulties may be referred for cognitive
evaluation, and standardised assessment tools such as the Wechsler Preschool and Primary Scale of
Intelligence Fourth Edition (WPPSI-IV) or Wechsler Intelligence Scale for Children Fifth Edition (WISC-V), or
other tests designed to evaluate the student’s specific needs, may be requested.
Where possible, the recommended tools of assessment should be used when assessing students to determine
eligibility for the Program for Students with Disabilities. When assessing students with CCN, the assessing
psychologist must consider the impact of significant language, physical or sensory difficulties on the student’s
ability to participate in the assessment process. Psychologists will be aware that a lack of expressive language
does not necessarily mean the student has no language ability, nor a general low level of ability. It is important
not to wrongly attribute low performance on a test to low cognitive ability when language, physical or sensory
difficulty may be contributing to the student’s level of performance.
In planning the assessment, the psychologist will be guided by the relevant test manual, Program for Students
with Disabilities Intellectual Disabilities Professional Guidelines and the APS assessment of students with
special needs principles (APS and SPA, 2014), which have been highlighted in boxes below.
Steps in the development of an assessment plan
1. Prior to testing a student with CCN, psychologists should become familiar with the student’s strengths,
limitations, and their preferred communication mode and any augmentative or alternative communication
system that is used.
Observations of the student should be undertaken, and discussions conducted with school staff and family
members should be undertaken to obtain information about the student’s behaviours and day-to-day
functioning.
Further input and assessments from medical professionals and other allied health professionals including
speech pathologists, occupational therapists and physiotherapists may also be useful when developing an
assessment plan.
Psychologists will consider the all information provided about the student’s functioning, in particular
information about any additional disabilities and conditions in planning the assessment process.

Practitioners take account of the possible effects of factors that may impact on the assessment
process, including language, cultural background and disability.

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2. Psychologists should consider the requisite skills needed for participating in a particular test, including
receptive language ability, scanning ability, pointing response etc. when planning to assess a student with
CCN.
Information about the student’s preferred response style will be required, for example, does the student have
a preference for pointing, blinking, or nodding. Such information will help psychologists determine the nature
of any test accommodations that need to be considered in developing a suitable assessment plan.

Practitioners consider whether accommodations are required for an assessment, the suitability of
available accommodations to increase access to a testing opportunity, or the availability of an
alternative test that would not require accommodations to be made.

3. Psychologists should refer to the relevant test manual for advice on testing students with CCN and in
particular, accommodations and modifications to standard administration of the test that can be used to support
the student without invalidating the use of test norms.
Test administration manuals describe deviations from standard procedure that may be used by psychologists
when testing students with special needs. Psychologists should understand the impact of using
accommodations and modifications to standard test administration.

Practitioners apply accommodations only when it is necessary to provide more equitable access and
not when this will lead to an advantage for the student over other students.

4. Psychologists should use their clinical judgement to balance the communication needs of the student with
the need to maintain standard testing procedures. Any deviation from standardised administration should be
reported upon and considered by the psychologist when interpreting the test scores.

Practitioners consider the extent to which an accommodation may impact on the construct being
measured and document this in the report.

5. Where substantial modifications to test administration have been used in order to assist the student to
participate in the assessment process, it will no longer be possible to interpret the test results in a standard
way. The assessment may however provide useful information about the student’s current functioning and
assist in identifying relative strengths.

Practitioners recognise that modifications to a test will preclude the interpretation of the results with
reference to standardised procedures and test norms.

6. Whilst the Program for Students with Disabilities eligibility criteria need to be addressed, for some students
the use of the recommended assessment tool may not be the most appropriate form of assessment and other
methods for addressing the criteria for eligibility may need to be considered.
Psychologists should consider using a range of assessment tools (formal and informal) when making a
determination of the student’s cognitive ability where the student has CCN, or is primarily nonverbal.
When assessing students with CCN, who are unable to participate in a cognitive assessment using the
recommended tests for establishing eligibility for the Program for Students with Disabilities, psychologists
could consider using alternative tests of cognitive ability specified in the Intellectual Disability Program for
Students with Disabilities Professional Guidelines. See Appendix 1 for a list of suggested alternative tests.

Where there are no reasonable options for test accommodations to enable fair and valid access for
the student, practitioners make clear the limitations of the testing process used.

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7. As is the requirement for all assessments of intellectual disability, psychologists must complete the required
adaptive behaviour assessment and should collect and report on a comprehensive history from relevant
people, including parents/ caregivers and school staff.
For further information on the assessment of students with special needs, Psychologists are referred to:
 Practice Guide for the assessment of school age students in educational settings (APS and SPA,
October 2014)
 Practice guide for the use of psychological tests and instruments, APS Test and Testing Expert Group,
(Australian Psychological Society , September 2016)
 Practice guide for psychological testing with people with a disability, (APS Tests and Testing Group,
Australian Psychological Society , September 2016)
 Assessment of Children: Behavioural and Clinical Applications, Fourth Edition (Jerome Sattler, 2002)
 Assessment of Children: Cognitive Applications, Fourth Edition (Jerome Sattler, 2001)
 Intellectual Disability Program for Students with Disabilities Professional Guidelines, (DET, 2017).

7. ASSESSMENT CONSIDERATIONS FOR STUDENTS WITH COMPLEX

COMMUNICATION NEEDS
Most standardised, comprehensive assessments of cognition require an understanding of spoken language.
To respond, the student requires either a spoken language response and/or a gestural / manipulation
response.
When assessing students with CCN, psychologists will need to consider the following:
Many assessment tasks rely on an understanding of spoken
language.
1. Subtests that require a student to have
understanding (comprehension) of spoken A student with receptive language delay, auditory processing
challenges and/ or hearing impairment may find it difficult to
language
understand speech without the use of AAC (e.g. sign,
symbols) to augment the psychologist’s instructions.
A student with CCN, who is unable to use speech, will require
2. Subtests that require spoken output (language AAC. The assessing psychologist will need to consider the
response) student’s history and opportunity to have learnt their current
communication system method.
A student with motor, or sensory-motor challenges may find it
3. Subtests that require gestural/ manipulation difficult to manipulate objects, or access pictures or gestures
(e.g. point or scan)
output or fine motor output (gestural response)

A student with CCN may have challenges in one or all of these areas and when planning the assessment
process, psychologists will consider the skills assessed by a particular subtest and the student’s skills,
challenges and ability to understand and respond.
The following sections will assist psychologists to develop an appropriate assessment plan, which takes into
consideration the student’s communication needs and whether a recommended standardised assessment can
be conducted. There may be students for whom a standardised assessment tool is not suitable.

8
Determining the student’s ability to manage the language demands of the
assessment process
Communication Independence Model
The Communication Independence Model is a comprehensive, functional communication model designed to
meet assessment and intervention needs of individuals who have CCN (Gillette, 2005). The model identifies
skills the student with CCN requires to participate effectively in the typical communication situations they are
likely to encounter with their peers. (Beukelman & Mirenda, 2005).
The Communication Independence Model assists in:
 developing a communication profile for people with CCN,
 guiding professionals in identifying the most effective communication strategies for the student.

Communication Independence Model

Emerging
Student may use non-symbolic methods to communicate. Their
Has no reliable means of communication intent is interpreted based on observable behaviours.
symbolic communication
Student is dependent on trained partners familiar with their AAC system
and access method. The language available in the AAC system may
Context dependent require the communication partner to expand and clarify the message.

Communication is limited to The student may need additional vocabulary that is currently not available
communication partners or in their AAC system, but is required for the student to respond.
contexts Communication partners may not have received appropriate strategies,
vocabulary or training to support expansion of a student’s message,
thereby influencing the integrity of the student’s intent.
Independent
Can interact with both Student can spell needed vocabulary if the vocabulary is not available in
familiar and unfamiliar their AAC system.
partners on any topic
Gillette, Y. (2005)
Children typically learn the grammar of their language by observing and interacting with others who use the
same mode of communication. In contrast, the expressive language produced by a student who uses AAC is
reliant on the level of vocabulary made available to them to learn. This can place significant constraints on the
student’s comprehension and production of language using AAC (Sutton et al, 2002).
To be able to efficiently respond to instructions during a cognitive assessment, a student with CCN will be
dependent on having a range of vocabulary available, which has been previously modelled to him/her in the
AAC form (Porter, 2012). If a student has been predominantly immersed in a spoken language environment
with limited input and modelling of the language system they are learning, the student will be at a disadvantage
when required to respond to tasks that require a spoken output (Smith, 2015).
Similarly, if a student who relies on visual input (graphic symbols, sign language, words) to process spoken
language has not had sufficient language input (availability and/or opportunity to learn), this too will significantly
disadvantage them in completing tasks requiring a response to a verbal instruction.
It is therefore crucial that psychologists are familiar with the student’s communication needs and language
development prior to assessment. The table overleaf outlines some suggestions about gathering such
information on the student’s prior learning of his/her AAC system before administering the cognitive
assessment:

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Questions to ask to gather information on a student’s prior learning of AAC include:

- How long has the student had access to his/her current AAC system?
- How much opportunity has the student had to learn his/her AAC system?
- Does the student’s AAC system include a range of vocabulary to engage efficiently in the
cognitive assessment process or is it limited to specific pragmatic intents (e.g. requesting,
naming, pre-prepared messages)?
- Does the student rely on the visual input available in the AAC system to be able to understand
spoken language?
- Can the student use their AAC system independently (such as with an electronic speech
generating device, spelling, sign language) or does the student rely on a communication
partner, who is fluent in the use and access method of the AAC system (e.g. a non-electronic
communication such as a communication book, sign language, braille)?

Considering the language requirements of the assessment process

In determining whether the student has the language skills necessary to participate in the standardised
cognitive assessment process, psychologists should consider the following in relation to tasks requiring
understanding (comprehension) and/or spoken (expressive) language:

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Considering the language requirements of the assessment process

Does the student understand (comprehend) spoken

language?

and/or

Does the student have access to an AAC system and The student will need to be referred to a speech
the understanding of the language used to be pathologist who is trained to provide AAC intervention.
able to respond within the chosen cognitive
assessment? NO
YES

Support student to communicate as per their AAC

system.

Does the student have access to a robust The assessing psychologist may need to make the
(expressive) communication system? decision to administer a nonverbal test and/or the
NO
subtests that require nonverbal response.
YES

The assessing psychologist may need to make the

Has the student had the opportunity to
NO decision to administer a nonverbal test and/or the
learn and generate the type of vocabulary
subtests that require nonverbal response.
being assessed?
YES

Accommodations to use the student’s AAC

system can be made to complete the assessment

Determine the student’s ability to use

gestural/manipulation or fine motor output

The psychologist can use the Communication Independence Model to ascertain the level of the student’s
current communication skills.
Where the student’s current communication is context dependent, the psychologist will consider what
opportunities the student has had to learn language. Students who have only had the opportunity to learn
vocabulary for making requests, may not have the range of vocabulary needed to participate in a cognitive
assessment.

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 Non-verbal cognitive assessments involve measuring a student’s ability to reason without the use of
words. Non-verbal cognitive assessments, especially those that use gestures, rather than words, can
be useful for students who:
 rely on AAC to communicate but do not have access to a formal communication system and/or
 have not had prior opportunities to have learnt the language within that AAC system and/or
 who do not have significant sensory or motor challenges
 have a hearing impairment
 are from an EAL/ CALD background
Psychologists will determine whether the standard recommended tests for the Program for Students
with Disabilities can be administered, or whether a nonverbal assessment tool would be more suitable.
Psychologists are referred to the Intellectual Disability Program for Students with Disabilities
Professional Guidelines for a list of suggested nonverbal assessment tools.

Determining the student’s ability to manage the motor demands of the assessment
process
Children with disabilities may have challenges that result in different, not delayed, developmental pathways
(Porter, 2012). Many students with disabilities have sensory-motor challenges that result in different
movements and early communication behaviours. The use of gestures (e.g. pointing, manipulating objects)
may not be possible for students who have severe physical disabilities or sensory motor challenges. Students
with Autism may also have physical and sensory processing challenges affecting their acquisition of typical
gestures (Porter, 2012, p.3).
Where assessment tasks require gestural / manipulation output or fine motor output, the psychologist must
consider any motor challenges the student may have.
Students with CCN may use movement in a different way to communicate and the assessing psychologist will
need to be vigilant and cautious about interpreting their intent behind the response to test items.

Porter & Iacano (2007) state that every assessment task requires the student to receive a sensory input to process
an answer and to plan and execute a movement or motor response. When a student with complex challenges fails
in a task it is impossible to know which element(s) was preventing success.

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Gesture and the manipulation of objects require intact sensory and motor pathways to achieve accurate, well-
timed and successful movement. Challenges with sensory input and/or the planning and execution of
movement can be observed in many students, including those with CP, ASD, dyspraxia and syndromes.
Challenges with the perception of sensation may affect the student’s ability to perform gesture and fine motor
tasks. Sensory seeking and avoidance behaviours may also interfere with the student’s engagement in the
task. See Attachment A.
Challenges with the planning and execution of movement may affect the student’s ability to accurately perform
gesture and fine motor tasks and the movement may mislead the observer as to the student’s intended
movement. See Attachment B.
The Manual Ability Classification System (MACS) provides a useful system for determining a student’s ability
to use their hands to interact with the test material.

MACS was designed for children with cerebral palsy, to classify how children functionally use their hands to
handle objects in daily activities. As a functional descriptor, MACS can be easily applied to students with
other diagnoses. Further information may be obtained from the student’s occupational therapist or
physiotherapist.

The MACS describes five levels of hand function, based on the student’s self-initiated ability to handle objects
and their need for assistance or adaptation to perform manual activities in everyday life. MACS is intended to
classify what students usually do, not their best possible performance.

MACS does not differentiate each hand separately and the student’s MACS level is chosen according to the
level that best describes the student’s overall usual performance in the home, school or community setting.

In order to obtain knowledge about how a child handles various everyday objects, it is necessary to ask
someone who knows the child well.

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Can the student use their hands to interact with the test materials?
MACS
MACS Level Descriptor
Level
The student handles objects easily and
successfully. At most, there are limitations in the
Level 1 ease of performing manual tasks requiring speed
and accuracy. However, any limitations in
manual abilities do not restrict independence in
daily activities.
The student handles most objects but with
somewhat reduced quality and/or speed of
Level 2 achievement.
Alternative ways of performing tasks might be
used, but manual abilities do not usually restrict
independence in daily activities.
These students can manipulate test materials as
long as the materials do not require very refined
fine motor and manipulative skills.
The student handles objects with difficulty and
needs help to prepare and/or modify activities.
Level 3
Students need significantly more time to
complete a task.
Performance is slow and achieved with limited
success regarding quality and/or quantity.
Activities are performed independently if they
have been set up or adapted.
The student handles a limited selection of easily
managed objects in modified situations.
Level 4
The student performs parts of activities with
effort and with limited success and requires
continuous support during the activity. At best,
the student participates actively in only parts of
an activity.
The student requires assistance and/or adapted
equipment, for even partial achievement of the
activity.
The student does not handle objects and has
severely limited ability to perform even simple
Level 5 actions.
The student requires total assistance.
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Accommodations
The student’s hand skills do not or only mildly impact
on their ability to interact with test materials.
For any concerns, consult an occupational therapist.
Proceed with assessment
Assessors may need to consider using larger sized
objects in the test materials that are easier to
manipulate.
In addition, these students will have challenges with
timed assessment because they will take longer to
perform manually based tests.
Consultation with an occupational therapist is
recommended.
Proceed with assessment
Assessors need to consider:
1. Adjustments to the environment, to enable the
student’s best hand function, since the ability to
reach or handle objects is limited – e.g. correct
chair, table height, and other individual
adaptations.
2. The test materials will need to be modified –
larger objects, bigger pictures to target, less
items that are well spaced on a page. Consult an
occupational therapist
3. Students may complete some of the subtests but
will not complete a whole test in the set
timeframe.
4. Student may require short rest periods.
Proceed with assessment in consultation with
Occupational Therapist.
Students at MACS Level 4 and 5 will require
alternative access methods, as they will be unable to
interact manually with the materials independently.
Consider reports provided by the student’s
Physiotherapist, Occupational Therapist and
Speech Pathologist and consult if necessary to
consider next steps.
NB. The psychologist may determine that the
student’s motor challenges are such that
standardised assessment using one of the
recommended tests (for the Program for Students
with Disabilities) is not possible. An alternative
assessment, including use of non-standardised tests,
observation and informal assessment may be
considered.
What are the ways a student may access his/her AAC system?
The term ‘access method’ refers to the way a student selects an item from a set of vocabulary options.
Students who use aided AAC (use of an assistive device and/or non-electronic communication book), may
access their AAC system either via:
 Direct selection (e.g. whole hand on symbol, pointing to a symbol)
 Scanning
Prior to assessment, psychologists will need to obtain information on how the student accesses their AAC
system. Depending on the student’s access method, there will be accommodations needed to ensure the
student has time to process, plan and execute the movement to expressively communicate.
Direct Selection
The student will indicate the target vocabulary by directly finger pointing or placing their whole hand on their
selected symbol. Students with sensory-motor challenges may show some variability in the way a word is
directly targeted. For example:
 Student may point with an isolated finger
 Student may use whole hand/fist to directly target an item
 Student may point with a few fingers placed together to enable the student to receive more sensory
feedback.
 Student may need to bang and/or move their hand across the page before resting it on the target item.
 Student may initially look at the page and then look away while directly selecting the target item due
to challenges using two or more sensory modalities at the same time (i.e. looking and pointing).
In these situations, if the student’s direct selection technique is not clear, seek assistance from their
occupational therapist.

Scanning
Some students may be unable to directly select items. This may include students who face significant motor
and communication challenges, such as:
 Additional multiple challenges including visual challenges
 Additional multiple challenges including hearing challenges
 Beginning Communicators, or children who currently don’t have any effective forms of
communication
 When other communication strategies are not currently available/effective.
(Porter & Burkhart, 2006).

The person scanning the student’s AAC system may provide support by showing/pointing and/or speaking the
names of items. Porter (2008) outlines the three different partner scanning methods:
1. Visual - The student relies on visual recognition of the symbols. The communication partner scans by
showing or pointing to items with a finger or light, without verbally labelling the symbols. The student
will have had prior opportunities to have the language (pictographs, words) modelled to them in natural
contexts, so will have already mapped the meaning of the language presented in their AAC system.
2. Auditory - The communication partner reads aloud the labels for each symbol, or a group of symbols.
The student relies on their understanding of the spoken labels. This method may be used for students
who are unable to visually scan the language set out on the page.
3. Visual plus auditory – The communication partner both shows/points to and reads aloud the labels
for each symbol. The student may rely upon their understanding of the spoken labels and/or visually
recognise the symbols.

The student will need to move to communicate a ‘yes’ or ‘no’ response when accessing their AAC system
using the partner scanning method.

15
The movements to intelligibly communicate to accept and reject may be variable depending on the student’s
physical and sensory challenges. The effects of fatigue on these movements needs to be monitored and
considered.

Psychologists should liaise with the student’s physiotherapist, occupational therapist and speech pathologist
who are trained to support a student who relies on scanning as an access method to expressively
communicate.

The student will also need to have access to language to indicate ‘I don’t know’. This may be in the form of an
individual visual card that the student can directly point to, or included as an option if the student relies on
scanning as their access method.

Additional assessment challenges specific to students using AAC

Depending on the student’s progress in the Communication Independence Model, their understanding of
spoken language, the availability of an AAC system and, most importantly, opportunities to have learnt their
AAC system, additional challenges can occur. These include:
1) AAC relies on somebody (in this case the assessor) being able to understand and use the student’s
AAC system to reveal the student’s capabilities.
2) There are some students who do not have and/or have had minimal access to formal language to
communicate for various reasons. If a student has only had access and opportunity to learn how to
request, their ability to efficiently and effectively complete tasks requiring language other than
requesting, will be affected.
3) When interpreting the information gathered from assessment, psychologists should differentiate
between the requirements for subtests requiring a verbal response vs subtests that require the use of
gesture / fine motor skills. Psychologists need to be cautious not to make assumptions regarding
cognition based on an inability to gesture (Porter, 2018).

8. THE ASSESSMENT PROCESS

In order to ensure the validity of test results, it is important to maintain standard administration where possible.
Depending on the student’s need for adjustment, the psychologists may consider the following:
i) Standardised Assessment
When assessing a student with CCN, psychologists may attempt standardised assessment, but noting the
student’s CCN, place greater weight on nonverbal subtests as an estimate of cognitive abilities.

ii) Standardised Assessment with recommended accommodations or modifications

For some students, the assessing psychologist may consider modifying test administration, to take into
consideration the student’s particular disability. Psychologists should refer to the relevant test manual for
advice on administration procedures and modifications to standardised administration.
Accommodations to a cognitive assessment should not change the “construct” being measured by the
assessment tool. Accommodations are intended to reduce or even eliminate the effects of a student’s disability
and should not alter what the specific subtest is assessing. That is, accommodations should make the test
instruction accessible to the student and allow the student to demonstrate what they know.
If standardised administration is not possible, consideration may be given to the adjustments or alternative
assessment procedures required to achieve the best indication of the student’s cognitive abilities.

16
Modifications to standardised administration may invalidate the use of the test’s norms and the scores may
not be computed. All modifications from standardised administration and instructions should be documented
by the assessing psychologist and taken into consideration when interpreting the results. Psychologists should
use clinical judgement to evaluate the effect of modified procedures on test results.

Psychologists may consider using subtests that rely less upon expressive language skills to gather further
information about a student’s skills where the student is unable to complete the recommended tests for
establishing eligibility for the Program for Students with Disabilities. Valuable information may be obtained
about the student’s strengths and weaknesses in intellectual functioning despite the fact that a full scale score
cannot be determined.
Significant adjustments to standardised procedures may be required for some students to participate in a
cognitive assessment. Whilst it may not be possible to score an assessment that is conducted in this way, it
can provide useful information about a student’s functioning, which can assist in developing an appropriate
educational program.

In such cases, psychologists may consider using an alternative assessment more suited to assessing the
student’s abilities.

iii) Standardised Nonverbal Assessments

For some students, the assessing psychologist may determine that the recommended standardised
assessment tool is not appropriate, given the nature of the student’s significant communication difficulties. In
such cases, psychologists may consider using an alternative assessment and in particular tests that do not
rely upon the student’s verbal ability. The Intellectual Disability Program for Students with Disabilities
Professional Guidelines suggest some assessment tools that may be appropriate to use with this cohort of
students.

iv) Students who cannot participate in standardised cognitive assessment

For some students standardised cognitive assessment may not be possible. In such cases, psychologists
should provide detailed information about why the student is unable to be formally assessed using
standardised or alternative assessments. Psychologists should provide a rationale for using any alternative
formal or informal assessment and detailed information about the student’s response to any formal or informal
activities that were presented.
Observations and reports that are relevant to the student’s behaviour and cognition should also be provided.
A detailed description of consultation with other relevant professionals, particularly speech pathologists in the
case of nonverbal students or those with CCN should be provided, including a consideration of any
augmentative or alternative communication device used by the student.
Adjustments and accommodations during assessment are practices and procedures that may alter:
• presentation • response • setting • timing

The following table provides information to assist psychologists in selecting accommodations that facilitate
the student’s understanding of test materials and instructions and also enhances the student’s ability to
provide a response:

17
 Test Presentation
Accommodations that enable students to access
information in ways that do not require them to visually
read standard print. These alternate modes of access
are auditory, tactile and visual.
Examples:
Visual – large print, magnification device, material layout
and positioning, sign language, Braille, student’s
Augmentative and Alternative Communication systems.
Tactile – Braille
Auditory – Audio amplification device such as an FM audio
unit
Who Benefits: Students who have difficulty or inability to
visually read standard print due to a physical and/or,
sensory disability, and/or CCN.
Student Response
Accommodations that enable students to complete the
cognitive assessment in different ways or to solve or
organize problems using some type of assistive device or
a person fluent in the student’s Augmentative and
Alternative Communication system.
Examples:
 Braille
 Sign Language Interpreter
 If the student is unable to directly point to
symbols: A person who is fluent in the student’s
Augmentative and Alternative Communication
system will enable the student to access their
communication system.
 Speech generating device

Who Benefits: Students who have physical and/or

sensory challenges, and/ or CCN.

Setting
Accommodations that enable students to complete the
assessment to the best of their abilities, such as a change
in the location where a test is administered, or a change in
the conditions of the assessment setting.
Examples:
 Sound blocking headphones
 Different room with minimal visual and noise
distractions
 Consider a change in lighting
 Specialised equipment and seating to ensure
optimal positioning and successful movement
Who Benefits: Students who are easily distracted in large
group settings, bright lights or light gaze, have difficulty in
noisy environments and who concentrate best in an
individual setting.
Adapted from Iowa Guidelines for the Use of Accommodations during Instruction and District Wide Assessments for Students with
Disabilities (adapted from the CCSSO Accommodations Manual).
Timing
Accommodations that enable students to process, plan
and execute movements required to access the materials.
Such as additional time to process or consideration of
fatigue management.
Refer to the specified time accommodations outlined in the
testing manuals and/or implement and record individual
accommodations as required.
Examples:
 Extended time for individual tasks and total
assessment
 Multiple or frequent breaks
 Testing over multiple sessions
Who Benefits: Students who need more time than
generally allowed to complete activities, assignments, and
assessments, or have physical and/or sensory challenges
and/or CCN.

9. INTERPRETING ASSESSMENT FINDINGS

The results of a cognitive assessment provide useful information about a student’s cognitive abilities, but they
should not be interpreted in isolation. A diagnosis of intellectual disability is not made on the basis of a single
assessment; diagnosis is based on a thorough personal history and considered clinical observations. This
includes information gained from background history, parental report, observation of significant others, and
the environment (Johnson et al, 2012). In addition, it is essential to include information on the student’s
understanding of spoken language and his/her access to varied language, be it speech or AAC to
communicate.
For a student with CCN, it is not possible to undertake a formal assessment, nor make a diagnosis until the
potential impact of the student’s communication difficulties is known, and the need to accommodate sensory
and/or motor challenges has been considered and addressed if necessary. Both the student’s understanding
of the instructions and the methods they use to respond and communicate their answers must be considered.
For example, if the student uses AAC, the AAC modalities have been identified and the student has had
sufficient opportunities to learn how to use the system.

18
When testing a student with CCN it is important not to attribute low performance on a cognitive test to low
intellectual ability, when it may be better explained by the student’s language, physical or sensory limitations.

When a student’s history or current presentation suggests that there may be other factors such as language
difficulties, behaviour problems, trauma, mental health issues, limited or disrupted schooling etc. psychologists
should consider whether such other factors may better explain the assessment results, than a diagnosis of
intellectual disability. Similarly, if the student’s behaviour during the assessment may have adversely affected
the results due to poor engagement, inattention, impulsivity, low cooperation etc. the impact of such factors
needs to be considered by psychologists when interpreting test results.
Psychologists are directed to the relevant test administration and scoring manual, technical and interpretative
manual, or resources such as Essentials of WPPSI-IV Assessment (Raiford and Coalson 2014), Essentials of
WISC-V Assessment (Flanagan and Alfonso, 2017) and Intelligent Testing with the WISC-V (Kaufman, Raiford
and Coalson, 2016) for advice on the interpretation of test results.

10. REPORTING ASSESSMENT FINDINGS

The Practice guide for the assessment of school-age students in educational contexts, 2014 provides a set
principles to guide psychologists in writing assessment reports and recommendations.

Principle 36: Practitioners clearly and accurately outline assessment processes and tools in assessment
reports.
Principle 37: Practitioners highlight any limitations of the assessment and the implications of these
limitations.
Principle 38: Practitioners prepare high quality individualised reports.
Principle 39: Practitioners make clear whether a diagnosis is applicable.
Principle 40: Practitioners write assessment reports in clear language with consideration of all potential
recipients.
Principle 41: Practitioners seek to provide verbal feedback to ensure adequate understanding of the
assessment report
Principle 42: Practitioners do not include in reports any documentation or information that will compromise
the integrity of any test, or contravene copyright laws or any agreement with the supplier of
the test being used.
Principle 43: Practitioners make recommendations that address the referral question and provide any
additional information determined to be useful in meeting the student’s needs.

Reports should provide a summary of relevant background information, a description of the assessment
process, student’s test taking behaviour and an interpretation of the test results. All accommodations made
must be explicitly recorded in the report, along with the reasons why standardised administration was not used.
This includes accommodations to compensate for the student’s disability. The relevant test manual will
provide information that can guide psychologists in reporting on such assessments.
When using report templates such as those required by the Program for Students with Disabilities,
psychologists should address all areas outlined in the template, including documentation of the assessment
process and in particular any deviations from standard administration. Observations noted by the psychologist
during the assessment that may have impacted on the assessment results should be documented and
discussed.
The report should describe any assessment tools used, any attempts made to conduct the standardised
assessment, and a clear explanation of why standardised administration could not be completed. A detailed

19
discussion of alternative (non-standardised) procedures or instructions used to determine the student’s
intellectual functioning should be provided.
Where the recommended test instruments for the Program for Students with Disabilities have been deemed
inappropriate for testing the student, psychologists should provide the reasons why this is the case, describe
any attempts made to assess the student and provide a detailed discussion of the alternative procedures used
to determine the student’s intellectual functioning.
When making a diagnosis of intellectual disability, psychologists will refer to an appropriate classification
system (DSM-V, ICD-10 etc.) and will consider all available information, including other assessment results
(e.g. speech and language assessment, occupational therapy and physiotherapy assessment), an assessment
of adaptive behaviour and a thorough history provided by people who know the student well. The possible
impact of any deviations to standardised administration will be considered, along with any other circumstances
that may have impacted upon the student’s performance during the assessment.

Where standardised administration of a cognitive assessment has not been possible, the test norms cannot
be used to calculate the IQ.

In addition, reports should be comprehensive and individualised, with a focus on the student’s specific
strengths and challenges to learning, with a view to identifying, and where appropriate, making
recommendations on what supports are needed and whether further intervention is warranted. For example,
if a student has difficulty comprehending spoken instruction and has not had AAC available and/or
opportunities to learn AAC to communicate it may be advisable to consider further assessment once the
student is able to use AAC confidently to respond during an assessment.

11. SUMMARY
When assessing the cognitive ability of students with CCN the psychologist should note:

 Diagnosis and classification is not based upon results of a single test

 Other professionals working with the student should be consulted (speech pathologist, occupational
therapist, physiotherapist) as required
 Student’s needs have been accommodated to ensure access, understanding and participation during the
assessment process
 Test administration manuals provide guidance regarding accommodations and modifications
 The impact of all accommodations and modifications to standard administration should be considered
 Use of non-standard administration may mean that test norms can no longer be used
 Non-standard administration can provide useful information about a student’s functioning
 Variations to standard administration, or use of alternative tests should be reported
 Reports should focus on strengths and the support required for the student to learn.

20
APPENDIX 1
ALTERNATIVE STANDARDISED TESTS FOR STUDENTS WITH CCN
When assessing students for Program for Students with Disabilities eligibility, psychologists may determine
that the recommended standardised assessment tool is not appropriate, given the nature of the student’s
significant communication difficulties.
In such cases, psychologists may consider using an alternative assessment tool and in particular, tests that
do not rely upon the student’s verbal ability.
Below are some assessment tools that may be appropriate to use with this cohort of students:
 Wechsler Nonverbal Scale of Ability (WNV)
 Universal Nonverbal Intelligence Test Second Edition (UNIT-2)
 Test of Nonverbal Intelligence Fourth Edition (TONI-4)
 Comprehensive Test of Nonverbal Intelligence Second Edition (CTONI-2)
 Leiter Performance Scale Third Edition (LEITER-3)
 Naglieri Nonverbal Ability Test- Individual Administration (NNAT-Individual)
 Raven’s Educational (Progressive Matrices)
Please note that comprehensive batteries such as the WNV and UNIT are considered to be comprehensive
tests of cognitive ability. Tests such as the Naglieri and Raven’s Educational (Progressive Matrices) may
provide supporting evidence, but are not considered adequate as stand-alone assessments for the purposes
of establishing eligibility under the intellectual disability category of the Program for Students with Disabilities.

21
APPENDIX 2
STUDENTS WITH CCN AND ADDITIONAL CHALLENGES
A student with CCN may have a number of additional challenges to be considered in the assessment process.
For some students, standardised assessments will not be possible, as a range of adjustments need to be
made to facilitate their understanding of instructions, and enhance their ability to respond to demonstrate their
abilities during the assessment process.
Please refer to the table below for information relevant to particular student needs.
Sensory Processing Challenges Sensory processing includes the ability to Attachment A
detect sensory input (from both inside and
outside the body), modulate responses to
input, and/ or discriminate the nature of the
stimuli and store information about the
experience so that it can be applied for
function.
Motor Challenges Motor challenges include all conditions in Attachment B
which a student’s posture and/or controlled
voluntary movement is affected. This includes
situations where movement is reduced or
when a student has additional or extra
uncontrolled movement.
Deaf and hard of hearing Deaf is used to describe those who use Attachment C
Auslan (Australian Sign Language) to
communicate, and who identify as members
of the signing Deaf community. They are more
likely to have been born deaf or become deaf
early in life.
Hard of hearing is the term that Deaf
Australia now uses to describe those who
have acquired a hearing loss in late childhood
or adulthood, or who have a mild or moderate
hearing loss. These people usually
communicate using speech, lip-reading and
residual hearing (often amplified by hearing
aids).
Vision Challenges Vision impairment refers to a significant loss Attachment D
of vision in both eyes, which cannot be
corrected with glasses. The degree of loss
may vary significantly, which means that each
student with low vision or blindness needs
individual adjustments to learn most
effectively.
Deaf-blind Deaf blindness is described as a unique and Attachment E
isolating sensory disability resulting from the
combination of both a hearing loss and a
vision loss or impairment, which significantly
affects communication, socialisation mobility
and daily living.

22
ATTACHMENT A
UNDERSTANDING THE STUDENT WITH SENSORY PROCESSING
CHALLENGES
Sensory processing refers to the way the central and peripheral nervous systems manage incoming sensory
information from the sensory organs, namely visual, auditory, tactile, smell, taste, proprioception and vestibular
inputs.

A sensory processing challenge is the inability to use information received through our senses to function
smoothly in daily life.

The processing and integration of sensory input strongly affects development. Sensory functioning
characteristics include:
 Registration (detection) of stimuli
 Modulation (regulation of level or intensity)
 Praxis (planning of motor movements)

Students who are diagnosed as having ‘sensory sensitivity’ or ‘sensation avoiding’ behaviours are hyper-
reactive to sensation.

Students who are diagnosed as having ‘low registration’ or ‘sensation seeking’ behaviours are hypo-reactive
to sensation.

Many students with physical disabilities have sensory-motor challenges that result in qualitatively different
movements and early communication behaviours. Gestural communication may not be possible for students
who have severe sensory challenges (Porter, 2012).

The individual needs to be able to process the standard materials and spoken instruction and easily produce
the standard movements required to participate in the test in order to administer, score and interpret the results
using the standardised measures and interpretations of the test (Porter, 2018).

Has the student ever been assessed and identified as having sensory processing challenges?
Yes Maybe / I have some concerns

Obtain and review the student’s current occupational If you have any concerns about the student’s
therapy report (if available) prior to the assessment sensory processing – consult with an occupational
to see if it contains information regarding the therapist who specialises in paediatric sensory-
students sensory processing. motor challenges.

Considerations in cognitive assessment

A student who can accurately process the sensory information and the standard materials and spoken
instruction, may still require additional time and effort to produce the standard movements required to
participate in the test.

As task complexity increases, there are increased demands on working memory and the planning required to
move. This should be considered when interpreting the assessment scores.
It is essential to consider information provided by the student’s occupational therapist during the assessment
planning process as a source of expert information to enhance understanding of the issues that may influence
participation during the cognitive assessment, including whether the student:

23
  Has difficulties detecting, or is hyper-reactive to sensation (detection),
 Has difficulty in regulating their response to sensations (modulation),
 Positions his/her body in an unusual way and has difficulty planning how to organise and move their
body to target an assessment material (planning of motor-movements).
Table 1 guides psychologists during the assessment planning process to develop a thorough understanding
of the student’s sensory processing challenges and the effect these may have on interpreting assessment
responses.
The assessing psychologist, in consultation with the occupational therapist, needs to include accommodations
to ensure the student is able to participate fully during the cognitive assessment.
Table1: Considerations when assessing a student with sensory processing challenges
 Does the student press heavily/lightly when writing?
 Does the student use their hands repeatedly on their body or surface?
 Does the student have appropriate fingertip control and fine motor skills
Tactile Processing to control in-hand manipulation if holding an object?
 Can the student coordinate looking, listening, thinking and manipulation
of tactile objects?

 Does the student rely on regular opportunities to move to assist them to

Vestibular participate?
Processing

 Can the student sit in less supported seating?

Proprioceptive
Processing  Does the student require opportunities to feel their body in space, or
move in space to assist them to participate
 Is the student distracted by background sounds e.g. fan, clock ticking?
 Does the student do better when presented with a visual cue to support
Auditory Processing understanding of spoken language?
 Does the student look away when listening to an instruction?
 Does the student need directions repeated?
 Does the student have sensitivity to bright lights?
 Is the student easily distracted by other visual stimuli in the room?

Visual Processing  Does the student have difficulty keeping their eyes focused on a task for
an appropriate amount of time?
 Does the student have difficulty discriminating between similar printed
letters, shapes, figures or pictures?

24
ATTACHMENT B
UNDERSTANDING THE STUDENT WITH MOTOR CHALLENGES

Students with movement challenges of a neurological origin may move differently to their typically developing
peers. The movement observed can be very different from the movement that the student intended to make.
Many of the psychometric assessment tools require the student to initiate a physical movement to respond to
the test item. A student’s motor challenges can alter the observer’s interpretation and perception of the
student’s abilities, and may alter the student’s intended answers in an assessment environment.
“We cannot see cognition or receptive language – we infer cognition and receptive language from an
individual’s movement response to a carefully selected sensory input” (Porter, 2017).
As a result, it is necessary for the assessor to have a good understanding of the student’s key movement
issues affecting their participation and learning.
A student may have a range of movements to indicate a yes/no response related to their physical disability,
positioning and/or limited opportunities to learn and practice a consistent motor movement to accept and reject.
Psychologists therefore need to consider what strategies are needed that will support the individual to produce
more consistent and interpretable movements.

Has the student ever been assessed and identified as having fine or gross motor challenges?
Yes Maybe / I have some concerns
Obtain and review the student’s current If you have any concerns about the student’s
physiotherapy report (if available) to identify any movement – consult with a physiotherapist who
requirement for positioning and use of specialised specialises in paediatric motor challenges.
equipment to enable active movement.
Contact student’s physiotherapist.

Table 2 guides psychologists during the assessment planning process, in developing a thorough
understanding of the student’s disability, and the effect the disability may have on interpreting assessment
responses. It emphasises the value of consulting the student’s physiotherapist prior to the assessment, in
order to better to understand issues related to the student’s seating, positioning, movements to communicate,
and access methods.

25
Table 2: Considerations when conducting a cognitive assessment with a student who has motor
movement challenges

Are you able to understand the student’s movement

differences associated with their primary disability?
and
NO
Are you able to implement appropriate  Liaise with the student’s physiotherapist and/or
strategies to accommodate for these occupational therapist and/or family.
movement differences in the assessment?
YES

Can the student maintain the following position using

your standard chair and table:

- Feet flat on the floor

- Bottom back in the chair

NO
- Back straight  A physiotherapist and/or occupational therapist (if
available) and/or family should be consulted to assist
- Arms forward with easy access to the table
in problem solving the student’s position.
YES

- Head upright and in the middle

Effects of Fatigue: Can the student maintain
this position and participate for an appropriate
test period.
 With guidance, select a less physically demanding
NO position from which the student can still participate.
 Guidance on the appropriateness of completing
assessment over an extended time/ with regular short
breaks.

Once in a stable and symmetrical position: can the  Consult with allied health team.
student use their hands to manipulate the assessment
materials?  Tasks that require in hand manipulation may need to
be excluded from the assessment
- In hand manipulation
 Prior to the assessment, identify how the student
- Hand to hand NO
indicates a “yes”, “no”, “I do not know” response. If the
- Grasp, target, release student is unable to use movement to indicate a “yes”,
“no”, “I don’t know” response, accommodations are
required such as a visual eye gaze board (yes”, “no”,
YES

“I don’t know”).
 Provide adjustments to the way the questions are
presented accordingly
 Provide verbal feedback on your observations so that
both examiner and student are clear on what is
expected.

26
 Can the student intelligibly point (hand/index
finger) to objects or pictures in the
assessment using standardized materials.
Can the student point to items in a time efficient
manner that does not require cognitive thought?
YES
Do you know how long it takes for the student to
initiate the movement?
I.e. the time taken for the student to process
information and prepare and move their body
in response to a question.
YES
Proceed with the assessment
27
 Consider the options under alternative access. Read
the hints for supporting an individual to point with their
NO hand:
 Note that pointing with one hand requires the
individual to shift weight onto the other hand, the
student may need reminding of this. It may be easier
to position materials in line with the student’s shoulder
 Consider the student using an alternative access
method (e.g. eye gaze, partner assisted scanning),
where the examiner asks the question and then points
one at a time to each option, pausing for the specified
identified time that is needed before moving to the next
option. Examiner verbally provides ‘I don’t know’ as
the last option.
 Time dependent subtests may be unsuitable
NO  Consult with physiotherapist
NB. The psychologist may determine that the student’s
motor challenges are such that standardised assessment
using one of the recommended tests (for the Program for
Students with Disabilities) is not possible. An alternative
assessment, including use of non-standardised tests,
observation and informal assessment may be considered.
ATTACHMENT C
UNDERSTANDING THE STUDENT WITH HEARING IMPAIRMENT

Students who are Deaf and hard of hearing

Deaf is used to describe those who use Auslan (Australian Sign Language) to communicate, and who identify
as members of the signing Deaf community. They are more likely to have been born deaf or become deaf
early in life.
Hard of hearing is the term that Deaf Australia now uses to describe those who have acquired a hearing loss
in late childhood or adulthood, or who have a mild or moderate hearing loss. These people usually
communicate using speech, lip-reading and residual hearing (often amplified by hearing aids).
Students who are Deaf or hard of hearing may use:
 spoken language,
 sign language
 a combination of spoken language and signed systems.
For assessment results to reflect the abilities of the student, the psychologist may need to consider
accommodations suggested in the relevant test administration manual. In some cases emphasis may be on
the administration and interpretation of nonverbal subtests, or an alternative assessment may be used.
Where there are significant deviations from standard administration of a test, for example administering the
test in the student’s primary language and preferred mode of communication, useful information about the
student’s functioning will be obtained, however it is no longer possible to interpret the test results obtained in
the standard way.
The psychologist may be guided by the following resources:
WISC-V Technical Report #2 Testing Children Who are Deaf or Hard of Hearing, (Day et al, 2015)
Intelligent Testing with the WISC-V, (Kaufman, Raiford and Coalson, 2016)
WISC-IV Administration and Scoring Manual, (Wechsler, 2003)

Has the student ever been assessed and identified as having hearing challenges?
Yes Maybe / I have some concerns
Obtain and review the student’s current audiology If you have any concerns about the student’s hearing
report to see if it contains information regarding use – consult with an audiologist who specialises in
of specialised equipment and/or recommended paediatric hearing assessment.
accommodations.
Contact student’s teacher of the deaf for advice on
how to maximise the student’s participation in the
cognitive assessment.

28
ATTACHMENT D
UNDERSTANDING THE STUDENT WITH VISION IMPAIRMENT

Vision impairment refers to a significant loss of vision in both eyes, which cannot be corrected with glasses.
The degree of loss may vary significantly, which means that each student with low vision or blindness needs
individual adjustments to learn most effectively.
There are two main categories of vision impairment:
 low vision – people with low vision may also be referred to as partially sighted and
 blind – no light perception
The majority of students with vision impairment have low vision, which means they are print users but may
require special equipment and materials. Psychologists should also consider how the student can best use
their residual vision during the assessment.
An increasing number of children with a diagnosis of cortical vision impairment (CVI) are entering the
educational system. CVI is a temporary or permanent visual impairment caused by the disturbance of the
visual cortex or posterior visual pathways of the brain. The degree of neurological impairment depends upon
the time of onset and the location and intensity of the damage. The eyes may function typically, but the visual
systems of the brain do not consistently understand or interpret what the eyes see. In addition, students with
CVI may exhibit fluctuations in visual functioning from day to day.
Accommodations may be required to ensure these students are able to participate in the assessment process.
Further information about CVI is available from Vision Australia:
(https://visionaustralia.org/information/eye-conditions/cortical-vision-impairment)
and the Statewide Vision Resource Centre
(http://svrc.vic.edu.au/about/vision-and-vision-impairment/cvi/).
Roman-Lantzy (2008) provides additional information about assessment and intervention for students with
CVI.

Has the student ever been assessed and identified as having vision challenges?
Yes Maybe / I have some concerns
Obtain and review the student’s current vision If you have any concerns about the student’s vision
assessment report to see if it contains information – consult with a vision specialist who specialises in
regarding use of specialised equipment and/or paediatric vision assessment.
recommended accommodations.
Contact student’s visiting teacher or vision specialist
for advice on how to maximise the student’s
participation in the cognitive assessment.

Psychologists may refer to the relevant test administration manuals for guidance on assessing students with
vision impairment.

29
ATTACHMENT E
UNDERSTANDING THE STUDENT WHO IS DEAF-BLIND

Deaf blindness is described as a unique and isolating sensory disability resulting from the combination of both
a hearing and vision loss or impairment, which significantly affects communication, socialisation, mobility and
daily living.
Many professionals may have little or no experience working with students who are deaf-blind. An
interdisciplinary team approach with family consultation and collaboration should be used, to ensure that the
assessing psychologist is able to plan a fair and effective assessment process for such students.
Although standardised tests for typically developing children may have limitations for use with students with
deaf-blindness, there are assessment tools that have been specifically designed for children who are deaf-
blind or have other disabilities. These tools, used in combination with strategies such as family interviews and
informal and structured observations, may be helpful for organising data-gathering efforts and summarising a
child’s skills, interests, and challenges (Malloy, 2010, p. 3).
Some students who are deaf-blind may be less able to participate in standardised cognitive assessments, in
particular those that involve language, reading, problem-solving, memory, eye-hand coordination and abstract
thinking, as they may not enable the student to demonstrate their actual capabilities or learnt experiences
(Mar, 2010).
Although it may not be possible to obtain the standard scores required to establish eligibility for programs such
as the program for Students with Disabilities for example, the most important goal of any assessment is to
gain an understanding of a student’s real-life skills and understanding of concepts. For some students who are
deaf-blind, authentic assessment (based on real life tasks), obtaining information about the student in a variety
of everyday natural contexts may be more informative.

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