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The ET 6-6 A Method For Developmental Assessment F
The ET 6-6 A Method For Developmental Assessment F
of Macha & F.
Psychology
© 2008 Petermann:
Hogrefe
2008; Vol. The
& Huber ET 6–6
216(3):154–160
Publishers
The ET 6–6
A Method for Developmental Assessment
for German-Speaking Countries
Thorsten Macha and Franz Petermann
Center for Clinical Psychology and Rehabilitation, University of Bremen, Germany
Abstract. The ET 6–6 presents a procedure for the assessment of a developmental status in children from 6 months to 6 years of age
that uses experimentally based test tasks for a great variety of developmental skills. The results are shown in a multidimensional and
age-specific profile. The instrument has been standardized by testing 950 children.
Preventive medical check-ups for children that rely on med- 2004) argues that a large amount of interindividual and intra-
ical examination, short conversation with parents, and some individual variability is characteristic even for normal child
behavior monitoring may not be sufficient to detect or ex- development. Low-contact pathways, then, describe basic
clude the presence of a developmental disorder. The ET 6–6 abilities that may expedite or inhibit the development of
(Developmental Test 6 Months to 6 Years; Petermann, Stein, skills. A large number of such developmental pathways are
& Macha, 2006a) provides a standardized test procedure suit- supposed to interact in a complex manner such that they can-
able for a large age range that allows for norm-oriented as- not be observed by standard psychometric testing. Conse-
sessment based on a new model of development. quently, it is the interaction that forms an observable skill pattern
and that needs to be monitored by a developmental test.
The individual developmental process is modeled by a
circumscribed developmental cone (see Figure 1). The status
Theoretical Considerations at a particular time (e.g., T) can be obtained by considering
the appropriate section of the cone. At time 0, individual de-
The development of the ET 6–6 was based on suggestions velopment begins. At the time of birth (B), the individual
by pediatricians as well as results from research in devel- developmental process has already differentiated progres-
opmental neurology and neuropsychology. This resulted in sively, which is illustrated by the increased expansion of the
a multiperspective view: conic section. For example, at times t1 and t2, the differentia-
– Age: Is a skill profile of a child typical for a particular tion of the developmental paths are illustrated by P1 and P2.
developmental period? They attain stability after a certain time interval. By interac-
– Disorder: Do signs and symptoms relate to specific cat- tion of different developmental paths in the individual’s bio-
egories of developmental deviations? psychosocial context, specific skills are developed at time t3.
– Course: Can valid predictions of future development be Such skills are accessible to assessment and can be measured
derived from the instrument’s scoring pattern? by items of the ET 6–6. With the continuous influence of
developmental paths, these skills are further differentiated
The ET 6–6 is based on theories of maturation (Plomin et al., and lead to complex skills (C). The complex skills are known
1993; Scarr, 1992) as well as on learning theory, Piaget’s as context bound behavioral dispositions and frequently give
theory of cognitive development, and Bronfenbrenner’s eco- the impression of an abnormal development.
logical theory (2006). Other concepts considered include sen-
sitive phases, risk and protective factors, developmental
tasks, or milestones. A core characteristic of the ET 6–6 is the
concept of development as complex interaction instead of
linear progression. Sroufe (1997), for example, suggests a Methodic Implementation and
tree-like structure of developmental pathways (patterns), fea- Structure of the Test
turing increased differentiation with increasing age, and dif-
ferent normal and abnormal trajectories in different develop- For normal development and specific types of disorders,
mental areas. Touwen (1984; see Michaelis & Niemann, Petermann, Stein, and Macha (2006b) analyze configura-
Zeitschrift für Psychologie / Journal of Psychology 2008; Vol. 216(3):154–160 © 2008 Hogrefe & Huber Publishers
DOI 10.1027/0044-3409.216.3.154
T. Macha & F. Petermann: The ET 6–6 155
© 2008 Hogrefe & Huber Publishers Zeitschrift für Psychologie / Journal of Psychology 2008; Vol. 216(3):154–160
156 T. Macha & F. Petermann: The ET 6–6
Zeitschrift für Psychologie / Journal of Psychology 2008; Vol. 216(3):154–160 © 2008 Hogrefe & Huber Publishers
T. Macha & F. Petermann: The ET 6–6 157
© 2008 Hogrefe & Huber Publishers Zeitschrift für Psychologie / Journal of Psychology 2008; Vol. 216(3):154–160
158 T. Macha & F. Petermann: The ET 6–6
acquisition even in preverbal children. The German Lan- Table 2. Overview of validation studies of the ET 6–6
guage Development Test for 2 years olds (SETK-2; Grimm,
Studies Authors (year)
2000) as well as the German Language Development Test
for 3- to 5-year-olds (SETK 3–5; Grimm, 2001) also vali- Extreme group comparisons
date ET 6–6 indications of language disorders (Lissmann, – Premature infants Manual
Domsch, & Lohaus, 2006). Predictive validity of the ET – Premature infants Macha, Proske, & Petermann
6–6 has been demonstrated in a pilot study by Lissmann et (2005)
al. (2006) using the Bayley Scales (Bayley II; Bayley, – Premature infants Hampel, Kropf, Petermann, Kö-
1993) as a reference. nig, Gloger-Tippelt, & Dikici
(2007)
– Very premature infants Rapp, Thyen, Müller-Steinhardt,
& Kohl (2005)
Physical disorders
Longitudinal Studies
– Heart disease Hülser, Dubowny, Knobl,
Meyer, & Schölmerich (2007)
Petermann et al. (2006b) used a sample of N = 41 normal
– Perinatal stroke Daseking, Lemcke, Macha, & Pe-
children to demonstrate a high but regular fluctuation of ET termann (2007)
6–6 scores even within the normal range (1 SD unit
Behavioral disorders
above/below the average) in children from their 3rd to their
4th year. Lissmann et al. (2006) found similar variability in – Externalizing behavior disor- Gadow (2003)
ders
children assessed at 6, 12, and 24 months of age. Here,
significant test-retest correlations were obtained between Criterion validity
the ages 6 months and 12 months in the cognitive and emo- – Intelligence assessment (K- Manual
tional domain, whereas there was far less stability from 6 ABC)
to 24 months and 12 to 24 months of age (Lissmann, Korn- – Language (SETK-2; SETK Lissmann, Domsch, & Lohaus
theuer, & Lohaus, 2007). 3–5) (2006)
– Specific cognitive abilities Goertz, Knopf, Kolling, Frahsek,
& Kressley (2006)
Goertz, Kolling, Frahsek, &
Knopf (2008)
Practicability – Developmental assessment Lissmann, Domsch, & Lohaus
(BSID II) (2006)
Aspects of practicability and predictive validity of the ET Longitudinal studies
6–6 were investigated in a single-case study of a child with – Normal children (ages 2–3) Manual
severe developmental disorders (Heubrock, Spranger, Lex, – Normal infants (6–24 months) Lissmann, Domsch, & Lohaus
Lepach, & Petermann, 2003). Profound retardation is ex- (2006)
pected to produce substantial, and noticeable, deviation Lissmann, Korntheuer, & Lo-
from the normal range in a developmental profile from the haus (2007)
ET 6–6, on the premise that the child is challenged with the Practicability
tasks suitable for his or her actual age. Deliberately choos- – Practicability of verbal testing Macha, Daseking, Vogel, & Pe-
ing a test level for earlier ages, on the other hand, will pro- termann (2008)
vide differentiated information on actual competence in- – Practicability of motor testing Macha, Mayer, Petermann, Peter-
stead of deficits: information most valuable for indication mann, & Waldeck (2007)
of special training or therapy. – Extreme retardation Heubrock, Spranger, Lex, Le-
Results by Macha, Daseking, Vogel, and Petermann pach, & Petermann (2003)
(2008) suggest that language-oriented testing with the ET
6–6 might introduce bias in a developmental profile for
language-impaired children. Diagnosed children (ICD-10 Conclusion
F80.1 or F80.2, N = 26) of preschool age attained lower
profile scores (0.5 to 0.9 SD units) when tested with the ET Since 2000, the ET 6–6 has received widespread recogni-
6–6 than when tested with the completely nonverbal SON- tion and is increasingly used in German-speaking coun-
R (Janke & Petermann, 2006). Using a sample of children tries, in both practical health care settings and academic
with cerebral palsy (N = 23) Macha, Mayer, Petermann, research.
Petermann, and Waldeck (2007) point out the influence of In consideration of recent advances of child neuropsy-
motor skills on testing cognitive functions and argue that chology (Petermann & Lepach, 2007), the test will undergo
the ET 6–6 is suitable also for children with motor impair- extensive revision in near future, and will then, of course,
ment. be based on updated norms.
Zeitschrift für Psychologie / Journal of Psychology 2008; Vol. 216(3):154–160 © 2008 Hogrefe & Huber Publishers
T. Macha & F. Petermann: The ET 6–6 159
© 2008 Hogrefe & Huber Publishers Zeitschrift für Psychologie / Journal of Psychology 2008; Vol. 216(3):154–160
160 T. Macha & F. Petermann: The ET 6–6
Fulker, D.W. et al. (1993). Genetic change and continuity from Sroufe, L.A. (1997) Psychopathology as an outcome of develop-
fourteen to twenty months: The MacArthur Longitudinal Twin ment. Development and Psychopathology, 9, 251–268.
Study. Child Development, 64, 1354–1376. Touwen, B.C.L. (1984). Normale neurologische Entwicklung:
Rapp, M., Thyen, U., Müller-Steinhardt, K., & Kohl, M. (2005). Die nicht bestehenden Inter- und Intra-Item-Beziehungen
Morbidität und Mortalität extrem frühgeborener Kinder in [Normal neurologic development: The phenomenon of nonex-
Schleswig-Holstein. Nachuntersuchung von extrem frühgebo- isting interitem and intraitem relation]. In R. Michaelis, R.
renen Kindern unter 27 + 0 Schwangerschaftswochen im kor- Nolte, M. Buchwald-Saal, & G. Haas (Eds.), Entwicklungs-
rigierten Alter von drei bis sechs Jahren in Schleswig-Holstein neurologie [Developmental neurology] (pp. 17–24). Stuttgart:
[Morbidity and mortality of extremely low gestational age in- Kohlhammer.
fants in Schleswig-Holstein. Follow-up at three to six years
corrected age of infants < 27 + 0 weeks gestation in Schles-
wig-Holstein, Germany]. Zeitschrift für Geburtshilfe und Neo- Dipl.-Psych. Thorsten Macha / Prof. Dr. Franz Petermann
natologie, 209, 135–143.
Scarr, S. (1992). Developmental theories for the 1990s: Devel- Center of Clinical Psychology and Rehabilitation
opment and individual differences. Child Development, 63, Grazer Straße 2–6
1–19. D-28359 Bremen
Schneider, W., Wolke, D., Schlagmüller, M., & Meyer, R. (2004). Germany
Pathways to school achievement in very preterm und full term Tel. +49 421 218-4618
children: The Bavarian Longitudinal Study. European Journal Fax +49 421 218-4617
of Psychology of Education, 19, 385–406. E-mail fpeterm@uni-bremen.de
Zeitschrift für Psychologie / Journal of Psychology 2008; Vol. 216(3):154–160 © 2008 Hogrefe & Huber Publishers