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Assessment Reliability and Fidelity
to existing instruments are often used; however,
resulting information must be interpreted with caution
due to the alteration of standardized procedures
(Geenens, 1999; Mar, 1996). Moreover, such
adapted instruments often result in information that
underestimates potential (Linder, 2008; Mar, 1996;
Nelson, van Dijk, McDonnell, & Thompson, 2002; R.
van Dijk, Nelson, Postma, & van Dijk, in press).
Finally, standardized instruments may be both
inaccurate and biased because they do not account
for the impact that each disability has on every area
of development (Fraiberg, 1977; Linder, 2008;
Nelson, van Dijk, McDonnell, et al., 2002).
In an attempt to ameliorate such difficulties, Dr.
Jan van Dijk and colleagues in The Netherlands
developed an alternative approach to assessment
that has become known as the van Dijk Assessment
of Children and Youth with Multiple Disabilities and
Deaf-Blindness (Nelson & van Dijk, 2002; Nelson,
van Dijk, McDonnell, et al., 2002; Nelson, van Dijk,
Oster, et al., 2009; J. van Dijk, Klomberg, & Nelson,
1997). The assessment approach began as a
cognitive one based on theories of Werner and
Kaplan (1963) and Piaget (1964) and evolved to
include theories of social learning, transaction,
attachment, and neurobiology (Nelson, van Dijk,
Oster, et al., 2009). It is used throughout the world
and has been translated into Dutch, Russian,
Spanish, and Polish (Nelson & van Dijk, 2002).
The assessment process is family as well as child
guided. It begins with a family interview that includes
information about the child and his or her
preferences and also attempts to discover what
family members hope to learn about the child from
the assessment. The assessment then proceeds to
follow the lead and interests of the child rather than a
prescribed protocol with prescribed materials. Assessors
using the van Dijk framework for assessment
constantly adjust their emotions, cognitive
levels, and communications to those of the child as
they build conversations or interactions that incrementally
build upon the child’s interests (MacFarland,
1995; Nelson & MacFarland, 1997; Nelson & van
Dijk, 2002). The assessment examines the processes
individuals use as they learn and develop. These
processes include (a) maintaining and modulating
state, (b) using preferred learning channels, (c)
learning, remembering, and anticipating routines, and
(d) accommodating new experiences with existing
72 | AER Journal: Research and Practice in Visual Impairment and Blindness
schemes. Also examined are the child’s abilities to
form attachment, interact socially, communicate with
others, and solve problems. The end result of the
assessment is a written summarization of the child’s
strengths and needs in each of the assessed areas,
next steps for intervention, and specific suggestions
for intervention (Nelson & van Dijk, 2002; Nelson,
van Dijk, McDonnell, et al., 2002; Nelson, van Dijk,
Oster, et al., 2009; Silberman, Bruce, & Nelson,
2004; Westling & Fox, 2009). Specific questions
asked in the assessment are provided in Table 1
(Nelson, van Dijk, McDonnell, et al., 2002).
The fluid nature of the van Dijk assessment
creates significant challenges for evaluation of its
reliability. There is no prescribed protocol, implementation
order, or specific testing materials. Each
assessment is by design unique because the
assessor must follow the child’s interests and leads,
thus making it difficult to ascertain whether the
assessment was implemented correctly. Therefore, it
is important that techniques deemed critical to
successful implementation of the assessment be
identified and delineated. Similarly, there is no set
interpretation scale. The assessor must be able to
extract qualitative measures of the child’s learning
processes and needs from each observed assessment.
Consequently, an evaluation of the reliability of
the instrument must determine whether multiple
examiners can look at the same assessment and
come to similar conclusions.
The purpose of the current study is to establish
whether the van Dijk approach to assessing children is
a reliable instrument for use with the population of
individuals who have severe multiple disabilities
including sensory impairments. To accomplish this
purpose, the study is designed to answer the following
questions: (a) What are the specific quality indicators
for successful assessments using this framework? (b)
Are practitioners able to implement the assessment
with fidelity or adherence to elements considered
crucial to its effectiveness? (c) Are multiple examiners
reliably able to reach the same conclusions regarding
the presence or nonpresence of the quality indicators?
and (d) Are multiple examiners able to look at the
same child assessment and reliably come to similar
conclusions?
In order to answer the first question, three
individuals considered to be authorities on the
approach, Drs. Jan van Dijk, Catherine Nelson,