CSBS™ Manual: Communication and Symbolic Behavior Scales (CSBS™) - Tapa blanda

Excerpted from Chapters 1 and 2 of CSBS™ Manual: Communication and Symbolic Behavior Scales™, Normed Edition, by Amy M. Wetherby, Ph.D., CCC-SLP, and Barry M. Prizant, Ph.D., CCC–SLP

Copyright © 2003 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

The Communication and Symbolic Behavior Scales™ (CSBS™) is a standardized assessment tool designed to examine the communicative, social–affective, and symbolic abilities of children whose functional communication age is between 8 months and 2 years. It was designed to assess infants, toddlers, and preschool children and may be used with children whose chronological age ranges from about 8 months to 5–6 years if their developmental level of functioning is younger than 24 months. The purpose of the CSBS is twofold:

1. For early identification of children who have, or are at risk for, developing a communication impairment
   
   
2. For establishment of a profile of communication, social-affective, and symbolic functioning to monitor changes in a child's behavior over time and to direct planning of intervention.
   

WHAT DOES THE CSBS MEASURE?

The CSBS provides quantitative and qualitative information about a child's communicative and symbolic abilities. The results of the CSBS are converted to scores on 22 five–point scales. Some scales are developmentally organized and measure performance expected between 8 and 24 months of age. Other scales provide qualitative information concerning the child's behavior during the assessment. The CSBS measures the following parameters, which are summarized in cluster scores:

• Communicative Function
  
  
• Communicative Means—Gestural
  
  
• Communicative Means—Vocal
  
  
• Communicative Means—Verbal
  
  
• Reciprocity
  
  
• Social–Affective Signaling
  
  
• Symbolic Behavior
  

HOW IS THE CSBS ADMINISTERED?

The CSBS uses a standard but flexible format for sampling behavior from developmentally young children using direct sampling of a child's behavior and a caregiver questionnaire. The sampling procedures consist of the following strategies designed to encourage spontaneous behavior. The strategies range in degree of structure provided by the adults.

• Communicative temptations, which are situations designed to entice a child to communicate
  
  
• Book sharing
  
  
• Symbolic play, using materials that encourage pretending with objects
  
  
• Language comprehension probes
  
  
• Constructive play, using materials that encourage building with objects
  

Materials used during the CSBS Behavior Sample include action–based toys to entice spontaneous communication, books designed for young children, and play materials that assess how a child uses and plays with objects symbolically and constructively. Materials are presented in a designated sequence with minimal intrusion or direction on the part of the evaluator. The child's caregiver is present during the full evaluation and is instructed to respond naturally but not to direct the child's behavior in order to encourage spontaneous communication and play. The caregiver is involved in the CSBS in three ways:

1. As a participant, by being present and participating during the CSBS Behavior Sample
   
   
2. As a validator, by completing the CSBS Behavior Sample: Caregiver Perception Rating form to indicate how typical the child's behavior was during the sample
   
   
3. As a reporter and describer, by completing the CSBS Caregiver Questionnaire The CSBS Caregiver Questionnaire can be completed prior to the assessment of the child by mailing it to the caregiver; however, if needed, it can be completed during an interview with the caregiver.
   

Who Can Administer the CSBS?

The CSBS is best administered by a certified speech–language pathologist, early interventionist, psychologist, or other professional trained to assess developmentally young children.

How Long Does it Take to Administer and Score?

The CSBS Caregiver Questionnaire can be completed by a parent or caregiver in about 15–20 minutes. The CSBS Behavior Sample takes approximately 1 hour including a brief warm–up period and is videotaped for analysis and scoring. A trained evaluator can score the videotape in about 1 hour.

What Are the CSBS Materials?

The CSBS kit includes

• CSBS DP Manual, Normed Edition
  
  
• Carrying bag and materials for the CSBS Behavior Sample
  
  
• Two instructional videotapes for the Behavior Sample; these tutorials demonstrate the sampling procedures and scoring guidelines
  
  
• Record Forms for scoring and reporting results
  
  
• CSBS Caregiver Questionnaires
  

IMPORTANT FEATURES OF THE CSBS

Important features of the CSBS include

1. Comprehensive assessment of early nonverbal communicative behaviors that have been found to be correlates of language development in the most current research with typically developing children and children with disorders
   
   
2. Provision of specific guidelines for collecting a spontaneous communication sample and play behaviors using naturalistic procedures so that evaluators need not rely on the kind of elicited, evaluator–directed responses typically used on formal tests
   
   
3. A five–point rating scale in 22 assessment domains so that evaluators can document patterns of and changes in communicative, social, and symbolic behavior more precisely than is possible with the plus/minus scoring system typically used on tests and developmental checklists
   
   
4. Display of evaluation results in a communicative, social–affective, and symbolic profile of relative strengths and weaknesses across major domains of development such that a child's communicative behavior can be documented in reference to his or her developmental level of social ability and symbolic representation. This profile will be valuable for differential diagnosis and can be compared to profiles that are typical of different groups of children.
   
   
5. Presentation of guidelines for early identification of communication disorders and intervention planning based on assessment results.
   

ORGANIZATION OF THE MANUAL

This manual presents background on the development of the CSBS and specific instructions for administering, scoring, and interpreting the CSBS. Chapter 2 provides a description of the theoretical and empirical literature that was the basis for the development of the CSBS. Specific instructions for administering the Behavior Sample and Caregiver Questionnaire are presented in Chapter 3. Chapter 4 presents detailed definitions for scoring the 22 scales and for analyzing the videotaped samples. Chapter 5 provides information for scoring and interpretation. Chapter 6 provides the technical background and information about standardization and norming of the CSBS. Finally, Chapter 7 provides directions for interpretation of a child's CSBS profile for intervention planning. Finally, a glossary is provided that lists definitions of important terms and concepts.

Table 2.1.

The Communication and Symbolic Behavior Scales

Communicative Function

1. Behavior Regulation—Communicative acts used to regulate behavior of another person to obtain or restrict an environmental goal.
   
2. Joint Attention—Communicative acts used to direct another's attention to an object, event, or a topic of a communicative act.
   
3. Sociability of Communicative Functions—Proportion of communicative acts used for social interaction plus joint attention.
   

Communicative Means—Gestural

1. Conventional Gestures—:Gestural communicative acts whose meaning is shared by a general community, including giving, showing, pushing away, open-hand reaching, pointing, waving, nodding head, and shaking head.
   
2. Distal Gestures—Gestural communicative acts in which the child's hand does not touch a person or object (e.g., open–hand reaching, pointing at a distance, waving).
   
3. Coordination of Gesture and Vocalizations—Communicative acts that are composed of a gesture and a vocalization produced simultaneously or overlapping in time.
   

Communicative Means—Vocal

1. Vocal Acts without Gestures (Isolated Vocal Acts)—Transcribable vowels or vowel plus consonant combinations that are used as a communicative act and are not accompanied by a gesture.
   
2. Inventory of Different Consonants—Total number of different consonants produced as part of communicative acts.
   
3. Syllables with Consonants—Vocal communicative acts that are transcribable vowel plus consonant combinations.
   
4. Multisyllables—Vocal communicative acts that contain two or more syllables; syllables may be a vowel only or a vowel plus consonant.
   

Communicative Means—Verbal

1. Inventory of Different Words (Expressive Lexicon)—Total number of different words (i.e., spoken or signed) in communicative acts; a word or word approximation must be used to refer to a specific object, action, or attribute and only that word class.
   
2. Inventory of Different Word Combinations—Total number of different multiword combinations produced in communicative acts.
   

Reciprocity

1. Respondent Acts—Communicative acts that are in response to the adult's conventional gestures or speech.
   
2. Rate of Communicative Acts—Frequency of communicative acts displayed per minute.
   
3. Repair Strategies—Measure of the child's ability to repeat and/or modify a previous communicative act when a goal is not achieved.
   

Social-Affective Signaling

1. Gaze Shifts—Alternating eye gaze between a person and an object and back (i.e., either person–objectperson or object–person–object).
   
2. Shared Positive Affect—Clear facial expressions of pleasure or excitement, which may or may not be accompanied by a vocalization, that is directed toward the adult with eye gaze.
   
3. Episodes of Negative Affect—Clear vocal expressions of distress or frustration that begin when the vocalization is initiated and continue until the child has recovered and has displayed a neutral or positive affect.
   

Symbolic Behavior

1. Language Comprehension—Measure of comprehension of contextual cues, single words, and multiword utterances.
   
2. Inventory of Different Action Schemes—Total number of different action schemes used with objects in symbolic play.
   
3. Complexity of Action Schemes—Measure of the child's ability to use action schemes with objects toward self or other agents and ability to sequence different action schemes in pretend play.
   
4. Constructive Play (Combinatorial Play)

   —Measure of the child's ability to use objects in combination to construct a product (e.g., a tower).