【Knowledge Popularization】Deciphering PEP Assessment - Genealogy Children's Ability Assessment, How Much Do You Know?

The earlier autism is detected and intervened, the better the effect.

There are no specific assessment tools for children with ASD in the early stages of autism intervention

There were no assessment tools specifically for children with ASD in the early stages of autism intervention, until the advent of psychoeducational profile (PEP) in 1979, which was finally revised as PEP-3 in 2005 by Dr. Eric Schopler, an international pioneer of autism intervention and one of the founders of Structured Instruction (TEACCH).

PEP (Psychoeducational Profile) is a treatment and education of Autistic and related Communication Handicapped Children, chaired by Professor Eric Schopler and others at the University of North Carolina, USA. The evaluation tool developed in the TEACCH) project, the first specific assessment tool specifically for children with ASD, was published in 1979, PEP-R (revised version) in 1990, PEP-3 version in 2005, and the PEP-3 (third edition) Chinese version, which is currently used, was translated and introduced by the Hong Kong Heep Hong Kong Association in 2009.

Introduction to PEP versions

First Edition PEP

Psycho-educational Profile, PEP contains two sub-tables: the Functional Development Scale and the Pathology Scale. The functional scale has 95 assessment items, including 7 skills: imitation, perception, muscle capacity, hand-eye coordination, cognitive comprehension, language performance and behavior; the pathology scale needs to assess 44 items, including 5 areas: emotion, interpersonal and cooperative behavior, hobbies for games and materials, sensory patterns and language.

Both scales are completed by a professional doctor or teacher, and the evaluator explains the task to the child and observes and records the child's reaction.

PEP-R

The PEP-R was created in the context of the PASSAGE OF ACT in the United States. Compared to the original version, PEP-R has the following changes:

PEP-R added assessment programs suitable for children aged 2 and a half years, and formally incorporated parts of the "higher requirements" and "lower requirements" of the initial PEP supplementary assessment program into the PEP-R, adding a total of 32 projects.

The assessment of cognition and language has been enhanced, and difficult item 61B from the original edition has also been removed.

The pathology scale changed from 44 to 43. The behavioral domains of emotion and interpersonal relationships were combined, four projects originally belonging to the category of sensory pathology were transferred to the field of development, and three items were added to evaluate the response of different types of reinforcors.

Researchers such as Hanna (1992), Wiese (1992), tindal (1995) and others believe that the reliability validity of PEP and PEP-R for psychometrics is not good enough, and subsequent revisions have improved this.

PEP-3

PEP-3 is the third edition of PEP for children aged 2 to 7 and a half years or over in their physiology age but between the ages of 6 months and 7 years of development to assess skills and behaviors in children with autism and communication disorders.

PEP-3 is divided into two assessment packages – the Objective Assessment Package (field testing) and the Caregiver Reporting Package (Parent Questionnaire).

1. Objective assessment package: contains 3 categories, a total of 10 sub-tests, 172 quiz items

Communication skills

Includes 3 sub-tests of cognitive speaking/pre-language, language expression, and language comprehension

Cognitive speaking/prelinguality: 34 items in total; focusing on cognition and oral memory. Among them, the project measures problem-solving ability, collation, collation, and visual kinesthetic integration. Examples of projects include masonry, finding hidden objects, repeating sentences and repeating numbers.

Verbal expression: 25 items in total; measure children's ability to express themselves by words or movements. Examples of projects include asking for food or drink, using majority words, reading words or sentences aloud, and saying shapes large and small.

Language comprehension: 19 items in total; measure children's ability to understand speech. Examples of projects include pointing out the color, body part, recognizing words, and demonstrating the meaning of certain verbs in motion.

Motor skills

Contains 3-point tests for fine motor, coarse movement, and visual action imitation

Fine movements: 20 in total; assessing the child's ability to coordinate different parts of the body. These tests show that children aged three to four are generally able to acquire the competencies needed for life. These items include blowing soap bubbles, grasping the first three fingers or scissor grip, removing beads from the villi and applying color to the body.

Gross exercises: 15 in total; children's ability to control various parts of their body was assessed. Examples of projects include alternating feet up the steps, using cups and drinks without spilling, transferring objects from one hand to the other, and swinging the ropes that put on the beads.

Visual-motor imitation: 10 in total; children's ability to imitate visual and kinesthetic items was assessed. Precisely because imitation has a fundamental relationship with language, this sub-test has great significance for autism. To learn words, children must be willing and capable of imitating them. Examples of projects include mimicking the movements of small and large muscles and mimicking the correct way to use objects.

Behavioral assessment

It includes 4 sub-tests of emotional expression, social interaction, action behavior characteristics, and oral behavior characteristics

Emotional expression: 11 in total; assessed the extent to which children exhibited appropriate emotional responses. Examples of projects include the use of facial expressions or body postures to express feelings, the panic of showing a degree of adaptation in the test, and the enjoyment of the game of being itched by the tester.

Social interactions: 12 in total, assessing children's social interactions with others. Examples of projects include social interaction with the tester, shared interest and focus with the tester, meeting the tester's requirements and maintaining eye contact.

Motor-behavioral characteristics—non-verbal: 15 items in total: to assess tactile and perceptual behaviors specific to children with autism. Children with autism appear to be constantly engrossed in a certain part of an object, as well as repetitive and formulaic behavioral manifestations. Examples of projects include assessing how children play with test materials. Respond to sounds and try the taste of food. Since failed scores are shown as negative scores (e.g., reacting inappropriately, showing weird and excessive interest in blocks), a high score indicates that there is no manifestation of these behaviors, while a low score indicates the presence of these behaviors.

Oral behavioural characteristics: 11 in total, assessing children's ability to speak appropriately, such as rare repetition or playing sounds. Examples of projects include repeating words or phrases, making sounds that are meaningless or difficult to understand, and using strange language or self-created language. As with the Action Behavior Characteristics-Nonverbality score, a high score indicates that these behaviors are not present, while a low score indicates the presence of these behaviors.

2. Caregiver Report: Contains 2 clinical sections and 3 sub-tests

Clinical Component—Caregiver estimates the child's current level of development and the severity of the problem within different diagnostic categories

Sub-tests — abnormal behavior, self-care ability and adaptive behavior, a total of 38 items

AAPEP

Adolescent and Adult Psychoeducational Profile, this scale is designed for adolescents and adults with autism, focusing on many aspects of community life, focusing on work skills, independent skills, leisure and recreation skills, job performance, communication skills, interpersonal skills and other abilities. The scale consists of three scales, Direct Observation, Home, and School/Work, completed by the tester, the parent interviewer, and the teacher. 48 test questions.

In general, the applicable age of different versions of PEP varies with the adjustment of the assessment entry module and the renewal of the norm, such as PEP-R for children aged 6 months to 12 years, and PEP-3 for children aged 2 years to 7 years and 6 months.

Introduction to Chinese version of the PEP

PEP-3 Hong Kong Revision

In 2009, the PEP-3 Chinese edition was published by the Heep Hong Society in Hong Kong under the authority of Division TEACCH of the University of North Carolina. Heep Hong Kong conducted a reliability and validity study on the PEP-3 Chinese edition and confirmed that it is a reliable and effective assessment tool for children with Chinese autism.

The study established norm data on children with autism and children in general in Hong Kong. Individualized education and training programs are designed for children by automatically calculating scores and listing recommended training goals based on the results of the assessment. Heep Hong Kong has compiled the Child Development Assessment Form for the development of normal children aged 0 to 6 years as a reference for assessment.

Taiwanese version of PEP

The earliest research on PEP in Taiwan can be found in the paper "Educational Diagnosis of Children with Autism and Developmental Disorders - Introduction to PEP" published by scholar Zhang Zhengfen (1984). Since then, with the advent of the revised version of the PEP scale, PEP-3 has also completed the revision of the Chinese traditional version in Taiwan, and has carried out the measurement of its reliability, validity, and responsiveness as a good tool. The study and analysis of PEP-3 characteristics by Jiang Fumei et al. in 2010 showed that the complete introduction of PEP-3 should be cautious, and it is necessary to establish version and normal model data suitable for Taiwan.

C-PEP

C-PEP is Chinese simplified version of the PEP scale. Since its introduction in 1995, it has been revised many times and established local normal model data.

The C-PEP was revised on the basis of the original PEP, and considering that the American normal model was not necessarily fully applicable to China, it did not follow the introduction of the original PEP-3. In addition, the first version of the PEP is concise, PEP-3 is relatively numerous and takes a long time, and some of the PEP-3 score tests have a high correlation and the validity needs to be further verified.

In the revision, C-PEP selected the 16 Chinese characters that children first recognized to replace the project involving language materials; the pictures used in the project were replaced, which is more suitable for the cognitive level of children in China; the language story reading book is annotated with Hanyu Pinyin on the basis of the Chinese text.

C-PEP contains two subscales, the Functional Development Scale and the Pathology Scale. The Functional Development Scale consists of 95 items that measure the following functional areas:

Imitation: Used to measure children's language and movement imitation ability

Perception: Used to measure both visual and auditory functions, such as eye following bubbles, puzzle gaze, finding objects in the cup, sound localization, etc

Motor skills: include fine movements and coarse movements

Hand-eye coordination: mainly related to writing and painting skills, such as coloring, copying, building wood

Cognitive performance and oral cognition: Language comprehension is required around testing language and cognition. Cognitive performance focuses on the ability to perform or achieve a project, and oral cognition focuses on the ability to respond to spoken language.

The Pathology Scale consists of 44 items that identify and assess the pathological behavior and severity of children in five areas: emotion, interpersonal and cooperative behavior, hobbies for play and material, sensory patterns, and language.

The results of the PEP analysis require the use of an age-equivalent scale, which refers to the functional development score given by the PEP scale and the corresponding age-related table. This control table is equivalent to the age norm table of the PEP, and after the participant's functional development score is measured, the age equivalent of the PEP (i.e., developmental age) can be checked on this table. The scores recorded on the scoring table are then drawn to the profile of functional development and pathology, which can intuitively guide the formulation of individualized training programs and behavior correction, which is more suitable for the evaluation of autistic children with great individual differences and highly uneven ability development.

In 2015, the research of Yu Songmei, Jia Meixiang and others showed that the revised Chinese version of C-PEP has good validity and reliability, and the results of the reliability study are consistent with the relevant research of Western researchers and the relevant reports of scholars in Hong Kong, China, which can be used as an effective tool for clinical evaluation of autistic children in China.

PEP is suitable for the individualized assessment and correction of children with autism and related developmental disorders, providing information about the current development level of children, pointing out the characteristics and extent of deviations from normal development of children, and providing a scientific basis for clinicians, special education workers and parents to formulate the next step of individualized education programs.

Source: Autism Knowledge Base