Transdisciplinary Play-Based Assessment-2:
A Team Approach
TPBA2 FIDELITY CHECKLIST (draft)
Name of Observer: / Date of Observation:Location of Observation:
Team Members
Play Facilitator: / Parent Facilitator:
School Psychologist / Speech Pathologist:
Occupational Therapist: / Physical Therapist:
Other: / Other:
Directions: Team Members complete the form as a self-reflection tool.
Outside observers also use the tool to provide input and feedback on the TPBA2 team process.
Rate each item as: 0 (no evidence obtained), 1(evidence obtained through observation or interview), or .5 (evidence is developing).
Play Environment/Toys, materials, and equipment for TPBA2
1. The assessment environment is adaptable and flexible to meet the needs of the child and family (e.g., may conduct in the home, preschool
environment and other locations outside the designated assessment room).
2. The assessment environment meets at least four of the following seven characteristics:
☐There is appropriate designated space to conduct the TPBA2.
☐Adequate indoor /outdoor or gym space is available for gross motor play.
☐Appropriate furniture for children of different sizes is available.
☐Appropriate storage for children’s toys/materials is available.
☐Appropriate seating for the family is available.
☐Assessment materials are available to take for off-site.
☐The environment provides adequate space for others to observe the TPBA2 either within the room or without entering the room (e.g.,
through a window or closed circuit T.V.).
3. The play setting contains 10 of the following 14 types of toys, materials, and equipment.
☐Toys available are of appropriate developmental level
☐Appropriate number of toys are available (not too many or too few) at one time
☐A variety of materials are available to elicit a broad range of skills, including vision and hearing
☐Appropriate familiar (i.e.; likely to have seen before) and unfamiliar (novel) toys are available
☐A range of simple to challenging materials are available
☐Materials present represent a range of intensity of sensory stimulation
☐Materials are presented that provide opportunities for independent and social play
☐Toys and materials adequately assess fine and gross motor
☐The family is encouraged to bring a few familiar toys
☐The family is encouraged to bring a snack (something to eat and drink, and special utensils, if needed
☐The family is encouraged to bring a favorite book for their child
☐Duplicate toys are present
Standard / Observation Question / Yes / Dev / No / Notes and Comments
☐A variety of theme boxes with child motivating materials relevant to
the local community is available
☐Unique materials are available to address specialized assessment
questions (e.g., assistive devices, specialized equipment, high/low tech
modifications, and positioning equipment).
Total Score for Play Environment: ______of 3
Assessment Process
4.Team members respond to family needs and schedule a timely evaluation.
5. Team provides a family-friendly letter, brochure or other written explanation with an appointment time and place, an explanation of the TPBA2 process, and a description of the family’s role in the process.
6. A phone call is made to the family prior to the day of the assessment to answer questions, describe the process, and clarify information
received on the preliminary forms.
7. Information is gathered from parents using designated forms with appropriate translation as needed and with respect for cultural differences.
8. The team obtains and reviews at least 4 of 5 of the following materials prior to the assessment session:
☐The team obtains social/developmental and health history.
☐The team obtains information regarding daily routines of the family.
☐The team obtains information about the parents’ perceptions of the child’s functioning.
☐The team obtains information from outside sources (i.e.; medical, therapy, or early intervention records)
☐Previous evaluation results with family permission.
9. All About Me and Routines Rating Forms are obtained from other primary caregivers (e.g. childcare teacher, family member, daycare
provider).
10. Forms are completed in an interview format when appropriate (e.g., parents are unable to complete forms, parents prefer an interview
format, or forms are not returned).
11. Team roles (e.g. parent or play facilitator) are determined through matching the priorities and concerns of the child and family.
12. The team uses preliminary information to plan the materials, team roles, and focus of the TPBA2.
13. The team uses preliminary information to plan the TPBA2 structure (when will parent, peers, enter; when to do outdoors, etc.) and
needed modifications for the family and child (seating, assistive devices, etc.).
14. The timing of activities allows for observation of a range of abilities of behaviors across all domains (for example snack time, gross motor
play, book, reading, and social play.).
15. Were play partners (e.g., parents, facilitator, peers) introduced into the play session based on the comfort and needs of the child and
family?
16. Did the team involve the family in numerous aspects of the assessment in a comfortable way, including at least 3 of the following:
☐Entering
☐Playing with the child
☐Separation/Reunion
☐Snack
☐Departure
17. Was the sequence of play materials and situations determined by the child’s interests and motivations as much as possible (unless
perseverative behaviors are a concern).
18. Did the combination of spontaneous (without prompting) and elicited behaviors enable observation of both typical and potential
performance?
19. The child is observed in other settings such as home, childcare setting, playground, therapy sessions, or other community setting.
20. The team has developed a system to provide support and suggestions to the play facilitator to help elicit desired skills.
21. The team participates in a parent debriefing (verbally and in writing) regarding the experience of the assessment and the child’s skills.
Standard / Observation Question / Yes / Dev / No / Notes and Comments
22. Parents are given a significant voice in the de-briefing process for their input regarding strengths, next steps, and collaborative problem solving on ideas for home.
23. The team has a post-assessment meeting to review and discuss observations of all domains.
24. Following the assessment the family facilitator provides the team additional relevant informationabout 4 of the following 6 items:
☐History
☐Development
☐Routines
☐Behaviors
☐Feelings, attitudes, and values of family members
☐Observation of the family-child during the session compared to the child’s interactions in other contexts
25. The team integrates information from a variety of sources (e.g., parents, therapy notes) to identify the child’s full range of abilities.
26. The team uses scripted data notes for responding to questions in the TPBA2 observation guidelines for determining how a child is functioning and effective strategies for intervention.
27. During the post-assessment meeting, the team members are able to determine a range of the child’s abilities and find a “cluster” age level (age-level where the child’s skills fall most frequently) for both sub-categories and domains of development.
28. During the post-assessment meeting, the team members are able to determine age levels from observation of “like- skills” (i.e., those that are similar to items listed on the age tables).
29. During the post-assessment meeting, professional judgment and expertise are used to establish age range and next developmental steps.
30. The team completes one (not individual) comprehensive, meaningful report for parents and educators that integrate data from observation guidelines and age tables.
31. Functional recommendations including strategies relevant to the child’s daily life are suggested to address the child’s needs across environments including home, school, and community.
32. If parents feel the assessment did not reveal typical skills and behaviors, further observations or testing is completed.
Total Score for Assessment Process: ______of 29
Roles of Team Members: Family Facilitator
33. The family facilitator makes sure the family comprehends the assessment process and provides information to the parent during the evaluation.
34. The family facilitator obtains additional relevant information as needed and appropriate during the evaluation.
35. The family facilitator makes the family members comfortable by responding to their cues for when and how they are ready to participate in the TPBA2.
36. The family facilitator explains what the play facilitator is trying to elicit across the various disciplines during the play session.
37. The family facilitator demonstrates skills in listening to the concerns and observations of the family.
38. The family facilitator demonstrates skill in asking open-ended questions when possible to avoid leading the parents.
39.The family facilitator asks follow-up questions as needed for clarification.
40. The family facilitator is non-judgmental about the parents’ comments.
41. The parent facilitator asks for and provides functional examples of developmental skills.
42. The family facilitator moderates the pace and amount of information requested or provided
43. The family facilitator uses parent-friendly language.
44. The family facilitator reframes negative comments by the parent to help them see the child’s positive aspects.
45. The family facilitator responds to and reflects the verbal and nonverbal feelings expressed by the parents.
46. The family facilitator demonstrates ability to summarize key points.
47. An interpreter is used with the child and family as needed during the assessment.
Total Score for Family Facilitator: ______of 15
Standard / Observation Question / Yes / Dev / No / Notes and Comments
Team Roles: Play Facilitator
48. The play facilitator is able to elicit skills across disciplines with support from all team members.
49.The play facilitator demonstrates rapport with the child and family members during the play.
50. The play facilitator demonstrates the ability to modify the environment or materials as needed to maintain the child’s attention and interest and elicit a full range of skills and behaviors.
51. The play facilitator involves siblings and/or peers if possible.
52. The play facilitator and child are actively, enthusiastically, and positively engaged in the play, as demonstrated through smiling, laughing, and mutual engagement.
53. The play facilitator is able to follow the child’s lead to choose activities of interest (as appropriate).
54. The play facilitator provides wait time for the child to initiate and response.
55. The play facilitator provides immediate responses to actions and verbal and non-verbal cues initiated by the child.
56. The play facilitator imitates the child as a means for gaining attention and increasing turn taking (as appropriate).
57. The play facilitator motivates the child’s interest in non-preferred activities.
58.There is a balance in control between the play facilitator and the child.
59. The play facilitator scaffolds higher level skills.
60. The play facilitator provides minimal assists to prompt higher level actions.
61. The play facilitator asks minimal closed questions (only as appropriate to see if the child can answer that type of question) and uses commenting and open-ended questions.
62. The play facilitator can moderate the pace of play (not too much time on any activities, but long enough to allow for scaffolding).
63. The play facilitator Integrates assistive devices (high tech and low tech) as needed to try intervention approaches.
Total Score for Play Facilitator: ______of 16
Team Roles: All
64.Team members read manuals related to their own discipline and utilize the manual TPBA2 as a resource.
65. Team members exhibit role support (sharing information with other team members to expand their expertise).
66. Team members demonstrate role expansion (incorporating other domain information into one’s own expertise).
67. Team members take notes and make observations across domains.
68. Team members identify strengths and areas of improvement for themselves and the team with regard to implementation of TPBA2.
Total Score for Team Roles: ______of 5
Grand Total: ______/68 (______%)
Fidelity = 85%
______YOU ARE ON YOUR WAY TO MEETING THE FIDELITY REQUIREMENTS OF TPBA2
______CONGRATULATIONS YOU HAVE MET THE REQUIREMENTS FOR FIDELITY TO TPBA2