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Childhood Disabilities: Early Identification and Intervention

 

The Greenspan Functional Emotional Assessment Scale

(Material for this scale came from Chapter 9, pp 381-430 of Infancy and Early Childhood, by Stanley I. Greenspan, M.D., International Universities Press, Madison, WI, 1997.)

  • Name of Child:
  • Date(s) of observation:
  • Date of Rating:
  • Name of observer:
  • Date of Birth:
  • Place of observation(s):
  • Chronological Age:
  • Who Present at observation(s):

Directions: After you have observed and interacted with the child, use the rating scale to rate the child in each capacity.

I: Self-regulation and Interest in the World (3 months)

Rating Scale:

  • 0 = capacity not present
  • 1 = capacity fleetingly present
  • 2 = capacity intermittently present
  • 3 = capacity present most of the time
  • 4 = capacity present all of the time in all circumstances
  • N/A = Not Applicable, because there was no opportunity to observe the presence or absence of this capacity

By three months, the infant can be calm; recovers from crying with comforting; is able to be alert; looks at one when talked to and brightens up when provided with appropriate visual, auditory, and/or tactile experiences.

Primary Emotional:

  1. 0 1 2 3 4 N/A Shows interest in different sensations for 3+ seconds
  2. 0 1 2 3 4 N/A Remains calm and focused for 2 + minutes

Emotional Range-Sensorimotor:

  1. 0 1 2 3 4 N/A Looks at sights for 3+ seconds
  2. 0 1 2 3 4 N/A Listens to sounds for 3+ seconds
  3. 0 1 2 3 4 N/A Relaxes, smiles, vocalizes or looks in response to light or firm touch
  4. 0 1 2 3 4 N/A Relaxes, smiles, vocalizes or looks in response to moving of limbs
  5. 0 1 2 3 4 N/A Tolerates/shows pleasure in gentle movement in space
  6. 0 1 2 3 4 N/A Tolerates/shows pleasure in smells
  7. 0 1 2 3 4 N/A Relaxes/shows pleasure when held firmly
  8. 0 1 2 3 4 N/A Relaxes/shows pleasure when rocked rhythmically
  9. 0 1 2 3 4 N/A Recovers from distress within 20 minutes with help from the caregiver

Emotional Range-Affective:

  1. 0 1 2 3 4 N/A Shows interest in caregiver
  2. 0 1 2 3 4 N/A Shows interest in happy caregiver
  3. 0 1 2 3 4 N/A Shows interest in assertive caregiver

____ Child's Score 56 Child's Potential Score

II. Forming Relationships, Attachment and Intimacy (5 months)

Rating Scale:

  • 0 = capacity not present
  • 1 = capacity fleetingly present
  • 2 = capacity intermittently present
  • 3 = capacity present most of the time
  • 4 = capacity present all of the time in all circumstances
  • N/A = Not Applicable, because there was no opportunity to observe the presence or absence of this capacity

By five months, infant evidences positive loving affect toward primary caregiver and other key caregivers; looks and/or smiles spontaneously and responds to their facial expressions, voices, or touch with signs of pleasure such as smiling, relaxing, "cooing."

Primary Emotional:

  1. 0 1 2 3 4 N/A Responds to social overtures with an emotional response of any kind (with a smile, frown, reach, vocalization, or other intentional behavior.
  2. 0 1 2 3 4 N/A Responds to social overtures with obvious pleasure (smile, joyful, vocalization, etc.)

Emotional Range: Sensorimotor:

Shows emotional interest or pleasure in caregivers':

  1. 0 1 2 3 4 N/A Vocalizations (high pitch or low pitch; loud, medium, or soft tone)
  2. 0 1 2 3 4 N/A Facial expressions
  3. 0 1 2 3 4 N/A Touch (part of body: back, abdomen, face, arms or legs and type of touch: light or firm)
  4. 0 1 2 3 4 N/A Gently moving the infant's arms or legs
  5. 0 1 2 3 4 N/A Moving infant horizontally or vertically in space (which rhythm works best: fast, slow, _____)
  6. 0 1 2 3 4 N/A Responds to your overtures with curiosity and assertive interest (e.g., by studying your face)

Emotional Range: Affective:

  1. 0 1 2 3 4 N/A Evidences a relaxed sense of security and/or comfort when held or rocked.
  2. 0 1 2 3 4 N/A Evidences signs of pleasure when either talked to, held, looked at, moved around, touched.
  3. 0 1 2 3 4 N/A Evidences a curious, assertive interest in the caregiver
  4. 0 1 2 3 4 N/A Anticipates with curiosity or excitement the re-presentation of an interesting object that has been presented a moment earlier (e.g., smiles or babbles to show interest).
  5. 0 1 2 3 4 N/A Evidences signs of discomfort or lack of pleasure or sadness when during interactive play caregiver is unresponsive for 30-60 seconds.
  6. 0 1 2 3 4 N/A Evidences anger or protest when frustrated
  7. 0 1 2 3 4 N/A Can recover from distress with caregiver's social overtures within 15 minutes.

____ Child's Score 60 Child's Potential Score

III. Intentional Two Way Communication (Nine Months)

Rating Scale:

  • 0 = capacity not present
  • 1 = capacity fleetingly present
  • 2 = capacity intermittently present
  • 3 = capacity present most of the time
  • 4 = capacity present all of the time in all circumstances
  • N/A = Not Applicable, because there was no opportunity to observe the presence or absence of this capacity

By nine months the infant is able to interact in a purposeful (i.e., intentional, reciprocal, cause and effect) manner; is able to initiate signals and respond purposefully to another person's signals. Uses multiple sensory modalities, the motor system, and a range of emotions in these intentional interactions.

Primary Emotional:

  1. 0 1 2 3 4 N/A Responds to caregiver's gestures with intentional gestures (e.g., reaches out in response to outstretched arms, returns a flirtatious vocalization of caregiver begets a playful look and a series of vocalizations).
  2. 0 1 2 3 4 N/A Initiates intentional interactions (e.g., spontaneously reaches for caregiver's nose, hair, or mouth; uses hand movements to indicate wish for a certain toy or to be picked up).

Emotional Range: Sensorimotor

Responds intentionally to caregiver's:

  1. 0 1 2 3 4 N/A Vocalizations
  2. 0 1 2 3 4 N/A Facial expressions
  3. 0 1 2 3 4 N/A Touch (e.g., hold caregiver's hand when being touched or tickled)
  4. 0 1 2 3 4 N/A Moving infant in space

Emotional Range: Affective

Child uses gestures to indicate:

  1. 0 1 2 3 4 N/A Closeness (e.g., by hugging back when hugged, reaching out to be picked up)
  2. 0 1 2 3 4 N/A  Pleasure & Excitement (e.g. by touching and exploring caregiver's hair)
  3. 0 1 2 3 4 N/A Assertive curiosity (e.g., by touching and exploring caregiver's hair)
  4. 0 1 2 3 4 N/A Protest or anger (e.g. by pushing food off table or screaming when desired toy not brought)
  5. 0 1 2 3 4 N/A Fear (e.g., by turning away, looking scared or crying when a stranger approaches too quickly
  6. 0 1 2 3 4 N/A Recovers from distress within 10 minutes by being involved in social interactions

____ Child's Score 48 Child's Potential Score

IV. Complex Sense of Self I: Behavioral Organization (13 months)

Rating Scale:

  • 0 = capacity not present
  • 1 = capacity fleetingly present
  • 2 = capacity intermittently present
  • 3 = capacity present most of the time
  • 4 = capacity present all of the time in all circumstances
  • N/A = Not Applicable, because there was no opportunity to observe the presence or absence of this capacity

By thirteen months, the infant begins to develop a complex sense of self by organizing behavior and emotion. The toddler sequences a number of gestures together and responds consistently to caregiver's gestures, thereby forming chains of interaction (i.e., opens and closes a number of sequential circles of communication). The toddler also manifests a wide range of organized, socially meaningful behaviors and feelings dealing with warmth, pleasure, assertion, exploration, protest, and anger.

Primary Emotional:

  1. 0 1 2 3 4 N/A Strings 3 or more circles of communication as part of a complex pattern of communication. Each unit or circle of communication begins with an infant behavior and ends with the infant building on and responding to the caregiver's response. (e.g., takes caregiver by hand, walks caregiver to refrigerator, points, vocalizes, responds to caregiver's questions with more noise and gestures, and continues gestural exchange until caregiver opens the door to get what the child wants)

Emotional Range: Sensorimotor

The infant can organize three or more circles of communication (with a responsive caregiver) by:

  1. 0 1 2 3 4 N/A Using vocalizations or words
  2. 0 1 2 3 4 N/A Using facial expressions
  3. 0 1 2 3 4 N/A Involving reciprocal touching or holding
  4. 0 1 2 3 4 N/A Involving movement in space (e.g., roughhousing)
  5. 0 1 2 3 4 N/A Using motor patterns (e.g., chase games, searching for objects, handing objects back and forth)

Emotional Range: Affective

Can organize, with caregiver support (i.e., responsive empathetic reading and responding to infant's communications), three or more circles of communication around:

  1. 0 1 2 3 4 N/A Negotiating Closeness (e.g., uses facial expression, gestures, and vocalizations to reach out for a hug, kiss or cuddle, or uses imitation, such as talking on toy phone while caregiver is using a real phone)
  2. 0 1 2 3 4 N/A Pleasure and excitement (uses looks and vocalizations to invite another person to share excitement over something: shares "Jokes" with other children or adults by laughing together at some provocation)
  3. 0 1 2 3 4 N/A Assertive curiosity and exploration (explores independently; uses ability to communicate across space to feel close to caregiver while exploring or playing on own)
  4. 0 1 2 3 4 N/A Cautious or fearful behavior. Infant hides behind caregiver when in a new setting; negotiates with caregiver degrees of protection needed.
  5. 0 1 2 3 4 N/A Anger (deliberately hits, pinches, yells, bangs, screams, or lies on floor to demonstrate anger; occasionally uses cold or angry looks instead)
  6. 0 1 2 3 4 N/A Recovers from distress and remains organized while distressed by entering into complex gestural negotiations for what the child wants (e.g., banging on a door to go outside and play).

____ Child's Score 52 Child's Potential Score

V. Complex Sense of Self II: Behavioral Elaboration (18 months)

Rating Scale:

  • 0 = capacity not present
  • 1 = capacity fleetingly present
  • 2 = capacity intermittently present
  • 3 = capacity present most of the time
  • 4 = capacity present all of the time in all circumstances
  • N/A = Not Applicable, because there was no opportunity to observe the presence or absence of this capacity

By eighteen months the infant elaborates sequences of interaction which convey basic emotional themes.

Primary Emotional:

  1. 0 1 2 3 4 N/A Comprehends and communicates, via gestures, basic emotional themes as evidenced by the ability, with a responsive caregiver, to open and close ten (10) or more consecutive circles of communications.
  2. 0 1 2 3 4 N/A Imitates or copies another person's behavior, and then uses the newly learned behavior intentionally to convey an emotional theme(e.g., putting on daddy's hat and walking around the house with a big smile clearly waiting for an admiring laugh).

Emotional Range: Sensorimotor

Elaborates complex interactions (i.e., 10 or more consecutive circles of communication using:

  1. 0 1 2 3 4 N/A Vocalizations and/or words
  2. 0 1 2 3 4 N/A Facial expressions
  3. 0 1 2 3 4 N/A Reciprocal touching or holding
  4. 0 1 2 3 4 N/A Movement in space (rough and tumble play)
  5. 0 1 2 3 4 N/A Large motor activity (e.g., chase games, climbing games)

Emotional Range: Affective

  1. 0 1 2 3 4 N/A Closeness and Dependency (e.g., uses facial expression, gestures, and vocalizations to reach out for a hug, kiss or cuddle, or uses imitation, such as talking on toy phone while caregiver is using a real phone)
  2. 0 1 2 3 4 N/A Pleasure and excitement (uses looks and vocalizations to invite another person to share excitement over something: shares "Jokes" with other children or adults by laughing together at some provocation)
  3. 0 1 2 3 4 N/A Assertiveness and exploration (explores independently; uses ability to communicate across space to feel close to caregiver while exploring or playing on own)
  4. 0 1 2 3 4 N/A Cautious or fearful behavior. Child can via vocalization, motor gestures or a few words tell caregiver exactly how to be protective in a new situation (e.g., hides behind caregiver but pushes caregiver toward the toy or toward new people as though to run interference) or says, "No" and hides behind caregiver.
  5. 0 1 2 3 4 N/A Anger (deliberately hits, pinches, yells, bangs, screams, or lies on floor to demonstrate anger; occasionally uses cold or angry looks instead all behaviors under the control of the child)
  6. 0 1 2 3 4 N/A Limit setting (understands and responds to caregiver's limits whether expressed through words - "No, stop that!" - or gestures - shaking finger, angry face)
  7. 0 1 2 3 4 N/A Uses imitation to deal with and recover from distress (e.g., bangs on floor and yells after being yelled at)

____ Child's Score 56 Child's Potential Score

VI. Emotional Ideas: I - Representational Capacity (24 months)

Rating Scale:

  • 0 = capacity not present
  • 1 = capacity fleetingly present
  • 2 = capacity intermittently present
  • 3 = capacity present most of the time
  • 4 = capacity present all of the time in all circumstances
  • N/A = Not Applicable, because there was no opportunity to observe the presence or absence of this capacity

By twenty-four months the child creates mental representations of feelings and ideas which can be expressed symbolically (e.g., pretend play and words).

Primary Emotional:

  1. 0 1 2 3 4 N/A Can construct Creates pretend dreams with two or more ideas (e.g., trucks crash then pick up rocks, dolls hug then have a tea party; ideas need not relate)
  2. 0 1 2 3 4 N/A Uses words, pictures, gestures to convey two or more ideas at a time (e.g., "No sleep. Play"); ideas need not be related

Emotional Range: Sensorimotor:

Can communicate symbolically about intentions, wishes, needs or feeling with:

  1. 0 1 2 3 4 N/A words
  2. 0 1 2 3 4 N/A Complex gestures and facial expressions
  3. 0 1 2 3 4 N/A touch (e.g., lots of hugging or roughhousing)
  4. 0 1 2 3 4 N/A Motor movement (e.g., showing caregiver what to dol)

Emotional Range: Affective:

Can use pretend play or words employing at least one idea to communicate themes dealing with:

  1. 0 1 2 3 4 N/A Closeness (e.g., has doll say: "Hug me." Then child answers: "I give you kiss." "Want mommy.")
  1. 0 1 2 3 4 N/A Pleasure and excitement (e.g., makes funny words or faces then laughs)
  2. 0 1 2 3 4 N/A Assertive curiosity (e.g., makes pretend airplane zoom around room, then says its's going to the moon, care racing etc)
  3. 0 1 2 3 4 N/A Caution or Fearful behavior (e.g. says "scared" or stages drama in which doll is afraid of loud noise then call for mother)
  1. 0 1 2 3 4 N/A Anger (e.g., dolls fighting or hitting, "me mad." or has soldiers shoot guns at one another then fall down)
  2. 0 1 2 3 4 N/A Limit setting (e.g.,child says to self:"no hit." or has dolls follow rules at tea party)
  3. 0 1 2 3 4 N/A Can use pretend play and/or words to recover from and deal with tantrum or distress (e.g., after a few minutes of tantruming child uses words and sounds to argue with caregiver or plays out eating the cookie the child couldn't really have).

____ Child's Score 52 Child's Potential Score

VII. Emotional Ideas: II-Representational Elaboration (30 months)

Rating Scale:

  • 0 = capacity not present
  • 1 = capacity fleetingly present
  • 2 = capacity intermittently present
  • 3 = capacity present most of the time
  • 4 = capacity present all of the time in all circumstances
  • N/A = Not Applicable, because there was no opportunity to observe the presence or absence of this capacity

By thirty months, the child, in both make-believe play and symbolic communication, can elaborate a number of ideas that go beyond basic needs (e.g., "want juice") and deal with more complex intentions, wishes or feelings (e.g., themes of closeness or dependency, separation, exploration, assertiveness, anger, self pride or showing off).

Primary Emotional:

  1. 0 1 2 3 4 N/A Creates pretend drama with two or more ideas (trucks are crashing and then they pick up rocks; or dolls are hugging and then have a tea party). Ideas need not be related or logically connected to one another, even if the ideas themselves are unrealistic (e.g., the car is visiting the moon and gets there by flying fast.)
  2. 0 1 2 3 4 N/A Uses symbolic communication (e.g., words, pictures, motor patterns) to convey two or more ideas at a time in terms of complex intentions, wishes or feelings (e.g., "daddy play with car." "No sleep, play"). Ideas need not be logically connected to one another.

Emotional Range: Sensorimotor:

Can communicate symbolically about intentions, wishes or feelings with:

  1. 0 1 2 3 4 N/A words
  2. 0 1 2 3 4 N/A Complex gestures and facial expressions (e.g., acting tired and needy)
  3. 0 1 2 3 4 N/A touch (e.g., lots of hugging or roughhousing like they do on T.V.)
  4. 0 1 2 3 4 N/A Can participate in simple spatial and motor games with rules (e.g., taking turns going down a slide or throwing a ball)

Emotional Range: Affective:

Can use pretend play or other symbolic communication (e.g., words) to communicate themes containing two or more ideas dealing with:

  1. 0 1 2 3 4 N/A Closeness (e.g., doll gets hurt and Mommy fixes it.)
  2. 0 1 2 3 4 N/A Pleasure and excitement (e.g., says funny words or bathroom words, such as "doody," and laughs)
  3. 0 1 2 3 4 N/A Assertiveness and exploration (e.g., pretend airplane zooms around the room, good soldiers search for missing princess)
  4. 0 1 2 3 4 N/A Cautious or fearful behavior (e.g., pretend play where monster scares baby doll)
  5. 0 1 2 3 4 N/A Anger (e.g., good soldiers fight bad ones)
  6. 0 1 2 3 4 N/A Limit setting (e.g., doll follow rules at tea party or soldiers can hit only bad guys because of the rules)
  7. 0 1 2 3 4 N/A Uses pretend play that has a logical sequence of ideas to recover from distress, often suggesting way of coping with the distress (e.g., the child eats the cookie he could not get in reality)

____ Child's Score 44 Child's Potential Score

VIII. Emotional Thinking (36 months)

Rating Scale:

  • 0 = capacity not present
  • 1 = capacity fleetingly present
  • 2 = capacity intermittently present
  • 3 = capacity present most of the time
  • 4 = capacity present all of the time in all circumstances
  • N/A = Not Applicable, because there was no opportunity to observe the presence or absence of this capacity

By thirty six months, ideas dealing with complex intentions, wishes, and feelings in pretend play or other types of symbolic communication logically tied to one another. The child knows what is real from unreal and switches back and forth between fantasy and reality with little difficulty.

Primary Emotional:

  1. 0 1 2 3 4 N/A Pretend play, however unrealistic, involves twom or more ideas that are logically tied to one antoher  (e.g., "the car is visiting the moon" [and gets there] "by flying fast"). In addition, child can build on adult's pretend play idea (i.e., close a circle of communication). For example: child is cooking a soup and adult asks what is in it and child says, "rocks and dirt" or "ants and spiders."
  2. 0 1 2 3 4 N/A Symbolic communication involves two or more ideas that are logically connected and grounded in reality: "No go to sleep"; "Want to watch television." "Why?" asks the adult. "Because not tired." Child can close symbolic circles of communication (e.g., child says "Want to go outside." Adult asks, "What will you do?" Child replies, "play".

Emotional Range: Sensorimotor:

Can communicate symbolically, logically connecting together two or more ideas, about intentions, wishes , needs or feelings with

  1. 0 1 2 3 4 N/A Words
  2. 0 1 2 3 4 N/A Complex gestures and facial expressions (e.g., pretending to be an angry dog or cat).
  3. 0 1 2 3 4 N/A Touch (e.g., lots of hugging or roughhousing as part of pretend drama where child is the "daddy")
  4. 0 1 2 3 4 N/A Can organize spatial and motor games with rules (e.g., takes turns in going up small incline or holds hands with others and goes around in a circle).

Emotional Range: Affective:

Can use pretend play or words to communicate themes containing two or more logically connected ideas dealing with the following:

  1. 0 1 2 3 4 N/A Closeness or dependency (e.g., doll gets hurt and mommy doll fixes it)
  2. 0 1 2 3 4 N/A Pleasure and excitement (e.g., says bathroom words like doody and laughs)
  3. 0 1 2 3 4 N/A Assertiveness and exploration (e.g., good soldiers search for missing princess)
  4. 0 1 2 3 4 N/A Cautious or fearful behavior (e.g., scary monster scares baby doll)
  5. 0 1 2 3 4 N/A Limit Setting (e.g., the soldiers can only hit bad guys because of the "rules")
  6. 0 1 2 3 4 N/A Uses pretend play to recover from anger (e.g., plays out eating the cookie he could not get in reality)

____ Child's Score 48 Child's Potential Score

IX. 42 - 48 Months

  • Rating Scale:
  • 0 = capacity not present
  • 1 = capacity fleetingly present
  • 2 = capacity intermittently present
  • 3 = capacity present most of the time
  • 4 = capacity present all of the time in all circumstances
  • N/A = Not Applicable, because there was no opportunity to observe the presence or absence of this capacity

By forty-two to forty-eight months, the child is capable of elaborating complex pretend play and symbolic communication dealing with complex intentions, wishes or feelings. The play or direct communication is characterized by three or more ideas that are logically connected and informed by concepts involving causality, time, and space.

Primary Emotional:

  1. 0 1 2 3 4 N/A Elaborates complex, partially planned pretend play with three or more logically connected ideas dealing with intentions, wishes or feelings. The planned quality (e.g., a special car is used) and "How," "Why," or "when" elaborations give dept to the drama.
  2. 0 1 2 3 4 N/A Participates in reality-based circle closing symbolic conversations using three or more ideas dealing with intentions, wishes or feelings. In a reality-based dialogue, the child can deal with causality.
  3. 0 1 2 3 4 N/A Distinguishes reality and fantasy
  4. 0 1 2 3 4 N/A Uses concepts of time and space to deal with intentions, wishes and/or feelings.

Emotional Range: Sensorimotor:

The child is able to use elaborate, complex, logically connected ideas (three or more and communicate using:

  1. 0 1 2 3 4 N/A Words
  2. 0 1 2 3 4 N/A Complex gestures and facial expressions
  3. 0 1 2 3 4 N/A Touch
  4. 0 1 2 3 4 N/A Can organize spatial and motor games with rules

Emotional Range: Affective:

The child is able to use elaborate, complex, logically connected ideas (three or more) when dealing with:

  1. 0 1 2 3 4 N/A Closeness or dependency
  2. 0 1 2 3 4 N/A Pleasure and excitement
  3. 0 1 2 3 4 N/A Assertiveness and exploration
  4. 0 1 2 3 4 N/A Cautious or fearful behavior
  5. 0 1 2 3 4 N/A Anger
  6. 0 1 2 3 4 N/A Limit setting - Child can set limits for self by reasoning about the consequences. Even though he doesn't always follow them, child now is able to understand rules in terms of limits. He can also form abstract principles. "You shouldn't be mean to them."
  7. 0 1 2 3 4 N/A Separation and loss - Child can picture mom in home while he is at school or in waiting room while he is in office, and relate some feelings of sadness and loss (e.g., "She is in waiting room. I miss her a little, but I am having fun.").

____ Child's Score 56 Child's Potential Score

____ Child's Overall Score

____ Child's Overall Potential Score

____ Child's Ratio Score

 

 

 

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