Participants

Participants were intentionally selected so that they could share experiences, knowledge and perspectives relevant to the understanding of the phenomenon under study (Creswell & Guetterman, 2024) and according to the following selection criteria: 1) professionals who make up the EI with experience of participation in assessment moments for at least 1 year; and 2) professionals with specialized training in EI (post-graduation or master's course). In the selection of participants, their social representativeness and diversity were valued. Thus, eight professionals who are part of the EI participated in this study.

The participants were exclusively female, which is consistent with the gender distribution typically found among professional teams within the Portuguese National Early Childhood Intervention System. All participants worked in local Early Intervention teams in the District of Braga. The mean age of the participants was 39 years, and they had an average of five years of professional experience in Early Childhood Intervention. Of the eight professionals, three are speech therapists, two kindergarten teachers, one nurse, one social worker, and one psychologist. To ensure the anonymity of the participants, fictitious names will be used. The total number of participants was defined according to data saturation, i.e., the number of participants was considered sufficient when the collection of new data did not generate different insights or did not reveal new perspectives (Creswell & Guetterman, 2024).

Data collection tool

The semi-structured interview was used as a data collection tool in order to privilege the direct contact between the researcher and the participants in the study, allowing them to express in an authentic way their perceptions, interpretations, and experiences on the phenomenon under study.

Previously, an interview script consisting of two parts was built. The first part presents introductory questions that characterize the participants in the study, and the second part aims to respond to the research goals formulated. Subsequently, I present an example of a question:

The interview script was developed based on a review of the relevant literature on the topic under study and in alignment with the defined research objectives. The guide was validated by a professional who met the study’s inclusion criteria but did not participate in the study. The validation process focused on the appropriateness of the formulated questions and their clarity.

The interviews had a duration of between 30 and 45 minutes. All participants provided informed consent for the interviews to be audio-recorded, ensuring the confidentiality of the data collected and the anonymity of the participants. The interviews were conducted between March and June 2022. Participants were contacted individually, interview after interview, and the selection process was completed according to the redundancy criterion.

Context and procedures of data collection

A request for authorization was sent to the Regional Subcommittee of National Early Childhood Intervention System. After this authorization, the nine teams of this district were contacted and only four teams showed willingness to collaborate. The coordinators of these teams carried out a survey of the number of professionals who met the selection criteria and of the number of professionals who showed interest in collaborating in this study.

The eight professionals who volunteered to participate were aware that their participation was voluntary and confidential, and all of them signed the Free and Informed Consent Form.

Data analysis

Data analysis was performed using the content analysis. Content analysis involves the systematic organization of the information collected to deepen understanding and facilitate the presentation of results. Content analysis was conducted following Bardin (2018), with coding performed independently by two researchers to ensure reliability.

The content analysis was conducted along the following stages: a) Constitution of the corpus. That is, the identification of the universe of the analysis, which in the case of this study is equivalent to the data collected through semi-structured interviews conducted with EI professionals (transcripts and field notes); b) Separation into coding units – It corresponded to the decomposition of the whole, each interview being the segment of content that constituted the basis for the elaboration of the categorization; c) Specification of a category system - To carry out the analysis, it was essential to detail a category system, which enabled the conceptual classification of the units referring to the same topic. The category system used in this research was developed at different moments (before, during and after data collection), using inductive and deductive analysis.

To ensure the material’s reliability and validity, two coders, both familiar and holding theoretical and practical knowledge about assessment in EI, coded the data independently. Intercoder reliability was assessed using the percentage agreement index, yielding a high value (89.79%), above the threshold considered acceptable in the literature (80–85%) (Coutinho, 2011). Therefore, final coding was carried out, organizing the units into categories and subcategories. Figure 1 shows schematically the category system developed and used in this research.

Figure 1Category and subcategory system 

Assessment planning

Most of the participants mention that the planning of the assessment is realized in the first contact with the families, that is, when they host them into the EI team. Only one of the participants mentions that this planning takes place very moment of the assessment.

For all participants, the identification of the family's concerns is an important and significant procedure in the EI process and is therefore carried out at a very early stage of the child's arrival in the team. Most of them reveal that the family's concerns are ascertained and taken into account at the time of hosting them, that they are added to the planning of the assessment, as Pandora says:

Nádia emphasizes the importance of understanding the family's concerns at the time of planning the assessment, stating that "already in this first moment of welcoming, parents will talk a lot about what the child's life history has been so far, what their concerns are". Mariana also reinforces that "in the hosting (...), we try to ask some questions about the child's development, to understand what the complaints are".

Another indicator valued by the participants is the importance of providing information regarding the functioning of the team, the approach used, and the resources available in the team regarding the support of families in EI. Camila reinforces this idea, stating that the "explanation of how EI works and what you can expect from our team" is carried out. In turn. “Patricia adds that parents are also provided with information about "the functioning of the team".

Four of the participants also mention that, at this moment of planning, families are informed and made aware of their rights to social support benefits. Camila points out that "we take advantage of this moment to provide information on subsidies and on support to families". Patricia also mentions this idea, when she points out that "they also direct them to some support and subsidies".

Although it is clear in the speech of most participants that they recognize the importance of the family's participation in the assessment process, only two participants reported that they provided the family prior information about the roles that families can adopt during the assessment process. Thus, Sofia explains that they try to understand "what participation they want to have, they are given information on how the assessment can happen, and they are given the possibility to participate in it"; Pandora, in turn, explains, "we reflect again on assessment, what will really happen and what role parents want to play".

All participants report that there is an exchange of information with the family about the logistical issues of the moment of assessment, which most of the time is preceded by a telephone call, when they decide the place, time, and date of the assessment.

Regarding the choice of the setting of the assessment, Sónia highlights the importance of "parents choose, to give parents this freedom, to do it at school, to do it at home".

In relation to the moment of the assessment, when parents really want to be present, Patricia explains that "they are the ones who choose, we always try to adjust to the time when they are available".

Still, regarding the elements present at the moment of assessment, seven of the participants mentioned that the family shows a great desire to involve the early childhood educator. Camila mentions that "Usually the family chooses the educational setting ... because they think that it is also good the presence of the early childhood educator who also knows the child well".

Conducting the assessment

Assessment in EI, according to the participants, serves two purposes, namely, to determine the child's eligibility for intervention and/or to obtain information about the child's development and performance in routine moments. Sara mentions that the "first assessment we do is just an eligibility assessment, but afterwards, to build the Individual Early Intervention Plan, we need a deeper assessment".

Regarding the dynamics adopted during the conduction of the assessment, the participants report that the assessment is realized in a transdisciplinary team led by one of the professionals, designated as facilitator, with the participation of the family. Pandora says that "there is a professional who gives some clues and instructions for the family to be able to feel safe and [that] conducts that moment". The participants report that parents are present and actively participate in the assessment, namely in the assessment of the children's functioning in their routine moments.

In relation the formal assessment tools used, all participants reported the use of the Schedule of Growing Skills (SGS-II) to assess the child's development and skills and determine their eligibility for EI support, and the routine-based interview (RBI) to assess the child's functioning in relation to her levels of autonomy, participation and social relationships in her natural settings and, more specifically, in her routine moments. Patricia points out that "SGS gives us more confidence in relation to development, and RBI more [confidence] in the routine and concerns of the family". Nádia reveals that “the moment of assessment is carried out informally through educator". Sara also mentions that she does not apply assessment tools but that she talks to "parents and educators".

Most of the participants highlight the importance of observing children in their natural settings, when they are playing with their toys and with the people who are significant to them. As Nadia describes, "the part of observing the environment, and the environment is not only the physical part, but also the relational part, all of this gives us a lot of information for the assessment ...”. Sofia also adds the importance of "the issue of assessment through play and, therefore, also observing the child in her interaction with toys".

All participants mentioned the use of different strategies to enhance the results at the moment of assessment, namely: the areas of interest of the child; the participation of the most significant family member to the child; the use of simple and concrete language; and the use of positive feedback during the assessment.

At this point in the assessment, the family's formal and informal support networks are also identified. All participants reveal that they realize this identification by asking the family about the most significant people in their lives. Sonia says that "we ask the family who are the reference people who help them". Two participants consider that the ecomap is an important tool for the assessment of family support networks. Camila reinforces that the ecomap helps to "understand who helps and in what way".

All participants mentioned that at the end of the assessment moment, together with the family, some potential goals of the Individual Early Intervention Plan are drawn. Camila explains, "during the assessment, we are already talking, we are drawing up what can be a goal, whether it makes sense to the family for this to be a goal or not". Sofia states that "the richest moment, where the outlining of goals in a more concrete way already appears, is when we apply RBI".

Sharing of results

The sharing of results is described by most participants as a phase that can be divided into two moments: in the first moment, the results are shared and analyzed with the family, and, in the second moment, a report/synthesis is delivered to the family. Sara mentions that during and at the end of the assessment process, "we give feedback to the family, we already give them the results of that evaluation". Camila also adds that "The sharing of results is almost just delivering a report, because during the assessment we are already talking". Patrícia reinforces that "At the end of the assessment we show parents which are the areas in which their child is within the parameters, and what they would be expected to do at that age".

Sofia also mentions that the sharing of results is carried out through a call realized by one of the professionals, "one of the team members will call the family to return the result to them and give feedback on the information that was collected". Pandora further adds that "it usually happens in the [child’s] home". Sónia mentions that some sharing is done through WhatsApp, "sharing videos, information ... This has helped us a lot in sharing information, sharing goals, doubts, etc.".

The participants also mention that the sharing of results with the family includes, in most cases, the kindergarten teacher who supports the child in the educational setting where the child is included. Patricia reinforces, "the early childhood educator is part of the sharing of results, because she is also present at the time of the assessment". Nadia adds: "if the assessment is carried out in the pre-school setting, sharing is carried out with the early childhood educator, with the mother, with the father". Pandora explains that the first sharing is realized only in the presence of the family, and that they then ask the parents "if they want to do this sharing alone or with the kindergarten teacher".

In addition to the kindergarten teacher, two of the participants consider it pertinent to extend the sharing of results of the assessment to other professionals who accompany the child in clinical settings. Camila reveals that they always ask the family "to share with the professionals who support the child, generalizing these results to all of the child's contexts". In the same vein, Pandora also reinforces that "families share the report with whomever they want".

The participants also highlight the importance of the moment of sharing the results for the definition of the goals that will be included in the Individual Early Intervention Plan. Sonia explains: "We try to get parents to decide which goals we can work towards ... these are never goals created by us ... We try to get parents to prioritize what's important for them".

Positive aspects of the assessment process

Valuing the family and their participation in the assessment process as a member of the team was an indicator highlighted by all participants. Sofia says "... the greatest advantage..., the fact that we work with the family, privileging the power that the family has in the development of the child". Sónia also highlights the importance of "knowing the functionality of the family ... understanding how the child works in that context".

Another aspect highlighted by the participants regarding the assessment process is related to collaboration and teamwork. Sara says that it is "a moment that has more than one professional, there are several perspectives on the same child, which allows information to be shared". The appreciation of this process as a moment of sharing and transfer of knowledge and information among professionals is evident in Camila's statement, "Transdisciplinary makes the sharing of knowledge very rich, I learned a lot".

The participation of other significant stakeholders for the child is also very important in the assessment process. Mariana says, "It's always good to meet the early childhood educators and be able to go to the classrooms." Sofia also adds that early childhood educators "often help to outline goals in a sequential way".

Weaknesses in the assessment process

The most important indicator of the weaknesses of the assessment process is related to the time factor, both the time of allocation of professionals to the team and the time of the families themselves. Sónia considers that there is a lack of "availability, time, both to prepare the assessment and for the moment of the assessment, ..."; Mariana highlights the amount of bureaucracy in the assessment process as a factor that implies time, "we have to fill out a lot of documents and this is sometimes very difficult to accomplish in the time we have".

The excessive number of children in the waiting list limits the time for carrying out assessments in different settings, with different actors, and also conditions the knowledge of the child's ecological system and the possibility of obtaining information from other professionals. Sofia mentions "we don't have the time, (...) to understand a little better this ecological system of the child, to know the perspective of other actors".

The lack of availability of family time to participate in the assessment is due to work constraints. Pandora explains that "the Portuguese legal system does not allow families to accompany their children as often as necessary".

Another of the weaknesses of the assessment process mentioned by the participants is related to the lack of human resources. Sónia points out that "the lack of professionals from all areas, ..., compromise any assessment".

Recommendations

One of the recommendations most pointed out by the participants is related to the need for human resources. Camila reinforces that, considering the high number of cases dealt with at EI, it is necessary to "... strengthen teams, ..., hire new professionals". Patricia also reinforces the need for teams to integrate professionals from different disciplinary areas.

Another recommendation concerns the need for more training in the field of EI and the possibility for deepening knowledge, particularly with regard to authentic assessment. Sofia says that the shift from a formal assessment to an authentic one requires "more time, more play, more authenticity". Sara adds that it is necessary to "observe more settings and talk to more stakeholders".

The participants also consider that it is necessary to prepare the family for the moment of assessment. Pandora considers it essential to "inform the family about how the assessment is carried out and what role the parents can choose and play".

The flexibility of labor policies is another recommendation that the participants consider important, so that families can participate in the entire assessment process without being penalized. Nadia recommends "a policy that allows parents to participate without having to worry about work". Nadia suggests that professionals can help families overcome their work unavailability: "services should have schedules that suit families".

Assessment planning

All participants value the planning of the assessment; however, they exhibit difficulties in highlighting a specific and unique moment for its realization. They carry out this moment at different stages of the process, and most participants report that the planning is realized at the first moment of welcoming the family. In the context of authentic assessment, it is essential that families are seen as members of the EI team and feel comfortable with the assessment practices, so that they can share vital information about their children, express their real needs and concerns (Macy et al., 2019).

In the planning stage, professionals should also seek information from the family about the child's interests, abilities, and needs and, together, identify the team members and the assessment style that best suit and adapt to the needs and goals of the child and her family. According to Bagnato, et al. (2014), collaboration between professionals and families is essential for understanding the family's concerns and choices regarding the assessment process, methods, materials, and settings that best respond to the child's needs.

The importance of identifying families’ concerns, priorities, and resources is considered an essential aspect of the assessment process and of the quality of support provided at EI (Division of Early Childhood of the Council for Exceptional Children (DEC, 2014; Magalhães & Pereira, 2013; Pereira & Oliveira, 2017). The family's participation in the whole EI process strengthens their skills in promoting learning opportunities to the child as well as positive developmental outcomes (Dunst, 2020; Keilty, 2020; Keilty et al., 2022).

Conducting the assessment

The assessment, from the perspective of the participants, serves two purposes: to determine the child's eligibility for intervention and/or to obtain information about the child's development and performance in routine moments.

Thus, they consider that the assessment can be conducted in a single moment, or in two separate moments. First, the child's eligibility for EI support is determined, and later, if the child is eligible for EI support, the child's development assessment is carried out.

The adoption of more active roles on the part of the families in the assessment of the child corresponds to levels of greater involvement of families in the assessment (Laranjeira & Serrano, 2017; Pinto & Serrano, 2017). Still, according to the participants' answers, the level of parental participation varies according to the setting chosen to realize the assessment. They report that most families choose to carry out the assessment in the educational context, to allow greater collaboration on the part of kindergarten teachers in this process. However, the participants reinforce that the choice of this setting compromises the presence and participation of parents, compared to the assessments carried out in the home environment. These results are also mentioned by Pereira and Oliveira (2017), who add that, in cases where EI support takes place in the school setting, the articulation with parents is more restricted and carried out essentially through written records, thus giving greater primacy to the role of the kindergarten teacher.

According to Pereira and Serrano (2014), family-centered practices are more evident when support is provided in the home setting, in line with the perspective of Bagnato (2007), who considers it extremely pertinent that the assessment takes place in natural settings, since it is possible to obtain authentic information about the child's skills, the resources, the family’s resources and priorities. The appreciation of natural settings and routine moments in EI is also valued by Dunst et al. (2014).

The participants report that the moment in which parents participate most actively is related to the assessment of the child's routines, through the routine-based interview, carried out in the home setting. Pereira and Oliveira (2017) describe the informal collection of data related to the family's and the child's routines as one of the main points of the assessment process and collaboration with the family during the RBI.

Pereira et al. (2020), and Boavida et al. (2013) highlight the importance of the RBI, considering it as a tool that promotes relationships and makes it easier to know the child's functioning, the family's concerns and priorities, being structured to the development of functional goals for the Individual Early Intervention Plan. For McWilliam (2012), understanding the functioning of the child and of the family in their daily routines is essential for the elaboration of a meaningful and real intervention plan.

Sharing of results

Sharing and discussing the results of the assessment with the family is described by most of the participants as a phase that can be divided into two stages. The first stage takes place at the end of the assessment, with the sharing of information on the child's performance. In the second stage of sharing, a functional report/synthesis is given to the family with the results of the assessment, and the most relevant and worrying aspects for the family are also discussed. This process of sharing results was also observed in the studies realized in Portugal by Magalhães and Pereira (2013) and by Pereira and Oliveira (2017).

According to Bagnato (2007), it is essential that professionals convey the results of the assessment in a useful and clear way to the family, emphasizing the strengths, the skills, the priorities in promoting optimal performance, and the limitations of the assessment itself. Sharing of results, the last step in the evaluation process, should be carried out in a way that is understandable, useful, and in a way that strengthens and promotes the skills of families (DEC, 2014; Pereira & Serrano, 2014).

During the sharing of the results of the assessment, the participants also mention the presence of other significant elements in the child's life, in addition to the family, highlighting, at this moment, the participation of the early childhood educator and other professionals who support the child.

DEC (2014) considers it essential that the family and other significant elements in the child's life have access to information and the opportunity to participate and be effectively involved in the assessment process. This perspective is also valued by McWilliam (2012), who considers that the child's regular caregivers who do not belong to the child's household should be involved in the whole process of EI support, to create and maximize learning opportunities for the child in her natural settings and routine moments. Pereira and Serrano (2014) reinforce this perspective by stating that EI professionals value collaborative practices with families, namely the establishment of positive relationships, the respect, appropriate responses to their concerns, and the recognition of the family as a member of the team.

One of the weaknesses of the assessment process most highlighted by the participants is the scarcity of human resources, a fact that they consider a limitation to the functioning of the team, namely its support at the child’s home. These difficulties limit the child's learning opportunities in her significant contexts, as well as the active participation of families in the EI support process (Mas et al., 2020; Morales-Murillo et al., 2021).

As a recommendation, the participants highlight the need to invest in training in the field of EI, enabling the deepening of knowledge, namely with regard to recommended practices in EI and, more specifically, at the level of principles and practices in assessment. Improving the quality of services and support at EI requires investment in different training formats, to promote and build knowledge, acquire skills, adapt attitudes, and improve professional performance (Dunst, 2015; Dunst et al., 2014; Dunst et al., 2019).