A multimodal approach to the assessment and treatment of children with learning difficulties
The object of the research reported in this thesis was to evaluate the potential effectiveness of applying a Multimodal approach - as described by Lazarus (1976, 1981) - to trying to help children with learning difficulties referred through schools to a Child Guidance Service. It was the intention, as far as possible, to work within the normal constraints imposed on the system within which the Educational Psychologist has to work. The research adopted a methodology based on the Decision Theoretic Model described by Edwards, Guttentag and Snapper (1975). This entailed the prior setting of objectives against which the strategies under consideration were evaluated. The Multimodal strategy was evaluated against two existing strategies which were in current use within Child Guidance Services. One of the strategies was tightly controlled and structured, whereas the other was more open to flexibility and adaptations. The evaluation was carried out in two phases: an Assessment phase and an Intervention phase. In the Assessment phase, information was gathered on children involved in all three of the strategies, which was used to assess their suitability for receiving specialist support. This information was evaluated by 'third party' expert judges against the specific assessment objectives which had previously been set. Using the Decision Theoretic Methodology the Utility, or perceived usefulness, of each assessment was derived. This was then compared with subjective opinions which had been developed previously based on descriptions of the three strategies. The results demonstrated that both in terms of the prior subjective opinions, and also on the basis of the actual assessments made, the Multimodal Approach was the most useful in terms of meeting the given objectives. Subsequent progress of children going through each of the three strategies was monitored. In addition to starting data, further data was gathered on two subsequent occasions: on average nine months in each case. On the basis of the data gathered independent 'expert judges' were asked to evaluate the child's progress against the set objectives that relate to intervention. At the end of the first period the picture was unclear as to which of the strategies was proving the most effective, although the Multimodal Approach was marginally the most attractive when all other things were equal. However, by the end of the second period it became clear that the Multimodal Approach was seen as producing the best outcomes, with the Structured Approach being second, and the Unstructured Approach third. In terms of the objectives that had been set, it was concluded that the Multimodal Approach was the most useful in terms of giving a full and potentially useful assessment, but that the broad spectrum approach of the Multimodal paradigm required a considerable period of time in which to operate before notable gains could be detected. The implications of the outcome utilitities are discussed fully in the body of the thesis.The thesis also contains a review of literature on the Multimodal paradigm, a review of literature on learning difficulties which seeks to place the research in the context of the seven modalities of the Multimodal BASIC IB, and there is also a review of the literature on research methodology which seeks to place the methodology adopted in the context of psychological experimentation in general. The thesis concludes with discussions on the future applicability of both the Multimodal approach, and the Decision Theoretic Methodology to Child Guidance Practice in general.