Adaptive hierarchical test procedure for developmentally delayed adults: Taking the "difficult" out of "difficult to test"

Successful audiological assessment of adult clients with developmental disabilities requires that a respectful and trusting client-examiner relationship be established. Test protocols must meet the purpose of the assessment while matching the abilities of the client. In this article, the components of an assessment framework and strategies for evaluating individuals with developmental disabilities are described. The approach is client-centered and emphasizes each client's strengths and abilities throughout all phases of assessment. To support our recommendations for test selection, we provide a hierarchical test battery and decision matrix. This was derived from clinical experience, literature review, and a retrospective analysis of audiological records for 108 adults with mental retardation evaluated at the University of Arizona Hearing Clinic from May 1998 to May 2000.