HELP

Hawaii Early Learning Profile or HELP is a criterion-referenced assessment that provides an in-depth framework for assessing development, treatment planning, and measuring ongoing progress of developmental skills for children from birth up to six years of age. Primarily used in early childhood settings, the HELP supports federal requirements for part C of the Individuals with Disabilities Education Act, (IDEA) and Early Head Start Programs.

What is the Hawaii Early Learning profile?

The purpose of the HELP is to identify individual needs, track progress, and create goals. This assessment is an important tool for occupational therapists as it is family-centered, allowing the caregivers to support the engagement of the family and client in the assessment process. 

The HELP assesses multiple areas of development which are also referred to as strands. Areas include:

• Cognitive: Skills for learning, problem solving and developmental stages of play.

• Language: Receptive and expressive communication.

• Gross Motor: Movements of large muscles.

• Fine Motor: Small muscle movement

• Social-Emotional: How the child expresses self and relates to others.

• Self-Help skills: Caring for self and participating in activities of daily living.

• Regulatory/Sensory Organization: Organizing, responding, and adapting to routine sensory experiences in a daily routine.

The Hawaii Early Learning Profile (HELP) is an assessment used with children from birth to six years of age.

There are different versions of this to test:

• Hawaii Early Learning Profile from birth to three years

• Hawaii Early Learning Profile for ages three to six years

• Hawaii Early Learning Profile for Special Preschoolers Assessment Checklist (HSPAC) for children three to six years old

• Hawaii Early Learning Profile for Preschoolers, 2nd edition also for ages three to six years old

Because the test is criterion-based and not norm-referenced, it can't determine eligibility for services. Clinicians usually select another occupational therapy assessment with normative values or standardized scores to accompany the Hawaii Early Learning Profile during an evaluation. The Hawaii Early Learning Profile assessment can monitor growth progression, create goals, and offer valuable treatment planning for children. Trained clinicians administer this test, and scoring is extensive to compile scores for all test items. Weaknesses of this assessment include limited evidence to support its effectiveness and inter-rater reliability.

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Administering the HELP Assessment

Administration for the Hawaii Early Learning Profile includes checklists, strands, charts, and activity guides to follow a child’s growth development. Administration involves observation of the student, interactions during play activities with the child, and an interview with the parent/caregiver, allowing data collection during natural activities, versus a formal academic assessment. 

Administration is done by an early childhood specialist, including teachers, nurses, occupational therapists, physical therapists, and other pediatric specialists. Assessment guidelines include observational opportunities and with general administrations described from each area assessed. 

Further guidance to measure skills and behaviors for test items is provided in the manual to assist the administrator in assigning credit. Adaptations to skills are also available to guide clinicians to support various abilities during the assessment.

Steps involved in administration include allowing an hour to administer the complete HELP assessment with additional time required for score interpretation. Administration is grouped into five sections including free play, structured facilitation, movement activities, feeding, and a closing period. 

This test offers many opportunities for caregiver involvement and keeping the child active to support engagement and rapport building through the administration of the assessment.

Score interpretation uses an approximate age-based level of development for all but one strand or area, Regulatory/Sensory Organization, based on credit the client receives on individual items. The Regulatory/Sensory Organization area reports children as one of three categories, under-reactive, over-reactive, or typical. This test is not standardized, and age norms are not derived from this assessment. The score is not a numeral value as it is designed to be curriculum-based, offering data on a child’s strengths and weaknesses along with activities to support development.

Using HELP results for treatment planning

Since the HELP is curriculum-based, it complements skills with identification numbers that coincide with curriculum planning tools. The Hawaii Early Learning Profile has a published activity guide designed to help multiple professionals and families with activity ideas to support the child’s unique strengths and weaknesses for each developmental area. Family and caregivers can discuss priorities and create goals during this assessment along with data gathered primarily supporting progress for each child as an individual versus comparison to a normative sample. Since this test is not standardized, it can be administered as frequently as needed to track progress over time.   

Collaborating with caregivers and other professionals

Administration includes a family-centered interview, offering the caregivers time to discuss priorities, concerns, questions, and the child’s occupational profile. The family-centeredness of this assessment supports rapport and allows the caregiver a more active role in their child’s treatment plan. Another strength of this family-centered assessment is that it allows flexibility in interview questions to respect the client and family culture.  A variety of professionals can administer this assessment to promote growth and development in children. The Hawaii Early Learning Profile is used for educational purposes but may need to be accompanied by a standardized, normative value outcome measure when used within healthcare teams, as occupational therapists need to demonstrate measurable progress, generally described as a change in numeral value. Team members can administer this assessment together to promote coordinated care of the child, along with specific behavior and skill data collected in each developmental area to define areas of focus in the treatment plan.