Randal County Early Intervention Assessment Summary for Billy

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					Randal County Early
Intervention Assessment
Summary for Billy Donaldson

              Julie Falconer/Social Worker
           Michelle Bechtel/Physical Therapy
             Amanda Higgins/Psychologist
                 Carly Lopez/Nutritionist
     Stacy Walters / Speech and Language Therapist

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                                                     6/8/2009
Introduction
    Welcome to Randall County Early
          Intervention Program

This presentation was developed to help
 Mae and Jack’s family understand their
 child’s evaluation and provide a quick
 reference for activities they can do
 with Billy to work toward his individual
 goals and objectives.




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                                            6/8/2009
     What is the role of a parent in
       the assessment process?
           “Your Partnership”
   Because you know your child best, we invite you to
    Participate at a level you are comfortable with and
    always let us know if:
   You feel your child will work better if you are not present

   You may feel like an assessment would be more effective if you present
    test items yourselves.

   You may feel uncomfortable "helping" while professionals are watching. or
    helpless and frustrated when your child will not or cannot do something.

   try to remember, many professionals feel the same uneasiness and
    frustration whey they cannot get a child to respond.
   We are here you help relieve your fears and anxieties or validate concerns
    you have about your child. It is important for both families and
    professionals to share feelings and concerns. Sharing feelings can help to
    begin to develop a partnership.
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                                                                                 6/8/2009
    The Assessments
   Each member of
    your team has
    evaluated Billy
    and prepared a
    summary of the
    results. We
    have also          Social
    written some                        Nutritionist
    goals designed     Worker    OT
    to help you and
    your family work
    from a position    Mae      Billy   Jack
    of strength
    while helping
    Billy grow          PT               Teacher
                                Nurse

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                                                       6/8/2009
Your Social Worker: Julie Falconer
    Issues                                Recommendations
     Cannot sleep through the night         Would like to see if nutrition
                                            piece had an affect here
     Nutrition is difficult and Billy
     is too thin                            Nutritionist has designed a diet
                                            based on your doctor’s
                                            recommendations and
                                            supervision
     Need Online Support
                                            Will provide 3 discussion boards
                                            of parents who are experiencing
                Increase social             the same thing you are.
                opportunities for
                Billy                       When you are ready, we will get
                                            Billy signed up with PEAK. This
                                            is a program for kids his age.

                                                                                      5
                                                                               6/8/2009
Goals and Desired Outcomes
1.   Family will consult with pediatrician/Dr.
     to find foods to increase Billy’s calorie
     intake
2.   Billy will communicate his needs; food,
     drink, toys, etc., by using words and
     phrases.
3.   Billy will gain strength and movement by
     doing daily exercises with help from
     mom to stretch his muscles and lower
     joints
4.   Billy will sleep through the night without
     waking up more than once.
                                                         6
                                                  6/8/2009
Observations:                               Speech / Language
Billy completed many of the tasks in the 7-9
    month age range. He can understand
    some words but uses appropriate
                                                 Assessment,
    gestures and his voice together with
    pointing. Billy’s listening and talking
    skills fall in the 7-9 month range. He
                                               Stacey Walters
   babbles, imitates, mother, responds to
   name, waves or responds to “bye- bye”,
   attends to the conversation of others,
   says the words, bottle, Nanna
   (grandmother) shoes, boo, truck and
   “bye-bye”. He orients correctly to
   “mommy” and “daddy”.

Recommendations:
Billy’s language skills are 2-4 months
    delayed in development. Billy needs
    speech and language services at home in
    a play setting with SLP and Mae. Mae
    and Jack will have a a schedule of a
    variety of activities to do with Billy to
    strengthen his speech and language
    skills.


                                                               7
                                                        6/8/2009
Observations

                                         Physical Therapy:
Some distress when asked to
    perform specific tasks.
Billy crawled in a bunny-hop fashion,
    moving both legs
    simultaneously.
No reciprocal motion was present in
                                                 Michelle Bechtel
    lower body.                           Billy is able to roll over supine to
Billy was observed to prefer W-               prone and vice-versa.
    sitting, but was receptive to         Billy had a keen interest in moving
    this being corrected into a               toys and small toys.
    tailor position.                      His pincer grasp was inferior
Billy was able to stand to reach for          compared to other children his
    a toy, but did not take any steps         age.
    to acquire the item. He did not       He passed objects from hand to
    let go of support while standing.         hand at midline, never through
When standing, his Achilles tendons       When Billy was using hand-over-
    were tight, not allowing his heels        hand prompt, he demonstrated
    to touch the floor.                       limited independent scribbling
Billy also stood in somewhat of a             for a few seconds after the
    “squatted” position, without full         administrator faded the
    extension of his knee or hip              assistance.
    joints. Tightness in these joints     When Billy was sitting, his upper
    was also noted.                           extremities demonstrated
Billy is able to get into a sitting           appropriate strength and
    position on his own but needs             fluidity of movement.
    correction                            At one time when Billy tried to
He did not demonstrate quadruped              reach for a toy from a standing
    crawling position during this             position, it was noted that his
    assessment.                               right arm trembled. Trunk
.                                             control seemed appropriate
                                              during all phases of positioning.          8
                                                                                  6/8/2009
                  Physical Therapy
                 Recommendations:
   Billy would benefit from
    range-of-motion exercises
    with his lower extremities
    on a daily basis.
   Mae needs training to learn
    how to do stretching
    exercises with Billy. Family
    needs information on an
    alternative to W-sitting.
   Billy is encouraged to
    participate in more fine-
    motor activities, such as
    scribbling drawing and
    stacking blocks.
   Crossing midline should be
    encouraged in all play, and
    some proprioceptive
    stimulation, such as spinning,
    rocking, and/or swinging may
    be beneficial to brain
    development.
   Show Mae and Jack how to
    apply what they have
    learned.                                9
                                     6/8/2009
          Psychological Evaluation
              Amanda Higgins
Playing, Thinking, and Exploring (Cognitive Skills)

Things I do well:                   Things I find difficult or need
                                       help with:
   Ring a bell                        Imitate an adults actions;
   Put my fingers in pegboard          imitating stirring spoon in
    holes                               cup
   Put cubes in a cup when I am       Pick up a cup to find a
    asked                               hidden object
   Beginning to learn how to          Developing object
    drink from cup                      permanence
   Can get around and explore         Learning that objects have
   Can play with my toys; reach,       functions instead of just to
    grab, pull, bang and throw          chew on; phone, toothbrush
    his toys                           Play with one toy at a time
                                       Study objects
                                       Build and take apart toy and
                                        objects

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                                                                       6/8/2009
Interacting with Others
(Social/Emotional Skills)
  Things I do well:
                                     Things I find difficult
     Plays well with Dad and Mom      or need help with:
     Recognizes parents and their
      voices
     Coos and babbles, can             Expressing needs; Billy is
      communicate by pointing            unable to talk, but can point
      fingers and grunting at what       to objects or things that he
      he wants                           wants
     Responds to his name being        Billy is hyper susceptible to
      called                             illness, so he has not had a
      Expresses moods with               lot of opportunity to play
  
      different sounds and body          and interact with other
      movements                          children.
                                        Mimic facial expressions
                                        Play games like patty cake
                                         and peek-a-boo


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                                                                         6/8/2009
                  Plan of Action
                     Amanda Higgins
What we see now:                     Outcome Statement:
                               What we would like to see happen for
                                         our child/family
    Billy’s cognitive
    functioning is                Support for Mom and Dad.
    8.1months. He is
    significantly below his       Mom and Dad to continue to
    chronological age of 14        play with Billy.
    months and his adjusted       Billy’s eating habits improved.
    age for prematurity of        Sleep habits/routines to
    11.5 months.                   improve.
   His developmental levels
    in social/adaptive
    functioning are also
    significantly below his
    chronological and
    adjusted age.

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                                                                 6/8/2009
Strategies to address best practices within the
child/family’s everyday routines, activities, and
environments                       Amanda Higgins
   Continue to encourage
    parents to play with Billy.

   Play games with Billy like
    peek-a-boo and patty
    cake.

   Hide objects for Billy to
    find and help him
    understand that the
    objects are there even if
    he cannot see them.

   Talk and read books to
    Billy and point out and say
    names for different
    objects around the house.                             13
                                                    6/8/2009