Monday, May 31, 2010
Lazy
I'm too lazy to post right now, so I'll just link a post from Hartley's Life with 3 Boys (which I just love) titled We Are Just Human. I think all moms and dads of special needs kids will be able to relate. Enjoy.
Sunday, May 30, 2010
Learning with Uncle Josh
My brother came home from Germany this week, and he and Jesse have enjoyed spending time together. I didn't realize though, that Josh has been "helping" Jesse with his vocabulary. Well, I did, but I thought it was limited to words like "nudge." Nope. I wonder how suprised Jesse's SLP will be to see "titties" on his vocabulary list on Monday? LOL
Wednesday, May 26, 2010
Playing catch-up
I've been slacking on this blog. Big time. So I'm going to give some brief up-dates of a few things we've been up to.
ISSP
From the ISSP meeting we came up with the following three major goals:
1. To increase expressive vocabulary to 100+ words. To be implemented by family, home therapist (HT), and senior therapist (ST) in the home environment. To be reviewed October 2010.
2. Jesse will navigate his environment using heel-toe pattern. To be implemented by family, HT, and ST in the home and in the community. To be reviewed October 2010.
3. Jesse will understand and follow one and two step commands regarding safety. To be implemented by the family, HT, and ST in the home and in the community. To be reviewed October 2010.
As of now though, I think Jesse has likely already met goal #1. His vocabulary has just exploded. Jesse's SLP has told us that we're not going to be able to keep up with writing down his new words. And it's true! I'm going to try though. Probably tonight at work. I'd like to have a better idea of exactly how many words he does have. I suspect though, that it is around 100 words. Jesse's already come a long way in terms of meeting goal number 3 as well. I can actually hold his hand in parking lots now, whereas I used to have to carry him. He's much more compliant about important things, like holding my hand, and not running off. I'm still cautious, of course, and hold his hand tightly, but it so much better.
I think that the most difficult goal to meet is going to be #2 - dealing with the toe-walking. We have activities and exercises in play to encourage heel-toe walking, but so far, he goes straight back to toe-walking. I'm hopeful, but not convinced, that this goal will be met by October.
Home Therapy
Our HT is working out really well thus far. She's here from 8 am to 12 noon Monday - Friday. Jesse really seems to like her, and she's really patient with him. He's even saying her name. The therapy is going well and Jesse is mastering his programs without much trouble at all. He's working on puzzles, letters, matching, body parts, animal sounds (he knows a ton!!), prepositions, and following instructions.
My only concern with the home therapy, and it's a big one, is that the ST and her mentor seem to be very reluctant to move Jesse's therapy outside. The weather's getting nicer, and I don't want Jesse stuck inside this summer. Yes, his therapy is only in the morning, but Jesse naps for 2-3 hours every afternoon. That leaves little time for getting out and about. So right now I'm trying to come up with ways of doing his home therapy outside the home. I need to do some research on this over the weekend.
Chiropractor
We've decided to start taking Jesse to the same chiropractic clinic Steve and I use. One of the chiropractors there works with kids with developmental issues. She's trained in Brain Gym. We had our first appointment yesterday. She did a physical assessment and asked me lots of questions about Jesse and his development. It was interesting to say the least. She does think that she can help with the toe-walking and the w-sitting. She wants to do some craniosacral work, and possibly do some adjustments as well. She assured us that adjustments in kids are nothing like adjustments in adults. I was very happy with how calm and respectful she was. She told Jesse everything she was going to do, and adjusted her assessment and treatment to suit Jesse's desire to be up and about and active. Some of what she does seems very strange (which she warned me of!) but I'm not going to discount it unless I see that it's not helping. I can't say that I understand chiropractic care very much, but I do know that it works for me, so I'm willing to give it chance to help Jesse.
And last, but not least, we took Jesse to feed the ducks at the park on May 24th. He had a blast! Here's a video. You can here him asking for "more" bird seed. Don't mind my voice.
ISSP
From the ISSP meeting we came up with the following three major goals:
1. To increase expressive vocabulary to 100+ words. To be implemented by family, home therapist (HT), and senior therapist (ST) in the home environment. To be reviewed October 2010.
2. Jesse will navigate his environment using heel-toe pattern. To be implemented by family, HT, and ST in the home and in the community. To be reviewed October 2010.
3. Jesse will understand and follow one and two step commands regarding safety. To be implemented by the family, HT, and ST in the home and in the community. To be reviewed October 2010.
As of now though, I think Jesse has likely already met goal #1. His vocabulary has just exploded. Jesse's SLP has told us that we're not going to be able to keep up with writing down his new words. And it's true! I'm going to try though. Probably tonight at work. I'd like to have a better idea of exactly how many words he does have. I suspect though, that it is around 100 words. Jesse's already come a long way in terms of meeting goal number 3 as well. I can actually hold his hand in parking lots now, whereas I used to have to carry him. He's much more compliant about important things, like holding my hand, and not running off. I'm still cautious, of course, and hold his hand tightly, but it so much better.
I think that the most difficult goal to meet is going to be #2 - dealing with the toe-walking. We have activities and exercises in play to encourage heel-toe walking, but so far, he goes straight back to toe-walking. I'm hopeful, but not convinced, that this goal will be met by October.
Home Therapy
Our HT is working out really well thus far. She's here from 8 am to 12 noon Monday - Friday. Jesse really seems to like her, and she's really patient with him. He's even saying her name. The therapy is going well and Jesse is mastering his programs without much trouble at all. He's working on puzzles, letters, matching, body parts, animal sounds (he knows a ton!!), prepositions, and following instructions.
My only concern with the home therapy, and it's a big one, is that the ST and her mentor seem to be very reluctant to move Jesse's therapy outside. The weather's getting nicer, and I don't want Jesse stuck inside this summer. Yes, his therapy is only in the morning, but Jesse naps for 2-3 hours every afternoon. That leaves little time for getting out and about. So right now I'm trying to come up with ways of doing his home therapy outside the home. I need to do some research on this over the weekend.
Chiropractor
We've decided to start taking Jesse to the same chiropractic clinic Steve and I use. One of the chiropractors there works with kids with developmental issues. She's trained in Brain Gym. We had our first appointment yesterday. She did a physical assessment and asked me lots of questions about Jesse and his development. It was interesting to say the least. She does think that she can help with the toe-walking and the w-sitting. She wants to do some craniosacral work, and possibly do some adjustments as well. She assured us that adjustments in kids are nothing like adjustments in adults. I was very happy with how calm and respectful she was. She told Jesse everything she was going to do, and adjusted her assessment and treatment to suit Jesse's desire to be up and about and active. Some of what she does seems very strange (which she warned me of!) but I'm not going to discount it unless I see that it's not helping. I can't say that I understand chiropractic care very much, but I do know that it works for me, so I'm willing to give it chance to help Jesse.
And last, but not least, we took Jesse to feed the ducks at the park on May 24th. He had a blast! Here's a video. You can here him asking for "more" bird seed. Don't mind my voice.
Friday, May 21, 2010
Word Detective
I recently read a post on Hartley's Life with 3 Boys titled Sensory Detective. It was such an awesome post and I'm in complete and total agreement with it. This, along with recent developments in Jesse's expressive communication got me thinking about just how much of a detective I've had to become lately. In addition to the sensory issues, Jesse also likely has some degree of verbal dyspraxia. Since his vocabularly is growing by 1-3 words a day, and he's just now starting to put 3-word phrases together ("more juice please"), I'm constantly having to decipher what he's trying to tell me. And if I'm unable to figure it out, we're at risk of a meltdown. I'm getting better at it though.
For example, a couple days ago Jesse came running up to me in the kitchen holding a tiny piece of paper in his hand. He showed me and said, "babage!" I was stumped! He kept repeating it over and over, "Babage! Babage!" "What is it Jesse?" I asked. "Babage!" And then he started knocking on the cabinet door under the sink. Where we keep our GARBAGE can. I opened the childproofed cabinet door and sure enough, Jesse puts the tiny piece of paper in the garbage. "BABAGE!" He was so proud of himself! And I was so glad that I got it relatively quickly.
A few others that I've figured out recently:
"ma-mass" is Mickey Mouse
"doot" is both poop and milk
"dee" is Diego
"keys" is both keys and cheese
There are a couple others that come to mind, but I'm saving those for another post.
For example, a couple days ago Jesse came running up to me in the kitchen holding a tiny piece of paper in his hand. He showed me and said, "babage!" I was stumped! He kept repeating it over and over, "Babage! Babage!" "What is it Jesse?" I asked. "Babage!" And then he started knocking on the cabinet door under the sink. Where we keep our GARBAGE can. I opened the childproofed cabinet door and sure enough, Jesse puts the tiny piece of paper in the garbage. "BABAGE!" He was so proud of himself! And I was so glad that I got it relatively quickly.
A few others that I've figured out recently:
"ma-mass" is Mickey Mouse
"doot" is both poop and milk
"dee" is Diego
"keys" is both keys and cheese
There are a couple others that come to mind, but I'm saving those for another post.
Monday, May 17, 2010
Book Review
I keep saying I'm going to get around to it, and finally I have! My first book review. Forgive me though, it's been about 15 years since I've done one of these and I don't believe I even remember how. So no critiques of my critique please! If you've read the book though, please feel free to add your own review or comments in the comments section. I'd love to know what other people thought.
Motivate to Communicate: 300 Games and Activities for Your Child with Autism
by Simone Griffin and Dianne Sandler
I'm going to put the cart before the horse here and just say that this is a fabulous book chock block full of ideas and resources for working with children with autism. The authors, Simone Griffin, a speech and language therapist, and Dianne Sandler, a specialist teacher, both have years of experience working with kids with autism. And it shows! They take into account children's sensory issues and needs, as well as the child's level of communication ability (which can range from completely non-verbal, to relatively "normal").
First and foremost, this book shows parents how they can create communication opportunities throughout the day, with very little planning of set-up involved. Keeping desired objects (toys, books, DVDs, food, etc...) out of reach or in difficult-to-open containers forces (in a good way!) an autistic child to interact with their parent/therapist/caregiver in order to get what they want. Doing something unexpected (like having the child's sibling get in the bathtub with their socks on) or using "creative stupidity" (i.e. doing something intentionally to get a reaction, but pretending it's a mistake) encourages the child to comment or communicate in whatever way they can that they know something's different or not right. This section of the book, though short, is probably my favorite. I think that we, as parents, can get so caught up in our busy lives (especially when you're in the midst of so many doctor and therapy appointments) that you can over look these learning and communication opportities so easily. By being mindful of how to take advantage of every day happenings, you're able to work in so many communication opportunities so easily!
And that's just the introduction!!!
The rest of the book is full of the 300 specific ways you can motivate kids to engage and communicate. Chapter 1 is Motivate Me with Food. You can use different foods, from bread and toast to spaghetti and jello to do little activities that teach things like simple instructions, teach concepts (such as yes/no, big/little, long/short, shapes, colours, etc...), and experience food in a way that is not negative (which is too often the case for kids with autism). My only concern with this chapter is that it relies heavily on foods that would be in a gluten-free diet (breads, pastas, flours). Luckily there are still plenty of other suggestions, and other chapters.
Chapter 2 is Motivate Me with "Party Toys". Party toys include things like bubbles, balloons, slinkies, balls, cars, wind-up toys, magnetic toys, spinning toys, vibrating toys, light up toys, and stretchy and squishy toys. Many of these toys are very motivating, especially for kids who need lots of sensory stimulation. These are your typical dollar store fare. Which I tend to really dislike. I'm personally not a fan of cheap, made in China, decorated with questionable paint toys. Or ones with batteries that are at all accessible. But there are better options out there. And if you're worried about the quality/safety of certain toys that your child just LOVES, then you can always put them in a box on a high shelf and bring them out only during therapy or one-on-one play time with a parent/caregiver/therapist.
Chapter 3 is Motivate Me with Social Games. These games typically require engaging with other children or adults on some level. Hide-and-seek, pass-the-parcel, tag, musical chairs, and "I spy", are some typical examples. I love this chapter because you learn how you can help your child interact and play more with other kids. Many of the games may be beyond your child's current abilities, but there are things you can do to help them or even practice ahead of time.
Chapter 4 is Motivate Me with Outside Games. This chapter is full of ideas on how to use outside play time to encourage communication. I'm so glad they included this in the book, because I think that too often parents, caregivers and therapists can rely on structured indoor therapy. But these are KIDS! They need to get outside and run around and just play! Many kids with autism are VERY active (like Jesse) and this is really a necessity. The activities in this chapter include play with sand, water, snow, and messy things (like slime/goop, sawdust, soap flakes, etc...).
The last chapter, Chapter 5, is Motivate Me at Home and School. This chapter focuses on using toys and other things that you already have in your home or at your child's school. Like puzzles, books, and shape sorters. The possibilities are nearly endless. My favorite from this chapter is the Mr. Potato Head. We just picked one up for Jesse and he LOVES it! Such a great tool to use.
Also awesome about this book is the list of online resources, including internet businesses that sell toys for kids with disabilities, and websites that have information on autism and communication. Many of the sites are based in the UK, but they're still immensely helpful.
Overall, I'm really pleased with this book. I think it's a great resource and I think that every family affected by autism should have one, as should anyone who works with kids with autism. Actually, I think it would be a great book for anyone with a child with a speech/communication delay. Many of the strategies seem like they would lend themselves well to working with neurotypical children as well.
Motivate to Communicate: 300 Games and Activities for Your Child with Autism
by Simone Griffin and Dianne Sandler
I'm going to put the cart before the horse here and just say that this is a fabulous book chock block full of ideas and resources for working with children with autism. The authors, Simone Griffin, a speech and language therapist, and Dianne Sandler, a specialist teacher, both have years of experience working with kids with autism. And it shows! They take into account children's sensory issues and needs, as well as the child's level of communication ability (which can range from completely non-verbal, to relatively "normal").
First and foremost, this book shows parents how they can create communication opportunities throughout the day, with very little planning of set-up involved. Keeping desired objects (toys, books, DVDs, food, etc...) out of reach or in difficult-to-open containers forces (in a good way!) an autistic child to interact with their parent/therapist/caregiver in order to get what they want. Doing something unexpected (like having the child's sibling get in the bathtub with their socks on) or using "creative stupidity" (i.e. doing something intentionally to get a reaction, but pretending it's a mistake) encourages the child to comment or communicate in whatever way they can that they know something's different or not right. This section of the book, though short, is probably my favorite. I think that we, as parents, can get so caught up in our busy lives (especially when you're in the midst of so many doctor and therapy appointments) that you can over look these learning and communication opportities so easily. By being mindful of how to take advantage of every day happenings, you're able to work in so many communication opportunities so easily!
And that's just the introduction!!!
The rest of the book is full of the 300 specific ways you can motivate kids to engage and communicate. Chapter 1 is Motivate Me with Food. You can use different foods, from bread and toast to spaghetti and jello to do little activities that teach things like simple instructions, teach concepts (such as yes/no, big/little, long/short, shapes, colours, etc...), and experience food in a way that is not negative (which is too often the case for kids with autism). My only concern with this chapter is that it relies heavily on foods that would be in a gluten-free diet (breads, pastas, flours). Luckily there are still plenty of other suggestions, and other chapters.
Chapter 2 is Motivate Me with "Party Toys". Party toys include things like bubbles, balloons, slinkies, balls, cars, wind-up toys, magnetic toys, spinning toys, vibrating toys, light up toys, and stretchy and squishy toys. Many of these toys are very motivating, especially for kids who need lots of sensory stimulation. These are your typical dollar store fare. Which I tend to really dislike. I'm personally not a fan of cheap, made in China, decorated with questionable paint toys. Or ones with batteries that are at all accessible. But there are better options out there. And if you're worried about the quality/safety of certain toys that your child just LOVES, then you can always put them in a box on a high shelf and bring them out only during therapy or one-on-one play time with a parent/caregiver/therapist.
Chapter 3 is Motivate Me with Social Games. These games typically require engaging with other children or adults on some level. Hide-and-seek, pass-the-parcel, tag, musical chairs, and "I spy", are some typical examples. I love this chapter because you learn how you can help your child interact and play more with other kids. Many of the games may be beyond your child's current abilities, but there are things you can do to help them or even practice ahead of time.
Chapter 4 is Motivate Me with Outside Games. This chapter is full of ideas on how to use outside play time to encourage communication. I'm so glad they included this in the book, because I think that too often parents, caregivers and therapists can rely on structured indoor therapy. But these are KIDS! They need to get outside and run around and just play! Many kids with autism are VERY active (like Jesse) and this is really a necessity. The activities in this chapter include play with sand, water, snow, and messy things (like slime/goop, sawdust, soap flakes, etc...).
The last chapter, Chapter 5, is Motivate Me at Home and School. This chapter focuses on using toys and other things that you already have in your home or at your child's school. Like puzzles, books, and shape sorters. The possibilities are nearly endless. My favorite from this chapter is the Mr. Potato Head. We just picked one up for Jesse and he LOVES it! Such a great tool to use.
Also awesome about this book is the list of online resources, including internet businesses that sell toys for kids with disabilities, and websites that have information on autism and communication. Many of the sites are based in the UK, but they're still immensely helpful.
Overall, I'm really pleased with this book. I think it's a great resource and I think that every family affected by autism should have one, as should anyone who works with kids with autism. Actually, I think it would be a great book for anyone with a child with a speech/communication delay. Many of the strategies seem like they would lend themselves well to working with neurotypical children as well.
Monday, May 10, 2010
Amazed!!!
We had our weekly speech therapy appointment this morning. SLP was very impressed with Jesse's vocabulary growth over the past couple of weeks. In the two months since we started speech therapy, Jesse has gone from being about 14 months behind (12 month level at 26 months of age), to being just 4 months behind (24 month level at 28 months of age). I'm over the moon!!!
Thursday, May 6, 2010
Oldies but goodies
I've talked a lot about Jesse's toe-walking. It's been a huge issue for us for forever. I didn't realize it at the time, but when Jesse started cruising around 7 1/2 months of age, he was constantly up on his toes. Of course, some degree of that is normal for babies. What wasn't normal was that his toe-walking caused him to develop a contracture in his right foot that prevented him from coming down onto his heel. And this prevented him from getting his balance enough to even stand unassisted, let alone walk.
Jesse had always met his gross motor milestones on time or ahead of time. So when time kept creeping onward and Jesse still walking walking on his own, wasn't even STANDING on his own, I *knew* something wasn't right. He wasn't lazy. He wasn't "too good of a crawler." It wasn't because I did everything for him. Or carried him everywhere. Those were all the reasons I was given when I dared talk about my concerns.
Eventually I made the following video. It was taken with a crappy digital camera when Jesse was nearly 16 months old. This video confirmed for me that there really was an issue, which is clearly visible to anyone who watches it. I showed it to a friend of mine who works with kids as a physical therapist and she validated my concerns. It gave me the kick in the ass I needed to demand that I be taken seriously and that Jesse be properly assessed.
So, without further ado:
I also wanted to throw in this video....the day Jesse finally stood on his own....took his first steps....and walked clear across the room!!! This was taken about a month after the first video. After a couple weeks of physiotherapy. He was still up on his toes, still had the contracture, but had finally managed to get his balance enough to stand, to WALK! Boy, was I a proud mama that day!!!
Jesse had always met his gross motor milestones on time or ahead of time. So when time kept creeping onward and Jesse still walking walking on his own, wasn't even STANDING on his own, I *knew* something wasn't right. He wasn't lazy. He wasn't "too good of a crawler." It wasn't because I did everything for him. Or carried him everywhere. Those were all the reasons I was given when I dared talk about my concerns.
Eventually I made the following video. It was taken with a crappy digital camera when Jesse was nearly 16 months old. This video confirmed for me that there really was an issue, which is clearly visible to anyone who watches it. I showed it to a friend of mine who works with kids as a physical therapist and she validated my concerns. It gave me the kick in the ass I needed to demand that I be taken seriously and that Jesse be properly assessed.
So, without further ado:
I also wanted to throw in this video....the day Jesse finally stood on his own....took his first steps....and walked clear across the room!!! This was taken about a month after the first video. After a couple weeks of physiotherapy. He was still up on his toes, still had the contracture, but had finally managed to get his balance enough to stand, to WALK! Boy, was I a proud mama that day!!!
Tuesday, May 4, 2010
Jesse's ABA Client Report
I'm going to attempt to type this out, and post about the ISSP meeting as well. This will be pretty long. It'll probably be a hugely boring read for most people, but may be helpful to someone going through a similar experience.
The ABA Client Report was prepared by Jesse's Senior Therapist (ST). The report was based on her findings from the Brigance Early Childhood Screen II 0-35 months, and the Carolina Curriculum that she'd performed April 12, 2010. The following is taken directly from her report:
Findings and Service Plan:
The Brigance Early Childhood Screen II 0-35 months, as well as the Carolina Curriculum were completed through testing, and parental interview in April 2010. The results indicate that Jesse is showing the greastest delay in the area of Language development. My role as a Senior Therapist is to address these delays and in consultation with the therapy team, develop a program plan to assist Jesse with mastering skills appropriate for his age.
The purpose of today's report is to share information regarding Jesse's present developmental skill level and to project the program goals for the next six months.
Physical Develpment (Fine & Gross Motor):
This scale measures the child's ability to coordinate movements of large and small muscles of the body.
Jesse shows many strengths in both his fine and gross motor develpment. In terms of fine motor skills, Jesse attempts to solve problems by imitating adults, and is able to imitate sequences of two unrelated motor acts. He turns doorknobs with forearm rotation, puts small objects through small holes in containers, and builds block towers 8-10 blocks high. Jesse is able to put together and take apart pop-beads, and he demonstrates a right hand preference. He also demonstrates good tool use. He can hold a bowl and stir, and can transfer material with a spoon. Further, Jesse shows purposeful and well controlled scribbles and strokes.
Jesse also shows many gross motor strengths. He can jump on the floor, he can walk backwards, can take many steps on his tiptoes, and can run at least 10 feet without falling. He can rise on his tiptoes and can stand on one leg with a stable posture for 1-2 seconds. Jesse can throw a ball, can climb both slanted and vertical ladders, is able to use a slide independently, and runs in a variety of environments.
Goals:
-Jesse will unbotton large buttons found on clothing
-Jesse will imitate horizontal strokes
-Jesse will use heel-toe pattern when walking
-Jesse will walk up stairs, using an alternating pattern while holding onto a rail
-Jesse will pedal and steer a three-wheeled bike
Self-Help Development:
This scale measures a child's ability to cope independently with the environment and measure their skills with such tasks as eating and dressing.
Jesse shows many strengths within his self-help skills. He can use a fork, and can drink from a small glass held with one hand, but prefers a sippy cup. He is able to undress himself completely, is able to put on simple clothing such as pants, shoes, and socks, and can manipulate velcro and zippers. Jesse has strong grooming skills and is able to wash and dry his own hands, brush his teeth with assistance, and wash himself with a washcloth.
Goals:
-Jesse will put on a t-shirt
-Jesse will undo fasteners (i.e. large buttons and shoelaces)
Social Development:
This scale measures the child's interpersonal relationship abilities.
Jesse has very good eye contact and will respond to his name most of the time. He tolerates being taken into a variety of environments and frequently explores different environments. Jesse knows what toys can and cannot do and uses them appropriately. He tries to comfort others in distress and spontaneously shares with peers. He shows determination in choosing and continuing activities and shows pride in his achievements.
Goals:
-Jesse will share with another person
-Jesse will engage in simple turn taking games with another person
-Jesse will avoid common dangers in the home and environment
-Jesse will recognize himself and others in photographs
-Jesse will expand his play skills through imitation
Cognitive (Academic) Development
This scale meaures children at the preschool level and evaluates the child's development of skills pre-requisite to scholastic functioning.
Jesse is showing many strengths in the area of academic development. He sorts objects by size, builds block towers, and uses tools to solve problems. He can point to a hand that is hiding an object, and engages in adult role play. Jesse demonstrates good comprehension of cause and effect when playing, and understands the concept of "more" as an addition to some existing amount.
Goals:
-Jesse will demonstrate recognition of familiar objects
-Jesse will put together puzzles with four or five interconnected pieces
-Jesse will match identical pictures
-Jesse will attend to a story and repeat words and sounds
-Jesse will independently stack rings of graduated sizes
-Jesse will imitate block building
Communication:
This scale measures the child's expressive and receptive communication abilities with both verbal and non-verbal gestures.
Jesse is able to follow commands in familiar contexts and understands words used to inhibit actions, such as "wait," "stop," etc...He spontaneously uses words during play and spontaneously says familiar greetings and farewells at appropriate times. Jesse is able to point to many body parts, such as chin, neck, shoulder, and knee, and imitates the vocalizations of others.
Goals:
-Jesse will follow two-part related commands in novel contexts
-Jesse will use words to request actions
-Jesse will imitate two word phrases or sentences
-Jesse will increase his vocabulary to 50 words
-Jesse will increase his spontaneous communication
Summary:
Over the next six months Jesse will be followed by the Regional Autism Services division of the Direct Home Services program. I will conduct weekly visits to monitor Jesse's progress. Programs will be developed in accordance with the goals that will be outlined in the upcoming ISSP as well as parent priorities. At the end of this six-month period the assessments will be re-administered in order to assess Jesse's progress and to develop and implement new programs and goals for Jesse.
The ABA Client Report was prepared by Jesse's Senior Therapist (ST). The report was based on her findings from the Brigance Early Childhood Screen II 0-35 months, and the Carolina Curriculum that she'd performed April 12, 2010. The following is taken directly from her report:
Findings and Service Plan:
The Brigance Early Childhood Screen II 0-35 months, as well as the Carolina Curriculum were completed through testing, and parental interview in April 2010. The results indicate that Jesse is showing the greastest delay in the area of Language development. My role as a Senior Therapist is to address these delays and in consultation with the therapy team, develop a program plan to assist Jesse with mastering skills appropriate for his age.
The purpose of today's report is to share information regarding Jesse's present developmental skill level and to project the program goals for the next six months.
Physical Develpment (Fine & Gross Motor):
This scale measures the child's ability to coordinate movements of large and small muscles of the body.
Jesse shows many strengths in both his fine and gross motor develpment. In terms of fine motor skills, Jesse attempts to solve problems by imitating adults, and is able to imitate sequences of two unrelated motor acts. He turns doorknobs with forearm rotation, puts small objects through small holes in containers, and builds block towers 8-10 blocks high. Jesse is able to put together and take apart pop-beads, and he demonstrates a right hand preference. He also demonstrates good tool use. He can hold a bowl and stir, and can transfer material with a spoon. Further, Jesse shows purposeful and well controlled scribbles and strokes.
Jesse also shows many gross motor strengths. He can jump on the floor, he can walk backwards, can take many steps on his tiptoes, and can run at least 10 feet without falling. He can rise on his tiptoes and can stand on one leg with a stable posture for 1-2 seconds. Jesse can throw a ball, can climb both slanted and vertical ladders, is able to use a slide independently, and runs in a variety of environments.
Goals:
-Jesse will unbotton large buttons found on clothing
-Jesse will imitate horizontal strokes
-Jesse will use heel-toe pattern when walking
-Jesse will walk up stairs, using an alternating pattern while holding onto a rail
-Jesse will pedal and steer a three-wheeled bike
Self-Help Development:
This scale measures a child's ability to cope independently with the environment and measure their skills with such tasks as eating and dressing.
Jesse shows many strengths within his self-help skills. He can use a fork, and can drink from a small glass held with one hand, but prefers a sippy cup. He is able to undress himself completely, is able to put on simple clothing such as pants, shoes, and socks, and can manipulate velcro and zippers. Jesse has strong grooming skills and is able to wash and dry his own hands, brush his teeth with assistance, and wash himself with a washcloth.
Goals:
-Jesse will put on a t-shirt
-Jesse will undo fasteners (i.e. large buttons and shoelaces)
Social Development:
This scale measures the child's interpersonal relationship abilities.
Jesse has very good eye contact and will respond to his name most of the time. He tolerates being taken into a variety of environments and frequently explores different environments. Jesse knows what toys can and cannot do and uses them appropriately. He tries to comfort others in distress and spontaneously shares with peers. He shows determination in choosing and continuing activities and shows pride in his achievements.
Goals:
-Jesse will share with another person
-Jesse will engage in simple turn taking games with another person
-Jesse will avoid common dangers in the home and environment
-Jesse will recognize himself and others in photographs
-Jesse will expand his play skills through imitation
Cognitive (Academic) Development
This scale meaures children at the preschool level and evaluates the child's development of skills pre-requisite to scholastic functioning.
Jesse is showing many strengths in the area of academic development. He sorts objects by size, builds block towers, and uses tools to solve problems. He can point to a hand that is hiding an object, and engages in adult role play. Jesse demonstrates good comprehension of cause and effect when playing, and understands the concept of "more" as an addition to some existing amount.
Goals:
-Jesse will demonstrate recognition of familiar objects
-Jesse will put together puzzles with four or five interconnected pieces
-Jesse will match identical pictures
-Jesse will attend to a story and repeat words and sounds
-Jesse will independently stack rings of graduated sizes
-Jesse will imitate block building
Communication:
This scale measures the child's expressive and receptive communication abilities with both verbal and non-verbal gestures.
Jesse is able to follow commands in familiar contexts and understands words used to inhibit actions, such as "wait," "stop," etc...He spontaneously uses words during play and spontaneously says familiar greetings and farewells at appropriate times. Jesse is able to point to many body parts, such as chin, neck, shoulder, and knee, and imitates the vocalizations of others.
Goals:
-Jesse will follow two-part related commands in novel contexts
-Jesse will use words to request actions
-Jesse will imitate two word phrases or sentences
-Jesse will increase his vocabulary to 50 words
-Jesse will increase his spontaneous communication
Summary:
Over the next six months Jesse will be followed by the Regional Autism Services division of the Direct Home Services program. I will conduct weekly visits to monitor Jesse's progress. Programs will be developed in accordance with the goals that will be outlined in the upcoming ISSP as well as parent priorities. At the end of this six-month period the assessments will be re-administered in order to assess Jesse's progress and to develop and implement new programs and goals for Jesse.
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