If Only Lee's Summit Could Provide The Same Services That A Town of 2,000 Did
Jacob Tucker's Occupational Therapy Annual Report/Mackinaw School District (NOTE THE DIFFERENCE BETWEEN THIS REPORT AND THE REPORT FROM LEE'S SUMMIT)
May 4, 1998
5 years old
History: Jacob is currently receiving 60 minutes of direct therapy per week, with 60 minutes supervisory time per semester. Jacob attends Mackinaw grade school, and is in the P.M. ECE class, with Mrs.. Zuercher. His last MDC was April 1997.
Subjective: Jacob will complain, during therapy that certain weight bearing activities hurt his shoulders.
Objective:
Behavior: During therapy, Jacob is cooperative and tries to do what is asked of him. During unstructured times, he will become excited and rock back and forth, while flapping his hands.
Goal Performance: Jacob's current goals focus on:
1. Improving separation of upper extremity movements.
2. Improving gross motor and postural control.
3. Improving fine motor skills.
Jacob has mastered all 7 of his goals on his current IEP.
Independent Living Skills: Jacob is able to Donn/Doff his socks and shoes. He is able to un/button 1/4" buttons. He is able to zip, once engaged. He is unable to do snaps.
Neuromuscular: Jacob is able to hold prone extension 10 seconds, supine flexion 14 seconds, head flexion 15 seconds, contralateral 0 seconds, and he is able to do 10 sit ups independently. Media used 1/2 pound weights on ankles and wrists.
Sensory Integration: Jacob's postural control has improved. He is able to stand on his right foot for 15 seconds, and his left for 13 seconds. He is able to knee walk and hold 1/2 kneel position against gravity. He is not able to hop on one foot yet. Jacob will do some hand switching at midline. He does not have a consistent lead foot while galloping or kicking a ball.
VMI: 4/97 AE 4 years 3 months VMI: 4/98 4 years 7 months
Therapeutic Adaptations: None at this time.
Assessment: It appears that Jacob's trunk strength is still delayed. After a few feet of crabwalk, he will bottom out. He is unable to hole the contralateral position. Also, it seems that he tires easily while laying prone on his elbows. Jacob assumes a right handed static tripod grasp. When not in prone position, Jacob will use the scissors in his right hand and cut with pronated wrist. While coloring, he uses only vertical strokes. He is trying to write his name, he is inconsistent with writing left to right and there is some directionality confusion.
Plan: Occupational Therapy to provide 60 minutes of direct therapy per week, with 60 minutes of supervisory time per semester. Emphasis on improving fine motor skills, gross motor skills, separation of upper extremities.
I just got Jake's records and I am seeing that I should have been more diligent in the beginning. I am sharing them because I would like to see the parents of the younger kids get more for their kids. By sharing my experience, I hope to make yours different.
Sherri
This report is from the Dee-Mack School District of Mackinaw, IL. It is a small district that is made up of two towns that have a population of 2,000 combined. They gave Jake some tests when he was three years old and told me that he wasn't "right". They immediately put him into school. At that point, I didn't know that anything was wrong with him. They didn't have the resources to have an autism consultant, but they had human beings working for them and they did all that they could for Jake. They read everything that they could and researched until they found information on PDD-NOS and gave him services based on that.
Speech/Language Evaluation:
Jacob's speech/language evaluation revealed the following:
At C.A. 3-4, receptive language age 2/6, percentile 13; expressive language age 2-4, percentile 10, expressive vocabulary age was 2-11 at C.A. 3-4, percentile 25. Language comprehension scores for the word receptive labels 90%, 2 word labels 80%, 3 word labels 50%, 4 word labels 50%.
Language and social delays representative of pervasive developmental disorder. Lack of rapport with other children, restricted range of interest, strong attachment to objects and Thomas the Tank Engine.
Play-Based Assessment-Speech/Language
Discourse skills were very weak. Some echolalia noted. Repetitive behaviors were noted. Articulation voice and fluency are age appropriate. Semantic knowledge is at the categorical level (2+ years). Sentence structure is simple, with appropriate morphological markers. Great difficulty answering Wh and Yes/No questions.
Motor Skills/Play Based Assessment
Running is awkward. Walking, sitting ok. Couldn't jump off floor. Could alternate feet ascending stairs with support. Threw ball overhand 5 feet, but couldn't catch ball. He could kick stationary ball. Could cut paper, string beads, and work snap beads. Grasp on crayon changed from thumb up to thumb down with fist. Age ranges 18 months-41 months).
Social/Emotional Play Based Assessment
Jacob showed excitement through hand flapping, rocking, and/or tongue wagging. He preferred challenging tasks and was very persistent. He showed many repetitive and perseverative behaviors. Interactions with the facilitator were unusual. He initiates a few interactions and responded to verbal questions and comments about half the time.
Cognitive Play Based Assessment
Cognitive skills were judge to be from 36-48 mths. He used dramatic and constructive play. He did not use interactive play. He named colors, counted up to 12 and seemed to recognize some numerals. Imitation skills are low and turn taking was limited. He attended best to visual stimuli. He could sequence objects by size and understands concept of big.
Occupational Therapy PDMS FM AE 2.9 GM AE 3.0 VMI Raw 5 AE 4.3
Jacob displays a 19 month delay in fine motor and 18 month delay in gross motor skills according to the PDMS. Separation of upper extremity movements during fine motor tasks appeared delayed. Also, trunk strength appeared delayed.
Disability Diagnosis Primary Speech/Language Impaired
Jacob exhibits language and social delays. These impact on his ability to have normal interactions with peers and adults and affect his ability to perform academically up to his own capabilities. Fine and gross motor skills are also delayed.
Current Performance Levels:
Academic
Jacob needs work on labeling body parts, sorting and classifying, answer Wh questions, tracing over lines and symbols, and drawing a picture of himself.
Social/Emotional
Jacob plays mostly by himself and has difficulty staying on task, responding when he is being spoken to, and making eye contact. He also needs work on focusing during circle time.
Independent Functioning
Jacob is not potty trained yet and shows no interest in using the toilet. Jacob also needs work on eating one piece of food at a time and swallowing before he takes another piece of bite.
Sppech/Language/Communications
Jacob exhibits ??? like characteristics. He has made good gains in pragmatic language skills. Eye contact, attention to task, (I can't read the rest except she ends with "pleasant and darling child with signs of some higher level functioning for math and possible sight word reading. He exhibits a verbal language delay. Socialization skills are delayed.
Educational Setting Placements: The goals have percentages and monitoring schedules but I won't put those here.
Special Education Program (more than 50%)
Educational Goals and Short-Term Objectives Plan
Delayed readiness skills
Increase readiness skills
Jacob will label 10 body parts expressively
Jacob will classify objects by 2 categories
Jacob will answer Wh questions
Jacob will trace 1-/+
Jacob will draw a person complete with 5 body parts
Delayed Socialization Skills
Increase socialization skills
Jacob will focus during circle time for 3 minutes building towards 5 minutes
Jacob will focus on an activity for 5 minutes
Jacob will initiate play with one other child.
Jacob will initiate eye contact with one other person
Jacob exhibits receptive-expressive language skills and pragmatic socialization skills
Improve verbal expressions for peer interaction and increased communication
Jacob will answer Wh questions with the aid of pictured clues
Jacob will share toys with others upon request, when appropriate
Jacob will continue to exhibit appropriate eye contact with speaker/listeners
Jacob will give his last name, name of town, street name, birth date and father's first name upon request
Jacob will increase expressive vocabulary and language age scores by 6 months
Jacob will use auxiliary verbs and articles in his conversational speech.
Jacob will respond correctly to yes/no questions
Jacob will respond to simple Wh questions
Jacob will greet other people with "hi" upon request
Jacob will ask another child for an object
Jacob will give another child an object when requested
Jacob will complete the language evaluation as verbalizations increase and attention to task improves
Jacob will look at the speaker when his name is called.
Jacob will use eye contact with the listener
Jacob will attend to real objects and then pictured items when they are being labeled
Jacob will follow directions involving 1, 2, and 3 levels using real objects.
Jacob will categorize 40 pictured items into 4 categories of foods, pets, clothes, and toys.
Jacob will name the items
Gross Motor skills 30 months.
Jacob will do 3 sit0ups independently
Jacob will hold flexor superior position for 10 seconds
Jacob will hold pilot prone position while on a skateboard for 10 seconds with good hip extension
Jacob will pick up 20 beans using a superior piher grasp
Jacob will build a 3 cube design (bridge) without assistance and a demo present
Jacob will string 15 1" beads while prone on elbows
Jacob will cut out an O within 1/4" while prone on elbows.
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