While I have documentation of all her preschool goals and accomplishments, I don’t have the time to go into all that detail. So instead I will focus on her final goals and transitions from preschool to Kindergarten.
Goal #1 – Physical Therapy
By April 2014, when in various sitting positions, Bella will maintain prop sitting for 30secs, on 2 out of 3 days.
Progress 5/30/13 – Bella is able to maintain prop in sitting for 5 seconds on 2/3 days – Bella has demonstrated ability to sit up Independent with good posture for 15 seconds on one data day, most often she maintains good sitting balance for approx 5 seconds. This is a recent IEP goal, so minimal PT data available.
Short Term goal 10/11/13 – Bella will maintain prop sitting for 10 secs, on 2 out 3 data days.
Goal #2 – Occupational Therapy/Speech Therapy
By April 2014, using a Step by Step Communicator Switch, Bella will request continuation of 3 items/activities, with 80% accuracy with no more than 5 prompts.
Past data – Bella continues to use the switch consistently for food and now has expanded her requesting to continuation of a preferred activity. She activates the switch to request the continuation of swinging with 74% accuracy with no more than 2 prompts.
Progress 5/30/2013 – Completed – Average 72% with 2 1/2 prompts, swinging and requesting “more tickle” using her communication switch.
Goal #3 – Occupation Therapy/Feeding/Physical Therapy
By April 2014, with physical support at elbow and spoon attached to her hand, Bella will move a loaded spoon to her mouth, 8/10 opportunities.
Past data – On her most recent data day, Bella performed this skill 6 times for every 10 opportunities. However, she demonstrates inconsistency among data days, with her March 2013 average being 3/10.
Progress 5/30/13 – 5 out of 10, Bella has had great progress this quarter. She has started responding better to consecutive attempts at self-feeding, which is exciting to see! Great job, Bella!
Short Term Goal 10/11/13 – Bella will move a loaded spoon to her mouth, 6/10 opportunities.
Goal #4 – Physical Therapy
By September 2013, when in various positions, Bella will maintain head in upright position, for 60 secs, on 2 out of 3 data days.
Past data- Bella’s head control is inconsistent but on an average since school started she is holding head up 13 secs. In May 2012 she was holding head up on an average of 25 secs.
Progress 5/30/13 – No progress made – Bella continues to fluctuate with head control averaging 10 seconds, has demonstrated the ability to maintain head control for 90 seconds one time.
Short Term Goal – The goal of head control has been on Bella’s IEP for the past 4 years with no progress being made. This goal will still be worked on, but will no longer be part of her IEP curriculum or be tested.
Summary of Present Levels of Academic Achievement and Functional Performance
Long Range Vision: For Bella to self-feed and have more interaction with peers, adults, and toys.
Isabelle (Bella) is a 5 year, 7 month old girl who has attended the ECSE program since September 2010. She lives at home with her parents and younger brother.
PT: Bella still uses a KidKart wheelchair as her means of transportation. She is dependent on adults for transfers and positioning. She also has AFO’s that are used to provide her with support for the low tone in her ankles and feet. Bella uses a Leekey stander parents have loaned us from home. She also wears a Benik vest to provide some trunk support. Bella continues to grow and head control remains unchanged. She still periodically turns head to right and stacks head back to the left. Tried cervical collar but she became dependent on it. She has held her head up for up to 90 secs but on a average she is maintaining for 10 sec. Bella continues to have very low tone throughout her body from head to toe. We have worked more on her prop sitting when on the floor – this also works on her head control. When in criss cross or circle sitting on the floor, support is provided at hips and occasional assist is needed to place her arms on her knees or on the floor and she is able to support herself in sitting for up to 3 secs. Also work with Bella on her tummy; usually on a wedge so she can prop with her forearms and hold head up briefly. Elbow splints have been used when trying to prop in prone. When placed supine on her back on the floor she enjoys stretching out, kicking her legs, rolling to both sides, and reaching with hands.
Communication: Bella uses the Step by Step Communicator Switch to request objects and actions. She activates the switch (placed on the left side of her tray) to request for more food (“More please”). The switch is also used to communicate continuation of swinging and “rough housing”. The swing used is an adaptive, high-back, harness swing which has become a morning routine for Bella to start her day. She becomes very vocal during this time, displaying smiles and laughter. Bella vocally protests when the swinging comes to an end by making growling noises and vowelized vocalizations. She is observed to “smack” the switch for continuation of swinging with 74% accuracy with 4 prompts. On our last data collection day, prior to this report, Bella activated the switch 8 out of 10 opportunities with only 1 prompt. More laughter and smiles occur during a spinning movement of the swing as opposed to a back and forth movement. The switch follows Bella to group times as well as play time. The recording is changed to match the task at hand, so that Bella is responding as her peers do. This allows her peers to view Bella as an active participant throughout the school day.
Circle: Bella sits at circle time with her peers with an adult seated behind her to offer physical support. She is encouraged to participate in circle activities by utilizing a switch to respond to questions or perform a daily job. At times, Bella will become very vocal during this large group time. She is usually positioned to the right of the speaker or activity in order to encourage her to keep her head in an upright, midline position.
During large group time, various forms of stimuli have been presented to Bella to observe reactions (noise of a blender, loud noises of vehicles from a recording of the city, a balloon deflating, wind of a fan, scarf on her face, bubbles on her skin and varying temperatures of hot and cold, bubbles on her skin, colorful pictures, new faces). A reaction of “closing eyes” was seen for everything that was auditory – the louder the stimuli, the tighter the eyes shut, and the longer they remained closed. When the stimuli was tactile in nature, furrowing of the brow was noticed. Finally, when the stimuli was visual, no real reactions were noted.
Snack: Bella uses a specialized cup with a straw (adult pushes on the top and water will squirt out of the straw into her mouth.) and eats thickened food (consistency of oatmeal or applesauce) during snack time. The team has been working on improving Bella’s participation during snack time by attaching a spoon to her right hand with Velcro to support her ability to maintain her grasp. With physical support at the elbow level, an adult encourages Bella to move the loaded spoon to her mouth for a bite. In Oct. 2012, Bella was averaging 3/10 opportunities. She has made progress with this goal, with her most recent data day being 6 times for every 10 opportunities. Some days, Bella will protest during this time and, as a result, her success rate decreases. When an adult feeds her with a spoon intermittently during snack, Bella has been observed to have more success with it’s her turn to do so.
Bathroom: At this time, Bella wears diapers and requires full assistance during changing.
Play: During play, Bella independently grasps preferred items, especially noise-making toys. While lying on the floor, she enjoys rolling from side to side and reaching for various items. Bella has been observed to use mostly her right hand when grasping objects but will utilize her left hand if an adult facilitates it. She has been observed to turn towards a noise-making toy and maintain visual attention to the object as she reaches for it.
Strengths of Student
ability to use voice output device to request
happy child with a great laugh
eye contact is emerging
Parent Concerns for Enhancing the Student’s Education
self feeding
increased use of both hands
better eye contact
sleep
And that folks is Bella.
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