Six-month assessment (final draft)

Kidango Early Intervention Services
Progress Report

Child: Wyatt McLaughlin
Date of Report: June 2009
DOB: 7/8/08
Chronological Age: 11 months
Adjusted Age: 9 months

Background: Wyatt is a delightful, social little boy who loves to interact with people and the world in general. He particularly likes being introduced to new toys and games and is always looking for novel stimuli in his environment. He was born at 32 weeks gestational age with a birth weight of 1690 grams; medical complications include cleft palate, gastroesophageal reflux, and bronchopulmonary dysplasia. For further information, please refer to medical records and other reports. Wyatt lives at home with his parents in Oakland. His mother has a full-time job outside the home; his father works at home and takes care of Wyatt as well.

Kidango Intervention Program: Wyatt has been enrolled in home-based early intervention services since 1/26/09. He receives home visits with Lisa Katzman, Physical Therapist, for up to five hours per month.

Family Concerns & Priorities: Provide Wyatt with the appropriate services to optimize his developmental progress.

Objectives from last IFSP (1/15/09): Within the next six months, Wyatt will:
1. Hold a toy out to show it to his parents – achieved
2. Turn his head easily in either direction and eliminate his head tilt – achieved
3. Eat a variety of pureed and some textured solids (up to 4 oz. per day) – achieved
4. Vocalize and babble /ma/ ba /ga/ and /da/ sounds and use at least one word meaningfully – progressing
5. Sit independently, creep or crawl and attempt to pull to stand – achieved
6. Laugh out loud while playing with his parents and enjoy imitating them in play – achieved
7. Look at pictures in books – achieved
8. Poke with his index finger – achieved.

Assessment Method: Wyatt was evaluated using the Hawaii Early Learning Profile (H.E.L.P.), the Battelle Developmental Inventory, and the Rossetti Infant Toddler Language scale. He was assessed during both self-directed play and structured activities; clinical observations were made and parental report was obtained.

Cognitive Skills (how he thinks and solves problems): Wyatt loves to play with rattles and teething toys by holding, shaking, mouthing, and banging them; he actively uses his hands and mouth for sensory exploration of objects. He bangs toys on any available surface and he gets great pleasure from making as much noise as possible. He plays with paper by pulling, crumpling, and tearing it; he especially enjoys doing this when the paper in question is not meant for play! Wyatt slides and rolls objects on flat surfaces and he is quite fascinated by their movements. He imitates a variety of familiar gestures and is beginning to imitate new and “invisible” gestures as well. He is very responsive to noises and he searches for the source of sounds that are outside his visual field by turning his head, eyes, and body. Wyatt reaches for and holds a small toy in each hand; he reaches for a third object, but usually drops one of the other two in the process. He works for desired, out of reach items by reaching, pivoting, rolling, or stretching. Wyatt overcomes obstacles by creeping over or around them so that he can obtain a specific toy, and then resumes his play. He takes objects out of containers and takes a ring stack apart. Wyatt’s age equivalent in the cognitive area is 9 months in both attention/memory and perception/concepts skills.

Goals: Within six months, Wyatt will:
1. Reassemble two or more nesting cups
2. Place one or more objects inside a container.

Expressive Language Skills (how he communicates): Wyatt vocalizes in response to singing and objects that move; he uses sounds to express pleasure and displeasure and to gain attention. He shows how he feels by changing the tone of his voice, and he uses whining as a way to get what he wants. Wyatt laughs and babbles; he engages in turn-taking vocalizations with familiar adults, either as the leader or follower. He demonstrates sound play when he is alone or with other people. He interacts with adults by attempting to gain eye contact, than smiling joyfully. Wyatt vocalizes at least two different syllables (“ma” and “ga”), strings two or more of those syllables together, and uses several other sounds, including /ah/, /m/, /g/, /b/, and /h/. He also imitates some duplicated syllables, such as “mama” and “gaga.” He is very social and loves to communicate with others through his sounds, facial expressions, and body language. Wyatt’s expressive language skills are solid in the 3-6 month age range, with emerging skills in the 6-9 month age range.

Goals: Within six months, Wyatt will:
1. Use more consonants and consonant-vowel combinations in his vocalizations
2. Imitate more sounds and syllables.

Receptive Language Skills (what he understands): Wyatt quiets to the familiar voices of his parents; he enjoys hearing his grandparents speak, either in person or on the telephone. He moves in response to voices, shows awareness of a speaker, and attends to other voices. He turns his head toward a familiar voice, searches for the speaker, and watches the mouth of the person that is talking. Wyatt discriminates between different tones of voice, attends to music and singing, and responds to sounds when the source if not visible. He is learning to recognize his own name and currently responds to the tone of voice used more than the name itself. He responds by lifting his arms when someone asks if he wants to be picked up; he opens his mouth to show that he wants food or liquid. Wyatt’s receptive language skills are solid in the 0-3 month age range, with scattered skills up to the 6-9 month age range.

Goals: Within six months, Wyatt will:
1. Wave in response to someone saying “bye bye” to him
2. Show that he recognizes names of family members by searching for the appropriate person.

Gross Motor Skills (how he moves his body) and Fine Motor Skills (how he uses his hands and eyes): Wyatt has made tremendous progress in this area over the reporting period. While lying on his stomach, he lifts his head to 90 degrees, bears weight on his forearms, and pushes up to extended elbows. He rolls from side to side and from tummy to back without help. While lying on his back, Wyatt brings his hands and head to midline, lifts his feet to his mouth, and raises his hips by pushing with his feet. He needs a little help to move from side lying to sitting, but he transitions from tummy to hands/knees and then to sitting independently. He now uses creeping on hands and knees as his primary mobility method! Wyatt’s head and trunk control have really improved, and he can balance in sitting for extended periods of time without hand support. He pulls to standing by himself at the couch and in other places with help; he loves to do so using his parents’ clothing and/or bodies. Once Wyatt is in a standing position, he can balance with support at his hips. He is learning to move from sitting to standing, to balance in squatting, and to take steps with support. Wyatt’s age equivalent in the gross motor area is 9 months.

Wyatt has good functional use of his eyes, and he tracks people and objects in all planes of movement. He makes and sustains eye contact frequently with other people and he responds joyfully when he makes eye contact with his parents. He studies our faces and mouths often now, with particular attention to changes of expression or sound. Wyatt uses a variety of grasps, depending upon the size of the object, including palmar, radial palmar, and radial digital grasps. He uses raking, an inferior pincer grasp, or neat pincer grasp in order to pick up tiny items; fine motor controlled in more refined in the right hand than in the left. He reaches for objects with one or both hands, and he has no difficulty grasping a small toy in each hand for an extended period of time. Wyatt clasps his hands together and easily transfers items from one hand to the other. He loves to bang, shake, pat, and drop toys and gets a lot of pleasure from the noises that he makes with them. Wyatt’s age equivalent in the fine motor area is 9 months.

Goals: Within six months, Wyatt will:
1. Cruise around and between low pieces of furniture
2. Walk for a few steps without help
3. Use a neat pincer grasp on either side to pick up tiny objects
4. Stack two or more blocks, cups, or rings.

Social - Emotional Skills (how he interacts with others and expresses his feelings): Wyatt recognizes and loves to socialize with his family members; he greets his parents happily whenever they enter the room and lifts his arms so that they will hold him. He tends to be a little more cautious and slower to interact with less familiar people. Wyatt loves to explore adult facial features by touching, poking, probing, and patting; unfortunately, this doesn’t always feel good to the recipient of his attention! He is beginning to explore the environment enthusiastically, and safety precautions are becoming more important. He loves to interact with the family’s cat, and will pursue her until she hides under the coffee table where he is unable to reach her; he becomes very upset when he is unable to creep under the table after her! Wyatt inspects and observes his own hands, and he enjoys playing with his fingers, feet, and toes. He stares intently at a mirror, reaches toward it, and watches as his mirror image moves. He laughs, squeals, and vocalizes attitudes of pleasure and displeasure by changing his tone of voice, facial expressions, and body language. Wyatt seems to like all people, objects, and places and does not yet show clear dislike for anything. He responds to changes in others’ facial expressions and tries to understand what the speaker’s emotional intent might be. He demands social attention, enjoys frolic play, and is beginning to participate in simple cooperative games. Wyatt’s age equivalents in the personal-social area are 10 months in adult interaction skills and 6 months in self-concept/social role skills.

Goals: Within six months, Wyatt will:
1. Consistently respond to his name
2. Give a toy to a familiar adult spontaneously or upon request.

Self - Help Skills (how he eats, sleeps, and takes care of his needs): Wyatt coordinates sucking, swallowing, and breathing well. He recognizes the bottle and places both hands on his parents’ fingers or hands while he is drinking from it, without actually supporting the bottle. He swallows strained or pureed foods, and has been progressing toward thicker foods as well. Wyatt uses his tongue to move food in his mouth and his lips to clear food from a spoon; he mouths and munches soft solid foods. Thus far, his diet includes Cheerios, Gerber puffs, beans, chicken, rice, and tofu; he has eaten a fairly wide variety of fruits and vegetables as well. He cooperates with dressing by extending his arms and legs; Wyatt sleeps through the night and takes one or two naps each day; however, he fights going to sleep even though his parents use a consistent routine. His age equivalent in the self-care area is 10 months.

Goals: Within six months, Wyatt will:
1. Finger-feed himself more types of food
2. Scoop food and feed himself using a spoon with help as needed
3. Drink from an open-rim cup with less help.

Summary: Wyatt is a charming, engaging little boy who enjoys and benefits from home-based early intervention services. He has made wonderful progress in all areas of development, with speech/language skills being of greatest concern at this time. His parents provide him with a warm, nurturing home environment where he is free to learn and explore with their support. It is a pleasure working with Wyatt and his family. If there are questions regarding this report or the services that are being provided, please feel free to contact me at (510) 656-3949, extension 304.

Recommendations:
1. Continue early intervention services via home visits for up to five hours per month
2. Monitor vision and hearing status.

We have participated in the development and discussion of this progress report. We agree with and support the outcomes and services indicated in this assessment of Wyatt McLaughlin.


_____________________________________ _______________
Parent/ Guardian Date



_____________________________________ _______________
Lisa Katzman, MS, PT Date
Physical Therapist
Early Intervention Specialist