Professional Documents
Culture Documents
Logical 3/08,3/07,3/08
Multicaus 3/08,3/07,3/08
al
Grey area 3/08,3/07,3/08
Reflective 3/08,3/07,3/08
03/08 – moments of gleam and a couple of circles
when I get playfully in his way unplug the fan or
stop him from crawling under my desk
09/08 - join and shift the OC on AC to ram into
couch; shift OC on AC to blanket fan; fishing for feet –
flow; malingo toya – making a song – somewhat symbolic
3/09 – calmer and able to cuddle nearly the whole session
with mom, makes possible coaching mom for more
elaboration of circles and some flow with her; can talk about
toes, but not really more symbolic per se.
Axis I – Primary Diagnosis
Axis II - Functional Emotional Developmental Capacities
Axis III‐Regulatory‐Sensory
Processing Capacities
Axis IV‐Language Capacities
Axis V‐Visuospatial Capacities
AxisVI‐Child‐Caregiver and Family Patterns
AxisVII‐Stress
Sensor Postural Response to Intent to Visual Praxis -
y Communicatio Communica Exploration
n te
Sensory Best when core is Cues into important Often Spots fans at distance; Perseverative
seeking, supported words unintelligible ideas; can
fingers in eyes; rare
distractible expand w/
gleam support
7. assess space,
shape and
materials.
Axis I – Primary Diagnosis
Axis II - Functional Emotional Developmental Capacities
Axis III‐Regulatory‐Sensory Processing Capacities
AxisIV‐Language Capacities
AxisV‐Visuospatial Capacities
AxisVI‐Child‐Caregiver and Family
Patterns
AxisVII‐Stress
Learned to quiz him, and quizzing him
Can engage in some back and forth, coachable
Discomfort with him in public –so different from
other kids - improving
Stress: eye issue harrowing, but improving as he
becomes more connected.
MANY OF OUR FAMILIES HAVE A FORM OF PTSD!
Axis I – Primary Diagnosis
Axis II - Functional Emotional Developmental Capacities
Axis III‐Regulatory‐Sensory Processing Capacities
AxisIV‐Language Capacities
AxisV‐Visuospatial Capacities
AxisVI‐Child‐Caregiver and Family Patterns
AxisVII‐Stress
100. Interactive Disorders
200. Regulatory Sensory Processing Disorders
300. Neurodevelopmental
Disorders of Relating and
Communicating
400. Language Disorders
500. Learning Challenges
300.1 Type I: Early Symbolic, with Constrictions ; intermittent capacity for attending,
relating, reciprocal social interaction, including social problem solving, and beginning use of
300.2 Type II: Purposeful Problem Solving, with Constrictions; as above but only
fleeting social problem solving‐tend to make steady, methodical
progress
300.3 Type III: Intermittantly Engaged and Purposeful; only fleeting attention and
engagement, occasional reciprocal social interaction with lots of support ‐ slow,
slow progress
when he has lots of support.
What works: early on getting in the way, modifying
perseveration, getting him on his back, fanning him,
gradually more able to follow his lead, extending
interactions.
What doesn’t work: didactics, adding ideas too
quickly
Why: early on we used the drive of his perseveration to
power interaction, now can often engage him over less
intense things or using shared experiences (little piggies);
position and physical support are still key to his ability to
sustain interaction.
Medications have been very helpful to this child,
allowing him to respond to developmentally supportive
intervention.
Mar 08: we are in a dangerous crisis – dysregulated
and perseverative
Sept 08: with meds and direction to the intervention,
he can be ‘entrained’ into collaborative
interaction
Mar 09: we are confident that with coaching
his capacities will expand
Medication management, and more…
Guiding the whole team, once and
twice removed.
As the prescribing physician I have
responsibility, accountability, and
leverage - they come back
Will you be careful with the meds?
Will you look at the whole picture?
Will you continue to learn and
explore?