Carlena Lowell

SEI 524 Observation and Intervention Planning

1











Carlena Lowell
Observation and Intervention Planning Project
SEI 524
August 9, 2013











Carlena Lowell
SEI 524 Observation and Intervention Planning
2

*Initials have been used to maintain confidentiality
Background Information
SM is just over fourteen-months-old; she was due to be born June 27, 2012, and
was born just shy of five weeks early on May 26 in Portland, Maine. SM was 19 inches
long and weighed 4 lbs. 9 oz. at birth; however, she dropped to 4 lbs., 3 oz. while in the
NICU. She required a feeding tube only for the first day; from day two on, she breastfed
without difficulty. She spent five days in the NICU, and was then transferred closer to
home to Pen Bay Medical Center for one day. Within two weeks, SM was up to six
pounds. BM reports the doctors in the NICU referred to her as the rock star baby
because she was able to do things many babies born at that gestational age are
generally not able to do.
SM lives in a coastal town with her mother, BM, father, RM, and three dogs,
Cammy, Nautica, and Captain. SMs paternal grandfather lives very close to the family;
both paternal and maternal grandmothers live a bit further away, but visit often. The
private wharf RM lobsters from is connected to their driveway, and BM is a stay-at-
home mother to SM. BM has a background in early childhood education, and was a
preschool teacher for Head Start prior to SMs birth. Since SMs birth, the family has
received service from Parents as Teachers, which is an affiliation of the University of
Maines Cooperative Extension. BM and RM have found this to be incredibly helpful
and informative. SM is now meeting milestones typical with her age. Her gross motor
scores from an ASQ done by their home visitor through Parents as Teachers showed a
slight delay several months ago; however, the most recent screening showed closer to
Carlena Lowell
SEI 524 Observation and Intervention Planning
3

typical development in this area. SM still seems to have some difficulty with her gross
motor skills; however, she is persistent at continuing to try even if she does show some
frustration.
Observations of the Child
I was able to observe SM several times since the start of this class; I videotaped
much more footage than I posted between the two videos. According to Stanley I.
Greenspan and Serena Wieders Functional Emotional Developmental Capacities
(2006), SM exhibits many behaviors discussed in level three, and is emerging into level
four. I will discuss examples from each I observed during my sessions with her.
Level Three
On the first visit, SM was sitting on the floor when I took out my phone and held it up to
begin videotaping the session. As soon I did, SM looked up at me, raised an arm and
outstretched her index finger toward the phone; her other are arm was held straight out
to her side. She was only able to hold her arm up for about three seconds before she
started teetering back and forth; she dropped it and quickly stopped teetering. She then
vocalized, Eeehhh. I talked back about the phone, then lowered it toward her face,
then quickly pulled it back up several times. She responded by quickly smiling, and
maintaining eye contact.
After SM found her dog (discussed under level four), I became animated saying, You
found it! with a big smile, to which she quickly looked at me and laughed.
Carlena Lowell
SEI 524 Observation and Intervention Planning
4

At one point, SM found a thin wipes box and wanted it open. After one unsuccessful try
to get it open, she started vocalizing with a whine. She quickly picked it up, turned to
BM, and held it out for her to open. I brought her attention back to me by helping her
open it. She replied with a small laugh. I shut it again, and she repeated the same
behavior as the first time. When I opened it, again, she quickly laughed. This went on
more than seven times. This was an example of SMs ability to display appropriate
emotions according to the situation. It is also an example of her showing her ability at
long chains of back and forth interactions (level four).
At one point during a session, SM and I read a book with snaps, zippers and strings.
During the reading of this book, SM was distracted by a number of people in the room;
however, when I would say her name and point back at the book, she was able to
redirect her attention to the book again.
SM conveyed various emotions throughout my observations of her including closeness
(with stuffed animals, as well as her mother), assertive curiosity (with an 11-year-old girl
who was at their house), and protest (throwing food she did not want off her high chair
while at the same time letting out shouts of anger). I did not observe her exhibiting fear;
however, BM reports she does.
In addition, SM is able to recover from distress, generally in less than one minute. This
can be seen in the example with the baby wipes box. It was also observed when BM
left the room and went upstairs. SM began to make distressed vocalizations and facials
expressions; however, I was able to redirect her attention and she was able to balance
her attention between me and the stairs in anticipation of BM coming back down.
Carlena Lowell
SEI 524 Observation and Intervention Planning
5

Level Four
BM sat on the couch as I was on the floor with SM and began videotaping. When SM
noticed I was talking to the camera, she quickly turned only her head to be able to see
what I was directing my attention to before turning her entire body. She smiled and
made a series of vocalizations. I began to woof at her using her dog, she smiled, sat
down, scooted toward me and threw her arms up then down. She looked at me several
times throughout, smiling. She then pulled herself back up to the couch looking at BM
and the camera. I was able to woo her back in be woofing with the dog, then hiding the
dog behind my back. She carefully lowered herself to the floor, while holding onto the
couch with one hand. She then used her right arm and hand to steady her balance as
she scooted across the floor in a sitting position, primarily using her right leg.
While playing with her dog, SM grabbed another nearby stuffed bunny and pulled it to
the floor between us. I commented on her bringing someone else for us to play with.
When she got it between us, she looked down at it, then up at me for about 3 seconds,
then down at the bunny again; this indicates SMs ability at coordinated joint attention.
In addition to my own observations, BM shared with me SMs scores from recent
Ages and Stages Questionnaires as filled out by the home visitor from Parents as
Teachers:



Carlena Lowell
SEI 524 Observation and Intervention Planning
6

SM ASQ Scores 2 months 8 months 12 months
6/12/2013
12 month
7/3/2013
Communication 35 50 60 60
Gross motor 60 50 40 50
Fine motor 40 60 60 60
Problem Solving 60 60 60 60
Personal & Social 50 40 60 60

SM was able to improve all of her scores on the ASQs by one year of age with
the exception of the gross motor domain. SMs gross motor abilities can be seen, and
have been noted throughout the observations. When the home visitor administered the
12 month ASQ the first time, SM was not crawling, nor was she able to stand with
guidance from holding an adults hands. By the beginning of July she was able to stand
and balance while holding an adults hands. SM is able to pull to stand; however, does
not do much cruising around the furniture. She is able to get from one point to another
on the floor by scooting (as explained above); however, does not crawl. During my
observations she was able to take steps with guidance from adult hands. Since my
observations of SM, BM reported she took her first steps at just over 14 months.

Goals
Goal One
SM will increase her gross motor skills by being able to cruise around furniture with
ease, as determined by walking the lengths of the furniture in the familys living room to
obtain a desired object, without assistance from an adult.

Carlena Lowell
SEI 524 Observation and Intervention Planning
7

Rationale
I developed this goal to address SMs motor planning abilities. SM is able to
imitate physical gestures and physically indicate desires or needs in order to obtain
them. The next step will be to fluently move her body in space in order to problem
solve. By working toward this goal of cruising the lengths of furniture, she will increase
her gross motor fluency. Moreover, her problem solving abilities will increase as her
gross motor and motor planning abilities increase. With increased motor planning skills,
SM will be able to be more independent and exploratory in her environment, use toys
more functionally, and strengthen her self-help skills. Although she has taken her first
steps, being able to cruise around the furniture will enhance her ability to transition from
scooting on the floor to walking.
Goal Two
SM will increase her ability to solve problems as measured by successfully playing hide
and seek with her mother and father and signing more to indicate a desire for more
food.
Rationale
SM is emerging into level four of the FEDCs. Based on my observations and
play sessions with SM, I selected two specific indicators for this goal in order to increase
SMs shared problem solving skills. When playing with SM, many times I hid something
behind my back or under a blanket. SM was able to find the hidden item the majority of
the times indicating a need to move beyond this simple hiding game. By introducing the
game of hide and seek, not only will SMs problem solving skills increase, but it will
Carlena Lowell
SEI 524 Observation and Intervention Planning
8

provide opportunities for many circles of communication to be opened and closed.
Moreover, hide and seek is a game that can be scaffolded as SMs shared problem
solving abilities strengthen, as outlined under the Interventions section.
When SM is through eating a food in her high chair and is ready for more, she
indicates this by yelling and pointing. By teaching SM to sign the word more to signal
she is ready for more food, the development of both her shared problem solving and
communication skills will be encouraged. Eventually, her use of the sign more will be
able to be generalized to other situations.
Intervention
Throughout the implementation of the interventions, items that are motivating to
SM should be used. For goal one, motivating people such as BM, RM, and her cousin,
S, should be used, as well as motivating toys such as her doggie stuffed animal, her
lambie blanket, balls, and books should be used. For the second goal, highly
motivating people and highly motivating foods should be used.
Goal One
While SM is beginning to cruise the lengths of furniture, it will be important for two
people to be supporting her: one to be the motivator, and one to physically support her
to ensure safety, as well as scaffolding skills. There are several interventions that can
be practiced in order to encourage furniture cruising.
Begin by holding one of SMs hands while she supports herself with her other
arm on the edge of a couch.
Carlena Lowell
SEI 524 Observation and Intervention Planning
9

BM could slowly move around the coffee table as SM cruises along the edge to
chase her mother.
Play with toys on top of the coffee table so that SM needs to steady herself
against it for support; the toys can be moved just out of her reach to encourage
moving along the edge of the table.
Pop up on one side of the couch with a motivating toy, when she gets over to that
side of the couch, someone else will pop up on the other side of the couch to
encourage her to move back to that side. Someone should be prompting her to
cruise along the couch rather than sitting on the floor and scooting to the desired
destination.
As SM becomes more adept at cruising, the levels of prompting need to be faded
to the point where SM is independently cruising around the furniture.
Goal Two
When teaching SM to play hide and seek, BM and RM can do this in stages
according to SMs problem solving skills development. When introducing this game,
one parent can hide while SM is watching. The other parent can then verbally prompt
SM to go find the hiding parent. Once she becomes adept at this version of the game,
the hiding parent can hide without her looking, but in an obvious space so SM is able to
see part of the body. Again the other parent will be verbally prompting. From there the
game can move to the hiding parent completely hiding, with SMs only hint being the
verbal prompting. Eventually, the verbal prompting will be faded out as she becomes
more skillful at the game. By teaching the game in this manner, both parents and SM
are participants, increasing the opportunities for communication circles. These
Carlena Lowell
SEI 524 Observation and Intervention Planning
10

techniques will be catered to SMs Zone of Proximal Development, allowing her to solve
the problem of finding the hiding parent with as minimal prompting as possible.
In order to teach SM the sign for more, the use of a favorite foods will be
motivating and practical; therefore, to teach SM the sign for more, this intervention
should take place at meal or snack time while SM is in her high chair. This sign can be
taught through modeling from the parent, then using prompts to encourage SM to do it.
When SM indicates she is ready for more food by yelling, one of her parents can say,
More. You want more banana, while doing the sign for more in close proximity to SM.
When first introducing the sign for more, SM may need to have hand over hand
prompting in doing the sign. As she learns the skill, the prompting should be faded as
quickly as possible. In addition, as she learns the sign for more, BM and RM can
generalize it to other aspects of SMs life, such as playing. I have suggested beginning
with the sign for more, as this will aid in SMs problem solving techniques surrounding
mealtimes. However, this is also beneficial to SMs communication development as
well.






Carlena Lowell
SEI 524 Observation and Intervention Planning
11

Reference
Greenspan, S.I. & Wieder, S. (2006). Engaging autism. Philadelphia, PA: Da Capo
Press.