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GAGE PRE-INTERVENTION ASSESSMENT REPORT

Ed 425 (Strategies)
February 17, 2018
Demographics

Child’s Name: Gage Eddins


School: Henry’s Fork Elementary
Grade: Preschool
Date of Birth: 11/19/2012
Age: 5 years old
Phone: (208) 270-6656
Address: 236 West Main St. Parker, Saint Anthony, ID, 83445
Parent/ Guardian: Suzanne Eddins
Evaluation Date: May 28, 2011
Evaluator: Arianna Birth, Michelle Spurling, and Brandi Zollinger
How you know or acquire the examinee: Class Referral

Reason for Referral

Gage was referred for a case study through a strategies class at Brigham Young
University- Idaho from a special education preschool classroom at Henry’s Fork
Elementary. Mrs. Eddins voluntarily signed up to have Gage participate in this program.
Mrs. Eddins has expressed concern that Gage be given interventions to assist his
development with communication and behavior.

Background Information

Developmental History

Gage lives with his mother, infant brother, grandparents, three aunts, one uncle, and his
infant cousin. Gage’s parents are divorced and although we are not sure of the custody
rights, his mother has told us that Gage goes to visit his dad. He has been able to meet all
developmental milestones in the cognitive, social/emotional, and adaptive domains. His
mom spent a couple of years away from Gage, and he spent the time with his
grandparents. During this time, he met no communication milestones. The family reports
that it was only after his mother came back that he started to talk to develop his
communication skills.

Medical History

Gage is currently undergoing testing to see if he can be diagnosed with autism. Gage’s
mom says that he has IBS but other than that, has had no other serious medical
conditions. Gage has no documented hearing or vision issues, he is not on any current
medication, and has had no relevant medical procedures.
Educational History

Gage is enrolled in the Preschool at Henry’s Fork Elementary School in Saint Anthony.
He receives speech services and occupational therapy at Rexburg Rehab.