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PRE-INTERVENTION ASSESSMENT REPORT

Taneesha Bales
Ed 425 (Strategies)
October 17, 2017

Demographics:

Child’s Name: *******

School: N/A
Date of Birth: 6/14/ 2016
Age: 15 months
Phone: ************
Address: ***********
Parent/ Guardian: *******
Evaluation Date: October 3-17, 2017
Evaluator: Taneesha Bales
How you know or acquire the examinee: Class Referral

Reason for Referral:

Porter was referred for a case study through Brigham Young University-Idaho Strategies class.
He has not been in this service previously; so this is a new experience for him and his family.
Porter’s parents are concerned about Porter being developmentally delayed in walking and also
his language skills. They are seeking help in these areas before Porter gets too behind.

Porter will be tested through an assessment called the Vineland-II for all five developmental
domains (Physical, Communication, Self Help, Social Emotional and Cognition). Other sources
of assessment will be home observations as well as interviewing parents in order to determine
what areas of growth are the most important to focus on.

Background Information:

Developmental History

Porter’s mother had a normal pregnancy with no complications. However, She was tested
for Down syndrome while she was pregnant. As a result, they found out that Porter did
indeed have Down syndrome before he was born. Porter has a close family and lives at
home with his mother Liz while his father Dave works during the day. Porter has two older
siblings named Bailey who is five and Emmett who is six and half. They love him and play
with him daily. Liz is also expecting in March.

Social/Emotional History

Porter is generally a happy and content child. He is very easy going and is flexible with
daily routines. He goes to bed easily and bath time is smooth. Porter does however; need to
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be bottle-fed every night. Porter plays well with his siblings and has a healthy attachment
with his parents. He goes to strangers easily and is friendly with extended family.

Medical History

Porter was diagnosed with Down syndrome before he was born. He also developed a
clubfoot and had casts on his foot at 2 months old. Following that he has been wearing
braces, even though he doesn’t like them. Porter also has had his tonsils removed and tubes
in his ears.

Educational History

Porter receives occupational therapy services in the home in which they are working on
walking and holding a bottle on his own. Porter does not attend any other schooling or early
intervention facilities. However, Liz does both preschool and piano lessons in her home, and
Porter gets some social interaction and music during those times.

Observations

Porter is able to sit up independently and army crawl to get from place to place. This was
observed in the home when Porter army crawled to his mom to get a toy. However, he does
not yet crawl on his hands and knees. Porter does not stand up on his own or take any steps.
However in the interview Liz tells us that Porter does pull himself up to the couch and the
fireplace.

Porter also demonstrates some fine motor skills such as grasping a pencil. During the home
observation, Porter was able to scribble on a paper when given a pencil. He was also able to
pick up a toy block with one hand and transfer it with to the other hand in a hand off. Porter
is not able to hold a bottle up to his mouth. He was able to pick up the blocks with both his
left and right hand. According to the developmental checklist, Porter turns over container to
pour out contents.

Porter smiled several times throughout the observations. He interacts with his siblings
several times during the observation by wrestling and singing pat-a-cake. He did cry once
when Porter got flipped over and hit his head on the ground, during the observation. Porter
goes to mom when his name was being called. He also, clapped his hands when his sister
Bailey clapped her hands.

He was also able to track his mom with his eyes as she left the room. Porter was able to
identify his eyes and nose during the observation with a verbal prompt. In the interview, Liz
stated that Porter does not say any words; however, he does use two syllable words. This
was also observed when Porter said ‘dada.’ Porter also turns his head when he heard his
mother call his name twice. Porter was able to make eye contact with his sister four times
during a 10 minute interaction. In the interview, it was reported that Porter does not identify
objects from pictures.
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Results of Interviews

Routine Based Interview

The first routine that we talked about was breakfast. While Liz makes breakfast in the morning,
the younger ones may be watching a show. It is mostly Emmett that needs to be fully ready for
the day, as he is going to school. According to Liz, Porter does well in this routine, and it is the
other two children that require more attention. Her concern is giving Porter proper attention and
getting the other two children to school on time.

Liz normally drives Emmett (her eldest) to school. She will also carpool with a neighbor. When
it is her turn to take the children, Porter and Bailey come with. Emmett use to have afternoon
preschool, so she says getting up earlier and being ready in the morning has been an adjustment
and at times, a challenge. This is one of her concerns and more stressful parts of her day.

Liz holds a bachelors in education and holds preschool in her own home for her daughter Bailey.
She does this with a few friends who take turns teaching it to all of their preschoolers. Porter is
present during this time and the other moms help with him. Bailey says she enjoys preschool,
and loves to play with her little brother. This routine seems to work well and Liz likes that
Porter gets social interaction with other people.

Occupational therapist comes once a month to help Porter practice walking skills, stretch his
clubfoot, and hold a bottle on his own. Liz says it is difficult to find time to practice Porter’s
gross motor skills. She expresses that she is worried that once a month of occupational therapy is
not enough. Porter cries often during occupational therapy.

Liz also teaches piano on Wednesdays and Thursdays. Normally, her students come in families,
so the eldest about 12-13 years olds, helps with Porter during the younger children’s lessons. Liz
says that this routine can be stressful because she is having more students come in and want to
have lessons, and she isn’t sure where to fit them. However, Liz does like that Porter gets social
interaction with other people during piano, and she also enjoys teaching. Porter does well with
the other children during this time.

Porter cannot spoon feed himself and Liz and David take care of feeding him during this time.
Porter also doesn’t hand feed himself very much either. Liz expressed that she finds this routine
stressful because she cannot pay as much attention to other children. Also, both of her other
children has type 1 diabetes. Liz says that her children are not picky, but it can sometimes take
longer to prepare dinner due to having to watch the blood sugar levels.

Porter sleeps well at night. Liz normally rocks Porter to sleep after feeding him his bottle. Porter
does not hold his bottle on his own. This is one of the goals that Liz would like to work on.
Porter goes to bed around 8-8:30.
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Tests Administered

Routine Based Interview (RBI), Informal administered September 19, 2017

Trial/Intervention, Informal administered October 3, 2017
Vineland-11, Formal administered September, 26, 2017
Vineland
Raw Score Standard Percentile Rank
Communication 63 1
Receptive 16
Expressive 13
Daily Living Skills 67 1
Personal 10
Socialization 82 12
Interpersonal Relationships 22
Play and Leisure 14
Motor Development 62 1
Gross Motor 14
Fine Motor 18

Summary of Trial Intervention

Goal 1 Fine motor skills of grasping his cup and holding it up to get a drink.
Goal 2 walking and standing
Goal 3 identifying objects

Goal 1
This was one of our more successful trial interventions. We were attempting to help
Porter hold his cup and drink out of it on his own. We put beans in his bottle so that it would
make a noise. We did this in hopes that Porter might practice the fine motor skills to grasp the
bottle. This worked well; however, he was still unsuccessful. We then did hand over hand, which
was successful. Our visual cue of tapping the bottle encouraged Porter to lift up the bottle;
however, he didn’t drink it. The most successful thing that we did was to put Porter in a reclining
position. He was able to successfully lift his hands and drink his bottle for a moment.
Goal 2
During this trial intervention, we attempted to get Porter to stand and walk by himself.
We began by holding Porter by the waist and seeing if he would be able to stand. Then we
started trying to get him to walk by tapping his knee for a visual cue. We placed some of his
favorite toys and exciting objects approximately three feet in front of him. The goal was for him
to get to those toys by walking independently. Katie directly modeled for Porter by walking right
in front of him. Then we did hand over hand prompting by holding his hands and helping him
walk forward. This was when Porter was successful. Porter was quite engaged in this activity.
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Though he didn’t respond to direct modeling or direct verbal prompts, he did begin to start
moving his leg at the visual cue. Then, as we walked him along with his hands, we were able to
help Porter be successful.
Goal 3
This intervention was fairly simple. We wanted Porter to identify his eye by a direct
verbal prompt. Porter can already identify his nose; so we thought this could help him get some
range in his receptive language. Porter was successful at almost every level. We modeled,
verbalized the prompt, added visual cues by touching his eyes and ours. Porter was able to
identify his eyes at all of these levels separately.

Interpretation and Present Levels

Cognitive

From observations, interviews, and informal testing, Porter’s cognitive levels are below the
developmental milestones for a child his age. According to the developmental checklist, Porter
can recognize family members and interact by waving and singing songs. Porter is beginning to
identify objects and pictures in books and in his surroundings. If Porter continues to fall behind
in the cognition domain, he will fall behind in future schooling and education.

Porter is able to independently:

o Imitates gestures such as waving
o Engages in simple songs such as Pat-a-Cake and Peek-a-Boo
o Explores objects in different ways such as banging, throwing, chewing, dropping
Porter sometimes/ with help:
o Find object under one or two hidden covers
o Listen to a story for 10-15 minutes
o Identify objects in as pictures

Porter has yet to:

o Follow two step directions
o Identify multiple body parts (he can do one)
o Begin to sort shape or colors

Social/Emotional

From observations, interviews, and informal testing, Porter shows below average behavior in the
social and emotional domain of development. . In the Vineland-II, Porter is in the 12th percentile,
which means he is performing as well as or better than 12 out of 100 of his peers. Porter interacts
with his siblings for several minutes and play by wrestling and singing songs. He also is able to
push them away or cry when he feels hurt or they are becoming too rough with him. If Porter can
continue to progress in this domain, he can make friends easier and learn social cues.
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Porter is able to independently:

o Looks toward parent when hearing his parent’ voice
o Responds appropriately with three basic gestures
o Shows affection to familiar faces
Porter sometimes/ with help:
o Cries when parent leave
o Prefers mom or dad over other caregivers
o Tests parents at bedtime
Porter has yet to:
o Initiate play with peers or siblings
o Parallel play or model after peers
o Take turns with others
Adaptive

From observations, interviews, and informal testing, Porter exhibits behavior that is lower than
the adaptive behavior that is typically shown at this age. . In the Vineland-II, Porter is in the 1st
percentile, which means he is performing as well as or better than 1 out of 100 of his peers.
Porter is able to self-feed himself with crackers or other finger foods. He is also able to cry when
he is hungry or tired. Porter cannot yet hold his own cup and drink from it. Porter also cannot yet
use a spoon to feed himself. If Porter does not progress in the adaptive domain, he may need aids
or extra attention in schooling for self help needs such as eating and toileting.

Porter is able to independently:

o Sucks or chews on finger foods such as crackers and cookies
o Puts arms in when putting on his shirt
o Eats solid foods such as mashed potatoes and cooked vegetables
Porter sometimes:
o Hold his bottle and raises it to his mouth, but doesn’t suck
o Will drink bottle with assistance
o Allow his face to be washed or wiped
Porter has yet to:
o Feeds himself with a spoon
o Removes socks and shoes independently
o Drinks from a regular cup without a nipple

Motor

From observations, interviews, and informal testing, Porter is in the below average range for
motor development. . In the Vineland-II, Porter is in the 1st percentile, which means he is
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performing as well as or better than 1 out of 100 of his peers. Porter has not yet learned to walk
or stand. However, he does use army crawling to get from place to place. Porter scored higher in
the fine motor section by two points over the gross motor section. He is able to scribble with a
pencil on paper. He is also able to pick up small objects and transfer them from hand to hand. If
Porter does not progress in this domain he may have trouble participating in activities with his
peers.

Porter is able to independently:

o Sits unsupported for several minutes at a time (10 minutes)
o Moves, scoots, or crawls across the floor (army crawling)
o Reach for a toy or object
Porter sometimes with:
o Stand holding on to an edge for two minutes
o Stands with some support of one hand
o Turn pages in books both hardback and paperback
Porter has yet to:
o Crawl up the stairs
o Stand unsupported for one minute
o Unwrap small objects

Language

From observations, interviews, and informal testing, Porter is performing at a lower language
competency than that of other peers his age. . In the Vineland-II, Porter is in the 1st percentile,
which means he is performing as well as or better than 1 out of 100 of his peers. Porter is able to
recognize his own name; he also says two syllable nonsense words such as ‘dada’ or ‘baba.’
According to the interview, Porter does not yet follow one step directions. If Porter continues to
fall behind in language, his oral language will debilitate his social skills.

Porter is able to independently:

o Look and recognize when his name is being said
o Looks toward parent when hearing his parent’ voice
o Responds appropriately with three basic gestures
o Understands at least 10 words
Porter can sometimes:
o Use sign language to communicate wants and needs such as ‘more, water, thank
you, please, juice, cracker.’
o Come to mom when she asks
o Wave hello and goodbye from a direct verbal prompt
Porter has yet to:
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o Use verbal words to communicate wants and needs

o Understand
o Participate in reading stories aloud with an adult for 20 minutes

Recommendations

Through the skills observed and tested in both lab and home through the assessments,
observations, and interviews, it has been concluded that Porter is performing two standard
deviations below the mean in the motor, language, and adaptive domains. Specifically tested,
Porter was found in the 1st percentile rank in the motor domain in the Vineland-II. He was also
found in the 1st percentile rank for adaptive and language domains also in the Vineland-II (the 1st
percentile, meaning he performed as well as or better than 1 out of 100 of his peers). Because
Porter was medically identified with a genetic condition of having the extra 21 chromosome, he
has been diagnosed with Down syndrome which is covered under the intellectual disability in
IDEA. With this standard, Porter is eligible for Part C services and should be involved in early
intervention strategies and speech therapy. An IFSP should be created by professionals and
implemented in interventions as soon as possible.

Examples of specific intervention activities include:

o Continue to do home visits and participate in physical therapy
o Begin speech therapy with Porter ASAP
o Asses and monitor Porter’s progress routinely
o Begin implementing sign language in daily language prompts beginning at the least
intrusive stages.
o Helping Porter match picture cards to the corresponding oral word prompt. For example,
Porter where is the car? And Porter could point to the car.
o Have Porter help with bottle feeding by propping him up in a more slanted position.
Continue to practice fine motor skills that reflect the same grasping and lifting of the
arms motion.
o Sing, read books, and expose Porter to other children and people.

Summary

Porter is a 15-month-old little boy who is delayed in communication skills such as expressive
language. He is also showing atypical development in the social and emotional domain. Finally,
Porter is not exhibiting very many self-help or adaptive skills. Through the testing, interviews,
and observations, we can conclude Jace is performing below average in the communication,
social emotional, motor and self-help domains. Specific formal tests used to determine this were
the Vineland II. Other informal testing included an RBI, interview, and trial intervention
strategy. Porter is eligible for special services because he has been medically diagnosed with
Down syndrome. It is recommended that he is deemed eligible for Part C services, physcial
therapy, early intervention, and an IFSP.

Signature Line: Taneeha Bales

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