Wednesday, March 19, 2014

J is for "Jumping"? No, that's dancing.

After 3 cancellations due to snow, we were finally able to complete our initial screening through the school system. I've had a few people tell me to please keep them updated as we go through this process, but I've been too busy to write up a huge post of my thoughts and feelings. Instead I decided to keep it simple by uploading the written report I received after the meeting. Here we go!

Edit: I originally omitted the information that I provided during interview, but because someone may want to see what kind of information is asked, I decided to go ahead and include that part.
(Omitted child information, examiner information)

Throughout the screening information was gathered from (Bally's mom) and (Bally's maternal grandmother). Some of the information they shared was as follows:
  • (Bally) enjoys watching a TV show where Chinese is spoken. He can now say several words in Chinese and uses them appropriately. For example when asking for juice he will say, "I want (Chinese word for juice)."
  • A previous pediatrician diagnosed (Bally) with ASD. However, there was no formal testing involved.
  • (Bally) enjoys playing on the iPad. He will use a graphic design program to copy and draw various objects. His favorite is Angry Birds.
  • He will stack blocks or legos and then knock them down.
  • He communicates mainly by pulling or taking adults to what he wants. He does use single words. He is very echoic and will repeat things people say as well as repeating things heard on TV. He can also sign the alphabet.
  • He can write the alphabet and knows most of his sister's sight words from kindergarten. While playing in the room he took the magnetic letters and arranged them in alphabetical order.
  • (Bally's mom) gives (Bally) melatonin to help him sleep through the night.
  • (Bally)'s diet consists of: chicken nuggets, pretzels, chips, goldfish crackers, pancakes, waffles, pizza, juice, and flavored milk. ((Not mentioned: the examiner told us that he is likely carb-loading to fuel his insane amounts of energy, and that many with ASD have higher counts of yeast in their digestive tracts, also causing cravings for carbs))
  • (Bally's mom) reported few sensory issues other than wind blowing on him and haircuts.
  • (Bally) loves to squeeze playdoh but doesn't like to touch things that are wet and gooey.
  • She also reported that (Bally) likes to undress. He will take his clothing off several times a day. He will wear shoes but no socks. It is not uncommon for him to be wearing a pull-up, shoes, and hat.
  • (Bally) is not potty trained.
  • His voice quality is odd. His grandmother described it as his "robot talk".
  • (Bally) demonstrated finger stims, head stims, and jumping during the session.
  • (Bally's mom) reported that (Bally) loves to watch music videos and will copy the dance moves that he sees on them.

(Bally) was screened in the Birth Through Five facility at *** Elementary School. He was accompanied to the screening by his mother and his maternal grandmother. They were present during the screening and completed the parent interview portion of the screening at that time. (Bally) entered the room willingly but would not initially sit at the table. He did a lot of jumping and "dancing" at first. He found the ring stack and used the red, green, and orange pieces to play Angry Birds. He used the handle of the assessment tote as the sling shot and tried to knock the green piece off the window sill with the red piece. (Bally) came to the table and sat on the chair for a short period of time. During that time he did not remain seated but either stood on the chair and sat on the table. He was able to complete some of the tasks presented to him but only using prompting and promise of reward (pieces to play Angry Birds or nesting cups). While he was observed to have some higher level skills, such as knowing the letters of the alphabet, he was not able to functionally use these skills in a learning activity. Throughout the screening (Bally) did not respond to his name nor would he make eye contact with the examiner.

The Battelle Developmental Inventory contains items in the following domains: Adaptive, Personal-Social, Communication, Motor and Cognitive. The Adaptive domain assesses the child's abilities in eating, dressing, and toileting. It also looks at a child's ability to perform simple chores and initiate play. In the adaptive domain (Bally) demonstrated a master in the following skills: eating solid food, helping dress himself, asking for food or liquid with words or gestures, and removing his shoes without assistance. Emerging skills included: putting away toys when asked. Skills that he has not yet demonstrated included: using a spoon or other utensil to feed himself, blowing his nose with assistance, and washing and drying his hands without assistance.

The Personal-Social domain assesses the child's ability to interact with adults and peers. It also looks at a child's development of self-awareness, pride, and sensitivity to other's needs. In this domain (Bally) demonstrated master in the following skills: showing a desire for social attention, being aware of his feet, and displaying independent behavior. Emerging skills included: showing awareness of other people. Skills that he has not yet demonstrated included: smiling or vocalizing in response to adult attention, discriminating between  familiar and unfamiliar people, greeting familiar adults spontaneously, initiating social contact with peers in play, and responding positively when familiar adults or adults in authority initiate social contact.

The Communication domain assesses how well a child understands language as well as how well they express themselves through language. In this area (Bally) demonstrated ,mastery in the following skills: following 3 or more familiar verbal commands (using stacking pieces and promise of reward), spontaneously initiating sounds, words or gestures that are associated with objects in the immediate environment, and responding to the prepositions out and on (using the stacking pieces as Angry Birds). Emerging skills included: using 2-word utterances to express meaningful relationships. Skills that he has not yet demonstrated included: responding to who and what questions, using words to relate information about other people, their actions, or their experiences, and responding to where and when questions.

The Motor domain assesses a child's ability to control and use the large and small muscles of the body. In this area (Bally) demonstrated mastery in the following skills: running 10 feet without falling, scribbling linear and/or circular patterns spontaneously, and walking forward 2 or more steps on a line on the floor alternating feet. By parent report (Bally) can stack cube vertically and hop forward on one foot. These skills were scored as "sometimes". Skills that he has not yet demonstrated included: folding a sheet of paper, touching the fingertips of each hand successively with the thumb of the same hand, and drawing a person with 6 parts. (Bally) was not able to attempt any of these skills.

The Cognitive domain assesses a child's ability to attend to his environment and retrieve information from it. It also assesses a child's ability to solve problems and to discriminate object features. In this domain (Bally) demonstrated mastery in the following skills: attending to an ongoing sound or activity for 15 of more seconds, feeling and exploring objects, uncovering a hidden toy, nesting objects inside one another, and naming the colors red, green, and blue (what color is this Angry Bird?). He was able to locate hidden items in a picture scene leveling one with the pictures presented one at a time and verbal prompting throughout the activity. Emerging skills included: finding an object hidden under one or two cups and attending to a game of peek a boo. Skills that he has not yet demonstrated included: looking at/pointing at pictures in a book, locating hidden items in a picture scene level 2, recognizing visual differences among similar numerals and letters, and identifying the picture that is different.

Results of the Battelle Screening indicated scores below those expected for (Bally)'s chronological age in the following domains: Adaptive, Personal-Social, Communication, Motor, and Cognitive. The Total Screening Score was 85 which was an age equivalent of 19 months. This age equivalent also indicated a more than 25% delay. A referral review was scheduled [...] a school psychologist to be in attendance at the meeting.

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