week 3 assignment 2

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Evaluation Report: Jeremy

Identifying Information

Name: Jeremy Age: 4 Grade: Preschool

Reason for Referral

Jeremy was diagnosed with Pervasive Developmental Disorder/Autism at two years and ten months of age. The diagnosis was made after his parents became concerned just after his second birthday. In a matter of weeks Jeremy had stopped using the twenty words he had previously learned. He no longer showed any interest in his parents or toys. Although his eye contact was never as good as his parents thought appropriate, he now refused to look directly at anyone. He began throwing and lining up toys, and spinning objects. He preferred to spend his time bouncing repetitively in place and flapping his hands and fingers. Whenever his parents tried to intervene, Jeremy would scream, cry, bite his hand, and bang his head on the floor again and again.

Professionals at a developmental disabilities clinic at an area hospital assessed Jeremy and arrived at a diagnosis of childhood autism based on his developmental history (significant loss of skills around his second birthday), a score of 58 (severely autistic) on the Childhood Autism Rating Scale, and consultations with a speech therapist and occupational therapist.

Jeremy was enrolled in a self-contained early childhood and special education classroom located in his local school district at age three. His language, fine motor, self-care, and social skills were assessed and found to be at the twelve- to eighteen- month developmental level. Jeremy’s gross motor skills were determined to be age appropriate. Last year he attended the special program in the mornings only.

This year, Jeremy attends the self-contained classroom in the morning and a general preschool program in the afternoon. He also receives private speech and sensory integration therapy and participates in private piano and swimming lessons. Jeremy’s educational team agreed that next year he should attend a full-day integrated Montessori kindergarten class. Twenty typically developing children and six children with disabilities are enrolled in the Montessori classroom. Four adults currently manage this classroom: a teacher specially trained to set up and teach using Montessori methods and curricula, a teacher assistant with some Montessori training, an early childhood special education teacher, and a special education teacher assistant. This team of teachers often consults with speech, occupational, and physical therapists to ensure they are meeting the individual needs of students in the class.

Test Results

The most recent evaluation was conducted when Jeremy was four years and two months old. The results were: language skills, 23 months; social skills, 30 months; fine motor, 36 months; cognition, 48 months; gross motor, 42 months; and self-care, 42 months. The Child Autism Rating Scale was also administered, and this time Jeremy received a score of 35 (mildly- moderately autistic).

Observations from Teachers and Test Administrators

Speech/Language Skills

Jeremy repeats single words and cliché phrases. He expresses his desires and needs with single words. He uses two- to three-word phrases when prompted. He inconsistently answers simple yes-and-no questions. Receptively, he follows simple one- and two-step directions. Jeremy listens to short stories and can use pictures to sequence up to three events in the order they occurred in the story.

Social Skills

Jeremy is beginning to play appropriately with some toys, but he usually prefers to play with the same toys every day. He has difficulty selecting play items and transitioning from one activity to another. He needs constant adult attention and reinforcement to remain engaged during free playtime. He sometimes bounces in place repetitively until redirected. Although Jeremy prefers to play in areas without his peers, he often refuses to enter a play area unless an adult is beside him. He has begun to greet familiar people, including several peers, and sometimes makes unprompted eye contact when greeting or requesting.

Fine Motor Skills

Jeremy uses a variety of writing tools, but needs to be reminded to hold the tool correctly. He prints the letter “J” for his name. He has difficulty with tasks requiring the simultaneous use of both of his hands. He has difficulty crossing midline during specific fine motor tasks. Jeremy is beginning to explore materials such as finger paint, sand, and rice. He needs assistance with scissors. Jeremy manipulates blocks, one-inch pegs, and noninterlocking puzzles.

Cognitive Skills

Jeremy performs cognitive tasks at age level when provided with materials that allow him to give a nonverbal response. For example, he categorizes items by color, shape, size, and use. By pointing, Jeremy identifies pictures of items that are soft, hard, rough, big, small, tall, short, and long. He can order up to five items by size without a model. Jeremy identifies same and different, parts of a whole that are missing, and what comes next in a sequence of three pictures. Jeremy identifies all upper- and lowercase letters of the alphabet and matches three- and four- letter words with their corresponding pictures. Jeremy reads simple sentences such as, “The car

is red.” He identifies the numerals 1 through 20 and matches the numerals 1 through 12 with their corresponding number amount. Jeremy uses manipulatives to answer one-digit addition problems.

Gross Motor Skills

At first glance, Jeremy appears to have strong gross motor skills; upon closer examination, however, it is apparent that the gross motor movements he exhibits are repetitive and uncoordinated. He has low muscle tone. He runs, but with an awkward gait. He does not swing, climb up the sliding board, or ride a tricycle. Jeremy has difficulty following a sequence of motor movements during adaptive physical education class.

Adaptive Skills

Jeremy puts on and takes off his pants, shirt, shoes, and coat. He manipulates zippers and other clothing fasteners. He uses a spoon, fork, and cup independently. Jeremy uses the toilet but needs constant adult attention and praise. He will not go to the toilet without an adult.

Additional Information

Parental Concerns

Jeremy’s parents hope he will be able to attend first grade the year after next with his peers at his neighborhood elementary school. They are very pleased about next year’s placement in the Montessori kindergarten, and the work being done with him in his current early childhood special education and integrated preschool settings. They would like Jeremy to be in general education, with support as needed. His parents do not understand why educators do not value Jeremy’s cognitive skills as much as they do. They wish his teachers would use his cognitive skills to compensate for areas in which he has more difficulty. They feel as though they are always trying to convince other people that Jeremy is smart and can learn.

Jeremy’s parents hope he will have the option of some kind of postsecondary education, be it going to college or a trade school. They hope he can someday choose a vocation that makes him happy. They hope he will not require assisted living as an adult. They are afraid to hope that Jeremy will someday marry and have a family. Their biggest fear is that society will regulate Jeremy to a life of dependent care.

Summary and Recommendations

Jeremy is a physically healthy preschool student diagnosed with autism just after his second birthday. He has received an array of early childhood education services and has made great strides in all developmental areas. While there is no denying his progress, Jeremy lags behind his typically developing peers in most domains. He has supportive parents who are concerned that professionals might not recognize their son’s abilities and focus too much on his disabilities. It appears that he would benefit from another year in his special education preschool and

collaboration with the team from the school where he is scheduled to attend kindergarten. At this young age it is difficult to predict with any accuracy how much progress Jeremy will make in the next six to nine months, so open communication, collaboration, and planning among the preschool staff, the elementary school staff, and Jeremy’s parents is essential during this time.