Special Education

Nora J, currently 17 months of age was referred for early intervention services by her pediatrician due to failure to thrive associated with encephalitis, cardiac anomalies, seizures, and spasticity, most likely cerebral palsy. A cardiologist and neurologist are also monitoring Nora. Nora is on an NG tube and has not had a complete night's sleep due to night tube feeding.

Nora is able to drink about one ounce of liquid from a sprouted cup when it is held for her. She is able to accept a variety of foods and is able to move them around in her mouth with her tongue. She can swallow about 5 spoonfuls of familiar baby foods without choking. She had choked on everything until about 8 and a half months. Sometimes Nora will choke or gag when new foods are introduced, does not scoop food or bring spoon to mouth. She does not finger feed, and needs assistance when drinking from a sippy cup.

Nora watches people and is interested in what is happening around her, recognizes familiar people and children, likes toys that make sounds, demonstrates recognition of toys and objects by looking at them when named. Nora plays by reaching for and batting toys, patting pictures, and is able to hold toys when they are placed in her hand.

Nora is able to hold her head up when placed in her adapted seat, held supported in a sitting or standing position. She is also able to hold her head up when placed or her side. She is able to roll from her back to her stomach and move short distances. She is motivated to get to her toys but is unable if they are more than 12 inches away.

Nora is able to make throaty guttural sounds to let her family know when she wants held, when she doesn't like a particular food, and if she wants some attention. She enjoys books, sound play with familiar adults and is beginning to attempt to imitate sounds. Nora enjoys being with familiar adults, she watches her siblings play. She is able to laugh and smile at others. She often cries and fusses when her needs are not understood. Nora is also not able to assist with dressing or bathing.

Scenario # 2

Sopheap is a 22 month month female of Cambodian descent. The Family Resource Network referred her for early intervention services. She has a visual impairment in her left eye and the ophthalmologist at the County Hospital estimates that she only has 20 percent vision in that eye. Since Sopheap is completely non verbal he is unable to completely assess the extent of her sight.

Sopheap is physically a very active child when "dancing" and moving to music. She does little else. When there is no music playing in the house, she gets highly agitated, flapping her hands, spits on the walls, and runs through the house. As soon as Mom or Grandmother puts on the music, she is able to calm down within 3-5 minutes. Once calm she is able to play with her favorite toys (Disney Princess figurines). She is able to stay on this task for approximately 5 minutes. The only other activity she enjoys is scribbling in her Disney Princess coloring book.

Sopheap is non verbal, but is capable of expressing her needs accurately by pointing, gesturing, and physically guiding her parents to her desired object. Sopheap is entirely cared for by mother and maternal grandmother. Father works long hours, at

different shifts and sees his daughter for about an hour a day.

Sopheap rarely will respond to her father. She also does not interact with her 7 year old brother and 5-year-old sister. Both children are typically developing.

Sopheap is very uncooperative in dressing. It is a struggle to get her dressed in the morning. She refuses to wear socks or shoes at all times. Sopheap will only eat cold food with a smooth consistency, such as applesauce, cold cream of wheat, and cold mashed potatoes.

Scenario # 3

Juan is a 28-month-old first-born male to a Hispanic family. The family lives with her parents and maternal grandmother in Stockton. He was referred to early intervention services by the Concillio, for suspected developmental delays. Both parents are employed full-time and Grandmother is the sole caregiver during the day. The parents speak English to Juan at home, however Grandmother speaks only Spanish to Juan during the weekdays. Both Mom and dad leave for work before Juan wakes in the morning.

Juan has very little intelligible language in either English or Spanish. He does babble and make sounds. He understands simple commands in Spanish and understands "No", Hi, and can wave “Bye Bye”. He never attempts to ask questions or make demands. Grandmother seems to attend to his every need. Juan is well behaved and quiet and poses no problem behaviors at home or in the community.

Juan is able to feed himself finger food, but does not use a spoon or spork. He has no interest in being toilet training and is still in a diaper. He does drink from a sippy cup on weekends with his parents, but Grandmother still bottle-feeds Juan during the day.

Juan spends hours watching TV with his Grandmother. He does play on his own, but cannot sort objects by colors and can only identify 3 body parts when asked.

The family has no relatives or friends with children in the area and Juan has never played or interacted directly with another toddler. He rarely has any opportunity to interact with adults other than his family.