1. Physical & Health Impairments Case Study James Dirks Elizabeth Peterson

2. Callie: Background Information 4 year old female, Pre-Kindergarten Non-Categorical Early Childhood Intellectual Disability Other Health Impairment- hydrocephalus Orthopedic Impairment- developmental delay, and severe hypotonia Speech Impairment Wheelchair dependent PALS Placement (Preschoolers Achieving Learning Skills) Two parent household - bilingual Only child Parents are expecting

3. Service Plan Educational Placement: PALS Callie receives Academic and Functional services Participates in lunch and ancillary with non- disabled peers Individualized Health Care Plan

4. Wheelchair  Out of her chair for 4 hours total  Wheelchair provided by parents Specialized Diet –  Soft diet fed by adult  Pedisure w/ fiber

5. Assistive Technology Need for assistive technology is identified and provided  Rifton activity chair – Callie has challenges in sitting up in a standard PK classroom sized chair. This chair provides support as well as a belt for safety purposes  Rifton toilet trainer – in supporting her self-help skills and safety while toilet training, Callie has access to a toilet training chair  Rifton gait trainer – provides her with independence and safety in her physical development. She utilizes this to help her learn to walk independently.

6. Pictures of Rifton chairs

7. Related Services Physical Therapy- 1 per 4 weeks for 30 minutes Speech Therapy- 8 per 9 weeks for 30 minutes Occupational Therapy- 1 per 3 weeks for 30 minutes Special Education Transportation

8. Present Levels of Academic Achievement and Functional Performance (PLAAFP) Student is able to give high fives upon request and has shown initiative when completing her task. She has learned to reach to touch or point to pictures/letters (may not be correct), move puzzle pieces (may not be in correct location), and push foam blocks over. Callie is able to match colors and celebrate own efforts.

9. PLAAFP Contd. Physical Therapy Student is able to assist by placing some weight through her legs with support. She attends school in her KidKart so the wheels are not in a position in which they can be self-propelled. She is able to stand and walk very short distances while supported in the gait trainer. She requires verbal and physical prompts to facilitate weight bearing through her legs. She is also able to walk with support at her trunk.

10. PLAAFP Contd. Occupational Therapy Student is better able to use her hands to manipulate desired classroom objects. She will now reach toward items she wants to hold. She is more willing to touch a larger variety of classroom manipulatives. She is able to bang objects on the table and will occasionally place them in desired location, but prefers to drop. She is able to remove objects from a large open container.

11. PLAAFP Contd. Physician/ Medical Report Student has a diagnosis of hydrocephalus and failure to thrive. Orthopedic Impairment document of disability and listed that student has a diagnosis of global developmental delay, and severe hypertonia. Student requires additional rest periods, physical therapy, occupational therapy, and a wheelchair for transport.

12. PLAAFP Contd. Speech No formal articulation evaluation could be conducted due to limited verbal output Oral peripheral exam conducted.  Callie presented with what appeared to be motor planning issues and oral motor difficulties secondary to her diagnosis.  Her dissociation skills with regards to her articulators (jaw, lips, tongue) were poor. Due to limited verbal limited output she communicates through crying and eye-contact

13. Medical Definitions Hydrocephalus- fluid surrounding the brain  http://www.ninds.nih.gov/disorders/hydrocephalu s/detail_hydrocephalus.htm Hypotonia- decreased muscle tone  http://www.ninds.nih.gov/disorders/hypotonia/hyp otonia.htm

14. Accommodations/Modifications Accommodations Modifications  Simplified language  Modified grading  Prerequisite skills instruction

15. Questions Can basic sign language assist in basic communication needs?  Yes! Research says sign language can assist children with a developmental disability in being able to better express their needs.  Learning basic signs (not requiring fine motor symbols) can assist in communicating life skill needs. What sources are available for parental training?  MHMRA has a division of services for Intellectual Disabilities and Autism Provide community training for parent training and support groups Callie has made minimal progress in her academic goals. What are some ways to encourage motivation for learning?  Although Callie does not display ADHD characteristics, a behavioral plan can be written to provide rewards for work completed (i.e. clapping, high-fives, marshmallows)  Writing a Behavior Plan will provide future educators information on her motivators

16. References Harris County Intellectual Disability and Autism Services. (2014). Retrieved October 13, 2014, http://www.mhmra.harris.org/IDD/iddservices.htm http://www.mhmra.harris.org/IDD/iddservices.htm Weinstock, D. (2000). The role of American sign language in improving behavioral functioning in developmentally delayed children with communication disorders. Master of Arts Thesis. Toro College. New York. Retrieved from: ERIC Friend, M. (2014). Special education: contemporary perspectives for school professionals. New Jersey. Pearson Education, Inc.