Results of Evaluation

Cuyahoga Board of Developmental Disabilities

Cleveland, Ohio
Phone #216-538-3611

Type: 6 month review

Name: Dean
Date of Birth: 5-4-15 Date of Evaluation: 6/13/2017
Chronological Age: 25 months Location of Evaluation: home
Parent(s): Mom & Dad Evaluators: JP Zalar, Emily Roll

Domain(s) assessed: adaptive, social-communication

Reason for referral: communication delay

Background Information: Dean lives with mom and dad. His step brother (12) and step sister
(11) visit on the weekends. The family has a support network Moms mom and family. Dean
originally was referred to Help Me Grow for a speech delay by his pediatrician. His current
IFSP goals are:
1. Dean will open his mouth to make sounds and single words during play.
2. Dean will play with a variety of toys with his hands appropriately.
3. Dean will be aware of his body and environment during play.
4. Dean will eat with utensils for a few bites.

Health History: Dean was born full term with a concern of a hole in the heart during pregnancy
and an induced delivery. Doctors were prepared to take Dean into surgery immediately upon
birth, yet after being born, tests revealed a healthy heart and no medical concerns were noted.
Typical development aside from pediatricians concern for language delay.

Previous assessment information: The Battelle Developmental Inventory 2nd Edition (BDI-2)
was administered 12/20/16. The scores supported the pediatricians concerns and showed a need
for Help Me Grow Services based on a concern about Deans ability to express language. All
other scores were in typical range.

Current Assessment Tools:

The Assessment, Evaluation and Programming System Second Edition (AEPS) Level 1, for
children birth through age 3, assessment focuses on Deans performance in his natural
environment, encourages parental involvement and translates test skills into real life, meaningful
goals for your child. Also, the scores can be used to track Deans progress over time and has
specific learning activities attached to support his development based on his current needs.
The results from these tests are one tool used to guide goal setting for the Individualized Family
Service Plan (IFSP) review on July 11, 2017.

Assessment Results:
Adaptive Skills: Adaptive skills refer to how well a child can take care of his own needs, such as
feeding, bathroom issues, and dressing himself.

Dean eats a variety of foods and uses his mouth to chew different textures of foods. He drinks
from a cup and a straw and eats from a spoon. He sometimes needs help scooping and has some
spills when bringing the food to his mouth. He brings food to his mouth with his fingers
independently and easily accepts food presented to him on a spoon.

Deans ability to dress himself includes taking off his shirt, coat, pants and shoes. He is not yet
interested in toileting, yet washes his hands with minimal help in getting the soap and turning on
or off the water. He also dries his hands and brushes his teeth. Sometimes Dean helps put the
tooth paste on the brush, other times he lets mom or dad do it. He enjoys brushing his teeth and
allows mom or dad to help get the finish brushing when he is done doing it on his own.

Activities that will support Dean at his current level of self-help skills include playing a
water or sand with scoops, buckets or other containers. By dumping and pouring different
materials, Dean will gain more control in eating with utensils. When in the pool, he enjoyed
pouring water out of the pan. We can build on this interest by offering different yogurt
containers, plastic cups or disposable containers to encourage more pouring practice. This will
also help him as he gets older and learns to pour juice into a cup or applesauce into a bowl.

Social-Communication Skills: Social-communication skills refer to how a child interacts with

the people around them. This can be through eye contact, attention, words, sounds, gestures,
sign language, and/or movements.

Dean is communicating his wants and needs to people primarily through gestures and sounds.
His sounds are becoming very deliberate and beginning to sound like words. For example, he
sometimes uses ba to refer to a ball and mo, mo, mo! to mean more. He also signs more
while saying mo to help those around him understand what he means. Dean also pretends to
talk on the phone and looks to his parents and others for responses to his games.

Dean is beginning to use words to label objects, such as ball or fish, and actions, such as go and
up. During play, Dean follows his parents and caregivers lead by imitating them. For example,
he dropped rocks out of the window. Emily extended the game by dropping a rock and saying
boom!. Dean then said Boo as he dropped rocks out the window. Dean also anticipates and
fills in the blank for common games such as mom saying One two Dean will say Tee
(for three) or Go!

When you have Deans attention, he recognizes his own name and responds with a smile. He
sometimes follows a direction when asked, Bring me the ______. Other times, Dean continues
playing. When asked to identify objects between two preferred items such as a ball and a shovel,
Dean grabbed his preferred item of the moment rather than pointing to the item asked for. This
may be due to his personal interest in the moment. Labeling objects is another developing skill
for Dean. He will sometimes answer What is that? or repeat a familiar word such as fish.
More word attempts are noticeable when he hears the word and sees the object. Such as when
dad held up the toy fish and said, Fish. Dean took the toy and said fi. He made a similar
sound later when he showed JP the fish toy. Mom and Dad already do a lot of labeling for Dean.
Continuing to give him the word for an item will support his vocabulary. Mom and Dad are
labeling items in English and speak English at home. Grandma primarily speaks Arabic to Dean
and he uses some Arabic sounds. Future assessments should watch for more Arabic words and
sounds, as his communication skills grow he may use both languages.

Activities which would support Dean at his current level of communication include games
mom and dad already play such as the Name Game. Mom, dad, grandma, brother, sister, etc
name items throughout the day. Wait for Dean to imitate the word. If he tries, celebrate and
reinforce his hard work. If he does not say anything, just repeat the word again to model it.

Another idea is playing Whats This? Dad is already doing this in the pool with toys, so we
can adapt the game to other routines. For example, in the bath, point to his arm and say,
Whats this? wait for his answer. Then say Arm. Youre right! Thats your arm. Arm..
Repeat with other body parts or bath toys. During quiet time or when at the doctor or a
restaurant, look at books and point to a picture. Another great way to play Name Game or
Whats That?

The AEPS results support our team and Deans family create functional and meaningful goals
based on their priorities. Based on those goals, the early intervention specialist should use the
activities provided with the AEPS curriculum guide to support growth. Administer the AEPS
again 6 months to monitor Deans growth and determine if goals are being met.

It was a pleasure working with Dean and his family. Please contact me at the above number with
any questions or for further information.

Signatures and Titles of Evaluators:

JP Zalar, Kent State Student

Emily Roll, Developmental Specialist, LISW-S, EI
Additional Information

Dean plays with his family members. He turns towards his name, claps and smiles when happy,
cries when sad or hurt, and runs away or crosses his arms when mad. He easily takes turns in play
with adults and grabs mom and others by the hand to show him desired items. He sits with an
adult for up to 15 minutes when engaged in a preferred activity.

Dean follows simple directions and stays calm when faced with frustrations such as someone
taking a toy from him. He writes with a pincer grasp on small post it notes and copies circles.
Dean enjoys looking at letters and having the adult say the letter. He will complete simple puzzles
and shape sorters and enjoys books. Dean enjoys pouring water and other materials. He will
press the button on a motorized car, then explore what happens when he holds the wheel.

Dean feeds himself with a spoon with minimal spilling. He drinks from open cups and straws. He is
beginning to show interest in the toilet and washes his hands and brushes his teeth with minimal
assistance as expected for his age. Dean still places non food items in his mouth and is being
redirected to food or teething toys. Dean opens the fridge to let mom know he is hungry.

Section V of the IFSP: Everyday Routines, Activities, and Places (ERAP) Demographics
and Timelines
A. What is a typical day like for your child and family?
Depends on what time they go to bed, but usually wake up around 10 am. Sometimes
mom gets up early to shower before he gets up. If he wakes up and she is not there, Dean
cries. After waking, mom changes Deans diaper and they eat breakfast. Usually Dean
eats foods such as waffles, bagels, rice pudding, or PBJ sandwiches. Mom states he is a
picky eater based on his taste preferences. Dean eats in the living room at a small table.
Mom knows he is finished when he throws his food away or puts his spoon in the sink.
After that they play and do chores. Sometimes the TV is on, but mom prefers to have it
off. Dean loves Elmo, Mickey Mouse and Super Why. He also loves to color. They eat
lunch about 1:00, then usually mom and dad take him to the park or mom will go to her
sisters or moms house to play with the cousins. Dad works second shift six days a
week. When Dean gets hungry, he goes to the refrigerator and gets out what he wants to
eat. Mom usually offers dinner about 8 pm then they watch TV together, have a bath,
 read some books and get ready for bed. Dean likes to wait up for dad to get home until
midnight or 1:00 am. Dean will only sleep in bed with mom. Mom reads to him until he
falls asleep. If he wakes and mom is not there, Dean cries and goes to find her.
B. What does your child and family like to do together?
The family enjoys going to the park, playing, swimming in their pool when the weather
allows, and going outside in the back yard. When the step brother and sister visit on the
weekends, they spend all day outside playing with the basketball hoop.
C. What does your child and family find challenging or difficult to do? (e.g. people,
activities)
Mom says, Nothing really. She continued that life with kids means taking more time in
the grocery and having less time for yourself.

More information was learned during the Routines Based Interview:

Summary & Order of Priorities:

Child Name: Dean DOB: 5.4.15 ET#:
*** updated on 6/20/17 the original RBI conducted on 12/20/16

Child lives with mom and dad. Step sister (11yo) and step brother (12yo) visit on weekends

Routine: Strengths and Needs Rating Priority Outcomes/Goals:

All routines Or
discussed in N/A
the RBI
Wake up, nap, Whats working well: Dean
bedtime usually wakes about 10 am on
his own, depending on when 2 3 We want Dean to
he goes to bed. He no longer calm for bed
uses a pacifier to sleep and within one hour
rarely naps anymore. She no of bedtime.
longer sleeps in a crib, instead
he sleeps in bed with mom and
they read until he falls asleep.
Dean typically stays up until
dad gets home until 12-1 am.

Whats not working well:

Typically Dean does not fall
asleep easily. He wants to
play.
Diapering, Whats working well: Dean We want Dean to
dressing, helps with dressing. Takes off sit on the toilet
toileting clothes and shoes and puts his 2 4 three times a
arms and legs into openings. day.
He pulls up his pants and puts
on and takes of front open
coats. He velcros his jacket.
Dean realizes when diaper is
messy and lets mom or dad
know he needs changed. He is
not yet interested in toileting,
yet washes his hands with
minimal help in getting the
soap and turning on or off the
water. He also dries his hands
independently.

Whats not working well:

Dean climbs into the shower
with mom and gets into all
the shampoo bottles. He
plays in the bathroom and
climbs on mom when she uses
the bathroom. He expresses
interest in and sits on the
potty occasionally.

Mealtimes Whats working well: Dean

eats at a table in the living room.
He signals he is hungry by 3 2 We want Dean to
opening the fridge and giving sit for mealtime.
mom the food he prefers. Mom We want Dean to
describes him as a picky eater,
play
only preferring certain foods
appropriately
based on his taste preferences.
He likes waffles, rice pudding, with toys (rather
bagels, hot dogs, PBJ sandwiches than dump them
and eats chicken when with his in water).
cousins, but not at home. When
he is finished, he throws away his
trash and puts dishes in the sink.
He drinks from a wide range of
cups, water bottles, and
containers with straws. He uses
 spoons with some spilling, his
fingers and sometimes a fork.

Whats not working well:

Dean prefers to graze. He will
try a few bites of a meal and
walk around. He eats in the
living room to eat more food.
Spending time Whats working well: Dean
with family, typically enjoys spending time
friends, and with other children. Mom says 5 N/A No concern in
other children he likes to play and be this area.
social. Deans big sister is like
a mini mom to him. He
loves playing basketball with
his big brother. Plays well
with cousins according to
mom. Enjoys being with aunts
and grandma, too.

Whats not working well: n/a

Play Whats working well: Dean
enjoys a variety of toys We would like
including blocks, books, cars, 5 1 Dean to use
musical toys, the pool, and single words
filling and dumping activities. during play to
He sometimes watches TV request or label.
while playing, but typically the
TV is off. He is places items to We want Dean to
his ear and pretends to call play safely in the
Elmo. He likes to watch mom living room
cook and clean, sometimes (without climbing
making messes like he wants and jumping on
to make more foe me to clean the furniture.)
up, according to mom. He
enjoys the park and cousin
time. Dean often plays with
his toys now, instead of
putting his toys in his mouth
like he used to. Dean uses a
few signs and sounds when
playing. He sometimes
imitates sounds and behaviors
in play. He pulls people to
 show them items or brings
toys to people to show them.
Dean draws on small pieces of
paper, such as post it notes,
staying on the paper. He
holds the pencil or pen as an
adult would.

Whats not working well:

Dean likes to climb furniture
and jump off. Mom is
concerned he will get hurt.
Mom is also concerned about
Dean using sounds, with only
a few words.
Bath time, Whats working well: Dean
tooth brushes his teeth. Sometimes 2 5 We want Dean to
brushing, Dean helps put the tooth paste cooperate during
cleaning up on the brush, other times he and enjoy bath
lets mom or dad do it. He time.
enjoys brushing his teeth and
allows mom or dad to help
finish brushing when he is
done doing it on his own.

Whats not working well:

Dean will climb in the shower
with mom. He will get into all
the soaps and lotions and is
all over the place according
to mom.

Getting Whats working well: Dean

around the typically does well in the
home and community. Dad reports that 5 N/A No concern in
community, as long as you give him a toy this area.
getting ready or something to keep him busy,
to go he will cooperate.

Whats not working well:

Mom says Dean seems to
understand her but
sometimes ignores her. She
reports he can be stubborn
and not cooperate.