Demographics

Name: Jace Patterson

School/Grade: Jace is not yet enrolled in school
Date of Birth: 2/21/2004
Age: 1 year, 11 months
Evaluation Date: December 2005-January 2006
Evaluators: Cloward, Anderson, Allen
Report Author: Danielle Duffin

Reason for Referral

Jace’s lack of verbal communication and lack of eye contact are at the top of his parent’s
concerns. They are looking to receive help in these specific areas because they feel that he has
missed these milestones and are concerned that it may be caused by a disability. Through
observations, interviews, and testing using the TABS, Vineland-II, and PLS-4 assessments, it
will be determined if Jace is eligible for receiving special education services.
Background
Developmental History
fJace had no complications at birth and developed in a normal pregnancy. Around 6 months of
age Jace didn’t make eye contact, and around 15 months his parents noticed that his speech was
delayed. Jace currently only babbles or uses sounds but will not use words and will not respond
when asked to simple yes or no questions. Jace’s communication consists of pulling one of his
parents to where he wants and cries until they guess what he wants. There is no mimicking,
throwing, pointing, or even jumping gestures. After seeing an autistic girl on the news, his
parents decided to have Jace tested.

Family Information and Social/ Emotional History

Jace has a very supportive and loving family. His mother is a “stay-at-home mom” and his
father currently studies at a university. Jace has one sibling, an infant sister, who he usually just
ignores but if she cries he will go and seek the help of his mother. Jace will look intensely at
books and loves watching cartoons on the TV. He eats finger foods for the most part and
sometimes will eat baby food while he eats in a high chair. When the Examiners first met with
the Patterson family Jace did not eat with a spoon. He sleeps through the night and takes a two-
hour nap each day. Jace does not have any toileting skills. Jace does get excited when one of his
parents comes home and will even give them hugs. Jace will also help his mom sometimes by
throwing out his sister’s diapers. Oftentimes he will repeat actions that he sees his parents doing.
For example, folding his arms after both parents have folded theirs, and waving goodbye. Jace
will sometimes play peek-a-boo or patty cake, and laughs when being tickled or rough housing
with his father. Jace attends a nursery class at his church and seems fine while there but will not
share the things he is playing with. There is also no imitation of other children while in the
nursery class. His mother shared that he is fine with new environments and gets over tantrums
fairly quickly.

Medical
Jace does not currently take any medications. He has good vision and was recently tested for his
hearing. He was screened twice for his hearing and they established that he could hear well. At
18 months of age, Jace had tubes put into his ears to help with the frequent ear infections he was
experiencing about every 4 months. Jace started babbling more once the tubs were put in but
does not form words yet. However, Jace has started saying “mil” for milk or for any other type of
drink.

Educational History
Jace does not currently have any formal education, but was recently enrolled into the Toddler
Lab at Brigham Young University-Idaho by his mother.

Observations
Cognitive
During the observation Jace showed preference to specific activities. At one point his mother
told him that his father was on the phone trying to get him to “talk.” Instead of talking he took
the phone and held it up to his ear. As Jace was playing with the Legos, he would stack them
about five blocks high. When prompted, he would place the correctly shaped blocks into the
holes. Jace also spent a lot of time playing around with the tripod. In one observation Jace would
not look at the examiner when she tried to get him to sit and read a book with her, but instead
continued to play with his toys. In his lab, when the teacher asked him to pick up his toys, he
chose to continue to play instead of picking them up. When Jace was asked to move from
between the easel to go play outside, he chose to stay underneath the easel instead.

Social/Emotional
Jace rarely answered examiners, teachers, or peers in their attempts to interact with him. He also
showed minimal amounts of emotion during the time of the observations. When he did interact
with his peers it was usually only by a few seconds of eye contact. When the examiner would
shake a toy trying to get his attention, he continued playing with his current activity without
paying attention to the examiner. Jace was putting Legos on the plug of the camera and when the
examiner pulled him away he fell to the floor and began to cry. When it was time to go outside
he jumped up and down and began to cry and when it was time to put things away he rolled
around on the floor and cried until his mother came.

Communication
During the observation, Jace didn’t communicate with words. Instead he would pull his mother
by the hand and grunt or cry until he received what he wanted. In the observation at home he
would tug at his mother’s hand until she got up. Then he would take her to the TV or the cabinet.
His mother would then have to guess what he wanted. If she asked if he wanted treats he stared
at the bin that had the treats until she put some on the table. At home he handed the examiner
some bubbles. When the examiner asked if Jace wanted him to blow bubbles, Jace would tap the
top of the bubbles or would back up. Every time the examiner would put the bottle of bubbles
down Jace would pick up the bottle and repeat his process. When he was in the toddler lab he
would pull the aid’s hand to the play bin and when she asked if he needed help, he placed her
hand on the ladder. When the other students would try to play with him or talk to him he would
not look away from what he was doing.

Physical
Jace was able to grab things without struggle. He used a hammer and would hit wooden blocks
with it. Many times during the observation Jace would grab a crayon or a pencil and would grip
with his whole hand. He would switch between his left and his right hand. Once Jace had the
crayon or pen in his hand he would proceed to write on paper, on the Legos, and on himself.
When prompted and shown how, Jace would take the top off of containers. Jace climbed on the
chair, the piano, the stool, and the chair in the kitchen. While in the toddler lab he climbed in
between the easel and tried to climb on a shelf before a teacher came and stopped him. Once Jace
was outside he would use both of his hands to crawl up onto the playground; he used both hands
and placed both his feet onto one step while he was climbing the stairs. Jace fell a few times
while standing and walking on the play structure.

Adaptive
While the examiners were in the observation, Jace showed that he could complete many self-help
skills independently but still needed help for others. During the home observation, Jace showed
that he could feed himself by grabbing the snack with the fingers and putting the snack in his
mouth. When he was asked to throw away the trash Jace continued with his activity instead of
throwing it away. While in lab Jace would grab a spoon during snack time but would sometimes
hold it upside down or with three fingers. Also during snack time he would hold a cup of water
up to his mouth but would spill the water all over himself. When it was time to go outside the aid
helped him put on his coat. When it was time to put on his shoes Jace would touch his shoes but
would not put his feet in them. Jace continued to play when it was time to clean up. The aid in
the toddler lab asked him to clean up but Jace did not respond and continued to play instead..

Tests Administered

Temperament and Atypical Behavior Scale (TABS): Used to identify temperament and self-
regulation problems and indicates if a child is at risk for atypical development or is already
developing atypically through a parent-completed checklist. Administered: December 12, 2005
Preschool Language Scale 4th Edition (PLS-4): Identifies children who have language delays or
disorders by measuring receptive and expressive language skills particularly with play, gesture,
vocal development, social communication, vocabulary, concepts, language structure, integrative
language skills, and phonological awareness. Administered: December 12, 2005
Vineland Adaptive Behavior Skills 2nd Edition (Vineland-II): Measures the adaptive behaviors of
a student through the five domains: Communication, Daily Living Skills, Socialization, Motor
Skills, and Maladaptive Behavior. Administered: December 12, 2005

Test Results
TABS
Raw Score Standard Score Percentile Rank
Detached 4 32 3
Hyper-Sensitive/Active 11 <26 <1
Underreactive 3 30 2
Dysregulated 0 53 61
Temperament & Regulatory 18 <51 <1
Index

PLS-4
Raw Score Standard Score Percentile Rank
 Auditory Comprehension 11 59 1
Expressive Communication 14 56 1
TOTAL TEST 25 53 1

Vineland – II
Raw Score Standard Score Percentile Rank
Communication - 60 <1
Receptive 4 7 -
Expressive 14 9 -
Daily Living Skills - 71 3
Personal 7 9 -
Domestic 1 12 -
Community 2 12 -
Socialization - 60 <1
Interpersonal Relationships 6 5 -
Play and Leisure Time 2 8 -
Coping Skills 1 10 -
Motor Skills - 100 50
Gross 51 16 -
Fine 18 14 -
TOTAL TEST - 73 4

Interpretations
Cognitive:
Data from observations, interviews, and the Brigance shows that Jace is developing consistently
with his age level expectations (or average). Jace has shown that he has reached many of the
cognitive developmental milestones a child his age should meet but still needs to grow in this
domain. Jace’s mother stated that he enjoyed looking at books and will do so for long periods of
time. It was also stated that he will sometimes participate in patty-cake and other movement
songs with adults. In the home observation Jace used the spoon to “scoop” out of a cup and then
put it into his mouth, like if he were eating. He also showed his ability to hold a phone up to his
ear and act as if he was talking to someone, despite not say any words or making any sounds.
Jace showed interest in exploring new objects and new areas. While home Jace showed that he
was able to put shapes into a bucket when prompted and shown by the examiner. After his
mother modeled how to do so, Jace opened the lid to the jar to retrieve a raisin from it. Jace was
hesitant to follow simple commands while being observed. While at home his mother asked him
to throw away a paper, he did not obey. While in the Toddler Lab he decided to play instead of
clean up his toys. The implications of this area are that Jace should be expected to solve
problems and remember learning content consisted with peers of his own age.

Social/Emotional:
Interviews, observations, and testing have shown that Jace is consistently below average
in social and emotional development. Jace scored about one percent of the normative sample on
the temperament and regulation subtests of the TABS and also on socialization subdomain of the
Vineland-II. Jace’s scores on the Vineland assessment show that he has trouble interacting with
others and struggles with any coping skills. His below-average scores coincide with the data
collected from the interviews and observations.
Despite below average performance, his parents indicated that he will get excited
whenever a parent comes home and will give them hugs. They also indicated that he shows two
or more emotions. Jace will laugh when roughhousing with his dad or being tickled, and will
sometimes play patty-cake and peek-a-boo with his mother. She also stated that Jace will
sometimes imitate behaviors he sees both his parents doing, such as waving goodbye and folding
his arms to pray. During the observation Jace made minimal eye contact when interacting with,
or being around others. This was shown when the examiner tried to play catch with Jace, push
the car, build towers, and play with the containers and shapes. This behavior was also seen in the
Toddler lab when the teacher asked Jace to clean up his things, put away his toys, and come
inside. Jace was easily aggravated and seemed overwhelmed by social environments and
demands. Jace’s lack of interest in social interaction will impact the types or number of
relationships he experiences. It will also affect his language and may cause him to continue to be
emotionally overwhelmed by social demands.

Jace can consistently:

 Cry and make sounds to gain caregivers attention
 Sustain periods of play with toys and objects
 Respond to affection from primary caregivers

Jace can partially or sometimes:

 Make eye contact
 Smile, wave, or laugh in response to positive interactions.
 Mimic others’ behaviors.

Jace cannot yet:

 Engage in parallel play with other children.
 Regulate tantrums.
 Recreate facial expressions.

Communication:
Jace’s communication level consistently falls below average based on the outcome of the
observations, interviews, and testing. Jace was observed both at home as well as in the Toddler
Lab. He is using very few communication skills to clearly communicate his needs or even to
interact with others. He makes poor eye contact, has no word knowledge and communicates
mainly through non-verbal techniques. Jace will pull or tug on someone if he wants them to go
somewhere or will point to an item that he wants or needs. Jace will make sounds like crying,
babbling, or whining to communicate his desires. Jace may not respond when he is being spoken
to and may not follow any directions that are given to him. Jace will most likely experience mild
to moderate frustration when he cannot express his wants.

Jace can consistently:

  Produce different sounds and syllables while babbling or screaming.
 Communicate frustration and dislike through screaming and crying.
 Communicate needs and wants by pulling the caregiver by the hand.
Jace can partially or sometimes:
 Respond when his name is called.
 Follow single step instructions with non-verbal cues.
 Identify location and source of sounds.
Jace cannot yet:
 Show understanding of specific words.
 Use single word sentences or phrases.
 Understand and respond to simple questions.
Physical

Observations, interviews, and testing show that Jace is performing consistently at an average
range in motor development. On the Vineland-II assessment, Jace scored in the average range in
both fine and gross motor skills. These scores incorporate data collected during the interview and
through observations. Motor skills are one of the strengths Jace’s mother considered him to have.
It was stated that Jace was able to kick a ball, but was unable to catch or throw it. Jace was able
to grip items firmly and was able to operate them as well. At home he was observed grabbing a
pencil with his whole hand and tried doodling on multiple objects. He also used a hammer to hit
on wooden pegs and in lab used a mallet to hit the drum and make noise. Because Jace’s motor
development and behavior performance is average for his age it can expected to see him
complete most age appropriate behaviors and tasks in this domain. These include but are not
limited to: running, jumping, climbing, grabbing objects, and manipulating toys and food.

Jace can consistently:

 Stand, walk, and run self-sufficiently.
 Climb chairs by placing both feet on each step.
 Hold writing materials with a full grip.

Jace can partially or sometimes:

 Kick a ball.
 Remove lids from containers.
 Construct towers with objects.

Jace cannot yet:

 Open doors.
 Jump up and down with both feet off the floor.
 Catch or throw a ball.
Adaptive

The data collected from testing, observations, and interviews indicate that Jace is performing
consistently below average for his adaptive skills. Jace scored in the third percentile in daily
living skills on the Vineland-II assessment. This indicates that he is performing equally or better
than 3 out of 100 children in the sample group. This data corresponds with the data collected
during the interviews and observations. Jace’s mother stated during an interview that Jace still
prefers his sippy cup and can put his arms into the shirtsleeves and can also put on his shoes, but
that he will rarely undress himself. His parents stated that he has slept through the night since he
was 8 months old but still is not potty trained. Jace is unable to drink out of a cup correctly. In
the lab, he was seen bringing a cup of water to his mouth and placing his hand on top of it
causing it to spill all over. Jace has a hard time consistently following set rules and routines as
well as cleaning up after himself. At the home, his mother asked him to throw away a piece of
paper and he did not respond. Self help and daily living skills are crucial for self-sufficient
living. This requires caregivers to do more for him than they typically do for other children.

Jace can consistently:

· Specify needs and wants of hunger and sleep
· Sleep through the night
· Eat finger foods

Jace can partially or sometimes:

· Eat with a spoon
· Reply to cues from caregivers about warnings of danger
· Respect some consistently set rules and routines

Jace cannot yet:

· Aid in helping dress or undress
· Use the toilet
· Clean up messes after himself

Recommendations
The data collected through testing, observation and interviews stipulates that Jace has
developmental delays in communication, adaptive, and social emotional skills. This shows that
Jace is meeting the requirements for an Individual Family Service Plan (IFSP) under part C of
the IDEA. Hence, it is recommended that the team work directly with the family to cultivate a
plan to meet Jace’s needs with long-term goals and short-term objectives. These are the
following recommendations:

For the professionals:

· Continue to monitor Jace and complete further testing to determine if Jace has autism or any
other disabilities
· Offer occupational therapy to assist Jace with fine motor development and daily living skills
· Offer speech therapy with the objectives to improve social and verbal communication skills
· Create a plan with his parents to improve social interaction skills at home, church, and lab
· Offer on-going services in the home by a developmental specialist to improve abilities in areas
that continue to be delayed developmentally

For the classroom:

· Have a consistent routine and use a picture schedule to help Jace be aware of what he needs to
be doing, including transitions and incorporating minor changes
· Provide Jace with a warning before ending an activity and starting a new one to help transitions
run smoothly.
· Modify the schedule regularly to build flexibility to change, but prepare Jace for the change at
least a day in advance.
· Involve Jace in peer activities to help him with communication skills and social or emotional
skills
· Consider using a reward to help with Jace’s behaviors and peer interactions
· Encourage Jace to communicate using verbal language or sign language to help with his
communication skills

For the parents:

· Offer Jace with opportunities to interact with peers and model appropriate interactions to help
with Jace’s social skills.
· Encourage Jace to communicate verbally or through sign to help with his communication skills.
· Model appropriate language, parallel talk, and self-talk with Jace to help with communication
skills
· Encourage Jace to complete activities or tasks independently to help with his adaptive skills
· Communicate with Jace’s therapists and teachers and incorporate suggested interventions.

Summary
Jace is a 23-month old boy who is the product of a 40-week pregnancy and normal birth. Jace
was tested and has shown to have normal hearing and vision. His parents developed a concern
about his development when he did not meet important developmental milestones. Jace makes
minimal eye contact when interacting with others or when others are around. He is unable to
form any words and communicates his wants and needs through pointing, pulling caregivers by
the hand, crying, and babbling. Jace is hypersensitive and has a hard time regulating emotions.
His motor development is normal and would be considered one of Jace’s strengths. Through
collecting data from testing, observation, and interviews, it was determined the Jace is
developmentally delayed in communication skills, adaptive skills, and social emotional skills.
These developmental delays qualify Jace under Part C of the IDEA. It is recommended that that
an IFSP be written for him with the family. Furthermore, it is also recommended that he begin
early intervention services, which would include occupational therapy and speech therapy, as
soon as possible. It is also recommended that Jace’s parents and teachers continue to work with
him on his communication, adaptive, and social emotional development at home and in the
toddler lab.