Julia's Progress Report

When I dropped Julia of at school today, I picked up her mid-year progress report. It looks like she is doing quite well, and making progress in all areas. Some things (like for example writing her name) are either out of date or something she only does at home. That's just one example of a couple of things I noticed that I have seen her do myself that she hasn't done at school, at least not when anyone was looking! Here are the results:

Physical Therapy

Current Performance Level( at time IEP was developed): Julia presents with hypotonia throughout her extremities and trunk. She presents with decreased proximal stability and hypermobility throughout her joints. Julia’s reflexes are present but diminished in all planes and direction secondary to her tone and generalized muscle weakness. Gravitational insecurity is demonstrated with Julia fearful of being suspended. Overall strength and endurance is decreased throughout with Julia having difficulty in sustaining an activity to strength and attention. Compensation is noted throughout her developmental sequence with Julia demonstrating a wide base of support, decreased trunk rotation, decreased proprioception and stability with Julia using her hands to push off from the floor from a squatting position. Julia is an independent walker with the following deviations noted: waddling type of pattern with flat footed slapping progression, wide base of support, decrease dorsiflexion, ankle pronation, decreased hip flexion and instability in hips and ankle joints. Running pattern is a fast walk. Stair climbing is immature with emerging step to pattern with reverting to a crawling pattern when ascending and a step to pattern when descending with minimal assistance needed. She is beginning to jump with the emergence of a gallop pattern. Unilateral balance is momentarily on either foot.

Goal: Julia will demonstrate improved postural strength, proximal stability and strength, overall strength and endurance and sitting balance to enhance the acquisition of her gross, locomotor and balance skills.

Progress: Julia has received PT services 2x per week within a sensorimotor group. She is able to complete a 5 step obstacle course given minimal assistance and has made nice progress is all areas. Currently, Julia is able to come to a stand using a half kneel progression in 50 % of trials. She can propel a scooter up to 25 ft but this is a slow and labored process. She is jumping at least 6 times and attempting to hop. She is able to balance on one foot for up to 2 seconds. She is ascending and descending stairs using a step to pattern. Julia is generally cooperative and hard working. She is a pleasure to work with.

Occupational Therapy

Current Performance Level(at time IEP was written): Occupational therapy testing indicates that Julia presents with low postural/proximal stability and tone. She exhibits weaknesses in the areas of visual motor/fine motor/ development and sensory-motor development. Sensory weaknesses are noted in the areas of modulation related to movement and visual input, sensory processing related to tone and endurance, oral sensory processing and registration.

Goal: Julia will improve sensory processing, sensory motor development and fine motor development.

Progress: Julia has made nice gains in OT. She can build a three cube tower. She is not yet building a bridge or steps. She holds a preschool pencil with a right handed finger grasp to a tight tripod/quadripod grasp. She can color within the boundaries of a three inch design, but doesn’t color it in completely. She is not yet tracing her name but she is beginning to print the letter J. She copies a horizontal, vertical and diagonal lines. She strings small beads. She uses a three jaw chuck to obtain small objects. Julia is a joy to have in therapy!

Communication

Current Performance Level(at time IEP was written): Julia is using three and four words sentences spontaneously. At times she is difficult to understand due to articulation errors, especially in utterances longer than two words. She is able to follow one and two step directions at times, but continues to be inconsistent in answering questions.

Goal: Julia will demonstrate improvements in articulation and listening skill development.

Progress: Julia has done very well during small group therapy lessons and has demonstrated much progress in articulation and listening skill development. She is able to produce k and g in all word positions and is able to be understood almost all of the time in conversation. She is able to point to pictures in a book, answer “wh” questions while looking at a book, and answer yes/no questions. She is much more talkative during group and is interacting very well with her peers. I anticipate continued progress in all areas of Julia’s language development.

Pre-Readiness

Current Performance Level(at time IEP was written): Julia is able to identify some body parts and state her age. She is inconsistent in being able to name objects within categories. Julia is able to identify some shapes, including a square, rectangle and triangle and 9 out of 9 colors. With prompting she can rote count to ten and recite most of the alphabet. At times, Julia is distracted by external noises and her own thoughts. She can also be impulsive at times. It appears that Julia does not always process information accurately and has difficulty understanding some task instruction despite modeling and practice.

Goal: Given decreasing prompts, Julia will increase time spent on non preferred tasks throughout the school day.

Progress: Julia has become comfortable in school. Julia continues to need a lot of prompting and encouragement to engage in no preferred tasks. She currently able to engage in interactive play with 1-2 peers for at least 3 minutes. However, at times, Julia needed to be redirected back to the appropriate activity. Julia is beginning to attend at circle with prompts and adult assistance.