Letter Regarding Julia

To Whom It May Concern:

Enclosed please find a signed evaluation consent form giving the Middleboro Public School System permission to evaluate my daughter, Julia for admission in to the public preschool.

In addition to the referral that you have already received, I would like to take this opportunity to share with you some of the concerns I have for Julia, as well as how I feel she will benefit from admission in to an integrated preschool program.

Julia was accepted at the age of one year in to the Early Intervention program for both speech and gross motor delays. She has been with Early Intervention since that time, and, has also, at various times had outside Physical and Occupational Therapy at Health South in Plymouth, Massachusetts. While she has made remarkable progress as a result of these interventions, as well as continued work at home, there are still areas of need that I feel would be appropriately addressed in an integrated preschool setting.

Julia’s gross motor delay continues to be of great concern. As noted in her referral, she has overall hypotonia (low muscle tone) and this contributes significantly to her delay in her acquisition of age appropriate gross motor skills. Julia feels very “loose” and does not show any resistance when her extremities are moved passively. Julia is unable to climb stairs independently, and requires a hand (or a railing, or, in some cases both) in order to make her way up or down stairs. Even with a hand or railing to hold on to, it is evident by the amount of effort she exerts and the frequent “shakiness” of her legs that stair climbing is very difficult for her. Julia has an immature gait, which still looks somewhat “waddle-like”, as it sometimes does when a child first learns to walk. Julia also has a very “stiff” run and does not appear to bend her legs appropriately when running. She also has issues with balance and is unable to stand on one foot for even a few seconds. Julia is unable to jump off of a small ledge or, for example, off of a gym mat on to the floor. Julia’s ankles, when in a standing position tend to turn in and her feet are flat.

While Julia has made substantial gains in the area of speech and says many words and sentences, she does have difficulties with language. This is most obvious when she is presented with choices (both physically and mentally presented). When given a choice (“Julia do you want apple juice or milk?”) She will either say, “Yes,” repeat the choice (“apple juice or milk”) or say the last thing you said (“milk”). If you go back and switch the order (“Julia do you want milk or apple juice?”) she will still repeat the last thing said, even if she had said milk prior. She also has difficulty answering questions. If for example, you were to ask Julia what color a block was (let’s assume it’s red) and she didn’t answer you, you might prompt her by saying, “Is it green?” This would be an attempt obviously, to get her to respond with, “No, it’s red” or even just “No.” What she says instead is “Yes” even though she will be looking at the block and know it is red.

Julia sometimes seems overwhelmed in certain social situations. She is intensely shy and takes quite some time to be comfortable in new situations. Even when she is eventually beginning to feel comfortable, she still sometimes will prefer to be alone and does not always interact with the other children.

Due to her low muscle tone and gross motor delay, I feel Julia should be receiving Physical Therapy Services every week. I would also like Julia to receive some help with her language skills, so that she will be able to make choices and have appropriate conversations. Constant exposure to children in a preschool setting will help Julia overcome her shyness and develop appropriate social skills.

I feel very strongly that Julia should be accepted in to this program. Thank you very much for your consideration!