We had a meeting for Charlotte's speech stuff today. The new case worker came and explained how everything will work. We reviewed the final report from the evaluation and then reviewed the plans forward.
Charlotte's social/emotional behavior during the evaluation was noted that she is very self directed and easily frustrated. When she gets upset she cries, throws toys, or has tantrums. This behavior may be just because of her lack of speech or there may be other underlying issues. The plan is to start the speech therapy and if the therapist sees that Charlotte is unable to learn because of behavior issues we will have a social/emotional evaluation and deal with that before attempting further speech therapy.
Charlotte's cognition was evaluated to be equivalent of a 19 month old. She problem solves appropriately for age, demonstrates use of everyday objects and imitates clapping and scribbling. For play skills she is functioning at 18 month level. She understands functional use of objects, demonstrates understanding of functional relationships, and demonstrates an anticipation of play activities. She does not engage in pretend play and does not sequence related actions in play (e.g. first feed the baby then lay the baby down to sleep).
Charlotte is functioning at an 18-21 month old level in receptive language skills. She follows one step commands, looks when she hears her name, attends to objects mentioned in conversation and gestures in response to verbal requests. She does not follow novel or two-step related commands or identify objects by category.
Charlotte's expressive language is at a 9-12 month old level. She uses some single words spontaneously to communicate, however she does not use these words consistently or uses them for a variety of communicative purposes. She imitates some familiar words or sounds but has difficulty imitating upon request. She vocalizes with intent frequently, but she does not use words or signs to indicate completion of an activity or to request an object. Instead she screams, whines or throws tantrums.
Charlotte will have 2 hours of speech therapy a week (twice a week, an hour each time) which will take place at our house. She will continue with therapy through the Early Start program until she is age 3 or no longer needs it. If she needs it past age 3 then we will go through the school district.
The goals are as follows:
- Charlotte will maintain stable health. The parents will schedule and attend all necessary doctor's appointments. Immunizations to be given as recommended by pediatrician. Hearing and vision will be monitored to regularly. Parents will schedule audiological evaluation as needed to rule out hearing loss.
- Charlotte will demonstrate age appropriate developmental skills in 3/5 trials, across 3 consecutive sessions. She will engage in 1-2 step symbolic (on others/dolls) and autosymbolic (on self) play. She will use two toys together in play, identify objects by simple categories (animals, food, clothing) and follow 2-step related commands. She will imitate consonant and vowel combinations (mama, dada, baba, gaga, etc), non-speech sounds (cars, vacuums, etc), and animal sounds in play. She will spontaneously use a word or sign to ask to have her needs met. She will increase her expressive vocabulary to 20 words for a variety of communicative functions and she will imitate the name of 5 familiar objects.
- Charlotte will successfully transition into a school program at the age of 3. A transition referral packet will be sent to the school district and district personnel, parents and the caseworker will attend a transition meeting. The child will be assessed by the school district and a start date for the school program will be identified. She will begin the district program on her 3rd birthday or the date following her 3rd birthday as determined at the meeting.
We will meet with the caseworker every 6 months to formally review Charlotte's progress and determine if she needs additional evaluations as well as if she needs to continue therapy. Charlotte will likely start therapy within the next 2 weeks.
Overall this was a lot of info and a lot to hear about her development. Many of the things we already knew, but it still seemed a bit shocking to see it all on paper. We are really glad the Early Start program exists and that we can get her help. We'll keep everyone updated!
