Preschool (Section 619) Child
Example Case Study:
“Kim” at 35 Months of Age
updated May 2014
The Early Childhood Technical Assistance Center
Improving Systems, Practices and Outcomes
This document is available online at:
http://ectacenter.org/~pdfs/knowledgepath/ifspoutcomes-iepgoals/KimCaseStudy-35mos.pdf It also appears as a part of the ECTA Center’s Developing High-Quality, Functional IFSP Outcomes and IEP Goals Training Package at:
A. Medical and Developmental Background:
Kim Doe, who is currently 35 months of age, was referred to the 619 program from Early intervention. She had been referred to Early Intervention at 17 months, by her pediatrician, Dr. Johnson, due to failure to thrive associated with cardiac anomalies, encephalitis, spasticity (most likely cerebral palsy) and seizures. Dr Johnson’s current health report for Kim provides a diagnosis of cerebral palsy, with significant spasticity. The history of seizure activity has resolved and Kim no longer takes medication. Her heart function has stabilized. Kim is still followed by neurology, in addition to her pediatrician, Dr. Johnson.
Kim had been hospitalized off and on in Denver, Colorado for the majority of her first 14 months of life due to seizures, numerous viral infections and significant nutritional issues. Kim had an NG tube from 6 months of age until she was successfully weaned from it by 20 months. Since that time she has been able to maintain steady, typical weight gain. She has maintained height and weight in the 25- 30th percentile for her age. However, she remains a very picky eater, who is orally hypersensitive with frequent choking or gagging when trying new foods.
Mrs. Doe thinks that early intervention has helped Kim make significant gains and supported the families’ capacity to care for her. Mrs. Doe is really interested in getting special education and related services started without delay. Now that Kim is more medically stable, Mrs. Doe is interested in returning to work, and wants to explore a preschool placement where Kim can receive special education services.
The most recent report from the early intervention occupational therapist included home observation and discussion with Kim’s Mom:
“Kim was able to hold and drink from a spouted cup, but arm movements remain spastic and she often splashes and or knocks over the cup when setting it down. She can finger feed a variety of small, soft foods, such as cut soft bread sandwiches, soft cooked vegetables, soft fruits, etc. She is beginning to use a spoon more effectively. Although she can chew effectively, she continues to have choking responses to rough, hard or chewy textures (meats, raw vegetables, fruits, etc) Her mother reports she continues to feed baby food to maintain nutrition, while having Kim practice using her spoon to feed herself at least half the meal. Mrs. Doe has a
Preschool (Section 619) Child Example Case Study: “Kim” at 35 Months of Age
list of foods she is gradually introducing in small bites to increase Kim’s ability to accept the foods the family typically eats.
Kim was able to assist with dressing (raise an arm, step into a pants leg when held). But due to significant challenges in moving her arms and legs she can not yet undress or dress independently. She can open and close Velcro tabs. Mrs. Doe reports that Kim has strong preferences and insists on choosing her clothes each day.
Kim has functional receptive language skills and routinely follows 2-3 step directions. She knows the names of her toys, colors, and various household objects. Kim uses 2-3 word phrases, expresses her wishes and dislikes with both words and gestures. Her pronunciation has not kept up with the vocabulary she tries to use. Kim tantrums 1-3 times daily when she can not communicate her desires, especially to her sister Jana (5 1/2 years old), since Kim is very motivated to play...
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