We suspected Presley had autism. We had her tested twice, both with “too early to tell” results. When we did our second round of Autism testing, Doctor Oswald (the doctor that tested Presley the second time around) had recommended we get Presley into a play group, school, pre-school or other social environment. The importance of socialization was stressed in most of our clinical testing’s. I’ve come to realize the importance of socialization, recently.
Presley started to use to potty at school! I was thrilled! I mean, to anyone else, potty training is stressful, but the kid usually gets the hang of it. For parents of children with Sensory processing disorder, potty training is a huge deal. First the kid can be over sensitive to objects (a cold potty seat in the morning, anyone?) or be scared of the sound of the flushing or even not like having that “empty” feeling of not having they’re bum covered. It’s a huge deal, most mothers of children with SPD usually say they’re child was potty trained at ages 5-7. So, at Presley’s school, she sees another little girl in her class go to the potty and Pres grabs the teacher by the hand and used the potty! She followed the leader; saw what she was doing and bam! Potty master Presley! I’m of course, proud of her. I’m a little jealous that I didn’t get to witness it, but, nonetheless, very proud of her. That brings me to the importance of socialization for children with SPD.
Most people know the importance of socialization. Socialization teaches us appropriate behaviors, what’s the “normal” thing to do in a situation and appropriate customs. Not only that, but socialization teaches us fundamental behavior, language, self help skills, the list goes on and on.
Presley, being in school, is doing great things for her. Her language is improving, as is her play skills. The child development institute says, “During the period of social growth [in school] there will be minor triumphs, but the road will undoubtedly be rutted with an occasional major disaster. Parents should not be disheartened. Children tend to have spurts of physical, intellectual, and social growth laced with periods of holding their own or even periods of regression.” There have been small periods of regression (we got a bunch of snow here in VA, Presley missed about a week of school) but overall the growth has been phenomenal.
Being around other children is greatly important for children in general. Learning key play skills, as well as social norm’s by observing children is key. According to the Child Development Institute, “Children with learning disabilities may have difficulty processing information from the social environment or have difficulty with self-expression.”
For Presley, being in school has helped her a great deal. From the potty, to appropriately playing with toys, learning verbal skills from the other students, and being away from mommy and playing with the teachers/other kids, she’s learned from socialization.
The Child Development Institute. (2009, February, 19). Helping Your Child with Socialization. Retrieved from: http://www.childdevelopmentinfo.com/parenting/socialization.shtml
Friday, February 19, 2010
Wednesday, February 3, 2010
Feeding disorders
When Presley was about two we had an evaluation with the “feeding clinic” here in Richmond at the Richmond Children’s Hospital. We ended up not perusing the feeding clinic for various reasons, but recently have decided to give it a go again.
I fed Presley a meal yesterday of mashed green-beans, small toddler spaghettis and mashed bananas. She tongue mashed some of her food, while swallowing other’s whole. Her OT was here yesterday and “mentioned” she eats at a 9 month old level, because she hasn’t picked up the older skill of moving her tongue around to her teeth.
The feeding clinic here goes the behavior rout when it comes to therapy. They tend to use ABA (applied behavioral analysis) when feeding. They work on a reward system. You take a bite, you get a toy. Studies show that feeding disorders are usually prevalent with neurologic disorders as well as behavioral issues.
With that being said, Presley’s issue consists mostly of texture based foods. She prefers soft foods and will not eat anything hard. Hard foods would be considered, crackers, cheese, anything crunchy. In applying behavioral therapy to texture issues, “the procedure consists of presenting light and rocking motion and increasing the texture over time.”
One of the most important things in feeding therapy is parent training. In the intensive program at the feeding clinic, the parent/child goes five days a week for eight hours a day for six consecutive weeks and eats four times. The parent watches on video for the first couple of weeks, while the occupational therapist feeds the child, then the last couple of weeks the parent is “taught” and feeds the child in the clinic setting, so that therapist can observe and correct.
Most studies show that feeding therapy at clinical locations is favorable.
Shore, B. P. C. (1997). Pediatric feeding disorders. The Kennedy Krieger institute. Retrieved February 3, 2010 from, http://feedingdisorders.kennedykrieger.org/pdf/Piazza_Shore.pdf.
I fed Presley a meal yesterday of mashed green-beans, small toddler spaghettis and mashed bananas. She tongue mashed some of her food, while swallowing other’s whole. Her OT was here yesterday and “mentioned” she eats at a 9 month old level, because she hasn’t picked up the older skill of moving her tongue around to her teeth.
The feeding clinic here goes the behavior rout when it comes to therapy. They tend to use ABA (applied behavioral analysis) when feeding. They work on a reward system. You take a bite, you get a toy. Studies show that feeding disorders are usually prevalent with neurologic disorders as well as behavioral issues.
With that being said, Presley’s issue consists mostly of texture based foods. She prefers soft foods and will not eat anything hard. Hard foods would be considered, crackers, cheese, anything crunchy. In applying behavioral therapy to texture issues, “the procedure consists of presenting light and rocking motion and increasing the texture over time.”
One of the most important things in feeding therapy is parent training. In the intensive program at the feeding clinic, the parent/child goes five days a week for eight hours a day for six consecutive weeks and eats four times. The parent watches on video for the first couple of weeks, while the occupational therapist feeds the child, then the last couple of weeks the parent is “taught” and feeds the child in the clinic setting, so that therapist can observe and correct.
Most studies show that feeding therapy at clinical locations is favorable.
Shore, B. P. C. (1997). Pediatric feeding disorders. The Kennedy Krieger institute. Retrieved February 3, 2010 from, http://feedingdisorders.kennedykrieger.org/pdf/Piazza_Shore.pdf.
Monday, January 18, 2010
Intro (repost)
**This blog was started in 2008 as a way of keeping my friends/family and strangers who have children with the same issues in the loop, with what’s going on with my daughter. For those of you who are wondering why I’m reposting an intro, it’s because, for my English class, I have to keep a blog. Most of the coming entries you will see are going to be research based. I’m looking forward to this project over the next coming months & being more informed, scientifically in what I have labeled ‘Presley’s Syndrome.’**
I've started this blog with the intent of keeping track of my daughters progress through therapy, as well as keeping her doctors, family and friends informed about whats going on.
Presley, who has a development delay has been informally diagnosed with Sensory integration disorder. We're in the process of having her tested for Autism or any other related disorder.
As I'm writing this she is 26 months old, we've had her in early intervention therapy for the past year. She is labeled as having a delay scattered between 12 to 18 months. Around 18 months she was seen by a local developmental pediatrician who thought she could have Autism but it could really go "either way." I was not satisfied with his session (an hour long, no bedside manor, no real interaction with Presley) and have made an appointment (March 5th to have her reevaluated by another team.
Here is a bit of what she has going on:
*Little eye contact, hardly turning to name
*Still eating purred baby foods, she gags on lumpy food, she has just started to properly "chew" but mostly swallows food whole.
*She spins in cirlces
*Sometimes hand flaps, hits her ears when she gets mad
*Not very social with peers her age, more connected with adults
*Has a big speech delay, shes at about a 12 month level for speech development. Her words consist of "hi" "hey" and rarley "All done"
*Shes very into being overstiumulated, lights, busy places and a lot going on she thrives in.
*She still wakes up around 1-3 times a night and has a hard time going to bed (she'd rather stand in bed and spin and play)
*Recently she has become very attached to myself and my husband (which is great!) before she could have really cared less if we were even around
*constant teeth grinding
So basically we're going to post videos of therpay sessions, photos of Presley being adorable and other random information.
-Alexandra
(Presleys momma!)
Thursday, October 29, 2009
updates
Its been quite a while since I’ve updated. Everything is just flying by and we’re all so busy.
Presley has been doing fantastic. She started school in September, goes for three hours and loves it! She receives speech therapy, OT and one-on-one time with her teachers. She gets out of the car each morning and tells me bye. She plays on the playground with a little boy and she has one little girl in her classroom with her. School is great!
She also received her cuddle swing. We’re working our way into it, she likes to swing in it as a taco. By the way, we got our insurance to pay for all of her equipment. Including her new super adorable weighted vest, from therapro. The vest is doing wonderful. If she starts to flip out, we put it on her and a weird calm comes over her.
We started OT again yesterday and we’re still working on her feeding issues, which are, pretty much, about where they were last time I posted about it. She’ll now take a bite off a soft baked cookie, however, we’re still feeding her purred food and she is still not feeding herself. She is now eating MORE, so her volume has increased greatly.
So that’s about all that’s going on, hopefully, I’ll have time to update more soon!
Presley has been doing fantastic. She started school in September, goes for three hours and loves it! She receives speech therapy, OT and one-on-one time with her teachers. She gets out of the car each morning and tells me bye. She plays on the playground with a little boy and she has one little girl in her classroom with her. School is great!
She also received her cuddle swing. We’re working our way into it, she likes to swing in it as a taco. By the way, we got our insurance to pay for all of her equipment. Including her new super adorable weighted vest, from therapro. The vest is doing wonderful. If she starts to flip out, we put it on her and a weird calm comes over her.
We started OT again yesterday and we’re still working on her feeding issues, which are, pretty much, about where they were last time I posted about it. She’ll now take a bite off a soft baked cookie, however, we’re still feeding her purred food and she is still not feeding herself. She is now eating MORE, so her volume has increased greatly.
So that’s about all that’s going on, hopefully, I’ll have time to update more soon!
Thursday, July 30, 2009
I haven’t posted in a very long time, so I guess I’m due to give some updates.
Presley’s birthday is August 11th & she will then age out of early intervention services. She’ll start early childhood special education September 8th & will be going to school Monday through Friday for three hours a day.
In school she’ll be receiving speech therapy twice a week. No OT. So we’ll continue doing that privately, until she’s at least eating solid food, herself. Again, she’s still not touching food and eating mostly pureed with the exception of organic snack bars (we call them cookies) made by earths best. They’re still soft, but do involve chewing a bit.
Start school has me a bit stressed out. I’m sure she’ll enjoy it. She loves other kids & had a really good time singing with the teacher during the evaluation.
Speaking of singing, her speech is awesome. She’s doing really great and will repeate almost anything we ask her to say. She’s still putting two word phrases together. The other day she pointed a big tree and said ‘momma tree’ then pointed to a small tree and said ‘baby tree.’ It was adorable, of course. She’s counting to thirteen and knows some Spanish. She knows all of her colors and letters & is improving greatly. She remembers things that I’ve forgot about. She’ll point something out from trip and it boggles my mind that she remembers.
In other news she’s eligible for ‘respite’ care. Basically, respite care is to give the fulltime caregiver a break. So my friend Anna is willing to be the ‘respite’ caregiver & she gets paid for it, so that’s also pretty sweet.
She’s also on a waiting list that is something like 30 years long. In case, as an adult she isn’t capable of taking care of herself. I cant remember the name, all I remember is that she’ll have to be considered ‘mentally retarded’ (that’s the words they used) by age 6 to qualify for it. With the way she’s improving I think that by age six most of this will be a distant memory. Hopefully.
So that’s about all that’s going on. I’ll be doing school shopping for my three year old little girl. Buying a backpack, clothes and all the goodies that is involved in school shopping. I get to take a ‘first day of school’ picture soon enough and have to worry about her while she’s gone during the day. Its all so crazy to me. A THREE year old in school! She could even ride the BUS! Though, I’ll be driving her, still crazy.
Presley’s birthday is August 11th & she will then age out of early intervention services. She’ll start early childhood special education September 8th & will be going to school Monday through Friday for three hours a day.
In school she’ll be receiving speech therapy twice a week. No OT. So we’ll continue doing that privately, until she’s at least eating solid food, herself. Again, she’s still not touching food and eating mostly pureed with the exception of organic snack bars (we call them cookies) made by earths best. They’re still soft, but do involve chewing a bit.
Start school has me a bit stressed out. I’m sure she’ll enjoy it. She loves other kids & had a really good time singing with the teacher during the evaluation.
Speaking of singing, her speech is awesome. She’s doing really great and will repeate almost anything we ask her to say. She’s still putting two word phrases together. The other day she pointed a big tree and said ‘momma tree’ then pointed to a small tree and said ‘baby tree.’ It was adorable, of course. She’s counting to thirteen and knows some Spanish. She knows all of her colors and letters & is improving greatly. She remembers things that I’ve forgot about. She’ll point something out from trip and it boggles my mind that she remembers.
In other news she’s eligible for ‘respite’ care. Basically, respite care is to give the fulltime caregiver a break. So my friend Anna is willing to be the ‘respite’ caregiver & she gets paid for it, so that’s also pretty sweet.
She’s also on a waiting list that is something like 30 years long. In case, as an adult she isn’t capable of taking care of herself. I cant remember the name, all I remember is that she’ll have to be considered ‘mentally retarded’ (that’s the words they used) by age 6 to qualify for it. With the way she’s improving I think that by age six most of this will be a distant memory. Hopefully.
So that’s about all that’s going on. I’ll be doing school shopping for my three year old little girl. Buying a backpack, clothes and all the goodies that is involved in school shopping. I get to take a ‘first day of school’ picture soon enough and have to worry about her while she’s gone during the day. Its all so crazy to me. A THREE year old in school! She could even ride the BUS! Though, I’ll be driving her, still crazy.
Tuesday, June 9, 2009
Developemntal disorders assessment clinic dianostic evaluation report! *phew!*
I lack the skills to take this whole report and make it into a cute PDF file, so I'm going to summarize it!
Tests Administered:
Autism diagnostic interview (ADI-R, partial)
Autism Dianostic Observaiton Schedule (ADOS, Module 1)
Caregiver-teacher report for (CTRF)
Child Behavior checklist (CBCL)
Direct Ovservation
Developmental Questionnaire
Infat/Toddler Sensory Profile
Scales of independdent behavior (SIV-R)
Social communication aquestionnaire (SCQ)
Results:
Social Understanding and Functioning
"Presley was clearly attached to her parents and demonstrated an interest in others. Presley was very affectionate and demonstrated a desire to maintain the positive attention of each person in the room."
"To do so Presley frequently showed items of interest to adults she pointed and visually referenced items of interest as well. She shared her excitement over events by directing facial expressions toward the examiner."
"Presleys eye contact was direct but inconsistent and no sustained. She referenced."
"Presley was emotionally expressive during times of self-directed activity during the evaluation. She directed her facial expressions at adults and her tantrumming behaviors were supplemented with various verbal and nonverbal behaviors (i.e stomping her feet, adopting a "sassy" tone of voice) when she did not initially get her way."
"Once joint-attention was established, however, Presley often appeared to not know what to do next and would often abandon the engagement and move on to the next person. Presley demonstrated increased difficulty with shared agenda. She often avoided and abandoned tasks presented by others."
"Overall, Presley demonstrated social interest and some foundational social kills. The quality of her social overtures to others was high. However she did not exhibit the ability to sustain engagement with others for several exchanges and exhibited a high rate of abandonment."
Speech and Language/Communication
"Based on clinical observation, Presley's receptive language skills were significantly delayed for her age."
"Distraction from or avoidance of sensory input frequently compromised her receptive language abilities."
"Presley responded to color labels and size labels (big/little), yet struggled with response to other early descriptors, as well as a range of nouns, verbs and locative words."
"Presley presented a vocalization to single-word use level. Limitations with expressive vocabulary, were noted, although Presley's strengths rested with the varied word types present as well as coordinated gestural use, facial expressions, and strong intent with vocalizations and verbalization's."
Several language samples were taken during ADOS, when playing with bubbles:
-No
-All done
-Pop
-Woa
-Ooo
-Eye (pointing to eye)
-True
-Blue
-Green
While playing with a balloon:
-A two
-uh-oh
-one two
-one two three
-no
-right there
"Though some of her speech may sound as if she is repeating something she has heard; Presley exhibits true words with typical prosodic patterns. During the evaluation, she played with intonation of her jargon and babble. Her vocal play is developmentally appropriate and helps her learn appropriate intonation for true words. notable was her elevated pitch, which may have been due to structural and /or neuromotor differences, including her small jaw, low oral muscle tone and sensory seeking patterns."
Stereotyped of repetitive behavior and limited patterns of interest
"Throughout the first half of the evaluation, Presley kept a small ball in each of her hands. She had such extreme difficult separating form them that she did not set them down to do other activities, even when motivated a snack."
"Presley exhibited minimal play developmental for her age. She engaged in some cause-and-effect play with a jack-in-the-box and pop-n-pals. She demonstrated emergent functional play, feeding a baby doll. Much of Presley's play during the evaluation involved exploring her environment and she demonstrated minimal incorporation of objects into her play."
Sensory processing and musculoskeletal functioning
"Results of the infant/toddler sensory profile, suggested that Prelsey exhibits deficits in sensory integration and modulation. Scales for low registration, sensation avoiding, low threshold, general sensory processing, tactile processing and vestibular processing were in the "Definie difference" range. Scales for sensory sensitivity visual processing, and oral processing here in the in "Probable difference" range. The only scale for which Presley's scores indicated "typical performance" was sensation seeking."
"In regards to musculoskeletal functioning, Presley was observed to have low tone and preferred "W" sitting."
"In the clinical setting Presley was observed to respond well to deep touch, which seemed to have a calming and focusing affect on her. during the evaluation, she especially enjoyed ticklin from the examiner and rough and tumble play."
"Activities that combine acceptable, non-threatening tactile information alone with proprioceptive input have a calming effect on presley and can help her relax. Further, Presley responds better when given periodic breaks during her day in a n area with decreased sensory information in order to calm and focus herself."
Adaptive Functioning
"Results of the Child behavior checklist (CBCL), indicated areas in which Presley is functioning differently than her same-age peers. Presley's behavior was rated in the "clinical" range (above the 97th perecentile) or "borderline clinical" (between the 93rd and 97th percentiles) for several scales, indication that her behavior is more challenging and more of a concern than would be expected for her age."
"Elevations on the withdrawn sub scale reflect the concerns related to autistic symptomatically that prompted the current evaluation. Elevation on the attention-related scales is likely related to Presley's engagement in her own (preferred) activities and her sensory seeking behavior. elevation the on the aggressive and oppositional scales may reflect a strong-willed temperament, but may also be in part related to Prelsey's language difficulties."
"Overall prelseys adaptive behavior is in the "very limited" range. Her skills are in specific ares of adaptive behavior, as compared to same-age peers, where generally consistent across domains, with the exception of motor skills and community living."
"Thus, Presley exhibits deficits in skills required to complete age-appropriate everyday tasks, and she requires extensive support in order to successfully manage activities of daily life."
Diagnostic impressions
"Presley demonstrated some social deficits, primarily difficulty with shared agenda and an inability to sustain interaction with others. However, her interest in others and the amount of time she initiated interaction with others is unlike the social behavior a child on the autism spectrum. Presley exhibited strong social motivation and interest. Diminished play development affected quality of interactions; as well, making it difficult sustain interaction with others. Though she demonstrated decreased capacity to incorporate objects into her play, Presley engaged in a nice imitation of adult examiner behavior with toys. She initiated joint attention by showing objects to others but did not consistently respond to others' initiations toward her.
Based on clinical observation, Presley demonstrated delayed receptive and expressive language skills for her age. Overall, her expressive language was driven by a desire to get her needs and wants met. She became more insistent if her requests were not initially met and she consistently got the attention of the person with whom she was communicating. presleys comprehension of simple directions was inconsistent and hindered by task abandonment and difficulty with shared agenda. She successfully and naturally combined verbal and nonverbal communication. in addition, Presley reasoned well to demonstration and prompting from examiners."
"Presley exhibited sensory seeking behavior."
Final diagnoses
"Overall, Presley's developmental profile appeared uneven. there were some patterns of Concern related ot the autism spectrum. A continuing concern is Prelsey's limited ability to sustain reciprocal interaction with others, especially if they activity is of low interest to her. Presley's language skills are uneven, but developing in a positive direction and she responds well to intervention. It is uncertain if her fixation on particular objects would remain present if sensory processing and play skills improve. Presley has respond well to previous intervention and recently blossomed. Many of the more concerting behaviors with regards to autism that Presley previously exhibited are diminishing. Scores on the ADI-R, ADOS and direct observation suggested that Presley does not meet criteria for a diagnosis of an autistic disorder. Therefore, at this time, it appears that there is not a reason to assign an autism diagnosis for Presley. If, however, the question of autism persists in the future, the parents may choose to pursue further diagnostic evaluation at the time.
Axis 1 Diagnosis: Rule out PDD
Axis 2 Diagnosis: Developmental Delays
Axis 3 Diagnosis: Sensory processing disorder
Tests Administered:
Autism diagnostic interview (ADI-R, partial)
Autism Dianostic Observaiton Schedule (ADOS, Module 1)
Caregiver-teacher report for (CTRF)
Child Behavior checklist (CBCL)
Direct Ovservation
Developmental Questionnaire
Infat/Toddler Sensory Profile
Scales of independdent behavior (SIV-R)
Social communication aquestionnaire (SCQ)
Results:
Social Understanding and Functioning
"Presley was clearly attached to her parents and demonstrated an interest in others. Presley was very affectionate and demonstrated a desire to maintain the positive attention of each person in the room."
"To do so Presley frequently showed items of interest to adults she pointed and visually referenced items of interest as well. She shared her excitement over events by directing facial expressions toward the examiner."
"Presleys eye contact was direct but inconsistent and no sustained. She referenced."
"Presley was emotionally expressive during times of self-directed activity during the evaluation. She directed her facial expressions at adults and her tantrumming behaviors were supplemented with various verbal and nonverbal behaviors (i.e stomping her feet, adopting a "sassy" tone of voice) when she did not initially get her way."
"Once joint-attention was established, however, Presley often appeared to not know what to do next and would often abandon the engagement and move on to the next person. Presley demonstrated increased difficulty with shared agenda. She often avoided and abandoned tasks presented by others."
"Overall, Presley demonstrated social interest and some foundational social kills. The quality of her social overtures to others was high. However she did not exhibit the ability to sustain engagement with others for several exchanges and exhibited a high rate of abandonment."
Speech and Language/Communication
"Based on clinical observation, Presley's receptive language skills were significantly delayed for her age."
"Distraction from or avoidance of sensory input frequently compromised her receptive language abilities."
"Presley responded to color labels and size labels (big/little), yet struggled with response to other early descriptors, as well as a range of nouns, verbs and locative words."
"Presley presented a vocalization to single-word use level. Limitations with expressive vocabulary, were noted, although Presley's strengths rested with the varied word types present as well as coordinated gestural use, facial expressions, and strong intent with vocalizations and verbalization's."
Several language samples were taken during ADOS, when playing with bubbles:
-No
-All done
-Pop
-Woa
-Ooo
-Eye (pointing to eye)
-True
-Blue
-Green
While playing with a balloon:
-A two
-uh-oh
-one two
-one two three
-no
-right there
"Though some of her speech may sound as if she is repeating something she has heard; Presley exhibits true words with typical prosodic patterns. During the evaluation, she played with intonation of her jargon and babble. Her vocal play is developmentally appropriate and helps her learn appropriate intonation for true words. notable was her elevated pitch, which may have been due to structural and /or neuromotor differences, including her small jaw, low oral muscle tone and sensory seeking patterns."
Stereotyped of repetitive behavior and limited patterns of interest
"Throughout the first half of the evaluation, Presley kept a small ball in each of her hands. She had such extreme difficult separating form them that she did not set them down to do other activities, even when motivated a snack."
"Presley exhibited minimal play developmental for her age. She engaged in some cause-and-effect play with a jack-in-the-box and pop-n-pals. She demonstrated emergent functional play, feeding a baby doll. Much of Presley's play during the evaluation involved exploring her environment and she demonstrated minimal incorporation of objects into her play."
Sensory processing and musculoskeletal functioning
"Results of the infant/toddler sensory profile, suggested that Prelsey exhibits deficits in sensory integration and modulation. Scales for low registration, sensation avoiding, low threshold, general sensory processing, tactile processing and vestibular processing were in the "Definie difference" range. Scales for sensory sensitivity visual processing, and oral processing here in the in "Probable difference" range. The only scale for which Presley's scores indicated "typical performance" was sensation seeking."
"In regards to musculoskeletal functioning, Presley was observed to have low tone and preferred "W" sitting."
"In the clinical setting Presley was observed to respond well to deep touch, which seemed to have a calming and focusing affect on her. during the evaluation, she especially enjoyed ticklin from the examiner and rough and tumble play."
"Activities that combine acceptable, non-threatening tactile information alone with proprioceptive input have a calming effect on presley and can help her relax. Further, Presley responds better when given periodic breaks during her day in a n area with decreased sensory information in order to calm and focus herself."
Adaptive Functioning
"Results of the Child behavior checklist (CBCL), indicated areas in which Presley is functioning differently than her same-age peers. Presley's behavior was rated in the "clinical" range (above the 97th perecentile) or "borderline clinical" (between the 93rd and 97th percentiles) for several scales, indication that her behavior is more challenging and more of a concern than would be expected for her age."
"Elevations on the withdrawn sub scale reflect the concerns related to autistic symptomatically that prompted the current evaluation. Elevation on the attention-related scales is likely related to Presley's engagement in her own (preferred) activities and her sensory seeking behavior. elevation the on the aggressive and oppositional scales may reflect a strong-willed temperament, but may also be in part related to Prelsey's language difficulties."
"Overall prelseys adaptive behavior is in the "very limited" range. Her skills are in specific ares of adaptive behavior, as compared to same-age peers, where generally consistent across domains, with the exception of motor skills and community living."
"Thus, Presley exhibits deficits in skills required to complete age-appropriate everyday tasks, and she requires extensive support in order to successfully manage activities of daily life."
Diagnostic impressions
"Presley demonstrated some social deficits, primarily difficulty with shared agenda and an inability to sustain interaction with others. However, her interest in others and the amount of time she initiated interaction with others is unlike the social behavior a child on the autism spectrum. Presley exhibited strong social motivation and interest. Diminished play development affected quality of interactions; as well, making it difficult sustain interaction with others. Though she demonstrated decreased capacity to incorporate objects into her play, Presley engaged in a nice imitation of adult examiner behavior with toys. She initiated joint attention by showing objects to others but did not consistently respond to others' initiations toward her.
Based on clinical observation, Presley demonstrated delayed receptive and expressive language skills for her age. Overall, her expressive language was driven by a desire to get her needs and wants met. She became more insistent if her requests were not initially met and she consistently got the attention of the person with whom she was communicating. presleys comprehension of simple directions was inconsistent and hindered by task abandonment and difficulty with shared agenda. She successfully and naturally combined verbal and nonverbal communication. in addition, Presley reasoned well to demonstration and prompting from examiners."
"Presley exhibited sensory seeking behavior."
Final diagnoses
"Overall, Presley's developmental profile appeared uneven. there were some patterns of Concern related ot the autism spectrum. A continuing concern is Prelsey's limited ability to sustain reciprocal interaction with others, especially if they activity is of low interest to her. Presley's language skills are uneven, but developing in a positive direction and she responds well to intervention. It is uncertain if her fixation on particular objects would remain present if sensory processing and play skills improve. Presley has respond well to previous intervention and recently blossomed. Many of the more concerting behaviors with regards to autism that Presley previously exhibited are diminishing. Scores on the ADI-R, ADOS and direct observation suggested that Presley does not meet criteria for a diagnosis of an autistic disorder. Therefore, at this time, it appears that there is not a reason to assign an autism diagnosis for Presley. If, however, the question of autism persists in the future, the parents may choose to pursue further diagnostic evaluation at the time.
Axis 1 Diagnosis: Rule out PDD
Axis 2 Diagnosis: Developmental Delays
Axis 3 Diagnosis: Sensory processing disorder
Sunday, April 26, 2009
4/26 pre-school
I started the long process of enrolling Pres in the pre-school special education program with our county’s schools. Tomorrow Britton and I go to view actual classrooms.
Last week I met with everyone to start the paperwork rolling. We have to have her do several evaluations over the summer. Including, a developmental evaluation, a medical evaluation, a OT observation, hearing test and an speech evaluation. I’m not looking forward to making her do these evaluations, as usually they don’t go well. Mostly its her screaming and wanting out of the room, growing board or just frustrated. Hopefully these wont be so bad.
Of course she is talking a load more now. Starting to put two compound words together and mimicking the heck out of us.
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