Progress Report: January 3, 2001

Developmental Therapy Progress Report Period: October 2000 to January 2001

Crystal Allbritton is a 17-month-old female who is seen for developmental therapy one time a week for sixty minutes. Therapy began in a daycare setting in October. In November, Riley Hospital diagnosed Crystal with spinal muscular atrophy. Since that time, Crystal has been seen in her home, where her mother is present and actively involved in each therapy session. The following is a summary of Crystal's developmental areas according to the Hawaii Early Learning Profile (HELP).

Cognitive-Crystal recognizes several people in addition to her immediate family. She responds to simple verbal requests and understands pointing. She enjoys looking at pictures in books and turns one to three pages at a time in a cardboard book. She stacks rings and takes them apart, places a round piece in the formboard, and looks at the place where a ball rolls out of sight. (14-18 months) Goals: Crystal will recognize and point to four animal pictures and begin matching sounds to animals. She will identify three body parts and recognize herself in a photograph. She will place a square piece in the formboard independently and assemble three nesting blocks.

Language-Crystal shows an understanding of words by using the appropriate behavior or gesture. She experiments with communication and is not frustrated when she is not understood. She greets with verbal cues, babbles in response to human voice, using intricate inflection, jabbers tunefully at play, and uses her voice in conjunction with pointing or gesturing to indicate her needs. (15-19 months) Goals: Crystal will use jargon language with good inflection and rate, echo the prominent or last word spoken, and imitate environmental sounds and two-word phrases. She will begin to use her own name to refer to herself and develop an expressive vocabulary of ten to twenty words.

Gross motor-When pulled to sitting, Crystal begins to hold her head in line with her body at a 45-degree angle. She is able to roll from both prone and supine positions. She sits independently while using her hands to manipulate toys and with assistance, demonstrates balancing reactions in sitting. She has recently begun using a stander, bearing almost all of her weight on her legs. She has also demonstrated an ability to stand while holding on to furniture, with held support at her buttocks and knees. Her mother reports, "She stood by herself for five to ten minutes the other day, while holding on to a table at the doctor's office." (5-8 months) Goals: Crystal will hold her head beyond the plane of her body when held in ventral suspension and hold her head in line with her body when pulled to sitting. She will lift her head and begin bearing some weight on her hands in prone. She will stand independently, but guarded, at furniture for ten to fifteen minutes.

Fine motor-Crystal uses both hands in midline, with one hand holding while the other manipulates. She points with her index finger, scribbles spontaneously, and places six round pegs in the pegboard. She puts many objects into a container and after demonstration, inverts the container to obtain those objects. (14-18 months) Goals: Crystal will imitate circular scribble and vertical crayon stroke, build a tower using three to four cubes, and string one one-inch bead

Social-Crystal shows a like or dislike for certain objects, people, and situations. She displays a wide variety of emotions and is beginning to show sense of humor. She shows toy preferences and plays ball cooperatively. (15-18 months) Goals: Crystal will experience a string sense of self-importance and begin to show jealousy at attention given to other family members. She will desire control of others and attempt to fight or resist, in order to defend her possessions. She will imitate doing housework and other real-life activities, exhibiting symbolic play with similar, but not real props.

Self-help-Per parent report: Crystal sleeps around eleven hours a night with one nap a day. She finger feeds herself and uses a spoon to scoop her food. She often turns the spoon over when bringing it to her mouth and seems to have an easier time using a fork. She holds (with two hands) and drinks from a cup with some spilling. She is able to use a regular cup, but has an easier time with a sippie cup. Crystal is able to remove her socks and cooperates with dressing by extending her arms. (12-15 months) Goals: Crystal will wash and dry her hands partially, hold a cup handle, place and remove a hat from her head, and remove her shoes when her laces are undone.

Crystal is developmentally appropriate in most areas. Therapy will focus on gross motor and self-help skills specifically, with continued work to maintain other areas of development. It is my recommendation that she continue to receive services from developmental, physical and occupational therapists.

Jill Cannon, RN Developmental Specialist, First Steps Evansville ARC Child Life Center


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