Tuesday, October 12, 2010

Saying good-bye to Speech and OT

I will start by saying this post is INCREDIBLY behind the times in many respects. Emily finished speech and OT at the end of August. But, as I mentioned in several prior posts, leaving two of the most helpful people in Emily's life was really difficult. I felt like I was taking away Emily's life-boat, her means of learning and progressing and expressing herself! Since therapy has ended and school has started, I've seen that this isn't in fact the case. Emily can survive in the school system; indeed, she is thriving, but we both still miss Shelly and Sue terribly.

What follows are excerpts from the discharge reports detailing Emily's progress to date (August 2010) and what type of goals her future teachers should think about. If you go back and read the reports about Emily's behaviors from the beginning of the year, the progress she has made is just amazing. Go Miss Em!

Speech Discharge Report:

"Emily initiates communication frequently at this point, using many single words, frequent two-word combos, and some longer 3-4 word utterances (eg I like it puzzle). She still has difficulty processing what people say to her; she does not answer questions beyond "Do you want..?" and she has difficulty following directions. Her attention at times appears to be hyper-focused on an item or activity and its is difficult to redirect her attention or to wait and take turns. Pictures are still very important to help her understand schedules and routines.

She seeks sensory input, has a high need for activity, has a need for order, and is highly distracted. She has difficulty regulating her emotions and needs her blanket and cup to help calm herself.

Goals include (1) Producing a sentence with a person's name + verb or noun + verb (2) Follow novel commands (eg put the cup on your head) (3) ID objects by function."

OT Discharge Report:

"Emily made great gains in OT in the last 5 months. Initally she demonstrated difficulty regulating herself in a large open space; however, she is now able to particpate in activites in large spaces without fleeting from activity to activity. Emily also demonstrated an improved ability to initiate play schemes, tolerate mixed toy themes, and request her blanket or drink when overwhelmed.

Emily is an adorable child who has demonstrated improved self-regulation and play since beginning OT. She is a child who benefits from visual supports with schedules and novel situations; however, once she gains an understanding of the situation the supports can be removed. Emily benefits from the cue "listen" to get her auditory attention to a situation or task as her visual system is presently stornger than her language processing system. Emily regulates herself with a blanket and a drink and will request or seek out those items when stressed.

A medical diagnostic evaluation is recommended to assist Emily and her family to determine any medical reason for Emily's speech/language delay and difference in self-regulation."

Despite the fact that Emily is behind her peers in terms of language and expressive play, I am so proud of the gains she has made. In the next month I will be attending parent-teacher conferences, and should be able to report on her progress with the new therapists. We are also waiting to find out if Emily will be seen by a developmental pediatrician (something easier said than done) to determine what other medical factors are involved in her developmental delays. I've been doing a lot of reading on the role of diet and development, and will have more on that topic in the coming weeks.

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