Nassau County Department of Health

NASSAU COUNTY DEPARTMENT OF HEALTH OFFICE OF CHILDREN WITH SPECIAL NEEDS PROGRESS REPORT

Child’s Name: John Smith Auth. # 4352237 DOB: 1/23/14 IFSP Period: From: 2/08/16 to: 8/07/16 Agency Name (if applicable): Kidz Therapy Services Name of Provider: Mary Jones Discipline: Special Instruction Name of EIOD: Dianna Dwyer Name of OSC: Jill Johnson

Date you started working with this child: 11/10/15 Frequency/Duration: 2 x 45 Where have services been delivered? Home, Uniondale, NY Number of units authorized: 54 Number of units utilized: 16 Number of units not utilized due to: Child illness/family vacation: 0 Therapist illness/scheduling: 0 Has a parent/caregiver been present for the sessions? If not, how have you communicated with the family? Ms. Holloway, John's mother, is present during the session and is available before and after the session as well. Please note services were not rendered since 5/10/16, as this therapist was unable to make contact with the parent.

IFSP FUNCTIONAL OUTCOMES (For each outcome, rate the progress in this time period: NP-No Progress; LP – Limited Progress; GP – Good Progress; OA – Outcome Achieved. Also include short-term objectives that are being worked on to achieve IFSP functional outcome.): To follow simple directions clearly. Good progress at the time. Increase eye contact. Good progress, at the time. Increase attending skills. Good progress, at the time. He will expand his play skills to include cause and effect and problem solving skills, complete puzzles, shapes sorters, play with a toy car and eventually feed a toy doll/bear (pretend play). Good progress, at the time. To attend to adult directed activities for longer periods. Good progress, at the time. He will increase verbal imitation skills. Good progress, at the time. To greet people. Limited progress, at the time.

Describe the strategies the family/caregiver have been taught to use to achieve each outcome and how these strategies are being incorporated into the child’s daily routines (e.g. mealtime, bath time, circle time, snack time etc.) Which family member(s) / caregiver(s) have you been working with? (For center-based services identify how you are communicating strategies for carryover.) Ms. Holloway has been open to attempting all reviewed strategies to aid in John's progress. She is present to observe the sessions and carry over skills targeted.

In addition to working with the family, describe all collaborative efforts made to address the IFSP outcomes of this child. Examples: Interactions with medical providers, other EI providers, day care staff, other caregivers, community resources (if other than IFSP team, written consent is necessary) Phone calls to the Speech therapist and Ongoing Service Coordinator occur bi-monthly.

of 3 Please provide an assessment of the child’s current level of functioning and progress made towards achieving outcomes. This ongoing assessment can include standardized testing, observations from the IFSP team, clinical opinion and professional judgment.

Please note formal testing was not completed as John has not been seen for Special Instruction services since 5/10/16.

Cognitive Skills: John will recognize his parent and family members visually. He will consistently reach for a desired object (Ex: cars). He does not look for family members when named. He does not consistently respond to his name. He enjoys repetitive actions that produce the same and different sounds. He will explore toys and activate cause and effect toys. He had begun to search for and uncover a toy that he has seen hidden. He grasps and pulls a string to obtain a toy. He does not consistently give/hand over a toy on request. John was beginning to show an understanding of simple commands such as “sit,” “stand,” or “put in” and would at times, follow through. John shows an understanding of a variety of cues.

Language Skills: John requests, “Give Me” gesturally, with verbal prompting and some of the time independently. He shows an understanding of language and will make a choice gesturally when asked, “What do you want?” and will point to the desired item. John continues to make inconsistent eye contact. He will vocalize when a desired item is briefly withheld to express frustration. John is beginning to wave.

Gross Motor Skills: John is able to squat to pick up a toy and return to standing independently. He will pull himself up on furniture to a standing position. John is able to seat himself in a small chair. He will walk in a hurried manner. John dances to music.

Fine Motor Skills: John will transfer an object from one hand to the other hand. He can pick up a one- inch cube with a grasp between the palm and fingers. John can build a tower of 5-6 blocks. He can insert a circular block in a form board and complete an 8 piece inset puzzle.

Social/Emotional Skills: John is a shy and curious boy. He is proud of his accomplishments. He will clap and look at his mother and then this teacher for them to imitate his clapping. He will smile in response to his accomplishment. John demonstrates feelings such as pleasure and anger via facial expressions, body language, crying, throwing items, vocalizing or walking away from the work area. John is beginning to show an understanding of “No,” by briefly stopping an activity then continuing while smiling. John initiates his own play. He has favored items and often chooses what he is familiar with. John continues to frustrate easily and vocalizes, changing his facial expressions and throwing items. His parent reports that he will yell, hit and kick. John continues to be easily distracted by stimuli and can be difficult to redirect back to the task at hand.

Self-Help Skills: John will hold his own cup and can drink from a sippy cup. He feeds himself however, he will often pocket food in his cheeks. John will pull his slippers and/or socks off.

of 3 Recommendations of provider or IFSP team: Include information which supports this recommendation. To resume special instruction services in order to aid John in his development. Decrease frustration levels. Respond consistently to his name. Expand play skills. Increase use of gestures/language to communicate. Increase attention to tasks. Monitor John's play and cognitive skills. Continue to provide John with positive reinforcement and advocate for him.

I certify that I have received and reviewed a copy of the child’s IFSP prior to starting services, have provided services in accordance with the IFSP service’s specified frequency and duration and have worked towards addressing the relevant IFSP outcomes. I further certify that my responses in this report are an accurate representation of the child’s current level of functioning.

Signature of Provider completing report: Mary Jones Date: 08/01/16

Discipline: Special Instruction Cell phone #516-555-5555 License # 12345-01

Signature of Supervisor/Reviewer: ______