Wednesday, April 3, 2013

Preparing for Alex IEP Meeting: The making of lists...

When I started working on the list of things I want in Alex's IEP, I slopped down my ideas on what I wanted to work on- things that he was struggling with in school and things we want at home. I looked at his current IEP, the long term goals I want for him, where I see him in 10 years, and listed what I thought might be the steps to get to there. I condensed the list down to 6 areas of concern, and gave it to them ahead of time to work what they could in where they could work it in. They wiggled and jiggled and condensed and managed and made as much of it fit as they could. One example is *spoiler alert* on #2, I mentioned his refusal to grasp objects. They took that and put it under #1 and his new goal is split into steps. Benchmarks, maybe. Like this:

1. Alex will carry the photo hand over hand for 5 feet without dropping it.
2. Alex will carry the photo hand over hand for 10 feet without dropping it.
3. Alex will carry the photo to a specific location.

I got what I wanted but since they had the list in advance, they saw a better place to work it in. Actually, a few places if you count #3 where he is carrying his tray.


Goals

1. Transitioning:

Long term goal is to have him walking independently.

He could use a list of plastic framed photographs of various places he visits during the day on a Velcro strip by the door. Leaving the classroom, they would hand him a photograph of where he was going and he would carry it to that place. Leaving that place, they would trade for a picture of the classroom and he would carry it to the classroom.

Having something in his hand that he wants to hold helps occupy him during the transition and gives him clear instructions on where he is going.

2. Self Care:

Dressing:

Long term goal is for him to dress himself.

We have worked on moving his limbs to aide in dressing and moved on to pulling his pants up/down. Once he mastered those, we moved on to the fine motor skills needed to button/snap/zip. The button/snap/zip was a little too hard for him so we traded for grasping/releasing as a first step to button/snap/zip. Last year that goal was taken out and I would like to put it back in to encourage him to grasp the clothing to pull them on.

He's also refusing to grasp his plate to put it in the sink or to grasp his toys to clean up without full hand over hand, which would interfere with his goal of carrying his tray through the line and throwing his tray in the trash after lunch. His inability to grasp/release would also hinder the goal of increasing bilateral skills by following a classroom routine of hanging up his backpack/jacket and putting his folder in the bin.

3. Bilateral Skills:

Long term goal is dressing himself.

He already has this goal in the form of feeding himself, carrying his tray, and following a classroom routine of hanging up his backpack/jacket and putting his folder in the bin. I would like to keep this goal. I would also like to keep the description of which hand he uses to eat vs work.


4. Grooming:

Long term goal is independent grooming.  

I would like for him to work on washing his hands as the first step to washing himself. He is to the point he enjoys the water running over his hands and will stim in the water (awesome progress) but he will not rub his hands together. (bilateral integration goal) 

I would like for him to let me brush his teeth. Last year the OT was working on desensitizing him to vibration for an electric toothbrush. She used vibrating toys on his hands, arms and moved to his head/face. I can now use hair clippers on the back/top of his head but he still doesn't like me around his face/ears. She was working on getting him to accept things in his mouth and he is doing much better with that. He is now chewing on his toys, has been kissing me recently, and he is willing to chew on a toothbrush but he still doesn't want me moving it around in his mouth.

5. Communication:

Long term goal is to have Alex holding a verbal conversation.

His current communication goals are following 1 step directions, learning 5 new vocabulary words/month (PECS), and requesting a desired item from a field of 2 photographs or verbally. I would like to add in one vocal vocabulary word that is functional and not echolalic. I would also like to continue working on verbal reciprocal communication using his echolalia as an aide.

6. Staff Change:

To help Alex cope with staff change.

Introduction- Can he be introduced to new people ahead of time when possible?
Observation- Can they visit his current classroom a few times to work with him before the change so they can see first hand what works?
Documentation- How can staff communicate from class to class about what he is capable of and how to get him to work?

I think it would be best to have a sort of plan as far as introductions, documentation, or communication if we can work it in.


Next, his SLP asked for a list of things that he's interested in to come up with ideas on how to motivate him to work. I figured since I was already making the list, I could go ahead and print it out just in case we needed it.

Interests

Music: He likes Nirvana, Pink, most all hard/alternative rock, country music with a happy beat, and you can't go wrong with pre-school songs like the 5 little ducks, Old MacDonald, the monkeys that jump on the bed, if you're happy and you know it, and that one song where the fingers greet each other. He likes the ants and the dinosaurs that march. He loves Ernie's Rubber Ducky song.

Toys/games: He likes to glance at books without help, looking at pictures of people he knows that he can crumple up and carry around (the glossy coupons keep him happy through the store), he loves his teething rings, balls and rubber duck type toys (palm size are best). He likes nesting objects. He's recently become interested in cars and hand sized things that roll around.

Movies: His favorite movies are The Wizard of Oz, Charlotte's Web, All Dogs go to Heaven, The Lion King, anything Care Bears, Sesame Street's Do the Alphabet (Ooga)... or pretty much anything Sesame Street- Baby Bear, Ernie and Elmo seem to be his favorites. Iffy movies are Shrek, Aladdin, The Iron Giant, Garfield, Finding Nemo.

Shows: His favorite shows are Dora, Elmo's World (which he will request by name) Blues Clues (requests by name), Lazy Town, Teletubies, Caillou, Clifford. Iffy shows are Fairly Odd Parents, SpongeBob (he asks for it and then hates it), Barney (requests by name but doesn't like the show).

Activities: He likes to run, dance, and play in water anywhere he can find it, He likes watching fish in the tank but can't resist throwing things in or splashing in it.


The one area I have trouble with every year is his list of strengths. I spend so much time looking at where he needs to improve and where he hasn't improved, I forget to think of the places he has done well. So, I made a list beforehand.

Strengths


Communication: Alex is good at communicating his thoughts/emotions with eye gaze, facial expression, and vocalizations. He's good at identifying tone, facial expression, and body language of the person talking to him but hears/believes the overt tone/body language/facial expression over the words used or the underlying purpose (joking). He's learning the conversational pattern using the question/answer of the standard greeting, "Oh, hi! How are you!?". He loves action words and seems to pick up phrases pretty easily, depending on the pattern in the words in the phrase, using his echolalia. His delayed echolalia helps him have an arsenal of words on hand for specific situations.

He's learning to self-advocate at home. He tells me "no" or "don't want it" when he doesn't want to do something, he tells me "all gone" when he is finished eating and is learning to tell me "more" or tap the table when he runs out of food before he's full. He uses the phrase "want it" when he wants something but is currently unable to tell me what "it" is.

Personality: Alex has a very easy going personality. He's generally happy and laughs easily. It takes a lot for him to be upset and he rarely expresses anger.

He is eager to please and loves praise. He works well for genuine praise and high fives.

Self care: Progress in the past year: He's learned to drink out of an open, heavy glass, does fairly well stabbing certain foods with a fork and has made significant progress using a spoon with a built up handle. He's pulling his pants up on his own when he feels them slipping.


7 comments:

  1. Nailed it! just like I knew you would. I love the list of strengths, I should start something like that for my Monkey.

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  2. You've done a tremendous job at this task. The detail and observations are as though I'm now completely familiar with him. Great job!

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