Dashawn’s Case
Dashawn was referred to the Infant & Toddler Connection of Wonderland by his Pediatrician, Dr. Purvis. Dr. Purvis sent over copies of the developmental screening and M-CHAT he completed with Dashawn. Based on parent report, Dashawn was born full-term, weighing 8lbs 3 oz., following an uncomplicated pregnancy. He has a history of ear infections and his sister received speech therapy when she was a toddler. Dashawn’s mother is not concerned about his hearing or vision. During the evaluation, Dashawn played with blocks, a ball, looked at books, and pointed to some body parts. He made some animal sounds, used jargon as he played, and said two words. Dashawn interacted with others around him, responded to his name, and following simple directions. He took turns in play, put shapes in a puzzle, and scribbled with crayons. He pretended to feed his Clifford dog and put him to sleep. Dashawn can take off his clothes and occasionally seems to be aware that his diaper is soiled. He eats without any problems except that he chokes often, according to his mother. Based on the evaluation, Dashawn was found eligible for weekly speech therapy services due to developmental delays. He is showing strengths in his gross and fine motor, social, receptive communication and self-help skills. Dashawn was born August 12, 2013.
Dashawn was referred to the Infant & Toddler Connection of Wonderland by his pediatrician, Dr. Purvis, due to concerns for his expressive language development. Dr. Purvis completed a developmental screening with Dashawn and his mother at 24 months well-child visit and noted that Dashawn was only using three words: mama, ball and juice. Dr. Purvis also completed the M-CHAT but no concerns for autism were noted based on the screening results. Dr. Purvis recommended that Dashawn be tested by the developmental pediatrician at the local children’s hospital, which is scheduled for May. Dashawn also had an audiological exam on July 3, 2018, which found his hearing to be within normal limits. Dashawn was born full-term, weighing 8lbs 3oz, following an uncomplicated pregnancy. Based on review of Dashawn’s medical records, the only complication noted after delivery was jaundice, three ear infections but otherwise has been a healthy child. Dashawn passed his newborn hearing screening at birth and no concerns have been noted for his vision. All immunizations are up-to-date.
Dashawn’s mother reports a family history of delayed communication development, as his sister also received early intervention services due to developmental delay. His assessment service planning was held in the family’s home with Dashawn, his mother, a speech therapist, a developmental service provider, and the service coordinator present. Dashawn was shy at first, but warmed up quickly to the assessment activities. He especially enjoyed playing with the ball, putting pegs in a pegboard, and scribbling with crayons. As Dashawn warmed up, he began to interact with those around him and would look around to be sure that everyone was watching and clapping for him. He took turns in play stacking blocks (up to a tower of eight) and knocking the tower down and tossing the ball back and forth. While playing with the ball, at one point Dashawn hit his head on the underside of the table and went to his mother for comfort. He quickly recovered and continued playing. Dashawn was able to follow directions to locate the ball, to give the ball to his mom, and other 1-2 step commands. During the assessment, Dashawn responded to his name, pointed to pictures in a book, and pointed to 5 body parts on a doll and himself. When looking at the book, Dashawn made the “woof” and “meow” sounds to pictures of dogs and cats, and used some jargon in play.
They only true words today were “mama” and “ball”. Dashawn’s mother said that Dashawn can also say “top’ for stop, to tell his sister to stop bothering him. Dashawn’s mother reports that Dashawn has tantrums often during the day when he gets frustrated or tired. Because Dashawn’s tantrums are so frequent, his mother said that it is difficult to take him out on errands and to the mall. Dashawn’s mother and sister have started trying to teach Dashawn a few signs (more, cracker, car) but Dashawn have not yet begun to use them.
Dashawn attended well to activities where he played one-on-one with an adult. He put the shapes in the puzzle and looked to the educator who was playing with him for help when the triangle would not fit correctly. He enjoyed scribbling and copying lines and playing a matching game during which he matched three objects on request. Dashawn played pretend with his Clifford stuffed animal, pretending that Clifford was eating and going to sleep. When Dashawn wanted to play a different game, he would put his hands on the toy bag that contained the testing materials, look at the educator, and vocalize “uh-uh” He was very purposeful in his communication but was not able to imitate words or sounds in play today.
Dashawn is able to move about independently by walking, climbing, and running. His mother reports that Dashawn’s ability to move is his greatest strength. Dashawn can push and carry large objects, like his child sized chair. He can jump from the bottom step in his house, climb up onto the couch to sit, and throw a large ball without falling. Dashawn helps put laundry away and helps throw trash away when asked. He can take off his clothes and occasionally seems to be aware of his diaper being soiled. Dashawn will vocalize to get assistance, using the same “uh-uh” sounds mentioned earlier, and will point to what he wants if out of reach. Dashawn eats well but has trouble chewing his food. His other reports that he will sometimes pack his cheeks “like a squirrel” then choke trying to swallow. She also reports that when he was an infant, he took a long time to drink his bottle. Dashawn can feed himself using fingers and will sometimes use a spoon. He also drinks from a sippy cup and will say “hush” to get juice when his cup is empty. Based on the assessment, Dashawn is showing strength in his gross and fine motor, social receptive communication, and self-help skills. He is showing developmental delays in his expressive communication and cognitive development. His expressive communication is limited by the fact that Dashawn is only using 4 words consistently at this time and seems to have a limited variety of sounds. He seems to have some difficulty coordinating the movements of his mouth to chew and make sounds. Dashawn’s cognitive delay appears to be related to his expressive communication, as his problem-solving skills appear to be appropriate for his age.
