Carlena Lowell

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Assessment, Evaluation and Programming System Report
Carlena Lowell
October 23, 2012












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*Names have been changed for confidentiality
Name: Jill Birth Date: January 27, 2009
Gender: Female Age: 3 years; 9 months
Address: 12 Fairview Drive Date of Report: October 25, 2012
Durham, NH 03824 Examiner: Carlena Lowell

Background Information:
Jill lives at home with her mother, Susan, father, Steve, and 15-year-old sister, Jessica.
Jill also has 20-year-old twin brothers who attend collage just over an hour away from
where they live. Jill was born via C-section three weeks early on January 27, 2009.
Jills mother Susan was given an amniocentesis before delivering Jill to ensure Jills
lungs were developed enough to support her outside the womb three weeks early. Jill
weighed 6 lbs., 13 oz. and was 17 inches long. Susan and Jills father Steve
consider Jill a blessing as they tried to have another child for eight years before
becoming pregnant with Jill. As a result of frequent miscarriages throughout the years
of trying for another child, Susan was given a variety of tests early in her pregnancy with
Jill. She was diagnosed with thrombophilia, or as it is sometimes called,
hypercoagulability. Two disorders contributing to this that Susan tested positive for
were MTHFR (methylenetetrahydrofolate reductase) and APS (antiphospholipid
syndrome). As a result of the thrombophilia, Susans blood clotted at a faster than
normal rate, and she was required to give herself a shot of Lovanox twice a day from
the time of her diagnosis until one week prior to the scheduled C-section, and then
again for two months after Jill was born. Throughout the pregnancy Susan was
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prescribed several other medications including baby aspirin, B12, folic acids, as well as
others. Susan also had ultrasounds and stress tests once a week for the duration of the
pregnancy.
Jill began crawling at age 7 months, walking at 1 year, and talking (Dada and Mama) at
1 years. Jill stopped taking naps around age two, and will only nap now if she is
overtired. Susan reports that from birth Jill has been a difficult sleeper, frequently
waking up in the night screaming. Jill is a typically developing child who started her first
year of preschool this past September. She is enrolled in a class of twelve children and
attends school four hours a morning, four mornings a week. This is Jills first preschool
or child care setting, as she has been home with Susan since birth.
Methods/Setting:
Jill was assessed by Carlena Lowell over the course the last week of September and
the first week of October 2012 using the Assessment, Evaluation, and Programming
System for Infants and Children, Second Edition (AEPS). Carlena is one of Jills two
teachers; therefore, was able to one section of the AEPS per couple of days over two
weeks. Jill was observed at her preschool during which arrivals, small and large group
times, meal times, free play both indoors and outdoors, and transitions took place. The
Child Observation Data Recording Form (CODRF), as well as the Social-
Communication Observation Form (SCOF), were both completed. In addition, an
interview with Susan was conducted on October 25, 2012.


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Behavioral Observations:
Throughout the two week period during which Jill was observed, she appeared to be an
easy going child, and also to enjoy her time at school. Upon arrival each morning, she
warmly greeted each teacher and many children by smiling and saying Good morning,
(name of person). She generally continued to smile and laugh throughout the
mornings. Jill rarely cried at school unless she was hurt. For the most part, Jill was
able to sit and stay focused for the five to ten minute large group time in the morning.
She was able to quickly answer most questions posed by the teachers at circle time,
including why and how questions. For example, when asked why we use walking feet
inside, Jill was able to answer so we dont fall and get hurt. Jill also enjoyed the
second circle just before lunch and attended well to and answered questions about the
stories being read.
Jill is able to follow the rules and routines at school with minimal reminders, with the
exception of walking feet inside and completing transitions. Jill tends to need additional
verbal support from teachers during transitions to stay focused on moving to the next
task. During free play, Jill often engages in activities that can be done using
independent or parallel play skills, such as using art materials and playing in the sand
table. However, her cooperative play skills are certainly emerging. Jill was observed
playing chase games with several peers outside on multiple days. Jill was able to
attend to preferred tasks for well over ten minutes. It seemed one of Jills favorite
activities in school is the art area. She enjoyed using a variety of materials including
paint (particularly finger paint), scissors and writing utensils. Jill often drew people, and
seemed to enjoy practicing her name writing independently. Jill also often played
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sensory activities such as play dough and the water and sand tables. Jill often got
distracted when washing her hands because she enjoys water play. When Jill had
difficulty with an activity, for example, drawing something she had never done before (a
heart), she would repeat several times, I cant do it. However, when the teacher
showed her how to do it on another piece of paper and then gave her verbal
encouragement to do it herself, she was able to successfully do it, and showed pride in
herself for accomplishing something she had not done before.
Family Resources, Concerns, and Priorities
One of the largest concerns Susan and Steve have right now for Jill is her feet. Her
right foot turns in which causes her to fall more often than peers her age whose feet are
not turned in. Jill has been seen by her pediatrician for this, and a referral has been
made to an orthopedist, and they have an appointment next week. The pediatrician
explained to Susan that there are three things that can cause in turned feet: the ankle,
the leg bones and the hips; Susan is anxious to find out what is causing the in turn. The
pediatrician also let her know in turned feet can be hereditary; Susan also had in turned
feet as a young child and was required to wear shoes with a bar between them to
correct the turns. Jill has appeared clumsy in the past as she falls often when running
and participating in other gross motor activities; however, upon speaking with her
doctor, it is realized this may be due to the in turned right foot.
Another current concern of Susan and Steve are working on Jill with at home is her
patience level and the concept of waiting. When Jill has to wait for something she
wants at home she often ends up crying if she cannot have it immediately. Susan
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expressed this trait is unlike her other three children who tended to be a bit more laid
back.
Susan grew up in Massachusetts and is the youngest of five children. She moved to
Maine as a young adult after her brother moved to Portland, Maine. Steve grew up a
few minutes from where they currently live and is the youngest of four children. Susan,
Steve and their children see Steves family frequently as they live close.
Previous Assessments and Evaluation Results
Jill was screened in the early weeks of the start of the school year using the Early
Screening Inventory-Revised (ESI-R) by the Education and Disabilities Coordinator for
the Head Start she attends. Jill was 3 years, 8 months at the time of the screening and
scored a total of 24 on the assessment. The cutoff score in the 3-year-old category for
a rescreen/referral is 16, and for the 4-year-old category the cutoff score is 21. Jill also
had a vision and hearing screening in October of this year; she passed both screenings.
Assessment Results
Fine Motor
The fine motor area assesses Jills ability in bilateral motor coordination (using both
hands, cutting, etc.) and emergent writing skills. Jill is able to use both hands to
manipulate objects with ease. When using writing utensils, Jill is able to use a three
finger pincer grasp; however, still tends to use a palmer grasp (holding the utensil in her
hand with her palm and all fingers. She is able to write her whole first name. Jill seems
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to enjoy cutting paper, and often requests to do it in the classroom. She is able to cut
paper in two easily; however, her ability to cut out shapes is still emerging.
Gross Motor
This area assesses Jills ability in balance and mobility, as well as play skills that use
large muscle groups such as running and kicking. Jill is able to run and avoid obstacles
most of the time. She is able to walk up and down stairs, jump forward, balance on one
foot, kick and throw a ball. Her hopping on one foot skills are emerging, as are her
bouncing and catching balls, and walking up and down stairs while alternating feet. Jill
sometimes falls while running. After having discussions with Susan, it is believed that
Jills in turned right foot may be the cause of this. Jills changes in to sneakers every
day before going outside; sneakers allow her to run with more ease than boots or other
shoes, although the falling is still of concern.
Adaptive
The adaptive domain looks at development in the areas of mealtime routines, personal
hygiene and dressing and undressing. Jill is able to carry out toileting functions
independently, including washing her hands with soap and water, and drying them off
with paper towel. Jill is able to eat a variety of textures of food; she is also able to eat
with utensils. Jills ability to spread food with a knife is still emerging at this point. She
is able to serve herself at the meal table, although she sometimes needs reminders not
to put the serving utensils in her mouth. Jill is able to brush her teeth and wash and dry
her face with minimal adult assistance. She is able to unfasten, untie and unzip clothing
articles. She is able to put on pullover garments, underpants and skirts independently.
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She is also able to thread and zip a zipper. Jill still needs assistance buttoning buttons,
putting on long pants, tights and front opening garments.
Cognitive
The cognitive domain assesses the areas of concepts (colors, shapes, sizes, etc.),
categorizing, sequencing, recalling events, problem solving, play, pre-math and pre-
literacy skills. Jill understands many skills in the areas of shapes, sizes, qualitative (e.g.
hot, soft, heavy, smooth, same), quantitative (e.g. all, many, none, some, more) and
different spatial relations (e.g. next to, beside, in front of, under). Her skills in
understanding temporal relations (e.g. yesterday, first, later, early) is emerging at this
point. Jill is able to group things in relation to objects, people, events and physical
attributes. She is able to place things in a row according to size or length. Jill
recognizes and identifies almost all of the letters of the alphabet. Jill is able to
participate in parallel play (playing beside peers with the same toys, but rarely
interacting) consistently; her cooperative play (playing with peers with the same goals in
mind) skills are starting to emerge. Her ability to count object using one to one
correspondence (labeling one item per number) up to ten is close to mastered. Jill
enjoys writing and discussing letters; she is beginning to show interest in both rhyming
words and the sounds of letters. Her ability to follow multiple step directions is still
emerging, as she often needs verbal prompts to stay on task (e.g. wash your hands,
and then put your coat on).


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Social Communication
This domain interprets Jills ability to communicate socially. It looks at the areas of
social-communicative interactions such as the use of rules of conversation, establishing
and varying social-communicative roles (physical orientation, varies tone of voice with
questions and statements), as well as the production of words, phrases and sentences,
such as verbs, nouns, adjectives and questions. Jills uses a large variety of types of
words, vocabulary, statements and questions for various reasons. She is able to
consistently use words, phrases, or sentences to inform, direct, ask questions, and
express anticipation, imagination, affect and emotions. She uses appropriate
conversational rules such as alternating between speaker and listener, answering
questions for clarification and responding to others topic initiations. Jills ability to use
socially appropriate physical orientation is emerging. She is able to establish an
appropriate distance from the person she is conversing with; however, Jill often lacks
eye contact and needs to be directed to look in the eyes of the speaker. Her eye
contact is more appropriate when she is speaking as opposed to listening. Jill uses a
vast majority of words, phrases and sentences. She is able to use most types verbs,
nouns, pronouns, adjectives, adverbs and prepositions. Jills ability to use some types
of words and questions is still emerging; not necessarily because she uses them
incorrectly, but more so because of a lack of using them. For example, using irregular
plural nouns such as mice and leaves, and asking when and where questions. Jill
still has some slight articulation errors; however, for her age these are not necessarily
inappropriate. For example, she says wed for red; the /w/ sound develops
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considerably sooner in young children than the /r/ sound, which develops in many
children anywhere between the ages of three and eight.
Social
The social development area looks at interactions with others, participation, interaction
with the environment, and knowledge of self and others. Jill is able (and often excited)
to greet others, particularly her teachers, she is able to share or exchange with others,
claim and defend her own possessions, participate appropriately in small and large
group activities, meet her own needs when she is sick, tired, hungry or thirsty, identify
her own and others emotions and able to state the gender of herself and others, as well
as her own age and name. Jills cooperative play skills are beginning to emerge;
however, much of the time she still engages in parallel or independent play. Her ability
to negotiate to resolve social conflicts is beginning to emerge as well. For example, if a
child has something she wants, she is beginning to be able to use her words to let them
know she wants it, although this is not consistent behavior for her yet. Her skills during
small group time are continuing to emerge as well. For instance, she is learning to paint
on her own paper and on others paper only if she asks first. One more area that is
emerging for Jill is her ability to follow classroom rules. She is able to follow many rules
most of the time, but still often needs reminders for a few, such as walking feet inside.
Summary and Recommendations
Jill is a typically developing 3 year, 9 month old child who attends a Head Start class of
twelve 3- and 4-year-old children. Jill scored 80% or above on the AEPS assessment in
the following areas: fine motor (80%), adaptive (80%), social-communication (91%) and
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social (92%). In the area of gross motor, Jill scored 60%, and in the cognitive area she
scored 66%. Jill has mastered many skills in the various areas such as printing her
name, jumping in place, and kicking and throwing balls, independent toileting skills,
demonstrating understanding of concepts such as size, colors, shapes, numeral
identification and spatial relationships, many social-communication aspects, and
participating in small and large group activities. Some skills still emerging for Jill are
cutting out shapes, using a consistent tripod grasp when using writing utensils,
consistently running without falling, bouncing and catching balls, dressing herself in long
pants, front opening garments and shoes, using fasteners on clothing, suggesting
acceptable solutions and using negotiations to solve problems, engaging in consistent
cooperative play, and consistently asking when and where questions. The following
are a few skills that have not yet started emerging for Jill; however, are the next
appropriate skills for her to develop given her mastered and emerging skills. These
include gross motor skills such as beginning to gallop and skip, running with more
consistency, following directions with three or more steps that are routinely given, using
rhyming skills, and producing correct sounds for letters.
In order to increase Jills emerging skills and begin the skills that have yet to emerge I
recommend the following:
1. Discuss the results of the orthopedic consultation with the family in regards to
Jills in turned right foot to assess approaches to teaching her gross motor skills
in the most appropriate manner. We will use various techniques to begin refining
her running skills and teaching her new gross motor skills including outside play
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games, and music and transitions that encourages using gross motor skills, as
well as recommended practices from the orthopedist via family report.
2. Encourage Jill to put her own sneakers on by giving step by step verbal
directions, as well as minimal physical prompting when necessary, of how to
manipulate the sneakers to get them on her feet. This can be practiced everyday
as she needs to change into them before going outside in order to support her
gross motor play. Also encourage Jill to independently dress herself in long
pants and front opening garments. There is occasionally need for Jill to dress
herself in long pants at school, and as winter approaches this will be done more
so with snow pants. However, Jill often has front opening garments to put on
before outside play.
3. Encourage Jill to follow routinely given two step directions. This skill should be
mastered prior to following routinely given three step directions which is located
in the C strand of the cognitive area of the AEPS. Jill often gets distracted by
things in the environment, causing her to not follow the verbal directions given to
her. A method to teaching her this may be to provide verbal prompts along with
pictures for her to take with her to remember what she is doing next. For
example, when given the verbal prompt of Jill, wash your hands and find your
seat at the table, pair it with gestures, or provide pictures from the daily schedule
to aid her in staying focused on the task at hand.
4. Encourage Jills cooperative play skills to increase by facilitating play in various
areas that emphasize more cooperative play skills such as the dramatic play
area and the block area. Jill tends to prefer activities in the classroom that use
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many independent or parallel play skills such as sensory tables (sand and water),
play dough and art activities. Since these are preferred activities for Jill, we will
also try to facilitate cooperative play in these areas by doing activities that
encourage social interaction such as creating a bakery at the play dough table in
which multiple children are involved.
5. Encourage Jill to begin being able to rhyme a given word. Her interest in
rhyming words is beginning to take shape as we have started discussing them
within the classroom. This will be taught through small and large group times by
using rhyming books and pictures, as well as by narration and pronunciation of
the teachers throughout the day.
6. Encourage Jill to begin identifying the sound that letters make. Jill enjoys writing
her name and identifying letters of the alphabet; therefore, we will begin teacher
her letter sounds using the letters of her name.