CASE STUDY : ABBIE

Janna Presley, Holly Koster, Samantha Newcomb, and Ryan Elsea

FORMAL ASSESSMENTS Developmental Assessment of Young

Children (DAYC) Standard scores on the DAYC were:

Adaptive 66, Social Emotional 78, Communication 67, Cognitive 63, Physical Development 60, and the General Development Quotient score is 69.

Qualifies for EI services

OVERVIEW OF OUTCOMES Outcomes are focused on Abbie’s needs

and her caregiver’s concerns: Difficulty sitting independently to play Lack of interest in toys

Inconsistent when responding to toys, keeps toys in midline, not reaching for toys

General delays in development Not weight bearing through legs, not catching herself when

loses balance, prefers to lay on back, minimal transitions Problems with feeding

Frequently chokes/gags on food Worried they are not doing everything needed to

help Abbie due to being inexperienced parents

OVERVIEW OF OUTCOMES Examples:

While sitting in boppy pillow, Abbie will reach for toys on her own and then hold them on her own during play 3 out of 5 trials each day during the week.

Abbie will reach arm out to catch herself when tilted to the side four out of five times while playing, four days of the week.

Abbie will independently transition in and out of sitting four out of five attempts while playing, three days of the week.

While playing, Abbie will bear weight through her lower extremities when placed in supportive standing three out of five attempts, three days of the week.

OVERVIEW OF OUTCOMES Examples (continued):

Abbie will play with toys in a supportive seat while bathing three days of the week

Abbie will sit in a supportive seat with the family during evening mealtimes for up to fifteen minutes four days of the week

Abbie will eat one meal a day consisting of baby cereal with decreased choking or gagging on 5 days of the week.

Foster family will express increased confidence in positioning Abbie during play.

Foster family will follow up on an ophthalmology and audiology screening.

INTERVENTION STRATEGIES

Assistive devices: Boppy pillow Supportive chair/seat Bath seat

Help Abbie engage in play with toys: Incorporating toys with different textures, lights, and sounds

Increase Abbie’s stability: Reaching and grasping activities Tilting reactions Transitioning and weight bearing activities Instructing parents to hold at Abbie’s hips

Improve Abbie’s feeding: Changing the textures of foods Pacing of feeding Altering utensils Changing the alignment of the head, neck, and body when

feeding

SPECIFIC ISSUES: RELIGION

Foster parents are devout Roman Catholics.

Birth mother prefers Abbie be raised according to a protestant religion.

What variables may influence this decision?

Who do you think gets the final say?

WHERE TO LOOK! State of Alabama Department of Human

Resources. (2001). The foster parent handbook: A guide for Alabama’s foster parents.

THE ANSWER: “The child needs the opportunity for

spiritual development; however, the foster parent must keep in mind the child’s and his family’s religious preference. At no time should the foster parent require or push the child to accept the foster parent’s religious beliefs or rituals. It is the role of the foster parent to provide transportation to social and religious activities”( State of Alabama Department of Human Resources,2001).

REFERENCES Kramer, P., Hinojosa, J., & Royeen, C.B. (2003). Perspectives in human

occupation: Participation in life. Baltimore, MD: Lippincott Williams & Wilkins.

Law, M., Cooper, B., Strong, S., Stewart, D., Rigby, P., & Letts, L. (1996). The person-environment-occupation model: A transactive approach to occupational performance, Canadian Journal of Occupational Therapy, 63, 9-23.

Rudolph, C.D., Link, D.T. (2002). Feeding disorders in infants and young children. Pediatric Gastroenterology and Nutrition, 49(1), 97-112.

State of Alabama Department of Human Resources. (2001). The foster parent handbook: A guide for Alabama’s foster parents. Retrieved from http://www.dhr.state.al.us/large_docs/fphandbook.pdf.

Washington K., Deitz, J.C., White, O.R., Schwartz, H.S. (2002). The effects of a contoured foam seat on postural alignment and upper-extremity function in infants with neuromotor impairments. Journal of The American Physical Therapy Association ,82(11),1064-1076.