PROGRESSIVE STEPS, INC.
Child Development Program
28093 Smyth Drive. Valencia, CA91355
(661) 295-0181 FAX (661) 295-9776
DEVELOPMENTAL EVALUATION
Child’s Name: Devivo, Nathan
Date of Evaluation: August 2008
Date of Birth: 08/07/06
Age: 24 months
Diagnosis: Severe Semilobar Holoprosencephaly
Parents: Marcela Devivo & Owen Andrew
Address: 17914 Vista Ct. Canyon Country, CA91387
Phone Number: (818) 482- 7562
Primary Language: English
RegionalCenter Coordinator: Argoncillo, Mercy
Progressive Steps CDS: Gittisarn, Dena
IDENTIFICATION OF THE CHILD
Nathan is a 24 month old male child who was referred for developmental services due to his diagnosis of Holoprosencephaly. Nathan was born full term gestation at 40 weeks via c-section. He weighed 9lbs. and was 19 inches in length. Mother explained that she had an uncomplicated pregnancy. During a routine ultrasound at 36 weeks, complications were observed and an unconfirmed diagnosis of Holoprosencephaly was given. Nathan was delivered at U.C.L.A. due to risk factors. Nathan at delivery required no breathing support and delivery was uncomplicated. Upon delivery an ultrasound of his head was given and then the diagnosis of Holoprosencephaly was confirmed. An echogram and barium/swallow tests were conducted, both within normal limits. Nathan had a brain shunt placed on November 17th 2006. Nathan was hospitalized for 23 days in December for a shunt infection and then he had a shunt revision on January 10th 2007.Nathan continues to be monitored closely due to his medical diagnosis.
FAMILY
Nathan lives with his mother and father in a home in Canyon Country, CA. Nathan is cared for by his parents and a full time nanny during the day.
MEDICATION/DIET
Nathan currently takes prevacid (4/5th of a capsule per day). Nathan takes Enfamil soy formula through a bottle. He does eat soft pureed foods, soft crackers and soft table foods.
HEALTH/IMMUNIZATIONS
Nathan currently weighs 21 lbs. and is 32 inches in length. He is not yet current with immunizations. Nathan’s health is stable at this time. Nathan occasionally has colds and congestion that will usually last 1 week.
VISUAL/AUDITORY EXAMINATION
No formal hearing exam was performed. An ophthalmologist examined Nathan; vision is within normal limits.
Page: 2
Devivo, Nathan
Developmental Evaluation-08/08
PHYSICIAN/SPECIALIST
Pediatrician(Dr. Feldman, Canyon Country). Ophthalmologist(Dr. Calvin, Encino). Neurosurgeon (Dr. Lazaress, U.C.L.A.). Gastroenterologist (Dr. Bahar, Tarzana).
PARENT CONCERNS
Nathan’s parents would like for him to continue with all therapies. At this time his parents would like Nathan to receive additional adaptive equipment (Hart Walker) to facilitate his development.
RECOMMENDATIONS
Continue with all developmental therapies for Nathan as recommended by each therapist. It is essential that therapists and parents evaluate monthly, Nathan’s progress and review current goals as a team.
CURRENT THERAPIES
Child Development (Progressive Steps) – 2 times per week in home.
Occupational Therapy (Progressive Steps) – 2 times per week in home.
Physical Therapy (Progressive Steps) - 2 times per week in home.
Physical Therapy (Bright Star) - 2 times per week at clinic.
Speech Therapy (Progressive Steps) - 1 time per week at clinic.
Horseback Therapy (Carousel Ranch) – 1 time per week.
THE HAWAII EARLY LEARNING PROFILE WAS USED AS AN ASSESSMENT INSTRUMENT and parent interview.
Cognition:6-14 months (scattered due to gross/fine motor delays). Nathan demonstrates consistency in problem solving (cause& effect) and picture recognition.
Social: 8-15 (scattered due to gross/fine motor delays).
* See attached reports for speech, occupational and physical therapy evaluations.
Cognition: Nathan is able to look from one object to another held a close distance. He is able to visually identify pictures (ball, baby, fish, dog, cat, and car) through eye gaze. Nathan is able to find a partially hidden object; he will look and with assistance attempt to move the cloth from the hidden object. He will continue a familiar activity by initiating movements; moving his body andreaching out with his right hand. He is able to reach for a nearby object; with physical assistance. He will consistently anticipate a slowly moving object. Nathan will touch and pull an adult’s hand to help restart an activity, especially a favorite one. Nathan appears to beginning to understand cause and effect with familiar activities.
Social: Nathan enjoys songs that involve hand motions; with assistance he brings hands together to clap. He consistently responds playfully to a mirror (smiles, laughs, pats, reach toward his image with his right hand).Nathan enjoys interaction with adults and children. He will reach towards his parents and familiar adults with physical assistance; to gain attention and interaction. Nathan appears to be extremely happy and social child.
Page: 3
Devivo, Nathan
Developmental Evaluation- 02/08
DEVELOPMENTAL GOALS
(Target Date: 02/09)
COGNITION and SOCIAL GOALS
-Nathan will understand object permanence with physical assistance from an adult, 90% of the time.
-Nathan will reach to activate a mechanical toy with physical assistance upon request, 90% of the time.
-Nathan will touch a communication device (large blue pad) to indicate he wants to restart an activity, 90% of the time.
-Nathan will identify 10+ pictures of objects, 2-3 held within his visual field, he will indicate through eye-gaze, 90% of the time.
-Nathan will indicate details in his favorite picturebook by using eye gaze to an adult, 90% of the time.
-Nathan will understand the concept of identifying which picture from three or four is the picture of a similar object before him, by using eye gaze to indicate, 90% of the time.
-Nathan will demonstrate an understanding of action pictures, thorough eye gaze, and 90% of the time.
-Nathan will enjoy songs; clapping his hands upon hearing a familiar song as, “Wheels on the bus” with physical assistance, 90% of the time.
-Nathan will make choices between two objects, by using eye-gaze, 90% of the time.
-Nathan will parallel play, plays next to other children with adult assistance, 90% of the time.
______
DENA GITTISARN B.A.
CHILD DEVELOPMENT/MENTAL HEALTH SPECIALIST