Name: / Calvin Johnson / D.O.B. / 5/10/85
Graduating School: / Parkland High School / Home
District: / Northern Lehigh
Graduating Teacher: / Mr. Richard Horn / Contact Number: / 610-XXX-XXXX
Anticipated Year of Graduation: / June 5, 2007 / Type of Program: / MDS Functional
Address: / 2700 North Cedar Crest Boulevard / Phone #: / 610-XXX-XXXX
Allentown, PA 18104 / SS#:
PARENT/GUARDIAN INFORMATION
Parent/Guardian Name: / Mr. Robert Flood
List residence: / 7608 Montgomery Avenue, Allentown, PA 18103
Phone: / 610-XXX-XXXX
Emergency Contact: / Deb Jones / Phone: / same as above
Second Contact: / Phone:
Attach a Vision statement and/or report for the individual if one is available.
1. DAILY LIVING SKILLS
A. Feeding
Likes / DislikesEats Everything / None Noted
Procedure: Indicate how the individual is positioned? Tell to what degree he/she participates in the activity. Include suggestions to facilitate the process.
Calvin does not assist. He is fed by caregivers. He wears a long bib for coverage. He can pick what he likes to start with or what he wants next. Drink is thickened.
Materials: What type of plate, cup, and utensils work best.
Calvin accepts a typical metal spoon with no problems.
How does the individual communicate this need?
Calvin points in the direction of his food, lunch, snacks, etc. He also vocalizes. He has a good appetite and generally eats the entire school lunch.
B. Toileting
Does the individual indicate? / Yes / How? / Calvin does tell when he is wet, but not before.Is he/she successful on the toilet? / No / Is there a recommended schedule? / No
How is he/she positioned? / He can stand to be changed or lie on a table.
Is there any special equipment used?
No, Calvin wears diapers.
C. Dressing
How does the individual participate in the activity?
He will pick up his coat, or outer garments, and try to extend arms into the item.
D. Additional Areas
Add relative information concerning tooth brushing, hand washing, etc.
Calvin requires hand-over-hand assistance and does not resist.
2. MOBILITY
Is the individual ambulatory? No Explain. He uses a manual wheelchair.
Does he/she require any assistance in the process? Calvin has difficulty with directions due to differences in strength of different sides.
Is there a distance limitation? No limitation; but he has very little control due to motoric differences.
What devices are used to facilitate ambulation? (walker, cane, gait trainer, etc.) He uses MOFOs.
What procedure is used for transfers? He can stand and assist.
Is a Hoyer Lift recommended? No
List any other considerations. None at the present time.
3. SEATING AND POSITIONING
What seating and positioning supports are used?
Calvin is typically in his wheelchair for the entire day.
List special considerations or concerns.
His left arm/side is stronger than his right.
What is the suggested time limitation on any position?
Calvin can sit in his chair for a full day other than bathroom changes with no noticed problems.
What safety assists are needed: tray, lap belt, harness, etc.
He wears a lap belt and uses a chest harness for transportation.
4. BEHAVIORAL CONSIDERATIONS
List all behaviors the individual exhibits along with the meaning that is attributed to them. Include strategies implemented to address the demonstration, e.g. hitting self seems to be an expression of anger. Best dealt with by refocusing.
Calvin will physically leave an area if he is bored. He can be verbally redirected a few times in order to get him back on task. He will grab or pull anything in his sight, and become vocal if he is not the center of attention. The individual in charge needs to be firm and tell him that he is being rude. He will move to an area that he wants to without permission. Calvin needs to be reminded as to what the present activity is. If he returns to the present activity without any misbehaviors, it is important to let him know that he can go back to the requested activity at a later time during the day.
Are any behaviors determined to be of danger to self or others? Explain.
Calvin exhibits very strong behaviors. He will pull at items and has tipped them over. A big caution is that Calvin does pull on and can tip over wheelchairs. He will do this even if another student is in his/her wheelchair. He has already pulled computers off the table.
5. COMMUNICATION
What are the present skills of the individual?
Calvin can point to items of his choice. He uses pictures, photographs, and printed words. He uses a communication book. He used single message vocal output devices in the classroom. He touches one leg for yes (left) and right left (no). Calvin can also vocalize. He used a spelling board in the past. Calvin can use reverse facilitation. In order words, he can take the communication partner’s hands and guide it to letters and words.
What are the access methods?
Calvin uses touch or pressure. There are considerations due to motor issues resulting from cerebral palsy.
What Vocal Output Communication Devices have been used successfully?
Calvin is successful with single message devices; BIGmack, One Step.
List any communication boards, books, or schedules that are used.
PCS symbols were used on horizational strips to indicate activities. Calvin had a communication book and was successful with it in the past.
Since behavior is also a communication mode, please list any behaviors as well as what the inferred message might be, e.g. individual will drop to the floor as a way of telling us he does not want to comply.
Small food reinforcers are used with Calvin. Cheerios have been used to help distract him.
Other behaviors under communication:
Calvin does not like to be ignored. He prefers adult male attention and likes to be validated. Cognitively, Calvin understands a lot.
6. ASSISTIVE TECHNOLOGY/ACCESS
List any devices that enable access.
Calvin uses a switch to access the computer and also a touch screen.
Tell how they are used.
Calvin uses the switch or touch window on PowerPoint shows or cause and effect computer programs.
7. COMPUTER
Is this a preferred activity?
Yes. In school, Calvin really likes to use the computer. He does need monitoring though so he does not cause any damage.
Is there recommended software? List.
He enjoys all programs that have been used in class.
What is the best method of access?
The best method for Calvin is a switch or touch window.
8. SENSORY STRATEGIES
What techniques or equipment assists the individual to attend to the task and decrease negative behaviors?
Walks in the hall outside
Positive reinforcement
Cognitive validation
Firm reprimand
Redirection
Are there any items that elicit negative responses?
Calvin reacts negatively to a nurse when she enters the room because of past experiences with his feeding tube. He would begin to flail his arms, pull at the tube, and vocalize loudly.
9. VOCATIONAL SKILLS
Attach a job skills inventory if one has been done.
Obtain information from special education personnel, job coaches, etc.
List any skills that allow partial or full participation.
See attached Ecological Evaluation and Job Coaches Notes.
10. LEISURE/RECREATION/COMMUNITY BASED ACTIVITIES
Provide a list of preferred activities.
Calvin enjoys listening to music and musical instruments along with playing computer programs. Calvin loves eating food.
11. AGENCIES
Indicate agencies involved in providing services, e.g. MH/MR and caseworker name with contact number; OVR; equipment companies; nursing agencies, etc.
Name of Agency Contact Name Contact Number
CLIU #21 Social Worker / Jenn George / 610-XXX-XXXXImpact Systems, Group Home / Carol Burkey / 610-XXX-XXXX
Lehigh County MH/MR Caseworker / Tom Miller / 610-XXX-XXXX
Residential Provider / Bernadette McGowan / 610-XXX-XXXX
12. TRANSPORTATION
What are the requirements needed to transport the individual. Indicate any safety precautions.
Calvin should be in his wheelchair with a lap belt and harness. A lift bus is used for his transportation.
What transportation considerations have been made to access the community?
Calvin’s group home provider has committed to transporting him to the adult day program, daily.
13. MEDICAL STATUS
Medical Condition/Disability Diagnosis: Cerebral Palsy/Mental Retardation
Concerns: None
List current medications with dosage and time.
No medications are taken in school or at the group home.Indicate seizures and protocol to be followed.
N/A
Doctor’s Name: / Dr. George Sell / Phone: / 610-XXX-XXXXHospital/Clinic Name: / Lehigh Valley Hospital / Phone: / 610-XXX-XXXX
14. ADDITIONAL INFORMATION
Team members who participated in the completion of this profile:
Name Role Contact Information
Mr. Richard Horn / Special Education Teacher / 610-XXX-XXXXMrs. Jenn George / CLIU #21 Social Worker / 610-XXX-XXXX
Ms. Joan Olewine / CLIU #21 Speech Therapist / 610-XXX-XXXX
Ms. Mary Newberry / CLIU #21 Occupational Therapist / 610-XXX-XXXX
Mr. Thomas Miller / MH/MR Caseworker / 610-XXX-XXXX
Ms. Bernadette McGowan / Residential Provider / 610-XXX-XXXX
Mr. Henry Hayes / Adult Day Care Provider (LifePath) / 610-XXX-XXXX
Mr. Calvin Johnson / Student / 610-XXX-XXXX
15. PROVIDE A CURRENT PHOTO FOR THE EXITING PROFILE.
16. PARENTAL INPUT
(Please list any information that may have been overlooked which you think is pertinent to the care and programming for the individual.)
This document is the result of a collaborative effort of Maia Geiger, Social Worker, and
Phoebe Sechrist, Speech and Language Pathologist, MA, CCC/SLP,
of the Carbon Lehigh Intermediate Unit #21. Created 2006, Updated 2008.
No parts of this document are to be used or reproduced without permission from Carbon Lehigh Intermediate Unit #21.