Communication and Behavorial Strengths and Needs

Emily demonstrates an understanding of basic concepts and vocabulary and can follow 3 step related and unrelated directions when interested in the task or directive. She has more difficulty with abstract concepts. Expressively, she is able to use correct grammatical forms and vocabulary and can formulate complete sentences to relate information. Emily’s pragmatic language skills are an area of weakness. She inconsistently expresses her feelings in appropriate ways, often invades the space of others when talking and/or touches people inappropriately (going up to someone and hugging them without warning). She requires facilitation for topic maintenance (her choice and another’s choice) and has difficulty responding to emotions of others and responding to social cues.

Emily demonstrates adequate attention for preferred tasks. She inconsistently asks for help and becomes easily frustrated. Emily will engage in avoidance behaviors, and attention seeking behaviors all of which are currently being inadvertently reinforced by the Head Start teachers in an attempt to avoid episodes of Emily throwing herself onto the ground, running away from the teacher, and crying during transitions from preferred to non preferred tasks. Emily’s overall performance in the classroom improves when there are fewer children present. Various strategies that have been incorporated into her routine and those that are being considered:
1. The use of a visual schedule for the general classroom routine. The visual schedule is being utilized inconsistently depending on the staff serving the classroom on a given day. Emily requires assistance to know what to do during more unstructured routines including “play time”. The utilization of a play schedule is being considered for use to help to Emily organize and plan this specific unstructured time.
2. She has been assigned “jobs” during the classroom in an effort to give Emily the adult attention she seeks but for positive behaviors/participation. Unfortunately, most of the interactions between the Head Start staff and Emily have occurred when Emily is displaying undesired behaviors.
3. A behavior modification chart has been introduced to the classroom where children hang their names on the Yellow poster when displaying the identified rules and “good behavior”. When the identified negative behaviors or breaking of class rules occurs, the child places his name on the Red poster. The intent is for the child to engage in a positive behavior or correct their behavior and quickly move his name back to yellow. Emily has been responding to this chart and technique when utilized consistently by the staff.
4. A timer is being utilized to assist Emily with her ability to transition.
Preferential seating has been considered for Emily so that she is in closer proximity to the teacher.
5. There have been discussions of utilizing some sort of token system but this has not yet been implemented. I will be pushing for this next week!!!
6. Concepts of self regulation are going to be introduced both within he individual OT sessions with carry over of techniques and strategies into the classroom. Concepts from the Alert Program will be utilized. Pictures and sequences will be used from the Stick Kids computer software (great program) as well as from the Super Duper fun decks (also a nice resource)

8. Implementation of social stories to assist with the social communication aspect will be something to investigate as well.
7. Due to inconsistent follow through by the Head Start Staff, Early Intervention staff have increased their support within the classroom to provide consistency for Emily within her natural environment and to model the techniques for the Head Start staff.