Larry Roan p 1
Case Study: Larry Roan
Prepared by: Jane Westervelt
PRESENTING INFORMATION
Larry Roan is an 18 year old male who presents with a cognitive developmental disability. He was accompanied by his father, Joe, and mother, Sally.
CASE HISTORY
1. Review the presenting information. List the major areas for obtaining pertinent information for the cases.
· Education
· Financial
· Medical records
· Psychological
· Social
· Physical
2. List specific items of information that would need to be obtained regarding each case.
· Education-
o How far did you go in school?
o What did you like or dislike about school?
o Why did you leave school?
o If you didn’t pass high school did you pass a high school equivalency exam?
o Have you received vocational training that has prepared you to enter a particular occupation?
· Financial-
o What is your primary source of support?
o Do you have other sources of support?
o Do you have any unpaid debts of significant size?
o What fixed living expenses, such as medications costs, cannot be reduced?
· Medical-
o Is the disability progressive or stable?
o Will assistive technology be needed or helpful?
o What was the age of onset?
o What are your symptoms?
o What medication(s) are you on?
· Psychological-
o Is he emotionally/psychologically able for work?
o Are any physical symptoms psychologically based?
o Does the person use “disability” as an excuse for failure?
o Where is he in accepting her disability?
o Does he want to work?
· Social-
o Does the family support his return to work?
o Who are the significant people in your life?
o Are you living with your family?
o Do you have any dependent-age children?
o Will the most significant family members be supportive of the rehabilitation plan?
o Do you have close friends?
· Physical
o What specific impairments are impaired?
o Are you taking any medication with potential side effects?
o How does your physical disability handicap daily functioning?
o Has your disabling condition become worse over the past year?
3. List strategies for obtaining this information.
o Interview with client and family w/consent
o Evaluation from other sources- Doctor’s, psychologists, vocational counselor
o Intake forms
o School Records
4. What are the presenting disabilities and specific barriers to employment for each case?
Larry Roan has mitral valve stenosis, which resulted in cognitive difficulties. He has limitations of frequent rest period, no heavy work, and no prolonged standing or walking.
5. Write and eligibility statement.
*Dr. Edward Evers diagnosed Larry Roan with mitral valve stenosis, which resulted in cognitive difficulties. He has limitations of frequent rest period, no heavy work, and no prolonged standing or walking.
Larry Roan p 1
BALANCE SHEET
BALANCE SHEET—Larry Roan
Consideration / Vet Assistant / Rating / Teacher’s Aide in Elementary or Special Ed class / Rating / Special Needs Camp Assistant / RatingGains for self / Work with animals
Nice environment
Minimal supervision / 4
3
2 / Creative outlet
Gets to help others
Play with kids / 3
4
3 / Gets to be in the woods
Gets to help others
Play with kids / 4
4
3
Losses for self / Less interaction with family
Less free time / 3
2 / Less independent work / 4 / Less interaction with family
Work is seasonal / 3
5
Gains for others / Becoming independent / 3 / Helping others learn new skills
Becoming independent / 3
3 / Helping others learn new skills
Mentoring / 3
3
Losses for others / Less time spent around the house / 4 / Less time to spend with family / 4 / Less time to spend with family / 4
Self-approval / Independent work
Income / 3
3 / Gets to be helpful
Income / 3
3 / Gets to be helpful
Income / 3
3
Self-disapproval / May have to follow orders
Concerned can’t do job
Can’t be out in woods / 3
4
3 / May have to follow directions
Can’t be out in woods / 3
3 / May have to follow directions / 3
Social approval / Should not have problems with society / Contributing by helping others / 4 / Contributing by helping others / 4
Social disapproval / None / None / None
Sum positive for #1 / 18 / Sum positive for #2 / 26 / Sum positive for #3 / 24
Sum negative for #1 / 18 / Sum negative for #2 / 14 / Sum negative for #3 / 15
Total for #1 / 0 / Total for #2 / 12 / Total for #3 / 9
Larry Roan p 1
INDIVIDUAL PLAN FOR EMPLOYMENT
Employment Goal: Teacher Assistant DOT- 24-9041.00
Intermediate Objectives:
1. Larry to attend work site daily and develop appropriate work behaviors and consistent interaction with children and teachers.
2. Larry to continue with medical care for management of his heart condition.
3. Larry to attend anger management class.
4. Larry to maintain bi-monthly contact with his VR counselor
Planned Services Vendor Cost
1. Personal and work adjustment VR no cost
counseling
2. Job development for Teacher’s Goodwill $31.50
Assistant Placement/20 Industries per hour
hours @ 20 hours
$630.00
3. Community Based Evaluation Goodwill $1,575
Job Coaching max. 50 hours Industries
@ $31.50 per hour
4. Medical care for heart condition personal medicaid
Physician
5. Anger management classes Psychological $70/hour
Associates @ 6 hours
$420
6. Supported employment long Dept. of Health no cost
term maintenance and Welfare
Client Statement:
O.K/ Looks good.
Estimated Date of Employment:
Counselor Signature: Client Signature
INTERMEDIATE OBJECTIVE FORM
Area Need
A. Educational/Vocational training
1. Participate in community based evaluation job coaching, June 22-July 24
B. Medical
1. Continue ongoing medical monitoring of his heart condition
C. Psychosocial
1. Attend personal and work adjustment counseling at VR, starting June 15 and continuing as needed
2. Attend anger management classes at Psychological Associates, July 1- August 19, once weekly
D. Vocational
1. Job development for Teacher’s Assistant placement
2. Pursue job with local schools
3. Maintain bi-monthly contact with VR counselor
E. Special Considerations
1. Supportive employer ideal
GOAL ATTAINMENT SCALING
Scale attainment levelsMost unfavorable treatment outcome likely / -2
Less than expected success with treatment / -1
Expected level of treatment success / 0
Better than expected success / +1
Best anticipated treatment success / +2
Work Adjustment
W= / Physical
W= / Social
W= / Vocational
W=
-2 / Misses work one or more times per week / Symptoms uncontrolled / Anger uncontrolled / No vocational interest/
unrealistic vocations
-1 / Misses work no more than twice per month / Symptoms interfere with work / Has three or less outbursts per week * / Vocational verbalization
(May still be unrealistic)
*
0 / Reports to worksite daily* / Symptoms moderate, may interfere with work* / Enrolls in anger management course / Recognizes limitations, shows interest in suitable jobs
+1 / Show appropriate work behaviors, arrives on time, etc** / Symptoms mild, controlled, do not interfere with work ** / Regularly attends anger management classes** / Completes job coaching position
+2 / Establishes consistent work routine / No symptoms / Completes anger management course / Obtains job
**
* = level at intake
** = level at evaluation