ACTIVITYACTIVITY 9.1 part 1, 2, &3 – Braylon COS Study Simulation

Braylon (36 months)

Child Outcomes Summary (COS) Study Simulation

Part 1:Referral – Birth History – Developmental Evaluation

Referral

Braylon and his family have participated in early interventionservicesfor the past eight months. During this time services were provided three times a month. At this time he is turning three years of age and will transition on to preschool.

Birth History

Braylon was born full term with no complications. He has had no history of ear infections. He walked at 11 months and started eating with utensils at 14 months.

Developmental Evaluation

A comprehensive developmental evaluation was completed at the family’s home to assist with the transition from early intervention to preschool. No special accommodations or modifications were needed and Braylon actively participated throughout the evaluation. His parents assisted with administration of some test items and shared information about his skills and abilities in a variety of everyday settings and situations.

Area / Instrument / Development Quotient / Z-score
Adaptive / Developmental Assessment of Young Children (DAYC) / 95 / -0.33
Social/Emotional / DAYC / 99 / -0.06
Communication / DAYC / 78 / -1.46
Motor / DAYC / 99 / -0.06
Cognitive / DAYC / 83 / -1.13
Language Sample / Goldman-Fristoe 2nd Ed. / Interpretation: Greater than six phoneme errors

Evaluation Summary

Adaptive: Braylon is nearly potty trained and has only a few accidents in a week. He sometimes needs reminders to use the potty when shopping or in less familiar settings. But he will also indicate his need to use the potty without prompting. Braylon eats independently using a spoon, pokes food with a fork,cuts with a knife, and drinks from an open cup without spilling. When spills happen Braylon assists with cleaning up the spill by wiping the area when given a rag to do so. Braylon puts on and takes off clothing but needs help when pants and shirts are snugly fitted. Sometimes Braylon is particular about how his pants come over his boots or how other clothes lay on his body. When this happens, he asks for help using single words or gestures to have his parents help himsituate his clothing just right.

Social/Emotional: Braylon is a social little boy with favored playmates. He knows the names of his frequent playmates and when they are playing together he will call them to join him (e.g., “come on”). Braylon engages in rough and tumble play with his younger brother. He is also proficient with trading toys with his younger brother. Yet, on occasion Braylon needs some adult help when a conflict over a toy escalates. With adult encouragement and reminders Braylon will let the other child have a turn(e.g., waits his turn during bowling or swinging at the park). If his brother or another child is hurt, Braylon responds with concerned attention. He is also very gentle around babies and will often bring them a toy or something if they are fussing. Braylon frequently says please and thank you when requesting or receiving a desired item (e.g., a requested toy or food item). In familiar settings, like his parents friends homes, Brayloneasily separates from his parents. When out and about he is stays by his parents and follows general safety rules about being out and about.

Communication:Braylon has made notable progress in his communication skill development since the family started with early intervention. His parents now understand about 60% of what he says in context. He demonstrates greater interest in pictures and books and points to and names several familiar pictures. When he does not know the name of the item he will demonstrate or say the action (e.g., looking at highchair he responded “baby sit,” looking at the picture of a watch he looked to the watches he saw others wearing). Braylon regularly adds animation or action to pictures he sees in books (e.g., saying oooh when he sees a bug, pretending to smell the flower in a book, making a flying action in response to a picture of a bird). Braylon follows several one step directions (e.g., put X in the trash, go get your X from your room). If the direction is familiar or if he’s given a prompt or gesture, like a point, he will correctly respond. He is working on learning descriptive words and concepts such as big/little, long/short, hot/cold, beside/under. Braylon frequently asks “what’s that?” or “where’s ___?”Braylon talks in one to three or four word sentences, but the longer the sentence the more difficult it is to understand what he is saying. When trying to convey a message – like talking about the snow outside – he repeats several words over and over (e.g., snowman, all better, fix it) rather than using a variety of words to tell his story. He is working on building his vocabulary to tell others about what he sees, what he’s doing, or what has happened.

During articulation testing, Braylon named approximately half of the words that were pictured andrequired for completion of thetest. Although he inconsistently repeated the names of items during the testing, he most often repeats back words that his parents ask him to during day to day interactions and playful games. When his parents say a word slowly and enunciate it Braylonoften repeatsit, sounding like or very close to the real word. The following are some of his responses during the articulation testing: house, dohwe/window, dup/cup, nite/knife, girl, poon/spoon, money/monkey, wa’eh/watch, fe’eh/feather, bentsil/pencil, peen/green, and ehper/zipper. As part of the speech and language sample takenBraylon produced nearly 40 utterances consisting of words and phrasesunrelated to the articulation testing. Some examples from that sample include: es ha/it’s hot, pay/play, eh/egg, man doing, esobeh/it’s open, nowmah/snowman, ah do/I do, Mama es eh/Mama get egg, eh fah/it fall, I kee/I clean, es a baby wawa/it’s a baby rabbit, es back/its black, mama woo/mama look. Braylon’s speech intelligibility (i.e., the degree to which others can understand what he says) for unfamiliar listeners is closer to 50%. Most of Braylon’s error patterns are still considered typical or slightly below his age (final consonant deletion, substitution, cluster reduction, reduplication, unstressed syllable deletion),but there were a couple of instances of initial consonant deletion, which is an error patterns for a younger child.

Motor: Motor skills continue to be a strength area for Braylon. He recently learned how to turn a somersault on the living room floor. He also catches a playground size ball thrown to him from about five feet away. Braylon climbs on furniture and playground equipment and successfully goes up and down the steps at the family’s home, sometimes placing only one foot on each step going both up and down.Braylon consistently uses his right hand in most activities and most often uses a three figure (adult type grasp) when coloring. He copies vertical and horizontal strokes and is learning to make circles, which he calls eggs. Braylon successfully completes inset puzzles effectively turning the pieces until they fit properly. He recently tried using scissors and was able to snip paper using a two-handed grasp on the scissors. With hand under hand prompting he used a one handed grasp to snip paper.

Cognitive: Braylon is learning the names of colors and knows the names of red, blue, yellow, orange, and green when asked to show me “X”colored item. He also identifies red and black (e.g., when playing with a red box he spontaneously said it’s a red box, he’ll also refer to his black Spiderman). His favorite color is red. When given a circle, square, and triangle he matches the shapes with a little prompting, but is not yet spontaneously naming the shapes. He does however know stars and hearts in books and will spontaneously label them.Braylon counts 1-2-1-2 and has counted to five when encouraged and prompted. When asked to give or get just one he does so inconsistently showing emerging understanding of the concept one. He nests four cups together and is persistent to stay with and complete the activity. During play, Braylon pretends to make his Spiderman fight, fly, kiss, eat, and sleep, most often linking two to three actions. When looking at books, Braylon turns the pages one at a time, knows how to have the book in an upright position, and identifies and names several familiar pictures.Braylon participates in songs and finger plays, such as Itsy Bitsy Spider, by making some of the actions and singing some of the words to the finger play song.

Part 2:Present Levels – Organized by the Three Outcomes

Present Levels by Early Childhood Outcome Areas

Positive social relationships:

Braylon and his younger brother play together often by rough housing and doing things like jumping on the bed. Braylon has 2 friends he plays particularly well with. He plays alongside them and contributes ideas to their play (e.g., let’s go in the tent, you take this toy). He is not yet planning play scenarios such as “I’m the driver,” or“you’re the baby.”Braylon shows interest in other children by going to where they are and initiating interactions either by saying something or joining them in what they are doing. When it comes to sharing toys, Braylon will offer a toy to another child, provided it is not his favorite one. If it’s his favorite he’ll say “mine.” He also trades or offers toys to his younger brother. When out and about, like shopping or running errands, Braylon notices other children and sometimes offers greetings by saying hi or bye or showing them something. He shows interest in talking to others and will try to share something about what he had done, yet he does not always have the words to convey his full message. For example, after seeing a movie recently he was trying to tell a little girl and her mom about the movie, but he adjusted the topic back to Spiderman and a recent owie he had on his finger. While Braylon engages in back and forth conversations and rarely demonstrates any frustration when others do not understand him he often resorts back to similar topics or phrases he knows, moving the topic from the one at hand. As the family does different things during the day Braylon adapts easily to changes in the routines and activities and follows most adult requests related to the day to day routine. He now stays at the table during meals and engages in simple conversation when it is a topic of interest (e.g., Spiderman). Yet, his contribution to the conversation is short phrases. Braylon displays great interest in back and forth conversations, but does not have the full vocabulary to convey the messages he wants to so he tends to use words that are already in his repertoire. When asked to follow a rule, like no hitting, he understands, but sometimes tests the limit. When this happens he goes to time out and after a few minutes he generally calms on his own and is okay to resume his play. He cries when he is upset, but is generally happy and shows this by smiling and laughing often. He is also showing advances in his sense of humor. Recently, he laughs at “potty talk.” He’ll say things like “butt”,“toilet” or “poopy” and then laugh.

Acquires and uses knowledge and skills:

Braylon’s favorite toy is Spiderman. When playing, he moves Spiderman’s body parts to make him do a variety of things, such as ride in a car, sleep, eat, go to the potty, fight, fly, and jump. He has interest in other toys and things as well, such as coloring on paper, painting, riding ride on toys, and climbing on the playground. Braylon puts things where they belong if reminded and encouraged to do so (e.g., put the toys in the basket). During play he shows creativity, such as when drawing a circle he’ll call it an egg and then ask his mom to crack it. She then responds by drawing a crack in his egg and he laughs and proceeds to ask for more. He will also try to draw spiders or ask others to do that. He will draw the body part and makes marks to draw the legs, but then often asks for his mom or dad to complete it for him. When asked what something is that has been drawn he typically labels it (e.g., “it’s a spider”, “it’s egg”). Braylonturns the pages, looks at books, and will bring books to his parents for them to read to him. He will sit for a story being read to him if there are not other distractions around, although he does not always stay engaged in the entire story.When looking at books he knows the names of several items and is starting to recognize more about the actions of things in books. For example, he can identify, by pointing at, who is running, drinking, or sleeping. He does not however typically use the words to name those or other actions. A favored finger play of Braylon’s is the Itsy Bitsy Spider. He remembers part of the finger play as well as some of the key words. He also does parts of patty cake. He answers questions like “what’s your name” by saying “Braylon” and can follow several one step requests, such as “get your cup”, “bring me a diaper for your brother”, or“go get your red Spiderman”.Braylon is also starting to ask “why” and “how” questions. With pre-academic concepts,Braylon matches colors and shapes during play activities. He names hearts and stars when he sees them pictured in familiar books and often refers to circles as eggs. He knows the meanings of mine and yours and his and hers, but does not typically say them when talking about other’s things. If asked to take just one of something or give one - like “give me one chip” - he will give you a chip or more, not showing functional understanding of the concept of one. Braylon rote counts 1-2-1-2 and is working on counting to five, but often misses 3. When talking Braylontypically says 2-3 word sentences. When he strings together words in a sentence, he becomes more difficult to understand unless the context is quite apparent.

Taking Appropriate Action to Get Needs Met:

Braylongets up on his ownor plays in his room before going to see who else is up. To get what he wants, Braylon typically asks using 1-2 words. If he is not understood he will try another way to express what he wants. He rarely gets frustrated and often finds a way to either get what he wants on his own (e.g., climbing up to get something from the cupboard) or asking in another way. At meal times,Braylon uses a spoon and fork independently to eatand drinks from a cup replacing it on the table upright. He recently independently used the drinking fountain at school on his own as there was a short step in front. Both at homeand out in the community Braylon shows safety awareness by not running out in the street or away from his parents and stays away from the stove when it’s on. When his nose is running he will wipe it with a Kleenex, if one is available or given to him. During bath time he tries to wash himself and will use the towel to dry off with a little bit of help. He knows the steps to brushing his teeth as well as the steps to washing his hands after using the toilet. Braylon is mostly toilet trained showing consistent daytime control. When clothes are fairly easy (i.e., not too tight or with lots of buttons) Braylon puts them on and takes them off. He can put clothes on a hook if it is the right height. Braylon shows good balance to be able to stand on one foot, jump up and down with both feet, and dance to music or make Spiderman moves. He is also quite good with a ball and generally kicks and throws them with accuracy by getting the ball to the target (e.g., another person or a basket or pretend target). Braylon has outgrown the afternoon nap and follows the directions and routines to go to bed without fussing.

Part 3:Study Questions

Functional Questions

Functional skills are those that are useful in meaningful contexts. They are not de-contextualized or isolated milestones. As you answer the following three questions, consider skill functionality. The skills included are linked to the associated outcome, but one of the options for each of the three questions is NOT functional.

  1. Outcome 1: Which of the following IS NOT a functional skill for Braylon?
  1. Braylon engages in back and forth conversations and rarely demonstrates any frustration when others do not understand him
  2. Braylon is a social little boy
  3. Is very gentle around babies and will often bring them a toy or something if they are fussing
  4. Braylon plays alongside peers and contributes ideas to their play (e.g., let’s go in the tent, you take this toy)
  5. He frequently says please and thank you when requesting or receiving a desired item
  1. Outcome 2: Which of the following IS NOT a functional skill for Braylon?
  1. When drawing a circle, he’ll call it an egg
  2. Names hearts and stars when he sees them pictured in familiar books
  3. Follows several one step requests, such as “get your cup”, “bring me a diaper for your brother”
  4. When playing, he makes his Spiderman do a variety of things, such as ride in a car, sleep, eat, go to the potty, fight, fly, and jump
  5. His favorite color is red
  1. Outcome 3: Which of the following IS NOT a functional skill for Braylon?
  1. Goes up and down the steps at the family’s home, sometimes placing only one foot on each step going both up and down
  2. When spills happen, Braylon assists with cleaning up the spill by wiping the area
  3. Uses a two-handed grasp
  4. At meal times, Braylon uses a spoon and fork independently to eat
  5. When his nose is running, Braylon will wipe it with a Kleenex, if one is available

Understanding Age-Expected Development