This is a summary of Eliza from the end of the 2004-2005 school year compiled by her teachers and therapists at her school.  This was before her diagnosis of Angelman Syndrome.

Present Level of Performance

05/23/2005

Academic:  Eliza has no speech at this time.  She vocalizes vowel sounds but no consonant sounds.  She also makes “razzing” noises with her mouth.  She expresses pleasure and displeasure by making noises using a different tone of voice.  She uses pulling behaviors to get objects, especially food items.  She will pull on an adult’s sleeve to get them to give her food; she also will pull on an adult/peer to get the object that the other person has in their hand.  She is learning to use a switch in order to request more food.  At this time, she appears to understand the idea of hitting the switch to get another piece of food.  A two-sided switch has been ordered for her and we will begin using this switch to make food choices when it arrives.  She does respond to her name by stopping her activity and sometimes looking in the person’s direction.  She also responds to “no” by stopping her behavior.  If she wants an object, she will push other objects out of the way.  If an object is hidden, she will look behind that object to find her desired item.  She plays with toys of a cause and effect nature.  She especially enjoys toys which make noise.  She is very auditorially motivated and will look around to find the source of a sound.  She is also distracted by sounds in her environment.  When walking down the hall, if she hears a sound, she will walk toward that sound.  She tends to mouth most objects presented to her, although this behavior has decreased from the beginning of the year.  She does not smile and vocalize to a mirror image.  Her eye contact with adults has increased from the beginning of the year, to about 3 seconds.  She does not imitate sounds or movements of other people.

Sensory:  Eliza has been diagnosed with ataxia (difficulty coordinating muscles in voluntary movement) and hypotonia (decreased tone or floppiness in muscles characterized by excessive range of motion of the joints and little muscle resistance when parts of the body are being moved).  At times, she demonstrates “shakiness” when participating in gross motor activities (related to her ataxia).  Her vision and hearing appear to be within normal limits.  She has had PE tubes inserted in the past.  She loves most sensory experiences (glue, shaving cream etc).  She especially loves water.  Her attention span is longer for sensory activities than other activities.  She also enjoys sensory experiences, which involve movement (i.e. being held and spun around).  When sensory experiences are a choice at center time, she will come back to them again and again.

Motor:  Eliza is an independent walker.  She does not recognize common dangers and will walk away from the group, if allowed.  She climbs on many objects in the classroom (Lego table etc) but when placed on an elevated surface, she appears afraid and will not put both of her feet down.  She needs assistance to walk up and down stairs.  She is able to remove objects from a container.  She transfers objects from one hand to the other.  She holds a crayon with a fist but does not make any marks on paper.  She often will only hold the crayon for 2 seconds before tossing it to the floor.  When presented with small objects, she often will transfer them to her left hand and then toss them to the floor.  She uses a two-finger grasp or pincer grasp to grab most small objects.  She is beginning to use a pincer grasp.  She uses her fingers to pull velcroed items off a horizontal surface.  She is beginning to hold an item and extend it to another person.  She will tract an object presented to her and reach for it but will switch hands at midline.  She will cross midline to grab an object if one hand is held down.

Adaptive:  Eliza does not follow a classroom routine.  She will wander around the classroom, exploring her environment.  She is able to take off her hat.  She takes off one sleeve of her coat independently.  She is not able to put on any clothing nor assist with dressing by holding out her arms and legs.  She drinks from a sippy cup.  She feeds herself finger food using a raking type grasp or a two-finger grasp.  She is not able to feed herself with a utensil.  She does anticipate when it is snack time and will get upset if other children begin eating before her.  She will protest if her feeding is interrupted (adult walks away).  She has a very limited attention span and during free playtime she will only explore each item for a few seconds.  When presented with an item at table time she will explore it for a longer period of time, especially if it is a cause/effect toy and especially if it makes noises/music.  She does not protest when a toy is taken away from her.  She will sit during activities such as circle, if in a higher chair (which she is not able to get in/out of herself).  If in a chair that she is able to get in/out of herself, she will stay for a few minutes and then get up and walk away.

Social Emotional:  Eliza is a very happy child.  She enjoys most activities in the classroom and will often laugh and make happy noises.  She shows excitement by “yelling” and flapping her arms.  She also moves the furniture by pushing it and appears to enjoy this activity.  She will smile in response to attention by an adult.  She also vocalizes in response to adult attention.  She will raise her hands and flap them when a familiar adult comes near her.  She explores the toys presented to her but does not play purposefully with toys other than cause/effect toys.  She does not demonstrate ownership of objects.  She stays in one center without redirection.  She seems to enjoy being around her peers but does not interact with them.  She will climb over them in order to reach a desired object.  She will also pull away toys from a peer if it is an item that she desires.  She recognizes familiar people but does not demonstrate stranger anxiety.