Ete 324 Case Study

Family Case Study ETE 324 Fall 2017 Torrie Haisma, Katherine Kurowski, Liana Pavese, Sydney Wilhelm

Family Case Study 1

Background Information This case study was done on the Smith* family and their son, Billy*. Billy was born to Jane* and John* on September 7, 2012 making him five years old. He lives with his biological mother and other siblings. His father does not live with them nor does he support them financially. However, Billy goes to see his father and enjoys spending time with him. Billy has a speech delay and receives services from a speech pathologist at Valeska Hinton School twice a week. He is in a normal Pre-K class that has students from three to five years old. His mother is the main support he receives at home. He keeps his toys upstairs mixed in with those of his siblings. Billy has a bunk bed and a T.V. in his room. Billy shares a room with his younger brother. He and his siblings sleep with their mom often. His older sibling received an IEP up until first grade but did not need any additional services after that. Jane* does house work and does nanny type jobs for those who employ her. Jane and John did not mention that they had any developmental delays. When Billy was younger tubes were placed in his ears to deal with drainage problems. Jane is not very involved with Billy’s education. When questions were asked about his education or social skills, Jane assumed everything was fine and didn’t provide any insight.

Data Analysis, Interpretation, Conclusion Our team successfully gathered information and data about the student, Billy. Interviews with his mom, classroom teacher, and speech pathologist were completed to gain more information about Billy. Observations were done to gather the information and data needed in both his home and at school. After meeting with Jane, Billy’s mother, little information was gathered about the student for the study. Jane did not portray that she knew a lot about Billy’s

Family Case Study 2

education and told us to talk to them directly. This is something that we found concerning. His teacher was not able to give us his IEP documents because we need permission from Dr. Lee. Liana, Torrie, Sydney, and Katy made up our team. All of the team members, but Katy, were able to do the initial interviews with the family and the initial observation of Billy. Liana and Katy, two of the team members, were able to observe Billy in an educational setting. Liana, Sydney, and Torrie were able to observe Billy during a few of his speech therapy sessions. He often slurred the letter “s”, but did not show any other language delays.

Type of Data

Date Collected

How and Where

Who

Parent Interview

9/23

Observed family in home environment and interviewed mom

Liana, Torrie, Sydney

In class observation

10/19

Observed student in classroom setting

Katy, Liana

Speech therapy observation 10/19

Observed student in speech therapy session

Liana

In class observation

Observed student in classroom setting

Katy

Speech therapy observation 10/30

Observed student in speech therapy session

Sydney

Speech therapy observation 11/30

Observed student in speech therapy session

Torrie, Liana

10/30

Analyses of data by developmental domains

Family Case Study 3

While observing Billy in both his home and school environment there were several developmental domains that stood out. In his classroom, he interacts and socializes with his classmates during activities, which falls under the social-communication area. During his interactions with those around him we scored him as a one. This means he inconsistently meets criterion. He was able to verbalize his needs, wants, and emotions a majority of the time, but the way in which he did so was extremely inconsistent. He used a combination of gestures, sounds, and words to communicate during these interactions. On the AEPS, there is a subcategory that ranks a child’s ability to vray voice to impart meaning. This is something that we felt Billy did not meet this criteria. These abilities are shown during their play time, he plays with and gets along with his peers both one on one and in small groups. Billy’s social skills are at the appropriate level for his age. In the classroom, he raises his hand and waits to be called on by his teacher. He seems to be very well behaved and follow directions easily. These are skills that would fit appropriately under the language comprehension domain within his age range. For the cognitive domain on the AEPS, Billy scores mainly inconsistent (1). A good amount of this is due to his speech delay in the phonological awareness and emergent reading subcategory. One criterion is that his is able to blend single sounds and syllables. While Billy is able to do so, it is inconsistent due to his current ability to enunciate certain sounds.

Identify strengths and needs of the child/family

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Billy exhibited several strengths during the observations. When first meeting with him and his mother at his home he seemed to be a typically developing five year old. At Billy’s home and school, Valeska, he was very well behaved and followed instructions from his mother and teachers well. When interviewing his mother, she seems to be his only support financially. Although, she did not seem to know a lot about Billy’s education. We asked several questions that pertained to his education and she never seemed to have a straight-forward answer. Billy could benefit from his mother, and father if possible, to be more involved in his education. This would allow him to have more support at home, while supplementing his academics. She should know more about what Billy is doing in school and the types of services he is receiving.

Descriptions of interventions Billy is currently attending Valeska Hinton and receiving Speech Therapy twice a week with a Speech Pathologist, Mrs. Kocher, at the school. His sessions are typically paired with another student (Libby*) and are 30 minutes in length. Once in the session, Billy had to be reminded of the structure. Mrs. Kocher pointed to two images on the wall above the table, “First Work” and “Then Play.” This reminds the students that they will work on an activity first and then they get time to play. I.

Procedure for the first Activity: A. Compare and Contrast: Pumpkin Painting 1. Mrs. Kocher introduces the activity by talking about the similarities and differences between Billy and Libby (i.e. boy, girl, both in Ms. Garman’s class, etc.)

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2. Billy is shown two pumpkins on a worksheet. Each pumpkin has a different item inside (i.e. car vs. bus, pencil or. crayon, sun vs. lamp, etc.) 3. Billy and Libby are asked to talk about some of the things that are the same and some things that are different between the two images. 4. Mrs. Kocher asks many questions about the items and follows up with questions and connections between the items. II.

Procedure for the second day activities: A. Coloring worksheet: Halloween Themed 1. Mrs. Kocher hands Billy and Libby a coloring paper with pictures related to Halloween on it. She asks the both of them what they see on the paper. They point out what they see and then describe and color each picture in. 2. What’s in the bag?: “Spooky” Halloween objects a) Mrs. Kocher has Billy and Libby reach into a bag filled with “spooky” objects and describe how they feel and look, and what they do. b) There multiple objects, such as, eyeballs (bouncy balls), cloth pumpkins, plastic-toy fingers, and wind-up toy vampires. Some of the objects were the same type of object, but they had some different characteristics. For example there were multiple eyeballs (bouncy balls), but were different colors. So with the Pathologist prompting Billy and Libby, they described these differences. c) Video about different Halloween costumes:

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3. The pathologist showed an animated video to Billy and Libby, which showed people dressed up in different Halloween costumes. Some of the costumes were of a ballerina, a vampire, a mummy, etc. Before the video showed each costume the character dressed up would be a dark figure, so them Billy and Libby would have to guess what the costume was of just from the outline of the character. a) Throughout the video Mrs. Kocher asked Billy and Libby what each one was and the different actions they did. So for example, the pathologist asked, “what do you think he/she is?” Billy or Libby or both would say “it’s a ghost!” The Pathologist then asked “what do ghosts do?”- she would prompt them by moving her arms- and this helped them to answer “they fly.” 4. In each activity Mrs. Kocher seemed to really enunciate the describing words for Billy and Libby. I really think that this helped them better understand the specific things that they went over throughout their time together.

Family Case Study 7

Progress of child In the first visit at his home, Billy seemed to be very quiet and shy. He played with his toys, along with his younger brother, but seemed to keep to himself more. Although, when observing Billy at his school he seemed much more outgoing and talkative with his peers and teachers. When observing Billy in his speech therapy session he participated in each of the activities, which required him to talk. He had a lot of fun working with his classmate, Libby, and his speech pathologist. He was not shy at all when answering questions and interacting with the activities. This could have been based on the environment that he was in; Billy might have felt more comfortable in the school environment, or it could have been the times that we observed at and the mood that he was in that day. It was really interesting to see the two different sides of Billy, and to see the progress he made from our first to last visit.

Summary of report This report provides background information on Billy and his developmental problem. It gives a brief discussion on the analysis of Billy and what our group members interpreted from the observations. Part of the report discusses the different observations that our group member did and what we learned about Billy. The observations took place in his home and at the learning center he attends. We were able to retain a lot of information on Billy from these observations. The report also contains Billy’s IEP documents. Each group member gives their individual reflection discussing how we felt the project and observations of Billy went. Also included is the interview questions and brief summaries of our observations, which record the date and time that they took place. Recommendation and planning matrix

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Section 1: Billy’s

Objective 1: Billy’s goals

Objective 2: Billy’s

first day of

for the second day

goals for the third day

Walks in, places

Walks in, places backpack in

Walks in, responds to

backpack in cubby,

cubby, says hi to teacher,

classmates saying hi,

removes jacket,

removes jacket, walks over to places things in cubby

walks over to table

table for lunch

observation Arrival

for lunch Lunch

Drinks milk, throws

Eats all food, asks about food Drinks milk and eats all

all food away

he doesn’t recognize, talks

food, talk with

about food he is eating with

classmates at lunch

teacher Circle

Picks up book to

Picks out book he likes, tell

Picks out book he likes,

Time

read, puts it away

friends about his book and

listens to friends explain

when asked, waits for why he likes it

why they like a book,

circle time.

responds appropriately

Outside

Rides bike and pulls

Rides bike and pulls friends

Initiates conversations

Play

friends around

around, asks them if they

with friends, rides bike

want a ride

and talks with peers

Participates with

Participates with new

Participates with new

normal group

classmates

classmates

Stations

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Clean-Up

Throw away all food

Throw away all food and

and trash, wash hands trash, wash hands, say thank

Closing

Throw away all food and trash, wash hands,

you for lunch

say thank you for lunch

Collects things and

Collects things and lines up

Collects things and lines

lines up at the door,

at the door, puts coat on by

up at the door, puts coat

needs assistance with

himself, says goodbye to

on, helps count line

coat

teacher and friends

Matrix Reasoning: Each of the goals in the matrix are designed to expand Billy’s speech skills. The first day, Billy displayed a lack of social skills. His teacher and her aide all welcome the students to the classroom and expect the students to respond. Billy did not respond to the teacher or her aide. During lunch, Billy does not talk with his peers. He focuses on eating his lunch and throws his food away when he is done. After he throws his food away, he sits down on a carpet and picks out a book he likes. His friends initiate a conversation with Billy about books but he does not respond. Throughout the day, Billy would raise his hands and answer questions when called upon. However, at recess, Billy would not conversate with his peers. Billy often played with other children but would not talk to them. All of the goals in the next two columns enhance Billy’s social skills. On the first day in the mornings, Billy is to respond to his teacher and her aide in the mornings. During lunch, Billy asks his teacher what some vegetables and fruit are on his plate. When she responds, he continues the conversation by telling her he likes what he is eating. He continues eating and does not talk anymore during lunch. Once he is done, Billy says “thank you” to his teacher for lunch

Family Case Study 10

and throws his trash away. While sitting down on the carpet for circle time, Billy talks with his friends about things they like. He interjects some, but does not talk much. During circle time Billy continue to wait to be called on to answer questions. Before recess, Billy does not participate in counting the line to go outside. He remains quiet and rides his bike with his friends. He asks a few people if they would like to be driven around but does not hold other conversations with his friends. Overall, Billy has made some progress when prompted by his teacher. On the third day, Billy made more changes to his social behavior. Billy entered the classroom and responded to his teacher and her aide. During lunch, Billy talked with his friends about the food they were eating and asked if they liked it or not. Billy would respond appropriately when his classmates gave him an answer. During circle time, Billy waited to be called on and offered more information about the subject to his teacher. He helped count the line to and from recess and held long conversations with his friends and the observers. Billy has changed his social behavior after being prompted by his teacher

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Records of observations/interviews

Introductory Meeting and Observation Date: 9/23 Duration: 30 minutes Team members present: Liana, Sydney, Torrie Meeting summary: Our group went to Billy’s family home to meet and have a short introductory meeting him and his mom. Upon arriving, there were children playing outside their house and the house next door, we later found out these children were Billy’s siblings and cousins. Once inside, we were greeted by his mom and a couple other family members. She invited us to have a seat in the living room and we began our parent interview and observations of Billy and his family. During the interview, Billy and the other children we playing inside and outside the house, freely moving from one area to another. They had a variety of toys (play trucks, blocks, bikes, etc.) and were constantly shifting from one toy to another. Billy’s mom sat across from us as we asked questions about her family life, living situation, and information about Billy. She encouraged Billy to play near by so that we could observe him and ask questions, when needed. Billy was very quiet as he played but we could tell by his facial expressions that he was listening pretty closely as we talked with his mom. A few times, he asked for assistance with his toys. For example, he asked his mom for help putting on a tool belt. This was done more through sounds/noises rather than speaking with actual words.

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First Classroom Observation Date: 10/19 Duration: 75 minutes Team members present: Katy and Liana Meeting summary: Billy arrived at school before Liana and I got to the classroom. His things were already hung up by the time we got there. Billy washed his hands and sat down to eat lunch. He drank his milk very fast but did not eat any food. After he cleaned off his plate he sat down on the circle rug and grabbed a book. His friends gathered around him and told them about their books. He sat and listened to them quietly, never taking his eyes off them or the books they were explaining. Once they got done explaining the books, Billy picked out all of the Clifford books and began identifying them one by one. He placed them on the ground and spread them out on the rug in front of him. Before Billy got the chance to read the books, circle time ended and it was time for the stretching song. The songs today from Go Noodle were Banana, Banana, Meatball and Pizza Man. These songs promote body awareness, gross motor skills, call and repeat, coordination, guided dance, and math skills. After the stretching songs it was time for the kids to play outside. Once the kids got their coats on, got in line, and went outside, they began playing with the bikes and playground equipment.Billy rode a two person bike the whole time. He enjoyed riding around and taking other children with him. The bike he was riding had pedals in the front seat only, so Billy was always peddling. If children were running around without a bike, Billy would call them over so he could pull them around. He looked like he had fun the whole time and was talking and laughing with his friends. Liana and I asked his teacher about how he is doing developmentally and she replied that although his skills are below average, he is developing at a normal rate.

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First Speech Therapy Observation Date: 10/19 Duration: 15 minutes Team members present: Liana Meeting summary: Billy’s speech therapy session was combined with that of another student in his regular classroom. The pathologist came to pick him and the other student up from class and they walked to her office together. While walking she was asking them questions about their day thus far and began to introduce what they were going to do for their session. Once they arrived in the office, each child sat down and waited for instruction. They were going to work on comparing and contrasting items on a worksheet. After they talked about each item, they were able to color it using paint markers. The pathologist made sure to ask many open-ended questions and follow up questions to the students’ responses.

Second Classroom Observation Date: 10/30 Duration: 45 minutes Team members present: Katy Meeting summary: Billy was late to school today. When he entered the classroom he immediately put his backpack and jacket in his side of the coat rack.Billy had trouble taking his sweatshirt off. He struggled to get it over his head for about ten minutes before he finally got it off. After he got his jacket down he washed his hands and sat down to eat his lunch. Lunch today was mini corn dogs, carrot slices, applesauce, and salad. Billy only ate his corn dogs,

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which is more than he ate on Thursday. After lunch, the kids sit down on the circle rug and pick a book to read. Billy picked a book about clocks today. He flipped through the pages multiple times before beginning to read. Once circle time was over, the students described what they are going to be for Halloween. Billy is going to be Spiderman. After the children shared their costumes, it was time for the children to listen to their stretch song. The teacher finds songs on Go Noodle. The songs today were Hello! and Bones, Bones. These songs promote guided dance, cross lateral skills, gross motor skills, body awareness, coordination, class routines, and science skills. The children love the songs. They dance along to the routines and sing the words if they know them. Billy stands in the front of the class and participates to the best of his ability.

Second Speech Therapy Observation Date: 10/30 Duration: 30 minutes Team members present: Sydney Meeting summary: Billy and one of his classmate’s worked with their speech pathologist on a few fun and interactive Halloween related activities. They followed the pathologists instruction very well. Each activity really emphasized describing words. They first analyzed and described what they saw on the coloring page that they were given. Then they reached into a bag and pulled out different objects; they described them based on how they looked and felt. The last activity was watching a movie where Billy and Libby described the Halloween characters in it. During each activity the Pathologist helped Billy and Libby through them by prompting them with questions. At the end of the session Billy and Libby received a Halloween sticker for being so cooperative.

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Third Speech Therapy Observation Date: 11/30 Duration: 30 minutes Team members present: Torrie and Liana Meeting Summary: Billy and his classmate that also gets the speech therapy at the same time, worked on activities regarding Christmas. The speech pathologist asked Billy and the other student if they knew what holiday was coming up and what we do to celebrate this holiday. They began by pulling a card out of a bucket that had pictures of presents on them. The students were to name the present and describe it. The speech pathologist also asked more in depth questions like what the present looks like or what it does. The next activity consisted of the speech pathologist describing a present and Billy and the other student had to say what the present was. She would say things like the color, what it looked like and how you play with it. The therapy session ended with the speech pathologist letting the students have some fun. She handed them a laminated picture of a gingerbread house and let them decorate it with pictures of candy, gingerbread men, frosting, people, etc.

Meeting log Meeting date Location

Talked about

Team members present

Time

9/12

Class

Case study

All

4:30-5:00

9/19

Class

Decided on roles Discussed parent interview

All

4:30-5:35

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questions and how to ask them appropriately 9/23

Westlake

Prepared for interview

Torrie, Liana, Sydney

2:30-3:30

10/10

Class

Divided up portions of the project and checked in with Dr. Lee

All

4:30-5

10/24

Class

Check in with Dr. Lee

All

4:30-5:00

10/30

Main Street Commons

Split up sections of the project and went over what still needs to be done

Katy, Liana, Torrie

5:15-6:40

10/31

Class

Checked in with Dr. Lee

Katy, Liana, Torrie

4:30-5:00

11/7

Class

Checked in with Dr. Lee Started looking at IEP document

Katy, Sydney, Liana (left early)

6:30-7:00

11/14

Class

Checked in with Dr. Lee

All present

4:30-5:00

11/28

Class

Checked in with Dr. Lee and got the whole class period to work. Completed IEP and AEPS.

Katy, Liana, Torrie

4:30 - 7

12/4

Main Street Commons

Finished up case study.

Katy, Liana, Torrie

5:15-6:30

Parent Interview Questions *ask if we can audio record?* 1. “Could you tell us about Billy?” (Age, physical characteristics, special need) Billy is one of the best kids I have, he is the most laid back and has no problem sitting and watching TV. He loves the toys that other peers do not like. Would enjoy putting an old clock back together for example. Most of the time he understands her but sometimes she has to repeat or say it differently. For the most part, he is really smart but he chooses

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to ignore certain people. When he was a baby he was delayed at everything: sitting up, rolling over, crawling, walking etc. 2. “Could you tell us about how you felt as a family when you found out about Billy’s special need(or the specific term they used)?” I wasn’t bothered in any way because I know all kids are different and learn at their own pace. I believe that Billy and our family will be okay in the end, no matter the hardships we face. 3. “How were you involved in the early intervention program?” All of his services came to our home. They started physical therapy first because he was delayed, then came the speech services but before that he learned sign language and he really enjoyed that. He was probably around 6 months old when he first started physical therapy. He’s had about 4 or 5 therapists for different reasons. They worked with him alone and I would normally sit back and watch except for when he was learning sign language I had to learn as well.

4. “Were there any indicators of Billy having ___________ before he was born?” **Be very sensitive here.** There was no way of knowing while I was pregnant. 5. “Could you tell us about the program Billy is in right now and what types of services he is receiving at that?” Billy still receives. I don’t know if its everyday or once a week. Sessions are on hold because the school is on three week break. Resume when they go back to school 6. “How is he doing with those services?”

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He is always very cooperative. 7. Does Billy’s special needs affect his siblings? No. My other two kids were at school. Both other kids had services as well and they would sometimes join and all do services together. I liked Brandon having time just with the therapist. My oldest plays football Monday-Thursday. When all of the kids go to school I go to work. I have to be done with work in time to take my oldest to practice every day and he has a game every Saturday so I don’t have a lot of time to myself. 8. Does Billy have any friends in his program? I’m sure he has kids that he picked out and likes to play with but he is usually kept to himself. 9. Is Billy’s program designed specifically for him or are there supports for you as well? His program is designed specifically for him and his needs 10. Who are Billy’s major supports? Billy knows his dad and likes to go see him, he actually asks to go see him quite often. He doesn’t really support Billy in any way but if I ask him to help or attend an event he may or may not come but Billy knows to not be upset if he doesn’t show up. There are things I don’t really involve him in on purpose. We have an ok co parent relationship. Financially I don’t get any assistance from him. Billy and the youngest child have the same dad. Two oldest have a different dad but same as each other. 14. What is your occupation? Personal assistant for doors. CNA work and work for handicap. I do pretty much everything for them if they are not able to move. I do things like cooking,

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cleaning, lifting them, dress them, run errands for them, and I help them fill out paperwork by writing for them. I work Friday, Saturday, and Sunday evenings and I am also trying to pick up another job.

Conclusion Throughout this case study we were able to view Billy in his home and school setting. His teacher, Ms. Garman, did not see Billy’s speech delay as an issue. She reported that although he is developing slowly, he is still hitting the developmental milestones appropriate for his age. Liana noted that Billy only had trouble with slurring the letter “s”. Billy didn’t appear to have any social anxieties or issues communicating his wants and needs to the teachers and his friends. Ms. Garman also noted that Billy follows directions very well when he is asked to do something. As a group we agree that Billy should continue to see his speech pathologist and work on further developing the letter “s”.