Adam is a 4;00 year old boy, who was referred to the LRC in June 2004 due to parental concerns regarding his communication skills with other children, social relationships, and general development. Adam's parents attended an initial intake interview with Dr Eman El Sayed on the 6th June, 2004. Following the intake it was recommended that Adam would be assessed by members of the LRC Child Development Team. The two assessing clinicians were Donia Fahim, Speech and Language therapist and Eman El Sayed, Paediatric Psychiatrist.
Adam attended the LRC on the 28th June, with his mother and father. Both clinicians were present during the assessment.
This report must be referred to in conjunction with the neuro-developmental assessment conducted by Dr Eman El-Sayed.
Case History
Please refer to the initial intake report.
The following is a summary of the assessment findings based on informal assessment and parental report aged 4;00 years. Although Adam is exposed to English at nursery his predominant language is Arabic and therefore this was the language used during the assessment.
Behaviour, Play Skills and Pragmatics
Regarding Adam's behaviour, Adam's social skills and behaviour are mildly delayed and more like a child aged between 3;00-3;06 years. His parents reported in the intake that Adam's use of eye-contact is inconsistent with adults and peers. Adam's eye-contact was observed to be within the normal range. He made and maintained eye-contact appropriately.
His attention skills do affect his use of eye-contact, in that if he is not attending to what is being said he will not look at the adult.
Adam appropriately initiated with the therapist, his mother and his father. He used language appropriate...
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Use simple language to comment on Adam's actions during every-day activities.
Do NOT ask Adam questions that require him to label or comment.
Use specific language and gestures to praise Adam. For example, when he sits at the table he should be told, "Adam you are doing good sitting."
Adam should be told what you want him to do and NOT what you don't want him to do. For example, if he throws a cup on the floor, the adult should say "Pick the cup up" and NOT "Don't throw your cup on the floor"
Spend 5 minutes daily playing with Adam, which is his special time and he chooses the toys and activities. During this time Adam should not be pressurised to talk. The adult playing with Adam should wait for him to start the talking, not direct his play and comment on his actions. This will be demonstrated in detail during the parent child interaction sessions.
Incidental teaching focuses on child-initiated interactions. (Hall, 2013) Incidental teaching is used to increase skills of individuals with autism spectrum disorders. (Hall, 2013) A study done by Hart and Risley (1975) looked at the incidental teaching process used at the preschool age to aide in teaching language. Incidental teaching has been the most frequent strategy that has been used to teach language. When using incidental teaching a child’s request may be verbal or nonverbal. Examples include reaching for an object that is out of one’s reach, requesting food or a toy or calling an adult’s name. There is a series of decisions that an adult can use to respond to the child’s request. These choices include: if the occasion should be used for incidental teaching: if so then a choice regarding the language behavior that is obtained from the child, and then a choice has to be made concerning the cue that will be used to initiate instruction, the cur could be focus of attention by itself, or in addition to the focused attention a verbal cue as well. If the individual does not respond to the cue, then a choice concerning the degree of prompt to be used, the “fullest degree: a request for imitation; medium degree: a request for partial imitation, or minimal degree: a request for the terminal language behavior.” (Hart & Risley, 1975) This study was performed on boys and girls between the ages of four years old to five years old. The baseline procedures ensured that the children had a variety of vocabulary for use in sentences. The sentences that they were taught was “I want x so I can y.” The second step of the procedure was the use of incidental teaching of compound sentences directed to teachers. After thirty-six days of school, the incidental teaching began to occur when the children needed assistance in trying to get different preschool materials.
The second edition of the Developmental Neuropsycholgical Assessment, or NEPSY-II, was developed specifically as a single measure assessment for children 3-years to 16-years 11-months of age. The test can be used in a general or selective method to obtain a general overview of neurological abilities, or the full diagnostic assessment can be used to obtain a comprehensive evaluation. The results can be used to investigate school-based or behavioral problems, as well as clinical or medical questions regarding executive functioning. Because the assessment involves a battery of tests that are flexible and can be tailored for each individual, it is a highly sought after test of executive functioning abilities in children.
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