Week 7: Observation Interpretation of Janice Charles

Week 7: Observation Interpretation of Janice Charles and Year 3 Checklist (Appendix C) Appendix C: Janice Charles Observation In this final submission, you will consider an observation of Janice, age 35 months. Janice is a new student in your early childhood center and will be 3 years old when she enrolls. Janice’s parents want to ensure she is successful in your program, as she has experienced many health problems and developmental delays due to her early hospitalizations for a chronic heart condition. Janice will attend your center three days a week for nine hours a day. Read and review the observations of Janice at 35 months, as well as the 36-month milestones recommended by the CDC: A: Medical and Developmental Background Janice, a 35-month-old girl, has a chronic heart condition identified at birth that resulted in multiple surgeries, and eventually necessitated a breathing tube that caused some feeding issues. As a result, Janice was fed supplemental nutrition through an NG tube for 10 months due to being severely underweight. Janice was weaned off the NG tube 10 months ago and is now eating soft foods, pureed foods, and some foods that dissolve easily, such as small crackers. Due to Janice’s condition, she has been receiving services since she was 18 months old. She has had occupational therapy once a week, physical therapy three times a week, and speech therapy once a week. Janice has yet to walk unassisted because her muscles are underdeveloped. She spends most of her time at home in a wheelchair but can also use a walker unassisted for 10 to 15 minutes at a time. Janice is eager to chat with her peers and adults and speaks quickly and in a high pitch. She is often difficult to understand for both other children and adults. This causes frustration on Janice’s end and results in many tears. Due to many catheterizations, Janice is also not toilet trained and wears a diaper, though she is eager to use the toilet “like a big girl.” B: Family Routines and Priorities Janice’s mother has been home with Janice her entire childhood. Janice’s older brother, Mark is five and typical developmentally. Mark went to kindergarten several months ago, and now Janice is eager to go to school like “a big girl.” Janice’s parents wanted her to attend daycare part time when she was two to spend more time with peer children, but unfortunately no early childhood center in the area was equipped with a space or a nurse to feed Janice via NG tube. Janice’s mother also would like to take a part time job. Janice’s father works full time and does not pick up or drop off Janice. Janice will attend your center three days a week for nine hours a day. Janice’s parents hope that after a “trial run” of three days a week for three months, Janice will be doing well enough to attend five days a week. The primary concern and goal of the observation is to discern what services Janice can have integrated into her daily routine at the center, and which ones would be better performed at home or at a designated therapy location. The observation will be performed during a half day visit of Janice to the classroom. Additionally, because Janice will be around more peers, therapists would like to be able to base their therapy tactics on Janice’s reactions to her new environment. C. Child Development Observation Date of observation: November 1st Time: 9:00 AM Duration: 30 minutes Location: 3-year-old Classroom and playground at Early Childhood Center Observations Janice is seated in her wheelchair at an activity table with several other children. The children are using shaving cream to draw pictures on the table. The children have on art smocks. Janice grows frustrated because she cannot reach the other implements (popsicle sticks, paint brushes, small toys) in the center of the table that other children can reach. She asks her teacher (she calls her teacher and all other caregivers “teacher”) to take her out of her wheelchair. Janice is taken out of her chair and stands at the table with another caregiver seated behind her holding her up while she plays in the shaving cream. She laughs and squeezes the shaving cream in her hands. Janice indicates to “teacher” that she wants to use a paintbrush a peer is using. She says, “Teacher I wanna brush he has!” The caregiver instructs Janice to ask the child to have a turn with the brush. Janice says, “Friend, can I have a turn with a brush now?” but does not make eye contact or any other indication with the peer. The request is also high pitched, and the words are slurred together. When the peer does not respond and continues to play with the brush, Janice starts crying. She repeats the request that is even harder to understand with her crying. The caregiver speaks to the peer and asks if he can let Janice have a turn with the brush. The child hands to brush to Janice. Janice says, “Thank You, friend” and sniffles a few more times before she uses the implement. Janice successfully grasps the implement. The grasp is rudimentary (closed fist) and not a pencil grasp. Janice is squealing and happy, telling her caregiver holding her up that she is making “Mommy pretty pictures.” Another caregiver stands at the door of the classroom and asks anyone who must use the toilet to come line up for a bathroom trip. Janice gets excited and says “Me! I want to potty like a big girl!” Janice’s teacher tells Janice that she can get cleaned up and join the other girls in the bathroom. Janice is cleaned up, put in her wheelchair, and taken to the bathroom with the other children. Janice tells the teacher that she wants to go. “I wanna use the potty just like Sam!” Sam is a peer child in the class who is using one of the toilets (the bathroom does not have stalls). Janice’s teacher explains that she will be able to use the potty soon. Janice begins crying and screams “Potty now! I’m a big girl too!” Janice is wheeled away from the bathroom because her crying is amplified in the bathroom and is disturbing other children. The teacher consoles Janice in the hallway, tells her she will get to use the toilet soon, and asks Janice what other big girl things she can do. Janice says to the teacher, “I go down slide so fast like a rocket ship!” The words are slurred together. The teacher says, “The slide?” Janice repeats herself. The teacher explains to Janice that they will go on the playground soon and she can show her the slide. After returning to the classroom, the rest of the students line up to go to the playground. Janice talks and giggles with her friends in line. On the playground, Janice is transferred from her wheelchair to her walker. A caregiver stands close to Janice on a paved portion of the playground. Much of the playground is covered with woodchips. Janice successfully maneuvers her walker to the edge of the paved portion and tries to push her walker into the wood chips unsuccessfully. She begins screaming at a high pitch “I wanna slide now!” A caregiver explains that she cannot use her walker in the woodchips. Janice begins sniffling and repeats her request to slide. The caregiver asks if she can carry her to the slide. Janice says, “Ok, we can slide now.” The caregiver places Janice on the top of the slide and releases her to go down. Janice has trouble maintaining her balance in a seated position and lies flat on the slide as she goes down. Janice giggles, laughs, and screams in excitement on the slide. Janice requests to go again, and the caregiver repeats. Janice sees her friend Sam at the bottom of the play structure where the slide is located. Janice says in a high-pitched voice, “Sam, friend! Wanna slide with us?” When Sam does not react, Janice repeats the request in a higher pitch and quicker cadence. Janice starts tearing up. A caregiver says to Janice, “Look Janice! Max is going down the slide too!” Janice sees Max and smiles. Janice goes down the slide with Max, laughing and giggling. Janice says, “I wanna see Sam friend” and points to Sam. The caregiver picks her up and takes her to the area where Sam and some other children are playing with a ball. Janice says to her caregiver, “Put me down now!” The caregiver asks Janice to be polite. Janice says, “Put me down now, please!” The caregiver seats Janice in the wood chips. Janice grabs the ball that a peer rolls to her. Janice picks up the ball in a seated position and pushes it towards the peer, but because the area has wood chips, it does not roll far enough. Janice begins crying. The peer rolls the ball back. Janice giggles and holds the ball. Child’s Name Child’s Age Today’s Date How your child plays, learns, speaks, acts, and moves offers important clues about your child’s development. Developmental milestones are things most children can do by a certain age. Check the milestones your child has reached by his or her 3rd birthday. Take this with you and talk with your child’s doctor at every visit about the milestones your child has reached and what to expect next. What Most Children Do at this Age: Social/Emotional o Copies adults and friends o Shows affection for friends without prompting o Takes turns in games o Shows concern for a crying friend o Understands the idea of “mine” and “his” or “hers” o Shows a wide range of emotions o Separates easily from mom and dad o May get upset with major changes in routine o Dresses and undresses self Language/Communication o Follows instructions with 2 or 3 steps o Can name most familiar things o Understands words like “in,” “on,” and “under” o Says first name, age, and sex o Names a friend o Says words like “I,” “me,” “we,” and “you” and some plurals (cars, dogs, cats) o Talks well enough for strangers to understand most of the time o Carries on a conversation using 2 to 3 sentences Cognitive (learning, thinking, problem-solving) o Can work toys with buttons, levers, and moving parts o Plays make-believe with dolls, animals, and people o Does puzzles with 3 or 4 pieces o Understands what “two” means o Copies a circle with pencil or crayon o Turns book pages one at a time o Builds towers of more than 6 blocks o Screws and unscrews jar lids or turns door handle Movement/Physical Development o Climbs well o Runs easily o Pedals a tricycle (3-wheel bike) o Walks up and down stairs, one foot on each step Act Early by Talking to Your Child’s Doctor if Your Child: o Falls down a lot or has trouble with stairs o Drools or has very unclear speech o Can’t work simple toys (such as peg boards, simple puzzles, turning handle) o Doesn’t speak in sentences o Doesn’t understand simple instructions o Doesn’t play pretend or make-believe o Doesn’t want to play with other children or with toys o Doesn’t make eye contact o Loses skills he once had Tell your child’s doctor or nurse if you notice any of these signs of possible developmental delay for this age and talk with someone in your community who is familiar with services for young children in your area, such as your local public school. For more information, go to www.cdc.gov/concerned or call 1-800-CDC-INFO (1-800-232-4636). Adapted from CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5, Fifth Edition, edited by Steven Shelov and Tanya Remer Altmann © 1991, 1993, 1998, 2004, 2009 by the American Academy of Pediatrics and BRIGHT FUTURES: GUIDELINES FOR HEALTH SUPERVISION OF INFANTS, CHILDREN, AND ADOLESCENTS, Third Edition, edited by Joseph Hagan, Jr., Judith S. Shaw, and Paula M. Duncan, 2008, Elk Grove Village, IL: American Academy of Pediatrics. This milestone checklist is not a substitute for a standardized, validated developmental screening tool. Help Your Child Learn and Grow You can help your child learn and grow. Talk, read, sing, and play together every day. Below are some activities to enjoy with your 3-year-old child today. What You Can Do for Your 3-Year-Old: o Go to play groups with your child or other places where there are other children, to encourage getting along with others. o Work with your child to solve the problem when he is upset. o Talk about your child’s emotions. For example, say, “I can tell you feel mad because you threw the puzzle piece.” Encourage your child to identify feelings in books. o Set rules and limits for your child and stick to them. If your child breaks a rule, give him a time out for 30 seconds to 1 minute in a chair or in his room. Praise your child for following the rules. o Give your child instructions with 2 or 3 steps. For example, “Go to your room and get your shoes and coat.” o Read to your child every day. Ask your child to point to things in the pictures and repeat words after you. o Give your child an “activity box” with paper, crayons, and coloring books. Color and draw lines and shapes with your child. o Play matching games. Ask your child to find objects in books or around the house that are the same. o Play counting games. Count body parts, stairs, and other things you use or see every day. o Hold your child’s hand going up and down stairs. When she can go up and down easily, encourage her to use the railing. o Play outside with your child. Go to the park or hiking trail. Allow your child to play freely and without structured activities. 4.Examine whether the child should receive services at home on days away from the center. If so, indicate how communication will be established between your center and the home services. 5. Choose how the services will be monitored, scheduled, and recorded. Describe how the child’s parents will learn about his/her progress. each need to have 250 words in the number 4and 5 I need to answer the Janice’s charle is all the information about observation and I need to answer the that I podt in

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