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Josh

Josh. A Case Study on Cerebral Palsy. Reference: Adapted from a case study developed by students at Program in Occupational Therapy at Washington University in Saint Louis http://enablemob.wustl.edu/CaseStudies/case_studies.htm. Fast Facts. 7 years old

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Josh

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  1. Josh A Case Study on Cerebral Palsy

  2. Reference: Adapted from a case study developed by students at Program in Occupational Therapy at Washington University in Saint Louis http://enablemob.wustl.edu/CaseStudies/case_studies.htm

  3. Fast Facts • 7 years old • Diagnosis of spastic, quadriplegic cerebral palsy • Drools excessively • Non-verbal, but understands simple conversation • Cognitive functioning at about 4-year-old level • Dad uninvolved, Mom works full time • Lives in group home with visits from Mom • Attends general elementary school in a rural area; has one-on-one aide

  4. Physical Issues • Spastic tone in all extremities • Has voluntary and involuntary UE movement • Cannot weight bear or ambulate • S-curve scoliosis • Windswept hips, pelvic obliquity, and pelvic rotation • Severe wrist contractures • Current services: • A physical therapist (PT) travels to his school two days a week to work with him. • No occupational therapy (OT) services • Teacher nor aide are trained in movement therapy. • He is placed in a positioner each day for a set time. • His aide works with him on stretching each day.

  5. Home Environmental Issues • Lives in a group home during week • Lights and TV are inaccessible to Josh • No accommodations for toys (blocks) • Visits with Mom during week and outings with Mom on weekends • Mom’s house/car currently inaccessible to chair • Bathroom has narrow doorway • 3 steps to enter house • Mom can’t lift chair into trunk • Unable to feed self at home • Totally dependent on mom and group home workers for feeding • No specialized utensils

  6. School Environmental Issues • Attends general elementary school in district • Strongly dependent on aide and teacher • Many items in classroom out of reach • Tables to low for wheelchair to fit under; sits apart from classmates • Uses same basic materials as other students (pencils, crayons, paper, etc.) • No specialized toys • Unable to feed self at school • Totally dependent on aide/teacher for feeding • No specialized utensils

  7. Mobility Issues • Current wheelchair: • Sunrise Medical power wheelchair. • Has specially designed joystick to accommodate for Josh’s wrist contractures. • Is 5 years old and has no more available growth. • Backup manual wheelchair. • Has one year of growth left. • Is too heavy for Mom to put in car. • Cannot access Mom’s house due to steps. • Older school grounds inaccessible in wheelchair • Uneven surfaces on playground • Most field trips and outings inaccessible in current chair • Zoo, shopping, etc.

  8. Communication Issues • Non-verbal, but understands simple conversation • Areas of communication • To teacher, aide • To parents • To peers • Current accommodations • Keyboard: Josh types slowly with one finger. • Picture Board: Simple communication board with pictures that Josh points to in order to indicate what he wants or needs.

  9. Interests & Favorite Activities • Watching TV • Watching videos about construction or building • “Helping” (watching) other kids at group home and school build with blocks • Learning about animals • Doing art at school • Going to the zoo with friends at group home • Going shopping with Mom

  10. Needs Assessment • Physical • No structured plan for positioning and movement • Limited access to PT/OT specialists • Environment • Group home • Mom’s house • School classroom/grounds • Toys inaccessible (i.e. blocks) • Mobility • Has almost outgrown power wheelchair • Backup chair is not motorized • Communication • Lack of typing skills • Limited by available pictures on board

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