Consultation Treatment Plan

1. Consultation Treatment Plan Student P

2. Reason For Referral • Student P’s CSE was coming up as part of New York State mandated 3-year re-evaluation process.

3. Socially History • Family: • Student P is a 5-year 5-month old boy, that is very polite and funny and loves to swim and bowl. • Student P lives with his mother, whom is a homemaker, student, and medical biller. He also lives with his two older sisters. (7th grade and 4th grade). • Student P’s parents divorced in 2011. His father does not live with them but he sees Student P every Wednesday from 6pm-9pm. As well as every other weekend.

4. Social History • Medical: • Student P was carried to full-term and there were no major problems noted, however, he was lactose intolerant and had a protein allergy at birth. • Student P hit all of his developmental milestones on time. • Student P is currently in “Excellent Health.”

5. Socially History • Student P received Early Intervention – Home based Services starting in July of 2009. • Student P was diagnosed in January 2010, with PDD-NOS. • (The doctor, whom we do not recommend, did no formal testing) • In April 2012, that same doctor, removed the diagnosis of PDD-NOS

6. Current Classification • Student P is currently classified as Speech and Language Impaired. • He is in an integrated classroom setting • He is receiving speech services 3x a week in a group.

7. Current Testing • Speech Testing: • Student P was administered the CELF-4 and TAPS (Test of Auditory Processing) • -Student P’s auditory processing skills are best described as inconsistent • -Although his processing skills are inconsistent, Student P’s other areas of speech, such as articulation, fluency, and voice production, are all good.

8. Current Testing • Psychological Evaluation: • WPPSI-IV

9. Classroom teacher interview • Student P’s teachers have many concerns regarding Student P’s ability to pay attention. He is often caught staring into space, looking around the room, playing with things around his table, his clothes, pencils or even just his own fingers. • Student P often needs prompting after the class have been given an instruction. For example: As seen in his formal observation, the class was taking a test and asked to please point to the flower. Student P continued to look at the teacher, and she had to specifically say “Student P, can you please point to the flower” • During the test, they were to color in the different parts of the flower, with different colors, as the teacher asked. On the last part of the flower was to be colored in red, Student P raised his hand and said he had already colored that part in yellow. Since it was a test both teacher’s simply said that this is part of listening and following directions.

10. CSE Meeting • When Student P’s mother came in for Student P’s CSE meeting, we had a lot of data to present and discuss. • After the speech and cognitive reports were presented, the teachers showed some of his work and talked about his behaviors in class. • Before anyone could say anything, Student P’s mother asked us if she thinks this could be ADD, not ADHD because he isn’t hyperactive. • The chairperson gave her some name of some pediatric developmental psychologists for her to see. She said she doesn’t want to wait, she believes this is what he has and wants to make an appointment as soon as possible, and is mad that the previous doctor did no formal testing. • His mother gave us some examples of Student P’s behaviors, such as his issue with “WH” questions.

11. CSE Decision • After talking and knowing that Student P’s behaviors are consistent both in school and at home and his mother wants to do all that she can to help him. The CSE decided to keep Student P’s current classification of Speech and Language Impaired, although his speech services for next year are going to drop from 3x a week to 2x a week in a group. • He is also going to maintain his classroom placement of being in an Integrated class setting. • Student P’s mother understands that Student P will most likely not need Speech Services next year and be declassified as Speech and Language Impaired. • Once she goes to the doctor, and if she gets a diagnosis, she will call and return to committee, to then discuss Student P’s future, because she is scared that he will “fall through the cracks if declassified.” • In the meantime the classroom teacher’s are trying an intervention in the classroom to see if they can help improve Student P’s attention skills.

12. Treatment plan • Short Term Goals: • To increase on-task behaviors • To reduce inattentive and disruptive behaviors • (Rathvon, 2008, p. 309) • Long Term Goals: • Gradually increase focus, attention, and concentration • Exhibit the ability to accurately follow one- and two- step directions without prompts • Parents and school staff recognize how difficulties with attention and self regulation impact the child, and work together to improve the child’s overall functioning. • (Jongsma, Winkelstern, 2006, p. 36)

13. Treatment Plan • Intervention for a child whom Does Not Remain On-Task • Objectives: • The student will remain on-task for the required length of time with supervision on 8 out of 10 trials. • The student will remain on task without supervision for the required length of time on 7 out of 10 trials. • The student will rely on environmental cues (i.e. timers, bells, other students, etc) to remain on task for the required length of time on 8 out of 10 trials. • The student will remain on-task for 5 minutes at a time. • The student will remain on-task long enough to finish the task on 6 out of 10 trials. • The student will ask for clarification of directions or instructions not understood on 8 out 10 trials. • (House, 2004, p. 73)

14. Treatment Plan • Interventions: • Establish Classroom rules:Work on-task, work quietly, remain in your seat, finish task, etc. • Assess the degree of task difficulty to determine whether or not the student will require additional information, time, assistance, etc., before beginning a task. • Schedule a fun educational activity (i.e. computer games) during the day to provide incentive for the student to stay on-task and behave appropriately. • Have student assemble all materials needed prior to beginning a task to reduce interruptions. • Provide an incentive statement along with a directive (i.e. “When you complete this assignment, you may earn a pass to the water fountain.”) • Deliver reinforcement for any and all measures of improvement.

15. Treatment plan • Seat the student away from those peers who create the most auditory and visual stimulation in the classroom. • Provide the student with increased opportunities for help or assistance on academic tasks (i.e. raise hand, ask for assistance, go to the teachers, etc.) • Provide assignments that involve immediate, short-term tasks. • Present tasks in the most attractive and interesting way possible. • Allow the student some movement while performing tasks. Monitor and limit the amount of movement. • Place the student with peers who will be appropriate role models and should facilitate his academic and behavioral success. • Move objects used for tactile stimulation (i.e. pencils, crayons, paper clips, etc.) away from the student’s reach. • (House, 2004, p. 73-76)

16. Other Intervention Strategies • There is also an Intervention called “Button, Button, Who’s Got the Button,” for Reducing Disruptive Behavior with Response cost • This intervention is really for younger students like pre-schoolers but it’s purpose is to increase on-task behaviors and reduce inattentive and disruptive behaviors with a response cost procedure. • This is for the whole class, which could still be helpful for Student P. • The teacher posts a ‘Happy Face Chart’ in the front of the classroom. The teacher explains that this is to show if they are all behaving in school everyday, and they will earn a chance to pull a prize from the surprise prize box, if they remember to follow all the rules. • The teacher should review the classroom rules (preferablly on a chart) and give the students some examples of expected behaviors. • Since the ‘Happy Face Chart’ works with buttons, the teacher should then show the class that the buttons will help them to follow the rules so that everyone can have fun at school. Tell them they that will lose a small button if they break a rule. If they have three small buttons left at the end of the activity, they will earn a large button. Everyone with three big buttons at the end of the school day will be able to draw from the Surprise box. • (Rathvon, 2008, p. 400) • Another Kindergarten teacher in the building does this, but it is not for individuals, it is for the whole table of children. She has been doing this for a few years and has had much success with it.

17. Prognosis • Student P’s Prognosis is uncertain. Student P is a very polite, funny, and motivated child. • Student P is still only 5 years old but since his attention is such a concern of both the school staff and his mother, they are going to the doctor to see what is going on. • If diagnosed and treated (Medicine being their last resort), Student P’s attention and focus may really improve and hopefully so will his academic performance. • Student P is still so young and he has a mother and school staff that is trying all they can to help him best succeed, so we all have high hopes for Student P’s future success.

18. References • House, S., N. (2004). Learning Intervention Manual: Goals, Objectives, and Intervention Strategies . Columbia, MO. Hawthorne Educational Services. • Jongsma, A., E. & Winkelstern, J., A. (2006). Early Childhood Education Intervention Treatment Planner. Hoboken, NJ. Wiley. • Rathvon, N. (2008). Effective School Interventions: Evidence-Based Strategies for Improving Student Outcomes. New York, NY. The Guilford Press.