Evaluations
ESD Early Intervention Program Evaluation
Sample Evaluation from an ESD
ESD
Early Intervention Program
I. NAME:
REPORT DATE: 6-9-98
PARENTS:
CHRONOLOG. AGE: 2 years 2 months
II. BACKGROUND & REFERRAL REASON
A. Referred By: KinderCare suggested that his parents call us.
Referral Reason:
CK is using less than ten words. He does not always respond to his name.
B. BackeroundAlistory:
ESD Occupational Therapy Evaluation
Education Service District
Early Intervention Program
I. NAME:
REPORT DATE: 6/3/99
AGE: 38 months
II. BACKGROUND & REFERRAL REASON
Referral Reason:
Home Program Evaluation
I hope my coming helped and that these notes are useful. CK is doing great. I am impressed. He has a ways to go, but I am imnressed. Lea is doing great too. Sometimes everything is a little overwhelming, but I hope by watching she got a few ideas on ways to include CK. Hope things are going well in all areas of your lives. I will talk with you soon. Let me know if there is anything else I can do for you. Thanks
Lea—
ESD Autism Evaluation
Education Service District
REGIONAL AUTISM SERVICES
Student: CK
Evaluation Date: 12/17/98
DOB: 2/22/96
Autism Specialist:
School: Early Intervention & Kindercare
Speech/Language Pathologist:
District: EIECSE
Teacher:
CK is a 2.10 year old boy, who was referred to the Regional Autism Program for evaluation on 11/13/98 by Early Intervention Service Coordinator. The areas of concern are language and social development. CK currently receives services at Early Intervention Toddler Group.
EVALUATION ACTIVITIES
Autism Medical Diagnosis Report
Consultative Report
CLINIC DATE: 03/12/1999
DISCIPLINE: PSYCHOLOGY/CASE COORDINATOR SUMMARY
Allergy Test Report
Date: 5/9/00
Name: CK
Acct. #: 105433
0: Reviewing lab tests: IAG test was positive with a 51 IAG which indicates he has marked problems with his tryptophan metabolism. IAG also disrupts membranes which could cause a leaky gut and probably problems with the bloodibrain barrier. His gliadomorphin is also elevated at 27 and urinary dermorphin is also elevated. His urinary organic acid test showed that he possibly has a B- 1 deficiency and a CoQ 10 deficiency. I suggest 5 0 mg/day. Essential fatty acid study was normal. He is on Efulex.? This is the first one we have found that has been normal. GI health panel is close to normal. He had I+ Rhodotorula yeast. He had low SIgA. His inflammatory markers were normal. His endolin? levels were normal.
A: I . PDD/autism.
2. Inflammatory bowel disease.
3. Glutathione deficiency.
P: I . Mercury Detox starting with I/day and increasing to 4 as tolerated.
Eye Exam
Board Certified in Vision Therapy
January 11,2001
RE: CK
CK was examined on January 9,2001. At the time of evaluation, the primary concern was regarding CK’s tendency to close one eye when he points to a particular object which has been occurring less frequently lately. CK also demonstrates unusual visual behaviors including opening his eyes very wide, crossing his eyes, squinting and turning his head to point. These behaviors were first noted at approximately one year of age.
CK’s general health is reportedly good. At the time of evaluation he was taking no medications, had no reported allergies and was taking vitamin supplements. CK has been receiving educational, speech, and occupational therapy through Early Intervention Services.
Motor Fitness Report
Motor Fitness Progress Report 7/2000
Special Physical and Motor Fitness Clinic
Progress Report for Parents
Spring Term 2000
CK
Group:
Clinician: