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Sample “Assessments Chart” (Page 1 of 2)

 

Date Where Who Results
Jun. 2001 to Aug. 2004  Parent  Milestones summary
Jun. 25, 2002  Rotary Children’s Centre Speech Therapist

 

 

 

Physical Therapist

 

 

Occu-
pational Therapist-         some delays in understanding and use of language for both chronological   and corrected ages-         very active-         brief attention span

-         doesn’t respond to signing attempts

-         recommendation to see on a regular basis

-         walks with mild knee varus (bow leg) right more so than left

-         mild intoeing

-         will continue to check him in relation to mild right sided tightness and knee varus.  Orthopaedic Clinic to assess joints

 -         regular basis needed to address oral-motor abilities and to develop strategies to facilitate play and fine motorJan. 27, 2003Rotary Children’s CentreP/TDischarge report-         age appropriate motor skills-         heel-toe gait pattern

-         safety issues

-         some dystonia which causes him to tripFeb. 10, 2003Rotary Children’s CentreSLPO/TApplication for Preschool Program-         delayed development-         delayed expressive

-         communication

 

Sample “Assessments Chart” (Page 2 of 2)

 

Date Where Who Results
Nov. 21, 2003 KidsAbility – Compuscore BDI ECE class chronological age of 35 months-         personal-social – 21 months-         adaptive – 22 months

-         motor – 28 months

-         communication – 24 months

-         cognitive – 27 months

-         BDI total – 24 monthsNov. 22, 2003K-WHS Preschool OutreachResource TeacherBattelle – 36 months-         personal-social – 21 months-         adaptive – 22 months

-         gross motor – 29 months

-         fine motor – 26 months

-         receptive – 27 months

-         expressive – 26 monthss

-         cognitive – 35 monthsSep. 9, 2006 Psychol-ogist-         ADHD – Combined Type-         Language disability-         Generalized Anxiety disorder

-         Limited coping mechanisms

-         Limited understanding of social pragmatics

-         Clinical pattern of oppositional behaviour

-         Weak fine motor skills