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1. CI Individual Instruction
(A)
2. CI Individual Instruction (B)
3. Motor and Social Skills Group
Case
Study #1 Individual
Instruction Case Study (A)
Jeffrey was a 38-month old child referred to us
by a developmental specialist who had diagnosed
him as having pervasive developmental disorder,
not otherwise specified. Jeffrey showed delays
in most areas of development including speech
and language skills, social/emotional skills,
gross motor skills, fine motor skills and self-help
skills.
His parents enrolled him in our one-to-one educational
therapy four days a week for two hours each day.
To help Jeffrey learn those social and behavioral
skills necessary to succeed in a small classroom,
he worked one-to-one with a teacher for the first
six weeks. Once he gained the skills necessary
for small group work, he joined a small classroom.
During the first several months of instruction,
Jeffrey worked closely with his teacher on developing
these specific skills:
Gross Motor Skills
- balancing
- building upper body strength and endurance
- learning to use both hands to complete a task
- developing basic recreation skills
- developing a sense of rhythm and timing
Fine Motor Skills
- developing in-hand manipulation skills, such
as rolling clay into a ball
or turning pages in a book
- developing ability to color
- developing ability to cut with scissors
- developing basic drawing skills
Behavioral and Social
Skills
- complying with the teacher when she gave him
directions
- using gestures or words to express his needs
and wants instead of having tantrums
- waiting his turn for a toy
- playing beside other students (parallel play)
- interacting with the other students during
supervised activities (interactive play)
Self-Help Skills
- feeding himself finger foods
- drinking through a straw
- drinking by himself from a small cup
- telling the teacher when he needed to use
the potty
- removing then putting back on his shoes
Jeffrey made steady progress as he continued his
instruction. He developed better strength and coordination,
learned to create shapes with play dough, color
large shapes, and cut in a relatively straight line,
share toys, understand what others said to him and
speak. As Jeffrey gained more skill, he gained more
understanding of his environment and the people
in it. He became more focused, attentive to others
and seemed to take pleasure from social interactions,
something he tended to avoid before we met him.
Instead of picking up toys and banging them, he
learned to play with them in ways for which they
were intended. Overall, Jeffrey seemed happier.
He spent less time crying and acting agitated and
more time smiling and giggling.
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Case
Study #2 Individual
Instruction Case Study (B)
Tommy was a five-year-old whose parents pulled him
out of pre-school because he had difficulty participating
in school activities. He was spending much of the
day wandering around the classroom, interacting
little with his classmates and often getting into
skirmishes with them over toys. He tended not to
listen to the teacher and did not stay with any
one activity for more than a few seconds or so.
When Tommy was evaluated at a local clinic, the
therapists found him to have an auditory processing
disorder, which contributed to his speech and language
delays and problems with fine motor development.
Tommy could not easily button and zip his clothes,
feed himself with a fork and spoon or grasp a crayon
or pencil. His gross motor skills appeared well-developed.
Tommy's parents enrolled him at CI five days a week
for four hours a day, from 9:00 to 1:00. Their goal
and ours was to teach him those skills necessary
to function successfully in a regular kindergarten
classroom the following school year. Therefore,
we arranged for fairly intensive instruction with
Tommy, with his parents reinforcing our instructional
goals at home for an additional thirty minutes a
day.
Our director wrote an instructional plan for Tommy
that included work in all developmental areas:
- gross and fine motor skills
- language skills
- communication and cognitive skills
- educational readiness skills
- self-help skills
- organizing the senses for use
- social and emotional skills
She placed a strong emphasis on those areas in which
he needed the most training, receptive and expressive
language and fine motor skills. His instructional
program included goals and objectives checklists
for each developmental area, step-by-step practice
materials and activities, charts to record Tommy's
work and graphs to show his monthly progress. His
parents used these same materials when they worked
with Tommy at home.
Tommy joined a group with a few other children who
were close to him in age and ability. These were
typical activities he completed in his four-hour
day with us:.
9:00 to 9:10 Warm up
Included having a conversation around a particular
theme and specific vocabulary words (e.g. Thanksgiving,
winter, family) during which the teacher helped
Tommy practice the language skills he was learning
and interact successfully with another child and
adult.
9:10 to 9:30 Fine motor activities
Included creating shapes with playdough, manipulating
small objects in the palm of his hand, cutting with
scissors, coloring simple shapes, putting pegs in
a pegboard, lacing shoelaces through lacing boards
and drawing simple shapes on the easel and chalkboard.
9:30 to 9:55 Language training
(one-on-one with the teacher) Included both receptive
and expressive language activities.
9:55 to 10:00 Short break
Included playing on swings, trampoline and slide
(sensory support activities and gross motor skills).
10:00 to 10:30 Art activity
Consisted of structured independent work to further
strengthen fine motor skills while teacher worked
one-on-one with another child.
10:30 to 11:00 Beginning math
concepts Included numerous hands-on activities,
which further supported Tommy’s fine motor
development in addition to quantitative understanding.
11:00 to 11:30 Gross motor
skills Included activities to continue strengthening
his muscle tone and coordination (which was already
well-developed), interactive ball games (which required
him to listen, follow directions and speak), walking
on low-lying balance beams and completing other
balance and sensory support activities, such as
swinging, turning somersaults and spinning.
11:30 to 11:55 Beginning reading
skills and more language training (one-on-one
with the teacher)
11:55 to 12:25 Lunch
Included informal social, language and self-help
skills training.
12:25 to 12:45 Beginning handwriting
skills (one-on-one with the teacher)
12:45 to 12:55 Interactive
gross motor activity Included such activities
as balloon toss, playing toss and catch while on
the swing and running an obstacle course.
12:55 to 1:00 Preparing to
go home
Over the next eight months, Tommy’s teacher,
his parents and the director communicated each week
about Tommy’s lessons and progress. They charted
his work and reviewed and graphed his progress so
the teaching team could determine how well Tommy
responded to the program overall and specific teaching
strategies. They made instructional adjustments
as needed.
As a result of the concentrated instruction and
the close coordination between Tommy’s teacher
and his parents, Tommy made excellent progress in
all areas, particularly in his language abilities.
Before the next school year began, his teacher at
The Cyzner Institute met with his new kindergarten
teacher to discuss Tommy’s progress and those
skills in which he needed additional practice and
support. Tommy had a successful kindergarten experience
that next year.
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Case
Study #3 Motor
and Social Skills Group Case Study
Five children between the ages of three and four
were referred to us for our Motor and Social Skills
Group, which met on Tuesdays and Thursdays from
1:30-3:00. These children had delays in social,
gross and fine motor skills, which affected their
ability to initiate play, engage in shared interactions
with peers and manipulate small objects like pencils,
crayons and scissors.
Many of these children saw therapists who worked
with them, one-to-one, to build these skills. However,
they did not have an opportunity to practice their
skills in small groups with their peers. Some children
had tried other organized gym programs but quickly
got discouraged because they could not successfully
participate in the activities. Others were enrolled
in regular pre-schools; however, they couldn’t
fully benefit from the social interactions they
had. These interactions demanded more than they
could give at that point in time. To help these
children develop the social, gross and fine motor
skills necessary to successfully participate in
group activities, their parents enrolled them in
our Motor and Social Skills Group.
A typical group session included these activities:
- Circle time during which the teacher welcomed
the children, prepared them for the group session
and had them work on the social skill of introducing
oneself, looking directly at others and telling
one’s name.
- Gross motor activity when children worked
on skills related to balance, upper body strength,
endurance, and playground and sports skills.
During this time, they also worked on turn taking
and following multi-step directions appropriate
for their age. Those waiting their turns often
participated in fine motor activities set up
on the periphery of the gross motor area.
- Snack, bathroom and break time when children
practiced interacting further with their peers.
- Social skills activity during which children
practiced sharing information about themselves,
taking turns, sharing toys and playing interactive
games.
- Wrap up time when children practiced saying
good-bye to their friends, and when the teacher
briefly reviewed the day’s session with
their parents.
During the course of the three-month sessions, all
the children gained new social and motor skills.
Their teachers observed more appropriate peer interaction
at pre-school. Their parents observed an increased
desire to go to the playground and play with other
children. Their occupational therapists noted improved
motor skills. The greatest increases, though, were
observed in the children who smiled more and interacted
with their peers with greater confidence.
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