We reviewed Little T's goals on Tuesday. Little T exceeds expectations in all areas of review. He's made remarkable progress, considering he's been hospitalised five times during the review period (six months) Yes, Little T has goals written down on paper that the state government (Early Start) pays to have met. It's all written on our IFSP (Individual Family Service Plan), because every government program must have an acronynm.
When we completed this IFSP on 5/13/05, Little T literally just lay there. Five months of chemo had ravaged his body. He couldn't lift his head. He made no sounds. He gazed at you with bright intelligent eyes, but no-one but his family and a few doctors and nurses who knew him well had any indication he was anything other than "delayed".
A lot of the goals are devised in conjunction with the child development specialists, and like any speciality they have a syntax all their own.
For those who want to see your tax dollars at work, need to fill out an ISFP, or are just curious about Little T's progress, here are the details.
Outcome: Language Skills: [Little T] will say two to three words - met!
Criteria:
Little T will
- increase vocalizations, babble in response to parents interacting with their own voices. [sic] - met
- use "mama/dada" specifically - Sadly, no. He babbles "dadadada" and "mamamamama" and sometimes I think he might be calling me, but I've never heard him say "mama"
- wave or respond to bye-bye. - met
Outcome: Gross Motor Skills: LT will be mobile without assistance - met!
Criteria: Little T will
- demonstrate improved head control in all positions, turning head freely from side to side. - met
- play on stomach, bearing weight on right arm and left arm as able. - Needs improvement. His G-tube makes stomach play uncomfortable.
- roll from stomach to back and back to front - met
- maintain a sitting position using his arms to prop for balance as needed - met
- bear full weight on legs in supported standing - met
- with adult supervision, stand without adult support while holding onto or leaning on a small piece of furniture (couch or coffee table)- met
Outcome: Adaptive: Little T will feed himself enough so that he gets enough calories - Didn't meet goal at all, but did work towards goal. Feeding issues take a long time to resolve and the five hospitalizations set him back.
Criteria: Little T will
- Increase amount of feedings taken orally under supervision of physician. - Met. He now takes 8-10 oz a day up from 2-4 oz a day. Though to met his caloric needs he needs to take 32 oz a day.
- learn how to feed himself finger foods - met
- learn how to drink liquids by himself - met and just days before the ISFP meeting
- learn how to drink from an open cup - not met. He needed to meet the goal above first.
Thida will learn how to feed Little T solids. - met
Outcome: Little T will put objects in a container and take them out again. - met
Criteria: Little T will
- bring objects to midline and transfer them from hand to hand - not met
- work for a toy during play/retrieve an item using other materials - the first goal was met, but not the second
- uncover a hidden toy during play - met
Outcome: Little T will hold and manipulate an obiect with his left arm and hand. - not met
Criteria: Little T will
- move his left arm and hand voluntarily - not met -he can shrug his left shoulder and curl the fingers of his left hand, but that's about it.
- reach for an object with his left hand - not met
- grasp an object with his left hand - not met You can curl his left fingers around an object and make him hold something, but that's not really grasping an object.
The goals he didn't meet are continued on the new IFSP and he also has new goals for the next 6 months. The new language goals don't sound like English to me, because now he's getting speech therapy and his speech therapist outlined them. Actually, I'm not going to list the new goals. It feels like I'm pressuring him if I do. I know he can't read, but we can. In six months time, I'll report back how he's doing.