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Verbal Behavior Eval 7/2001

Program Evaluation

CK

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:

Home Program Evaluation 7/2001

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

Consultative Report
CLINIC DATE: 03/12/1999
DISCIPLINE: PSYCHOLOGY/CASE COORDINATOR SUMMARY

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.

On food allergy test, he had a few I+. His sphingomyelin test was elevated slightly at 1:8 indicating some autoantibody. They have not started the Mercury Detox. They have not started the Defense. His current regimen is Efulex?, Super Nuthera?

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.

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 Progress Report 7/2000

Special Physical and Motor Fitness Clinic

Progress Report for Parents

Spring Term 2000

CK

Group:

Clinician:

Education Service District

Early Intervention Program

I. NAME:

REPORT DATE: 6/3/99

AGE: 38 months

II. BACKGROUND & REFERRAL REASON

Referral Reason: