A student with cerebral palsy may have cognitive and motor disabilities and require an IEP to access special education services through an IEP. The purpose of this paper is to present a student who experiences cerebral palsay, analyze the specific disabling conditions, the student presents and discuss complications involved with the disorder.
Cerebral palsy (CP) has been defined as “a group of disorders of the development of movement and posture, causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain” (Sugden & Beveridge, 2009, p.698). Children with disabilities such as cerebral palsy and other health impairments attending public school are entitled to educational programming that meets the individual needs of the student. The Individuals with Disabilities Education Act (IDEA) of 2004 requires parent participation in the decision making regarding educational programming for such children (2004). In addition, schools are charged with completing the Individualized Education Plan (IEP) designed to act as a roadmap for setting goals and objectives toward student progress. Snell & Brown (2006) point out the necessity for a team of school professionals to work together in the development of the IEP which in part must include the following criteria: 1) Assessment information is gathered identifying the students the individual needs and strengths, 2) The students present levels of performance (PLOP) 3) Determination as to which educational service provider will be responsible to work on the goals with the student as well as documentation delineating how, when and where the services will be implemented. 4) Annual goals, objectives and benchmarks must be recorded by identifying what students accomplishments. It will show the progress toward the goals and objectives and what accomplishment made by the student will prove the services provided for in the IEP are effective.
A student with cerebral palsy may have cognitive and motor disabilities, and requires an IEP to access special education services through an IEP. The purpose of this paper is to present a student who experiences CP, analyze the specific disabling conditions, the student presents, and discuss complications involved with the disorder. Included in the presentation is a discussion of the financial effects, assistance in the education system, and the treatment options available to the student. Finally, a design of two appropriate IEP goals to meet the student’s needs is presented.
Timmy is a bright, self-directed nine-year-old boy with CP. He attends his home school, an elementary school in a rural town. He attends regular education classes and special education classes during his school day. Timmy ambulates through out the school and on the playground in a power wheelchair which he drives using a switch activated head switch. Timmy exhibits cognitive delays in the area of math scoring at the 1.4 years grade equivalency, written language <1st grade equivalency and reading with 1.2 grade equivalency. Socially, Timmy is very likable and enjoys many friendships with peers at school. He is not a behavior problem in classes, although he frequently gets excited and calls out during class at inappropriate times. He is supported in the general education environment by a para-educator who helps him with written language and adaptive equipment needs.
Timmy is mildly delayed in language concepts, however he experiences a marked speech impairment resulting in dysarthria, a condition related to brain damage that inhibits the muscles in the mouth to develop normal speech patterns (Webster, 2002). Gross and fine motor functions are affected as well, and therefore, Timmy uses computer software for written language and has recently been evaluated for a speech augmentation device through a school system lending library for speech output devices. The cost of such devices is quite high about $8,000.00. The school is assisted with the evaluation process in collaboration with the speech therapy and rehabilitation department at the Children’s Hospital and Medical Center. Parents insurance will cover the cost of the device. School therapists will assist the parents in programming and updating language on the device.
Parents report Timmy is beginning to be excluded in out of school social events such as birthday parties and fun events. Mom feels that as Timmy gets older, he is less able to keep up with peers and therefore is not being invited to age appropriate events. In addition, parents express overall happiness with the academic program Timmy has received, however they are becoming more concerned about his functional abilities in daily living skills. As Timmy gets older and matures, parents would like to see Timmy be more independent in managing more of his self-care (Chiarello, Palisano, Maggs, Orlin, Almasri, Kang & Chang, 2010). Currently he is able to doff all clothes, but requires moderate to maximum assistance to don garments. He is unable to do teeth brushing, put on deodorant, or efficiently wash his face. He transfers to and from his wheelchair with some help to stand and pivot assists in dressing by bridging while lying on the bed to get his pants on and holding his feet up for his socks and shoes to be put on. Mother feels like he would be able to get his pants on with some training.
Timmy receives Physical Therapy (PT) at school for standing, mobility in his power chair and modifications to physical education programs. He currently receives Occupational Therapy (OT) for positioning within the classroom, fine motor activities; switch training for use with augmentive communication devices and computer access. The Speech and Language Pathologist (SLP) works with Timmy on articulation issues, language development and in evaluating the new speech output device.
The team of professionals meeting to discuss goals and objectives for Timmy’s IEP are Timmy, his mother, the special education teacher and general education teacher, the para-professional, the school counselor and school nurse; the speech, occupational and physical therapists. The team decides on many academic goals and objectives for Timmy’s continued progress that will not serve this report. Two annual goals have been decided upon due to the wishes and reasonability of the mother in requesting Timmy begin to work more comprehensively on self-care and independence with the new speech output device that will enable him to increase the time spent engaging with peers.
The first annual goal is written by the PT for Timmy.
PLOP: Timmy is not able to pull his pants up or down when using the restroom at school. He is able to doff lower extremity garments when laying flat on his back.
Annual Goal: With stand by assistance (for safety) of an adult, Timmy will stand at a toilet with a safety railing, doff his sweat pants (void of fasteners), turn and sit on the toilet safely 5 of 5 trials consecutively by 4/25/12.
Short Term Objectives:
? Over 3 of 10 trials, Timmy will with moderate to maximum assistance of one person. Timmy will stand at the toilet with safety bars and hold on for 30 seconds to acquire his balance, and pull his pants to his knees using one hand by 6/25/11.
? Over 5 of 10 trials, Timmy will with moderate assistance of one person. Timmy will stand at the toilet with safety bars, hold on for 30 seconds to acquire his balance, turn toward the toilet seat without loosing his balance, and pull his pants to his knees using one hand by11/15/11.
? Over 8 of 10 trials, Timmy will with moderate assistance of one person. Timmy will stand at the toilet with safety bars maintaining his balance, turn and sit on the toilet by 1/30/12.
? Over 8 of 10 trials, Timmy will with minimal assistance on one person stand, turn, doff garments while maintaining his balance, and sit on the toilet by 4/25/12.
? By 6/25/12, Timmy will independently stand, doff garments, sit, stand and return to his wheelchair.
The second annual goal is written by the SLP for Timmy to use his communication device.
PLOP: Timmy has shown interest and moderate proficiency in using the Dynavox augmentation communication device using scanning and switch activation. Timmy needs to increase his speed in using the device as well as learn the placement of new icons.
Annual goal: Using his familiar communication device, Timmy will locate and select a desired icon within 5 seconds in 5 consecutive trials.
By 6/25/11, Timmy will locate and select a desired icon within 15 seconds in 2 of 5 trials.
By 11/25/12, Timmy will locate and select a desired icon within 10 seconds in 2 of 5 trials.
By 1/30/12, Timmy will locate and select a desired icon within 5 seconds in 2 of 5 trials.
By 4/25/12, Timmy will locate and select a desired icon within 5 seconds in 4 of 5 trials.
By 6/25/12, Timmy will locate and select a desired icon within 5 seconds in 5 of 5 trials.
Thousands of students like Timmy are fortunate enough to have a good team of professionals including his mother who advocate on his behalf and work together to make the educational experiences provided by public school count. Teams working with students who experience CP and other health impairments understand that working together combines resources and cultivates maximum benefit for the students.