SPECIAL EDUCATION EARLY INTERVENTION TRANSITION EXAMPLE

Student Name: Student name.

Address: 123 ABC Drive

Somewhere NY

Telephone: 555-555-5555

Parent: Name

Date of Birth: 5/22/2019

Date of Report: 3/14/2020

Chronological Age: 2 years, 9 months

Treatment Site: Home

ICD9 Code: ###

Service Coordinator: Name of Coordinator

______ County Early Intervention

Teacher: Teacher Name, MSEd.

Special Educator

Background Information:

Student name is a 2 year 9-month-old child who lives at home with his Mother, brother and sister in Someplace, New York. He receives special education services 2 times a week, physical therapy, occupational therapy and speech services.

Evaluations:

Battelle Developmental Inventory 2^nd Edition

Student name’s special education teacher, through Name of school, evaluated him on 1/7/2020. Student name’s Developmental Quotient and Sub-Domain Scaled Scores can be found below.

Developmental Quotient

Adaptive

78 *

Personal- Social

81

Cognitive

66

Subdomain Scaled Score

Adaptive

Self-Care

1*

Personal Responsibility

9

Personal-Social

Adult Interaction

3

Peer Interaction

6

Self-Concept and Social Role

6

Cognitive

Attention and Memory

3

Reasoning and Academic Skill

6

Perception and Concepts

2

Cognitive Status:

During therapy session, Student name has been working on playing functionally with toys, expanding play schemes and increasing attention to adult directed activities. Student name is able to play functionally with cause and effect toys with and without teacher assistance. Student name plays functionally with a variety of toys. Student name will complete a 3D puzzle with teacher assistance, look at books with his teacher and complete an art activity (coloring). Student name has a short attention span for puzzles, books, stacking rings and art activities. To complete these tasks Student name will periodically require hand over hand, reminders to stop and slow down and first-then reminders. Student name does not consistently point to pictures in books. He has the ability to point to pictures but is usually more interested in other toys that the teacher has. Student name show preference for blocks, Mr. Potato Head, farm and music/ instruments. Student name enjoys building towers with his teacher and then knocking them down. Student name enjoys putting together Mr. Potato head. His teacher is working on making him identify the body parts by holding up two body parts and asking him “to find…” His teacher will also ask him to find his eyes, nose, mouth, ears, hands and feet and then point to them on himself too. Student name is not able to identify his body parts on his own. Student name enjoys playing with farm. He will hold the animals and observe them visually and with his hands. His teacher will sing “Old McDonald” when they are introduced one by one. Student name will follow teacher directives to put the animals to sleep in the barn. Student name enjoys music and instruments. When his teacher sings or plays instruments Student name will smile and sway back and forth. Student name also enjoys hitting the drum with a drumstick, shaking shaker and bell type instruments and putting a microphone to his mouth. He occasionally requires hand over hand to get the correct motion to use the instrument. Student name will show interest when a new toy is introduced and will explore it using his hands, eyes and mouth. Student name continues to work on his goal of functionally playing with toys. To increase his attention to adult directed activities his teacher uses positive reinforcement and first-then statements. Student name and his teacher are working on using signs to communicate wants and needs. Signs that Student name will use with his teacher include more, waiting, all done and stop.

Adaptive Status:

Student name is an independent child. According to Student name’s mother, Student name is able to independently move around the house and is able to entertain himself for 10 or more minutes requiring occasional supervision. He assists in dressing by putting out his arms and or legs and he will remove his clothes and shoes unassisted. Student name also shows care when around his infant sister. When Student name’s session is over his teacher will tell him it is time to clean up and Student name will willing help put toys away.

Social-Emotional Status:

Student name is a happy child. He shows excitement when his teacher comes in by waving and smiling. He waves both “hello” and “goodbye” Student name will shake head “yes” or “no” when he is given an option between toys or when asked a question and will sign “all done” when he is finished playing with a toy. He is learning new signs that his speech therapist is introducing to him, that his family and teacher carry over throughout other sessions and throughout his daily routine. He does not yet engage in cooperative play or pretend play skills. He shows interest and will imitate what his mother, brother, or sisters are doing and will make noise to get their attention. Student name is able to follow his daily routine and his routine with his teacher.

Present Level of Performance

Strengths:

-Building with blocks

-Playing with instruments and dancing

-Playing with cause and effect toys

-Answering yes or no questions by shaking his head.

-Communicating wants and needs

Needs:

-Pointing to pictures in books

-Attending to a variety of play schemes

-Increasing attention

-Finding appropriate materials to mouth

-Identifying body parts

Summary and Recommendations:

Student name is a sweet boy who continues to make gains in playing functionally with toys, pointing to pictures in books, attending to a variety of play schemes and increasing his attention. It is recommended that Student name continue to receive special education services to help with these cognitive needs.

Student name continues to meet ongoing eligibility requirements for participation in the Early Intervention program based on therapy sessions, observations, and evaluations completed on 1/7/2020.

It is a pleasure working with Student name. If you have any questions or concerns regarding this Progress Note, please feel free to contact Name of school at 555-555-5555

_______________________________

Teacher Name, MS Ed.

NPI Number: ###########

Special Educator