Provider Meeting for Ally* 10/21/13 3pm-4pm

In Attendance: Jackie * (Mom), Shelly* (Grandmother), Ronda* (Early Education Supervisor), Kara
(Developmental Specialist), Janice (Nurse Supervisor), Ernest (Nurse Coordinator), Hannah
(Monday/Friday Nurse), Bob (Targeted Case Manager), Louise (Speech Pathologist), Ella (Occupational
Therapist) and Ally (Child)
*Names changed to protect identity
Introductions
Kara- The behaviors that Kara was seeing such as hitting, avoiding, refusals, self-harming decreased after
3 weeks of attending preschool. She is currently focused on working on the avoiding behaviors,
following the classroom routine and making a choice and sticking to it. She currently is able to sustain
play for 3 minutes although she has displayed the ability to sustain play for up to 10 minutes. She is
great at parallel play; she is very independent, comfortable with the adults in the room and great with
transitions. It is noted that she is meeting her attendance at 50% due to medical issues.
Mom stated at home she rules the roost.
Kara is trying a variety of things to help with her behaviors. Her biggest concern was when she self-
injures. Kara is working with Ally in-home as well for her graduate program, which gives her a unique
opportunity to have carry over.
Mom is happy with the classroom structure and current ratios. If the ratios change and Kara is
responsible for more children this will be readdressed.
OT is going well. Currently most sessions are pull out. She had one day which she had refused to go to
OT.
She is receiving Speech right when she arrives. They are working on making a choice and sticking to it
and following a routine. Louise is seeing an increase in her willingness to use more words. Mom reports
she is using phrases such as come on and I did it at home. Louise is seeing no true 2-word phrases.
She is also initiating conversation more.
Kara and the nurse are conscious of the roles each of them plays in Allys day. Mom stated to Kara, If
you are comfortable with a situation or behavior, go for it, try it, but if you question yourself at all then
let Julie do it.
Louise is going to push her to do more once she knows her baseline. Louise prefers to have Ally say
More bubbles. Versus more please although less polite it is more functional speech. Mom is
working on phrases such as I want and this hurts at home. Louise stated that requesting comes first,
emotions and identifying pain are a higher level of speech.
Ally absences have been mostly due to eye related injuries. Corneal abrasions can lead to weeks off at a
time. She is almost to the point where she will have to get contacts put back into her eyes.
Ronda will contact CDS and ask, What are the rules with attendance when medical issues come into
play? What are the exceptions if there are any? What do we need to do to make sure attendance rules
do not apply to Ally? What documentation do we need to supply?
Currently Ally is receiving 90 minutes of Speech on her IEP, but currently only attending for 2- 30 minute
sessions while she is here at the center. This will remain the same until further discussion.
As far as attendance goes, some days she wakes up with issues and you will not know what these are
until that morning. The decision to send her to school is not made until a couple hours before school
starts, that is why she is attending in the afternoon.
Bob asked how she was sleeping. Mom reported that is has been rough due to her eyes. She is hoping
her eye issue will clear up and get better soon. A behavior plan is in place and the only thing that has
been added was the use of a chair for time outs. Will keep it as is for now.
Consistency between school and home is really important. The chair for when Ally becomes aggressive is
placed in the middle of the room at home so she cannot reach anything. She sits for 3 minutes at home.
Kara has gotten her to sit for 30 seconds, using the term calming our bodies and will increase this to 1
minute, then to 3 minutes when appropriate to keep it consistent with home. Louise suggested that if
Mom uses the sign stop to follow that put with options that are available to do and redirect her.
The nurses will no longer get involved with the IEPs unless they are fighting for more services or a
change is going to be made.
At the beginning of school Mom created a list that helped clarify, This is a self-care thing to be
provided by the nurses, and this is an educational thing then there is always a gray area with Allys
care. These will need to be worked out between Kara and the Nurse with open communication. Kara is
very pleased with the nurses being present at school and the consistent collaboration.