Dori Senatori

Abstract

 

       This paper will discuss a case study student with septo-optic dysplasia who currently attends a public school for students who are blind or visually impaired. The case study will address basic background information about the student, functional observations in two of the student’s environments at school, student interactions with objects and people in her environment, and an overview of the student’s current functional level for daily living skills.

 

Case Study Student

 

       My case study student named M is a 9 year old female with septo-optic dysplasia. M is overall in good health without any precautions for activity. M transferred to Texas School for the Blind and Visually Impaired where she now resides in the student dorms. M comes to TSBVI ifrom Abilene ISD as they were not able to meet her current educational needs. M receives special education services for visual impairment and speech impairment, and related services including, speech, orientation and mobility, occupational therapy and support from a behavior specialist. M has the tendency to wake up in the middle of the night with difficulty getting back to sleep, so she takes medication to assist with her sleep cycle (Focus Families, n.d.); however the medications tend to make her constipated with a tendency to bruise easily. M’s temperament can fluctuate quickly depending on the level of activity she is doing and/or if she wants to participate in the activity at that time. When M decides that she does not want to perform the activity, she may have a sudden, short emotional outburst which can include high pitched screams, physical aggression, self-abuse, disrobing, and throwing herself on the floor. Some things M likes are explore objects, receive proprioceptive input on a yoga ball, share toys with an adult, take turns in a game, interact with adults, swing and spin, clap, and listen to a quiet song close to her ear. M does not like using utensils when eating and becomes upset when they are introduced as she prefers to use her hands.

 

       The first functional observation took place in the elementary gym where the student receives adapted P.E. The lighting in the gym was very bright, and the gym has many windows which let in a lot of natural light. During the observation in the gym, there was music playing and two additional students who are also in M’s class, which made the noise level moderately loud mostly due to the music and the other students occasionally screaming while playing. The total number of students in class was three, with two staff members present. M interacts with the P.E. teacher and TA sporadically and seems to show a preference towards spinning herself prone over the bolster swing. Attempts were made to transition M to the next activity with an auditory and tactual cue; however M dropped to the floor and began to scream with attempts to bite the P.E. teacher. While this was happening, M was still near the bolster swing, so she began to feel around for the swing and climbed back on (in the prone position) to start swinging again.

 

       The second functional observation took place in the student’s classroom. The classroom lighting was set to low, which made the room feel very quiet and calm. During the classroom observation M was initially the only student in the room, and she was seated at the table eating a finger food snack with her teacher (K. Barnes, personal communication, August 2015). M used a scoop dish and would use her hand to feel around the bowl for more of the snack, tapping the bowl with her fingertips if she wanted more when the bowl became empty. M’s teacher spoke quietly in her ear while attempting to use hand under hand to help the student sign "more," but M continued to use her right fingertips to tap in the bowl and did not carryover the teacher’s request for the ‘more’ sign with both hands. The noise level in the room remained fairly quiet, even after another student entered and M did not acknowledge the other student but continued to eat her snack.

       M’s transfer file indicates that she has light perception in her right eye and bare light perception in her left eye; however when her teacher of students with visual impairments/special education teacher (K. Barnes, personal communication, August 2015) performed the Functional Vision Evaluation/Learning Media Assessment she had no response to light when tested. The student’s hearing is within normal limits as per her care summary; however during both observations she did not appear to perform the task the teacher asked her to do. M did not demonstrate tactile defensiveness during the observations and appeared to welcome deep pressure with finger squeezes, holding the teacher’s hand, walking barefoot over a bumpy mat and exploring her box of toys with different textures. M’s teacher (K. Barnes, personal communication, August 2015) indicates that she will eat/touch many different textures, including hummus, without a problem.

 

       Based on scores from the Developmental Profile, 3rd Edition evalution on 4/23/15, this case study student is cognitively functioning at a one-year-old level, requiring constant supervision for safety. M’s primary mode of learning is auditory and her secondary is tactual based on her FVE/LMA from 4/30/15. M requires simple language paired with familiar and functional objects in all of her routines and activities. M utilizes an object symbol calendar and a now and finished basket for all of her functional tasks and activities of daily living. The student’s motor function appears to demonstrate low muscle tone (NINDS, n.d.) during the adapted P.E. observation as she was unable to sustain a constant bilateral grasp with her upper and lower extremities when seated on the bolster swing, and she began to immediately slide off of the swing with minimal challenges. Socially, M appears to like to be around people, especially when receiving the attention of adults. During the observations, M did not appear to be upset by having other children in the room who were making noise. This student is non-verbal and inconsistently responds when her teachers use simple language paired with objects in familiar, functional routines and activities. M’s sudden outbursts can be her way of indicating hunger, thirst, pain, feeling bored or problems with a transition to a new space or activity.