Setting the Goals: Advance I Can

In my last blog, I talked about John's goals at Casa Colina. Today, I am going to show you the goals set up through the in-home program, Advance I CAN.

John currently receives 5 hours a week in the home through the I CAN program. The ADVANCE I can program is a home-based early intervention program that serves children birth to three years who demonstrate behaviors or concerns relating and communicating OR who have a diagnosis of autism spectrum disorder. They have a play-based therapy program that includes floortime teaching approaches and have individualized plans. Parents and families are encouraged to participate in the sessions at home to maximize the development of the toddler.

These goals were set about 1 month after the Casa Colina goals were set, so you will see the growth he had made just by the difference in the goals, as well as the crossover in certain areas that were seen.

You will also see the scattered skills he has, where he may have a 12 month old skill goal and a 30 month skill goal in the same category because he has some very advanced skills, but is missing some basic skills---especially with language.

Because of his age, once language has appeared, he has excelled fast through the age range goals. It has sort of shown us that he was talking before, as we thought, but was unable to move his mouth correctly to make the sounds. With speech therapy, he quickly learned many of the techniques of speech and his words just got clearer. Because of this, we couldn't say one way or another whether he was using two or three word phrases or if he knew who people were by name, or if he used pronouns, etc. because everything he said was unclear. Now that they are becoming more intelligible, we are able to say for certain he can and does understand, knows object names, uses some pronouns, etc. So, his goals, which originally started at an 11 month skill level have jumped dramatically over the last 2-3 months.

Again, John is currently 33 months old

COGNITIVE GOALS

1. John will listen to stories for 5 minutes (27-30 month skill)
2. John will demonstrate an understanding for action verbs (by doing them on request or by pointing to pictures describing action verbs) (25-30 month skill)
3. , John will compete a puzzle of 3-4 related pieces (30-36 month skill)

LANGUAGE GOALS
1. John will spontaneously say "dada" or "mama" specifically (11-14 month)

• John does this now and I would say has met this goal

2. John will spontaneously use intelligible two-word sentences (20-24 month skill)

• John is doing this and 3-4 word phrases, but getting them clearer and even more intelligible is the goal; I understand him about 80% of the time, but most people understand him about 30-40% of the time. Increasing the pronunciation is key.
  

3. John will give full name on request (both first and last) (30-33 month skill)

• He usually says "Ja" for "John" and "ho" for "Hoge" , so we are slowly getting "Ja Ho" :)

GROSS MOTOR GOALS

1. John will throw a small ball into a box while standing a distance (18-20 month skill)

• John can do this with prompting, but he'd rather dunk it and it is a struggle to keep him at a distance

2. John will jump backwards with both feet lifting off the floor landing at the same time (27-29 month skill)

• he bounces up and down but does not jump in any direction

3. John will catch an 8 inch ball from 2 feet away (35 month skill)

• John can do this when he is focused, but most of the time it is a fight to get him to want to play ball or focus on the ball
  

FINE MOTOR GOALS

1. John will build a tower using 6 1" cubes (22-24 month skill)

• The idea here is getting his fingers to release the block without knocking the tower down by pushing too hard as he releases

2. John will string 3 beads on a heavy cord without assistance (23-25 month skill)

• John has met this goal

3. John will fold a paper in half making a crease without crumpling the paper (24-26 month skill)

SOCIAL GOALS

1. John will defend possessions using the word "mine" (23-24 month skill)
2. John will begin to obey and respect simple rules (30 month skill)
3. John will participate in circle and interactive games (30 month skill)

SELF HELP

1. John will demonstrate an understanding of common dangers by staying away from them on request (24-30 month skill)
2. John will help bathing self (30 month +)
3. John will help dress with supervision requiring assistance with fastenings (30-33 month)

*John's self help skills dramatically changed once language increased. At home, he undresses and dresses himself with a little bit of assistance, he brushes his own teeth, will clean himself in the bathtub, etc. I would say that he is pretty close to his own age range in this category.

Setting the Goals: Casa Colina

Part of the Early Intervention program is to determine at what level John is at in each of the developmental areas and develop goals for him to achieve. His one-on-one time during Early Start at Casa Colina works on these goals, as well as reinforcement in the home and other areas in school. These goals were set in July after a few weeks of observation and testing. The Current Level for each category is where he was tested at to determine starting skills for goals. John is currently 33 months old.

Here are a list of John's goals through Casa Colina Early Start. Once he is evaluated through the START program new goals will be set. I am interested to see what level he will test at in each of these categories. You will see where he has made his progress and why I consider the early intervention a success. At the Regional Center testing, he was unable to do many of these goals or his attention was so poor, it was hard to tell if he could do them or not.

Gross Motor Goals
( current level was 26 months)

John will catch a large ball (25 month skill) -

• if paying attention, he can do this, but really doesn't want or like to play catch

John will keep his feet on tricycle petals (27 month skill)

• this last week he did this; usually he sits on it and then wants to walk away; this week he stayed on for an entire circle around the playground
  

John will run avoiding obstacles (27 month skill)

• this is a goal set because he usually isn't paying attention and needs to be reminded to "watch where he is going"
  

John will take a few steps on a balance beam (28 month skill)

• He did this the first time and has met this goal already;

John will jump a distance of 8-14 minches (30 month skill)

• He bounces up and down, but does not jump forward or backward with both feet together

Fine Motor Goals
(current level was 21 month)

John will imitate a vertical stroke (21 month skill)

• He will copy a horizontal stroke, but doing a vertical stroke is slowly developing

John will fold paper imitatively, not precisely (22 month old skill)

• John is doing pretty well with this, but he'd rather crumble it in a ball

John will string 3 one-inch beads (24 month old skill)

• John has met this goal already

John will snip with scissors (24 month old skill)

• John can close, but has a problem opening the scissors

John will replace a precise picture in a puzzle board (28 month old skill)

• John has met this goal, but needs more consistency

John will build a tower using 8 blocks (29.5 month skill)

• Attention and staying focused on the task is a big deal here; he also presses too hardand the blocks fall
  

John will build a 3 block bridge using cubes (31 month skill)

• John didn't understand the concept of this at first, but is starting to want to do it on his own
  

Receptive Language
(current level was 17 months)

John will attend to speaker when given 1-2 step directions with minimal prompts (22 months)

• John usually needs to be re-directed and reminded what he is supposed to do

John will identify 2 objects from a group (18 months)

• John has met this goal

John will begin to understand the use of action verbs using a preferred toy (19 months)

• John has met this goal

John will participate with the therapist in 3-5 directed tasks for 3-5 min

• John has a hard time staying focused

John will understand personal pronouns like "give it to me" or 'take to him" (20 months)

• John has met this goal

Expressive Language
(current level was 17 months)
*** this is the biggest area of improvement as far as day-to-day life at home

John will use 2-3 word sentences (27 months)

• John now says "ride in Grammy's car" "watch High School Musical" "I want playdough" pronunciation is poor and getting better, but he is using the words to make sentences and to show his wants/needs -- this area has come SOOO far
  

John will increase vocabulary on weekly basis (22 months)

• This has been amazing to watch

John will initiate and use 7-10 words in class (16 months)

• He was very verbal in class this week, meeting this goal and surpassing what was expected
  

John will imitate environmental sounds (19 months)

• He is starting to use car and airplane sounds, etc.

Cognition Goals
(Current level was 21 months)

John will understand the concept of 2 (33 months)

• This is a very difficult concept for John; he gets frustrated and doesn't really knowwhat he is supposed to do when asked for "2 of them"
  

John will demonstrate the use of common objects (26 months)

• He has met this goal

John will give one of many -- the concept of 1 (27 months)

• He sometimes can do this and sometimes cannot; depending on level of focus

John will match identical pictures (28 months)

• He has met this goal

John will listen to simple stories from 3-5 minutes (28 months)

• Working on increasing his attention

John will match 2 colors (28 months)

• John has met this goal

Socialization
(current level was 10 months)

John will value his property and say the word "mine" (27 month)

• John doesn't use "mine"

John will participate in a cooperative ball game when facilitated by adult (13 month)

• John protests when playing ball or catch

John will interact with peers using gestures (21 month)

• John watches the other kids, but rarely interacts

Self Help Goals
(current level was 23 months)

John will dress himself with assistance (30 month)

• John has met this goal

John will scoop food and feed himself with less spilling

• we are working on this

John will remove his shoes with laces undone (21 month)

• he has met this goal

John will drink from an open cup he holds with one hand (25 month)

• he has met this goal

John will put his shoes on with assistance (25.5 month)

• he has met this goal

John will wash and dry hands partially

• he has met this goal

Pre-school readiness goals

John will initiate a game with another child
John will participate in a group of 3 for 5-10 minutes with minimum redirection
John will participate in a group of 9 for 5-10 minutes with minimum redirection
John will seek and maintain eye contact for 50% of his interactions


Sensory Goals

John will actively participate in a variety of sensory activities without adverse behaviors
John will tolerate heavy work such as pushing and pulling therapy balls
John will tolerate movement on a swing or scooter board
John will tolerate a variety of tactile experiences such as foam soap, play-dough, and thera-putty