Cognitive Development Case Studies

Physical development

Gross Motor and Fine Motor

She plays by reaching for and batting toys, touching pictures and banging toys. She reaches with both hands and moves toys by swiping at them. She is able to hold toys that are placed in her hand, but she is not able to consistently open her hand to pick up an object by herself. She does not bring toys or hand to her mouth due to spasticity. She is able to hold her head up when in her adapted seat, is held in a sitting or standing position and when on her tummy or sided. She can sit momentarily when propped in a sitting position with hands on the floor or her knees. Kim is able to easily roll from her back to her tummy. Although she is able to roll from her tummy to her back, she has to do it

She is currently tube fed twice daily at noon and during the night because she needs to gain more weight. She is being weaned off her seizure medications since a recent EEG result shows no seizure activity. Kim is followed by neurology, cardiology, and her pediatrician.

Cognitive development

Kim is very visually aware and interested in her surroundings. She looks for toys when dropped or rolled from view. Kim likes the toys that made sounds. She understands the simple cause-effect relationships by touching toys to make sounds. Kim has the ability to participate in simple play with adult assistance (e.g., peek-a-boo, pat-a-cake). Kim shows some recognition of toys and objects when they were named. She recognizes her parents, sister as well as grandparents. It is difficult to determine Kim’s level of understanding due to motor challenges and inability to communicate thoughts, wants and needs.

Communication

Kim’s mother reported that Kim sometimes makes throaty sounds and gestures to let her family knows when she wants to be picked up, when she is full or doesn’t like a particular food. Kim sometimes makes sounds and uses gestures to show which book or toy she prefers. She is able to choose between books or toys when offered by others. If family does not understand her, she cries and fusses. Her mother reported that Kim has good movement of her lips and tongue, but she is not able to babble and make consonant sounds as a result of her NG tube which impacts her ability to communicate her thoughts, wants, and needs to her family.

Social or emotional development

Kim enjoys being with her parents, sister, grandparents, and other children. She enjoys watching her sister and the neighbor children play. She frequently laughs and smiles at others. Kim likes riding in the car and playing game with her grandparents. She cries and fusses when she is not understood and this happens several times a day. Kim’s NG tube affects her sleep at night, which leaves Kim fussy throughout the day.

Adaptive