Your chance to diagnose

In my practice 50% to 75% of my caseload are from my Regional Center contract to provide early intervention services to children up to the age of three. Monday I had a new evaluation. So for you out there, here is an exam for you. Parents and therapists alike are invited to participate. If you are a Mama in my tribe you're likely to score better that many of the therapsits out there.

Read portions of my evaluation below and write a brief summary, include your clinical impressions and recommendations.
Client:A two, nearly three, year old boy.
me,"Tell me about his talking."
Mom," Well, he use to have some animal sounds, but he is not making them any more."
me, "What does he say or what sounds do you hear.?"
Mom, "ma or mamamam, ba, da, yi, raspberries, humming, squeals."
me,"Does 'ma' or 'da' ever mean 'Mama' or 'Dada' or is it just a babble?"
Mom, "I think sometimes he does, if he is really mad."

me,"How does he let you know what he wants?"
Mom, "He takes my hand and pulls me, or pushes me, or pushes my hand in the direction of what he wants."
me, "Does he ever point to what he wants?"
Mom,"No."
me, "Does he point to pictures, like in a book."
Mom,"No."


Mom,"He really likes having things in order. If he picks up something off the table or his plate, he puts it back in exactly the same place. He's very neat, if cat chow comes out of the bowl onto the floor, he picks it up and puts it in. He loves to close doors, turn lights on and off and flush the toilet. We hope he'll still be so tidy when he is older!"

me, "What toys or activiteis does he enjoy?"
Mom,"He loves puzzles and is really good at them. Also, balls and cars. His favorite toy that plays music and lights up when you press the alphabet letters. Oh and he loves running. He could run all day. He has a lot of energy. He loves wrestling with his Dad."

me," How is eating for him? Does he have specific likes or dislikes?"
Mom, "OH Yeah! He is a very picky eater! He will only drink milk and it has to be in one of these 3 cups that are the some. He's chewed the straws down on the cups. I changed the straw, but then he wouldn't use the cup at all. He loves, pizza, and pasta-but only if it is filled pasta. He'll eat meat only if it is ground. He won't eat fruit unless it is babyfood. Even if I put in little chunks of banana in the baby food banana, he spits out the chunks. If I spill something on his tray, he likes touching it-like yogurt or milk. But he doesn't like hacing his hands dirty. He didn't like the playdough at school. I don't think he knew what to do with it so he just poked it with the little knife they gave him. He liked playing in the rice though, because he could pour it."

me,"I notice he is sitiing in your lap facing you. He did look at me and wave hello. Will he sit on the floor with you?"
Mom, "This is what he usually does when we are anywhere but home." She attempted to turn him to face away from her chest, and he refused both physically and by vocalizing. "He likes really tight hugs in situations like this, it seems to calm him. He is very afffectionate"
me,"Well, our first goal will be to get him use to tolerating being here. Our first step will be to see if he can tolerate facing out whiole you hold him. Then we'll see if he will tolerate sitting on your lap on the floor. At that time we'll have you sit further back on the carpet, in the corner. That way he won't consider that you might stand up and go out the door.This will also become a safe place for him"

Other things to consider:
I do not yet have any forms with history from the family-as they weren't able to get them until the day of the evaluation. (Does that matter?)
He is an only child. (why does that matter?)
Family (both parents present) never asked about prognosis or diagnosis.
They clearly adore him and do not appear overly concerned.