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Objective Case serves to illuminate how complex medical/neurological/motor history can be assessed creatively/thoroughly while maintaining standardization in an effort to determine true abilities of young girl. Earlier evaluation suggested NVIQ scores in the 30th percentile, however more recent school testing suggested performance in 2nd percentile. Method Nine-year-old, Caucasian, right-handed female with diagnoses of spastic CP, recent seizures with LOC, GERD, assessing functioning/academic needs. Pt born 40-weeks gestation via c-section due to fetal heartbeat loss resulting in emergency CPR/NICU admission for six weeks. MRI suggests significant hypoxia-related prenatal damage to right frontal/temporal regions. Nerve/muscle development results in leftward preference permitting rightward movement. Pt is nonverbal, implanted gastrostomy tube, utilizes modified sign-language/augmentative, alternative communication device (AACD). Current behavioral concerns in multiple settings. Pt prescribed esomeprazole, baclofen, oxcarbazepine. Results Results suggest deficits in adaptive functioning, set-shifting, language. Sustaining gaze was difficult, with subsequent invalid scores on numerous measures. Even with incorrect responses, Pt understood TEACh tasks. Given tools (calculator) at her disposal, Pt scored in 30th percentile on Math Computation. Further, TONI-4 nonverbal index was stronger than school expectations (10th percentile). PTONI negatively impacted by motor deficits. AACD offered limited vocabulary – Pt appeared well-aware of missing words when they arose (small vs. thin). Pt demonstrated high frustration-tolerance and ability to joke with examiners. Conclusions Conclusions: Pt’s performance and motivation were highly impressive given circumstances. Even with limiting factors, standardized measures can be utilized with critical qualitative observations to acquire more representative test results, provide adequate recommendations for ongoing care/accommodations, thereby advocating for academic success and improving Pt well-being. |
