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Ellen, a 6 year and 5 month old female, also known as Ellie, is from a home in which English is spoken. She was referred for a Speech and Language re-evaluation by the school district, West Hempstead, prompted by articulation difficulties and the need for a complete diagnostic evaluation. There is no evidence of similar difficulties found in Ellen's family history. Ellen resides with her biological mother and father. She is currently attending a special education program (readiness level first grade). At this time, therapeutic services are provided in speech therapy (2 times per week), physical therapy (2 times per week), and occupational therapy (2 times per week).

Birth history includes a remarkable full term vaginal delivery, with a birth weight of 5 lbs., 8 ozs. Maternal high blood pressure may have contributed to this full term birth. Anoxia and the umbilical cord positioned around the neck were identified at the time of birth. Subsequent medical conditions include a physical disability (cerebral palsy). Additionally, Ellen experiences grand mal non-febrile seizures approximately 1 time per month, for which Dilantin and Phenobarbital were prescribed. The attainment of developmental milestones is judged to be delayed at this time. Significant gross and fine motor delays are observed; Ellen demonstrates a wide based gait, has poor balance, falls frequently, and demonstrates poor general coordination, limited graphomotor skills, and difficulties in the manipulation of small objects. Marked difficulties were also noted in perceptual motor skills. Adaptive equipment currently used includes a walker and bilateral AFO splints. Expected ADL skills are emerging; Ellen uses a spoon and drinks from a spout cup.

Ellen was seen individually and observed in class for the current assessment, which was conducted in school. Ellen presents a portrait of a child who is friendly and sociable. Alertness and appropriate responsiveness to social and environmental stimuli were exhibited; she was highly cooperative and demonstrated excellent motivation for task completion. Attention span appeared to be mildly reduced with some distractibility noted as tasks increased in complexity. An appropriate activity level was evidenced. Performance improved considerably when prompting and structure were provided by the examiner. Test taking strategies are characterized by trial and error. Play was primarily cooperative in nature, with symbolic use of toys and objects established. Creative play is emerging. Ellen's ability to complete intermediate sorting/matching tasks has been established. Evaluative results are considered to be a reliable estimate of overall ability.