Kevin Case Study
1. Age, Exceptionality Kevin
is an 18 year old young man who attends Johnson High School. Kevin’s primary
exceptionality is intellectual disabilities, with a secondary exceptionality of an orthopedic impairment.
2. Present Levels of Academic Achievement and Functional Performance / Age-
appropriate Transition Assessment
Based on Florida Alternate Assessment and on and off campus situational
assessments, Kevin uses a manual wheelchair which has been adapted with trunk support and subasis bar. He is able to use his right hand to manipulate larger items and can use his left hand for stabilization. Kevin receives physical therapy one time a week for 30 minutes and has ongoing therapy services in the classroom, including positioning on adaptive equipment. He wears Ankle Foot Orthoses (AFOs) for stability when using a stander and a left hand-elbow mobilizer. Kevin’s physical therapist would like for him to have a motorized wheelchair but funds have not been available. Kevin also receives occupational therapy on a consultative basis. His teacher and the occupational therapist have been working on developing vocationally related jigs.
He has little intelligible speech other than single words and yes/no responses but
within the classroom has used an iTalk2 to communicate simple needs and choices and is learning to use a GoTalk20+. He does not use an augmentative communication device at home but does have a picture board, which transitions with him between school, the community and home. He requires physical prompting to use his picture board for most tasks. Kevin also receives speech therapy two times a week for 30 minutes each session.
He has generalized tonic-clonic seizures which are 85% controlled with two
different anti-convulsant medications (Tegretol and Mysoline). He is fed through a gastrostomy tube although he is able to take some pureed foods by mouth in limited amounts. Kevin can feed himself by mouth using a feeder but has to be closely monitored and reminded to eat slowly to avoid asphyxiation. Usually Kevin is only allowed to feed himself during special occasions such as a class party or special meal. The gastrostomy tube placement was primarily due to asphyxiation of food during meal times that resulted in recurrent upper respiratory infections (URIs). These URIs have greatly decreased since his surgery.
A functional vision assessment has indicated that Kevin’s visual acuity with
corrective lenses at near distances is 20/80 and at far distances is 20/100. His most effective visual field is slightly below eye level and he is able to localize to visual stimulus and fixate his gaze on objects and people as well as shift his gaze. Kevin does not like wearing his glasses but is cooperative in this area most of the time.
Kevin has good hearing. He has used the Making Action Plans (MAPs) person-centered planning process
Kevin and his family plan for him to stay in the public school until he ages out at
age 22, which will provide him with three more years of educational services.
He lives at home with his mother, father, 11-year-old sister, and a great aunt who
helps with his care. Kevin also has an older brother who is in college.
Kevin is approved for Medicaid waiver funded services. Kevin’s family is hopeful
that this funding source will provide him with an array of services based on his individual needs including:
o An augmentative communication device o Case management o One-on-one community and home support o Personal care services o Respite o Specialized equipment and services o Medical transportation o Supported employment o Home and community-based activities after high school graduation.
Kevin appears to have some understanding of becoming an adult and living more
independently, possibly away from his family. Kevin’s mother has very mixed feelings about Kevin’s future living arrangements. As Kevin’s primary caregiver since birth, she realizes that as time goes on it might be necessary to seek an out-of-home placement. Kevin’s father would very much like to see Kevin move into a group home or other supervised post-school living arrangement as soon after high school as possible. Kevin’s father would like to spend more time with his younger daughter and wife and believes that his elderly aunt is not going to be able to assist them much longer with Kevin’s personal care.
Kevin has no understanding of money and does not provide input into his
health/medical care. The Medicaid waiver program will assist with medical care, equipment, and supplies. Kevin’s parents plan to work with his support coordinator to obtain guardianship since Kevin has now turned 18 years of age.
Kevin enjoys interacting with other people, music, horticulture, computers, and
clerical type activities in which he has the opportunity to complete a project. He responds well to verbal praise and is able to stay focused on a task for 20+ minutes with occasional verbal redirection. Kevin has developed the skills to operate a variety of switch-activated devices (e.g., button maker, blender, etc.), use a paper shredder, and collate papers with a jig. Kevin has worked successfully on an assembly line in the school-based enterprise and has held an on-campus job in the school library checking books in and out using a scanning system and shelving books with the assistance of a teacher assistant. Kevin loves school and is always eager to learn new skills. He demonstrates a high level of motivation to please his teachers and his parents report that even when he is sick he wants to go to school.
While at home, Kevin’s mother and great-aunt provide total physical care.
Although Kevin could assist with some personal hygiene tasks, this is not a current expectation for him while in the home. With the exception of making choices regarding relatively minor concerns (e.g., selecting music to listen to or an item of clothing to wear), all decisions are made for Kevin by his parents. He goes into the community with his family on occasion, although the majority of his community experiences occur through the school. While at home Kevin enjoys
watching DVDs, looking at books, listening to music, watching his younger sister play video games, family meals, and making music on his electronic keyboard.
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