student 1

1. LIZBETH

2. TEAM
 Teacher: Jacqueline Thomas
 Occupational Therapist: Karen Nicholson
 Speech Language Pathologist: Diana Posadas

3. Caregiver Interview
 14 years old, Bilingual Spanish speaker
 Premature birth at 29 weeks, 2lbs
 Identical twin
 Dx: Mental Retardation
 Feeding tube from birth to 6 years old
 Modified Barium swallow at 5 years old results showed no signs of
aspiration
 Transitioned to liquids by mouth at 7 years old
 Transitioned to puree diet in school at 7 years old

4. Communication
 Able to express wants / needs
verbally , speech presents with
poor intelligibility
 16 cell Voice output device
 Lizbeth has expressed to mom
dissatisfaction with the puree diet

5. Physical Strengths
 Lizbeth is wheelchair bound and can
move herself around in it.
 She can stand with assistance when she
is by the changing table but only for a few
minutes while being changed. She
cannot walk or stand independently. She
needs moderate assistance to stand from
wheel chair with support on changing
table for toileting and dressing.
 She has been working with her physical
therapist to use a lift to practice walking

6. Feeding Screening
 Low muscle tone in trunk and all extremities.
 Stronger in upper extremities, weak abdominal muscles
 Tends to slip forward in the wheel chair but can adjust her position
given prompts
 Requires prompts to maintain upright position
 Tends to lean forward on the table with legs far behind her.
 Pelvis: decreased range of mobility
 Legs: positioned at less than a 90 degree angle
 Protracted shoulders

7.  Favors her left hand for feeding
 Independently brings utensil to mouth
 Scoops food
 Demonstrates jaw stability and lip closure
 Movements are slow and labored at times.
Feeding Screening

8. Adapted Bowl at Applebees

9. Currently,
 At home, Lizbeth maintains a diet of finely chopped
meals prepared by mom.
 Parent has been informed of the required Modified
Barium Swallow and Physician prescription required
to transition to finely chopped diet at school
 Access to bulked up spoon to increase motor control.

10. Intervention Plan
 Meal time plan will be developed upon Receipt of Doctors
prescription
 Lizbeth will be gradually introduced to chewables such as,
graham crackers
 Keep food log to document transition
 Goals
 Wipe mouth as needed
 Will maintain focus on mealtime activities
 Will make choices among textures
 Parent invitation to demonstrate meal prep done at home
 Apply pillow for trunk support and correct posture for
feeding