I have a new little guy on my caseload (I'm a preschool SLP) with CP. He is 3, but is functioning at the level of a 6-9 month old. He is deaf with a recently implanted CI, and enjoys noise producing toys (the only ones he's even semi interested in)
Some background.. He was born I believe at 7 months, way early.. Was kept in the NICU for 2 or 3 months. but was sedated most of the time because noise would make his heart rate go through the roof. Apparently his head was turned mostly to 1 side (right side facing down, left side exposed) for those 2 months in the NICU, or so mom says, so he tends to look towards that 1 side, but mostly just prefers to stay at midline if sitting up (propped up). He has a dx of being legally blind, but mom said they did the eye test when he was on some heavy meds so she doesn't think it's accurate.
I have no clue where to begin with him. He's vocalizing occasionally at school (mom brings him 1x/week for an hour & 45min), but reportedly carries on vocalizations like it;s a conversation when he's with mom in the car. He only produces some vowel sounds though, no consonants yet.
Half the time his eyes are closed, which is making it very difficult seeing as the classroom teacher and I decided to do a joint goal of attending/making purposeful vocalizations during large group time (ie calendar time, music, etc). One issue I have is that he is propped up by his para, but is sitting on the left side of the carpet, not the center. He doesn't generally look to anywhere but midline when propped up, so the teacher isn't even in his central line of vision. He's just looking off into the distance at the other side of the classroom when his eyes are open. Talked to the teacher about it, she says she has no room on the carpet for his para to sit in the middle because the kids have assigned spots, and the way the para has to be sitting to keep him up, she takes up multiple spots.
So, I'm kind of stuck.. I feel like I need him to be in direct line of sight with the teacher for starters, but past that, I don't know where to go with him. Imitate some reduplicated babbling with early consonants for him during some play? What are some strategies I could use during large group time to work on vocalizing? Or after group time when it's 1:1? I'd like to be working on joint attention, too, since he doesn't follow your hand if you point to a toy & talk about it, etc.. I've never worked with a kid this low, so I feel pretty lost. Any EI therapists out there that can provide some advice?!?
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