Background Information

School History

According to Sam's educational file, Sam has attended Blue Bird Elementary (BBE) since his school career started. He has never been held back; however, his kindergarten teacher did rate him as a fair candidate for retention. He has no history of receiving special education services, but has had a modified curriculum. In first grade, CARE team problemsolving helped provide interventions and modifications to assist Sam, but little progress was reported.

Information obtained from Sam's educational file revealed that Sam's grades throughout his school history have been mostly S's (Satisfactory). In kindergarten, Sam received all S's; however, his grade card showed that there were skills he did not master by the end of the year. These skills included recognizing the alphabet out of order, recognizing initial consonant sounds, beginning to recognize words, and knowing number words. He also couldn't recite the alphabet in order until the last quarter of the year.

Sam again received mostly S's in first grade (on a modified curriculum), with S's in math, spelling, and language. The area in which he struggled the most was work habits, in which he received a U (Unsatisfactory). The teacher commented that he needed to work on listening attentively and following directions. The area in which Sam was strongest was social development. In this area he received S+'s and E's (Excellent), with his teacher commenting that he worked with others and was courteous. Up to this point in second grade, Sam has not received any official grades, but his teacher reports that he is performing significantly below peers in all areas. Due to Sam's age, he has not yet taken any standardized group achievement tests.

According to Sam's educational file, he missed 2 days during the first semester of kindergarten and 7/ days during the second semester. In first grade Sam missed 3/ days during the first semester and 12 days during the second. Sam was absent approximately 1 of every 6 days during the second half of his first grade year. There is no reported history of disciplinary problems in Sam's file.

According to Sam's psychological file, modifications used in the first grade included small group instruction for reading in the Discovery Room. Sam was allowed to retake spelling lists as often as needed, and his list was reduced to 6 words instead of 10. Praise for work well done was used frequently. Rewards, consisting of prizes from the treasure box, were earned when the teacher found him working independently. A behavior system to increase on-task behavior was utilized. Sam's workload was reduced by approximately half. The length of his reading assignment was modified, assigning him short phrases and sentences when reading class books. Sam was allowed to bring in a book from home to read to the class. Individual directions were given to him after group instructions. In spite of some growth academically, Sam is still far below peers.

Sam was described by his first grade teacher as "an extremely active and usually a happy child. He also likes to socialize with others in class." Miss J reported that Sam often had difficulty working with children in small groups in the classroom; however, Sam's current teacher reports that he displays good social skills and is able to maintain friendships with same-age peers. She states that he is not a problem behaviorally, but that there is a noticeable difference in his behavior when he hasn't taken his Ritalin. At these times he will become preoccupied with something, such as a hangnail on his finger, and lose focus. According to Sam's mother, he enjoys playing soccer and flying kites. He is also involved in farm activities.

Medical History

According to Sam's mother, there were no pre-, peri-, or postnatal complications. Sam was a full-term baby born by vaginal delivery. He weighed 7 pounds. Developmental milestones were reported as acquired within normal limits. In August of 1996, when Sam was 2 years, 9-months-old, he had an incident in which he nearly drowned in a motel swimming pool. Sam's mother suspects that he was under water for one to two minutes. When his cousin pulled him up, he had a faint heartbeat but was not breathing. After Mrs. H began CPR, Sam vomited water and resumed breathing.

In the Fall of 1999, he was diagnosed with Attention Deficit Disorder and is on Ritalin (20 mg slow-release in the morning and 7/ mg at noon). His mother believes that this dosage is working well for Sam. His parents do not have any behavior concerns. According to school records, Sam passed both vision and hearing screenings in the Fall of 1998.

Sam's mother reported that asthma has weakened his vocal cords, leading to scar tissue and nodules. According to the speech pathologist, he had a speech/ language evaluation for voice concerns at the hospital approximately a year before kindergarten, but no services were deemed needed. Sam was evaluated by the speech pathologist at BBE in the Spring of 2000. His language skills were screened with the Clinical Evaluation of Language Fundamentals-Third Edition Screening Test. Sam did not meet criteria to pass this screening instrument. It was also noted during this screening that Sam's voice quality is hoarse and scratchy. He also had some aphonic (loss of voice) episodes while engaging in conversation. The teacher and special education teacher have mentioned Sam's voice quality as a concern. Sam's parents may want to consider consulting their pediatrician about this problem.


According to multiple sources, Sam has fair to good social skills. His mother reports that Sam has friends and gets along well with them. His current teacher also reports that he has same-age friends and is able to maintain these friendships. His previous teacher reported that he had some problems working in small groups; however, according to his current teacher, he works better in small groups.


According to a parent questionnaire, Sam lives with his father, Will, his mother, Cindy, and his 10-year-old brother Nick. Nick is a fourth grader at Blue Bird Elementary. According to the questionnaire, there is no history of educational, medical, or psychological problems among these family members. Mrs. H describes the family as fairly close, with occasional disputes, but nothing she would characterize as major problems.

Background of Referral Problem

Sam's academic functioning appears to have been a consistent concern since the beginning of his school career at BBE. He was referred to the CARE team by both his kindergarten and first grade teachers for being behind his same-age peers in the curriculum. In first grade, he received various interventions and modifications both in and outside of the classroom. Miss J reported some progress, but still identified him as being substantially lower than peers.

Currently, Sam's second grade teacher, Mrs. G, describes him as being significantly behind his peers academically. She describes him as being a hard worker, but not able to produce the same quality of work as his peers. She states that he often does not participate in group activities. His problems are the worst when he hasn't taken his medication and is unable to focus. During these times, he becomes preoccupied and doesn't get anything accomplished. He also struggles when Mrs. G is presenting lessons to the entire class. She feels that he becomes lost easily during these times. He is at his best when working in small groups and receiving individual attention and instructions. According to a parent interview, Sam's mother views Sam's academic progress as being inconsistent. Some weeks he does well, then other weeks he will really struggle. For example, he may do well in math for one month then say he's not interested and do poorly.

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