What is Autism?

Autism spectrum disorder (ASD) is a neurodevelopmental disorder. In other words, it is a lifelong disorder of the brain which can affect behavior, emotion, and mood. ASD is a spectrum disorder which means that the severity ranges from very minimal impairments needing minimal support to profound impairments needing extensive support. First and foremost, ASD is a disorder of social deficits with accompanying restricted and repetitive behaviors. It is identified by a cluster of symptoms, with specific criteria about the number and type of symptoms that must be present for ASD to be identified. That is why a child may display behaviors typically associated with ASD, such as strict adherence to routine, but not have autism. Although the criteria for ASD are the same for everyone, because of the variety of symptoms that may be present, two children with ASD can present with very different symptoms, behaviors, and needs. No two individuals with ASD are exactly alike.

How Does Posey County Special Services Identify ASD?

Posey County Special Services (PCSS) utilizes a number of approaches to identify students with ASD. This includes, but is not limited to, a thorough record review of the student, interviews with the parent(s)/ guardian(s), classroom observation, and direct and indirect assessment. Typically, a speech and language pathologist and an occupational therapist are involved in the assessment process as well.

What if My Child Already Has an ASD Diagnosis?

If your child already has an ASD diagnosis, the next step is to submit the report to the child’s school or directly to PCSS. Keep in mind that an outside diagnosis is not a guarantee of an educational eligibility of ASD. Once a psychologist has reviewed the outside report, the parent/guardian will be contacted and the next steps will be determined by the case conference committee.

References

Ham S., Sohn, I., Kim, N., Sim, H. J., & Cheon, K.(2015). Characteristics of brains in autism

spectrum disorder: Structure, function and connectivity across the life span. Experimental Neurobiology, 24(4), 273-284. https://doi.org/10.5607/en.2015.24.4.273

Kim, H, & Lim, C. (2016). Neuronal mechanisms and circuits underlying repetitive behaviors in mouse models of autism spectrum disorder. Behavioral and Brain Functions, 12(3). https://doi.org/10.1186/s12993-016-0087-y

What is a Developmental Delay?

A developmental delay (DD) can be defined as a severe delay in one developmental area or mild delays in two or more developmental areas. The developmental areas are motor (fine and/or gross), cognitive, receptive or expressive language, social or emotional, and self-help or other adaptive. Only children between the ages of 3 and 9 years can be eligible for DD.

How Does Posey County Special Services Identify DD?

Posey County Special Services (PCSS) utilizes a number of approaches to identify DD. This includes but is not limited to a thorough record review of the student, interviews with the parent(s)/ guardian(s), classroom observation (if applicable), and direct and indirect assessment. All five developmental areas listed above must be assessed for during the evaluation process.

What if My Child Already Has a DD Diagnosis?

If your child already has an outside diagnosis of DD, the next step is to submit the report to the child’s school or directly to PCSS. Keep in mind that an outside diagnosis is not a guarantee of an educational eligibility of DD. Once a psychologist has reviewed the outside report, the parent/guardian will be contacted and the next steps will be determined by the case conference committee.

Reference

Wahlstrom, D., Raiford, S. E., Breaux, K. C., Zhu, J., & Weiss, L. G. (2018). The wechsler preschool and primary scale of intelligence—fourth edition, wechsler intelligence scale for children— fifth edition, and wechsler individual achievement test—third edition. In D. P. Flanagan & E. M. McDonough (Eds.), Contemporary intellectual assessment: Theories, tests, and issues (pp. 245–282). The Guilford Press.

What is an Intellectual Disability?

Formally Cognitive Disability, An intellectual disability (ID) can be defined as a below average intelligence quotient (IQ) which can range from mild to severe and has a negative effect on education and socialization. Furthermore, the child’s adaptive functioning (ability be successful in tasks and socialization), is at about the same level of his or her level of intellectual impairment.

How Does Posey County Special Services Identify ID?

Posey County Special Services (PCSS) utilizes a number of approaches to identify ID. This includes, but is not limited to, a thorough record review of the student, interviews with the parent(s)/ guardian(s), classroom observation, and direct and indirect assessment. The Indiana State Board of Education Special Education Rules state that a norm-referenced intelligence test must be used. If valid data cannot be collected by a norm-referenced intelligence test, a criterion-referenced assessment is used. Adaptive rating scales must be administered as well.

What if My Child Already Has an ID Diagnosis?

If your child already has an outside diagnosis of ID, the next step is to submit the report to the child’s school or directly to PCSS. Keep in mind that an outside diagnosis is not a guarantee of an educational eligibility of ID. Once a psychologist has reviewed the outside report, the parent/guardian will be contacted and the next steps will be determined by the case conference committee.

References

Jimenez, B. (2020). Using assessment for planning standards-based individualized education programs. In D. M. Browder, F. Spooner and G.R. Courtade (Eds.), Teaching students with moderate to severe disabilities (pp. 62-93). The Guilford Press.

Brosh, C. R., & Knight, V. F. (2020) Promoting social skills and positive behavior

support. In D. M. Browder, F. Spooner and G.R. Courtade (Eds.), Teaching students with moderate to severe disabilities (pp. 62-93). The Guilford Press.

McGown, M. R., & Hennessey, J. M. (2019). The role of intelligence tests in the assessment of intellectual disability. In J. L. Matson (Ed.), Handbook of intellectual disabilities: Integrating theory, research and practice (pp. 367-384) Springer

What is Other Health Impairment?

Other health impairment (OHI) can be defined as the child having a limited amount of strength and/or alertness which can be related to a medical condition. The limited strength and/or alertness must be affecting the child’s education. Although attention-deficit/hyperactive disorder (ADHD) is the most common medical condition for children receiving services under the OHI eligibility, other health issues can include, but are not limited to, seizure disorder/epilepsy, diabetes, asthma, stroke, cerebral palsy, cardiac conditions, hemophilia, leukemia, rheumatic fever, sickle cell anemia, Tourette syndrome, nephritis, and genetic conditions such as Turner’s syndrome. A medical diagnosis from a doctor is not required for a child to receive services under OHI.

How Does Posey County Special Services Identify OHI?

Posey County Special Services (PCSS) utilizes a number of approaches to identify OHI. This includes, but is not limited to, a thorough record review of the student, interviews with the parent(s)/ guardian(s), classroom observation, and direct and indirect assessment. Additionally, RtI/MTSS data is required for the school’s team to consider OHI services.

What if My Child Already Has a Medical Diagnosis?

If your child already has a medical diagnosis, the next step is to submit the report to the child’s school or directly to PCSS. Keep in mind that an outside diagnosis is not a guarantee of an educational eligibility of OHI. Once a psychologist has reviewed the outside report, the parent/guardian will be contacted and the next steps will be determined by the case conference committee.

References

Haraway, D. L. (2012). Monitoring students with adhd within the rti framework. The Behavior Analyst, 3 (2) 17-21.

Langberg, J. M., Epstain, J. N., Girio, E. L., Becker, S. P., Vaughn, A. J. & Altaye, M. (2011). Materials organization, planning, and homework completion in middle school students with ADHD: Impact on educational performance. School Mental Health, 3 (2), 93-101.

What is Specific Learning Disability?

A specific learning disability (SLD) is a disorder in one or more of the basic psychological (thinking) processes involved in understanding and using language and affects a student’s school performance. An SLD shows itself when a child does not grow academically at the rate that would be expected for his or her age or grade. This lack of growth is to a significant degree. A child can have SLD issues in only one subject, such as math, or in a number of subjects, such as math, reading, and writing. Posey County Special Services (PCSS) has to consider a number of other factors when determining if a child meets criteria for services as a child with a SLD. The criteria have been set up by the Indiana State Board of Education Special Education Rules. PCSS must consider whether the student has received appropriate instruction, which may include response to intervention/ multi-tiered system of supports (RtI/MTSS). The team must also consider whether or how much the student’s learning may be affected by “exclusionary criteria.” Exclusionary criteria include visual, hearing, or motor disabilities; intellectual or emotional disabilities; cultural factors; environmental or economic disadvantage; and limited English proficiency.

How Does Posey County Special Services Identify Specific Learning Disabilities?

PCSS utilizes a combination of RtI/MTSS (see below for information about RtI/MTSS) and a pattern of strengths and weaknesses. An evaluation for SLD may include direct and indirect assessment procedures, review of records, analysis of RtI/MTSS data, relevant medical information, and information from the school and home settings.

What if My Child Already Has a SLD Diagnosis?

If your child already has an SLD diagnosis, the next step is to submit the report to the child’s school or directly to PCSS. Keep in mind that an outside diagnosis is not a guarantee of an educational eligibility of SLD. Even with an outside evaluation, RtI/MTSS data from the school is still required. Once a psychologist has reviewed the outside report, the parent/guardian will be contacted and the next steps will be determined by the case conference committee.

What is Response to Intervention/Multiple Tiered Support Systems (RtI/MTSS)

RtI/MTSS is a program designed to target academic and/or behavioral needs in the school setting. Although the program has a focus on students with academic or behavioral concerns, all students can benefit from RtI/MTSS services. The first step is to identify students who may need academic and/or behavioral support. Next, research-based interventions targeting the specific academic and/or behavioral concern are implemented. The child’s progress (or response) to the intervention(s) is closely monitored by school personnel and by PCSS. If the child has not improved enough with the intervention(s), then an evaluation is recommended.

*Special Note: The term “dyslexia” has become more popular in our culture, especially with recent state legislation focusing on early dyslexia identification and intervention. It is important to note that dyslexia is another term for a basic reading disorder or difficulties with sight word reading and/or word decoding. Dyslexia falls under the special education category of SLD. As with all reading disorders, dyslexia is a language-based disorder and is not related to letter/number reversal (writing or reading numbers and letter backwards or in reverse order). Therefore, if there are concerns with dyslexia, PCSS’s evaluation will be the same as for any reading disorder.

References

Fiorello, C. A., Hale, J. B., & Snyder, L. E. (2006). Cognitive hypothesis testing and RTI.

Psychology in Schools, 43 (8), 835-853. https://doi.org/10.1002/pits.20192

Hale, J. B., Wycoff, K. L. & Fiorello, C. A. (2011). Response to intervention and cognitive

hypothesis testing for identification and intervention of specific learning disabilities: The best of both worlds. In D.P. Flanagan and V.C. Alfonso (Eds.), Essentials of specific learning disability identification (pp. 173-201). John Wiley and Sons.

Naglieri, J. H., & Bornstein, B. T. (2003). Intelligence and achievement: Just how correlated are

they? Journal of Educational Assessment, 21 244-250. https://doi.org/10.1177/073428290302100302

Naglieri, J. H. (2011). The discrepancy consistency approach to specific learning disability

identification using the PASS theory. In D.P. Flanagan and V.C. Alfonso (Eds.), Essentials of specific learning disability identification (pp. 145-172). John Whiley and Sons

Snowling, M. J., Gooch, D. C., Hulme, C., Nash, H. M., & Hayiou-Thomas, M. E. (2019).

Developmental outcomes for children at high risk of dyslexia and children with developmental language disorder. Children Development, 90 (5) 548-564

What is a Traumatic Brain Injury?

A traumatic brain injury (TBI) can be defined as an acquired (not born with) injury to the brain by an external force resulting in social and/or academic impairment. Medical issues that affect the brain without external force do not fall under the TBI eligibility. Such examples include stroke, brain tumor or neurological degenerative disorder, such issues are more common under the other health impairment eligibility. Open or closed headed injuries with and without loss of consciousness are acceptable under the TBI eligibility. A TBI can be further classified based on severity which includes mild, moderate and severe. A mild TBI and a concussion are the same and can be used interchangeably.

How Does Posey County Special Services Identify a TBI?

Posey County Special Services (PCSS) utilizes a number of approaches to identify a TBI. This includes but is not limited to a thorough record review of the student, interviews with the parent(s)/ guardian(s), classroom observation, direct and indirect assessment. Additionally, impairment in one or more of the following areas must be evident post injury; cognition, language, memory, attention, reasoning, abstract thinking, judgement, problem solving, sensory, perceptual, motor abilities, psychosocial behavior, physical functions, information processing and speech. For an educational eligibility there must also be medical documentation of a brain injury.

What if My Child Already Has a TBI Diagnosis?

If your child already has an outside diagnosis of a TBI the next step is to submit the report to the child’s school or directly to PCSS. Keep in mind that an outside diagnosis is not a guarantee of an educational eligibility of TBI. Once a psychologist has a chance to look over the outside report the parent/guardian will be contacted and the next steps will be determined by the case conference committee.

References

Halstead, M. E. Walter, K. D., & Moffatt, K. (2018). Sports-related concussion in children and

adolescents. Pediatrics: Official Journal of the American Academy of Pediatrics, 142 (6) https://doi.org/10.1542/peds.2018-3074

Prasad, M. R., Swank P. R., & Ewing-Cobbs, L. (2016). Long-term school outcomes of children

and adolescents with traumatic brain injury. The Journal of Head Trauma Rehabilitation,

32 (1), 24-32. DOI: 10.1097/HTR.0000000000000218

By 2 months, most babies do the following:

Cognitive Milestones (learning, thinking, problem-solving)

• Begin to follow things with eyes and recognize people at a distance
• Begin to act bored (cries, fussy) if activity doesn’t change

Language/Communication Milestones

• Coo, make gurgling sounds
• Turn head toward sounds

Social/Emotional Milestones

• Begin to smile at people
• Try to look at parent

Adaptive/Self-Help Milestones

• When feeding, able to do at least 2 sucks in a row before pausing to breathe
• Have a rooting reflex where he/she will turn toward the breast or bottle when the side of his/her mouth is stroked
• Bring hands to mouth

Movement/Physical Milestones

• Hold up head and begin to push up when lying on tummy
• Make smoother movements with arms and legs

By 4 months, most babies do the following:

Cognitive Milestones (learning, thinking, problem-solving)

• Use hands and eyes together, such as seeing a toy and reaching for it
• Follow things with eyes from side to side, look back and forth between two objects

Language/Communication Milestones

• Begin to babble
• Cry in different ways to show hunger, pain, or being tired

Social/Emotional Milestones

• Like to play with people and might cry when playing stops
• Copy some movements and facial expressions (example: smiling or frowning)

Adaptive/Self-Help Milestones

• When eating, sucking, swallowing, and breathing are well coordinated
• When eating, able to do about 20 sucks before stopping to breathe

Movement/Physical Milestones

• Hold head steady, unsupported
• Push down on legs when feet are on a hard surface

By 6 months, most babies do the following:

Cognitive Milestones (learning, thinking, problem-solving)

• Show curiosity about things and try to get things that are out of reach
• Begin to pass things from one hand to the other
• Repeat arm or leg movements to cause an action to occur again

Language/Communication Milestones

• Respond to sounds by making sounds, like taking turns making sounds
• Laugh out loud
• String vowels together when babbling (“ah,” “eh,” “oh”)
• Briefly stop activity when name is called

Social/Emotional Milestones

• Respond to other people’s emotions and often seem happy
• Comfort self (sucks hand or thumb)
• Express desire to be picked up, initiate social contact
• Like to look at self in a mirror, may smile or pat own image in mirror
• Interact differently with caregivers than with strangers

Adaptive/Self-Help Milestones

• Begin to eat small amounts of thin, pureed foods such as infant cereal or pureed fruit from a spoon
• Start to suck or bite on a baby cookie
• Use some up and down chewing movements

Movement/Physical Milestones

• Roll over in both directions (front to back, back to front)
• Rock back and forth while in crawling position
• Sit by him/herself for at least 5 seconds with hips supported
• When standing, support weight on legs and might bounce

By 9 months, most babies do the following:

Cognitive Milestones (learning, thinking, problem-solving)

• Watch the path of something as it falls
• Look for things he/she sees you hide, find things that are partially hidden
• Move to get desired items (toy) and persist in effort
• Play peek-a-boo

Language/Communication Milestones

• Understand “no” (briefly stop activity when told “no”)/li>
• Copy sounds and gestures of others
• Make a lot of different sounds like “mamamama” and “bababababa”
• Use fingers to point at things

Social/Emotional Milestones

• May be afraid of strangers/li>
• May be clingy with familiar persons, extend arms to familiar persons
• Express affection

Adaptive/Self-Help Milestones

• Eat ground or junior baby foods or mashed table foods, close lips to remove food from spoon
• Hold or support bottle to drink
• Begin to drink from a cup held for him/her but may lose a lot of liquid, take large mouthfuls, and have trouble coordinating drinking and breathing (cough/choke)
• Sleep through the night/li>

Movement/Physical Milestones

• Pick up things like cereals between thumb and index (pointer) finger
• Stand alone while holding onto something, pull to stand
• Get into a sitting position and sit without support
• Crawl

By 12 months, most babies do the following:

Cognitive Milestones (learning, thinking, problem-solving)

• Find hidden things easily, such as a toy hidden under a blanket
• Look at the right picture or thing when it is named
• Start to use things correctly; for example, drinks from ac up, brushes hair
• Let items go from his/her grasp without help

Language/Communication Milestones

• Follow simple spoken commands, like “pick up the toy” or “give daddy the ball”
• Use simple gestures, like shaking head “no” or waving “bye-bye,” and copy gestures
• Say “mama” and “dada” and exclamations like “uh-oh!”
• Try to say words that you say
• Point to five or more familiar persons, animals, or toys when asked

Social/Emotional Milestones

• Is shy or nervous with strangers, cry when mom or dad leaves
• Show fear in some situations
• Imitate facial expressions, actions, and sounds
• Hand you a book when he/she wants to hear a story, bring toys to share with caregiver
• Repeat sounds or actions that cause positive attention or a positive response from others

Adaptive/Self-Help Milestones

• Start to feed self with finger foods
• Start to hold a spoon during meals (but may not feed self with it)
• Bite and chew food by himself/herself
• Drink from sippy cup independently
• Put out arm or leg to help with dressing
• Cooperate with hand washing

Movement/Physical Milestones

• Get into a sitting position without help
• Pull to a stand and walk while holding onto furniture (“cruising”)
• Walk three or more steps with help
• Hold crayon in a fist and may begin to scribble

By 18 months, most babies do the following:

Cognitive Milestones (learning, thinking, problem-solving)

• Show interest in a doll or stuffed animal by pretending to feed it
• Manage three or more toys by setting one aside when given a new toy
• Know what ordinary things are for; for example, telephone, brush, spoon
• Point to one or more body parts when asked

Language/Communication Milestones

• Point to show someone what he/she wants
• Say and shake head “no”
• Use at least 5 words
• Speech can be understood about 25% of the time
• Follow directions about placing an item “in” and “on” another

Social/Emotional Milestones

• Show affection to familiar people, attempt to comfort others
• May have temper tantrums
• Like to hand things to others as play
• Play simple pretend, such as feeding a doll

Adaptive/Self-Help Milestones

• Fuss when diaper needs to be changed
• Try to wash his/her own hands and face
• Help undress him/herself

Movement/Physical Milestones

• Use one hand consistently in most activities
• Drink from a cup
• Eat with a spoon
• Scribble on his/her own
• Walk alone, pull toys while walking
• Creep backwards down steps/li>

By 2 years, most children do the following:

Cognitive Milestones (learning, thinking, problem-solving)

• Play simple make-believe games
• Find things even when hidden under two or three covers
• Follow two-step instructions, such as “Pick up your shoes and put them in the closet”
• Name items in a picture book such as cat, bird, or dog
• Insert shapes into matching slots
• Complete sentences and rhymes in familiar books

Language/Communication Milestones

• Know names of familiar people and body parts
• Ask for some items by name
• Say phrases or sentences with 2 to 4 words
• Speech can be easily understood 50-75% of the time
• Point to things or pictures when they are named, point to things in a book
• Follow simple instructions

Social/Emotional Milestones

• Copy others, especially adults and other children
• Get excited with other children
• Engage mainly in parallel play (playing side-by-side, watching, copying), but begin to include other children, such as in chase games
• Show defiant behavior (doing what he/she has been told not to do)
• Ask for help when having trouble

Adaptive/Self-Help Milestones

• Remove loose clothing such as jacket or shirt without help
• Put on simple clothing by him/herself
• Use spoon without help

Movement/Physical Milestones

• Build tower of 4 or more blocks
• Make or copy straight lines and circles
• Walk up and down stairs while holding on
• Climb onto and down from furniture without help
• Kick a ball
• Throw a ball overhand

By 3 years, most children do the following:

Cognitive Milestones (learning, thinking, problem-solving)

• Stack rings on peg in order of size
• Work toys with buttons, levers, and moving parts
• Match simple shapes such as circle, square, and triangle
• Match objects by color, shape, and size
• Complete puzzles with 3 or 4 pieces
• Count to 5
• Understand what is meant by “one,” “two,” “one more,” and “all”
• Copy a circle with pencil or crayon
• Turn book pages one at a time

Language/Communication Milestones

• Use about 500 words and can name most familiar things
• Speech can be easily understood 75-100% of the time
• Say first name, age, and sex (boy or girl)
• Say words like “I,” “me,” “we,” and “you” and some plurals (cars, dogs, cats)
• Begin to ask questions; ask “what,” “where,” and “why” questions, ask yes/no questions (“It fast?”)
• Answer “who” and “whose” questions
• Understand words like “in,” “on,” and “under”
• Understand negation (“Which one is not on the table?)
• Follow instructions with 2 or 3 steps
• Carry on a conversation using 2 to 3 sentences

Social/Emotional Milestones

• Separate easily from mom and dad
• Prefer to play with others than by himself/herself, engage in interactive play, and use toys imaginatively
• Look at people when speaking with them, usually make eye contact with familiar people
• Show a wide range of emotions and recognize when another person is happy or sad
• Understand the idea of “mine” and “his” or “hers”
• Change activities when requested

Adaptive/Self-Help Milestones

• Dress and undress self
• Ask to use potty, have daytime control of toileting needs with occasional accidents
• Sit on toilet for at least 1 minutes with supervision
• Wash and dry hands and face.
• Use fork to stab food

Movement/Physical Milestones

• Build towers of more than 6 blocks
• Screw and unscrew jar lids or turn door handles
• String beads or complete simple lacing
• Scribble with crayons
• Snip paper with scissors
• Run easily
• Walk up and down stairs, one foot on each step

By 4 years, most children do the following:

Cognitive Milestones (learning, thinking, problem-solving)

• Match objects that have the same function (spoon and fork)
• Draw a person with 2 to 4 body parts
• Point to basic colors and simple shapes
• Name some colors, letters, and numbers
• Understand the idea of counting objects; for example, may count to 2 and point to items while attempting to count)
• Understand the ideas of same/different, more/less, and heavy/light
• Remember parts of a story
• Tell what he/she thinks is going to happen next in a story

Language/Communication Milestones

• Use about 800 words
• Speech can be understood nearly 100% of the time
• Sing a song or say a poem from memory, such as the “Itsy Bitsy Spider” or the “Wheels on the Bus"
• Tell stories
• Tell how simple objects are used
• Know some basic rules of grammar, such as correctly using “he” and “she”
• Answer most questions
• Understand more prepositional words, such as “in front,” “behind,” “up,” “down,” “top,” and “bottom”

Social/Emotional Milestones

• Play pretend and become more and more creative with make-believe play
• Engage most often in motor-based play and building (going down slide, building towers) but will also participate and copy what other kids are doing
• Would rather play with other children than alone, share toys
• Cooperate with other children
• Talk about what he/she likes and is interested in
• Sit and attend to an activity for 10-15 minutes
• Begin to express anger in words rather than physical action

Adaptive/Self-Help Milestones

• Manipulate large buttons or snaps
• Dress self completely (except tie shoes)
• Return items to where they belong
• Clean up spills
• Often want privacy in the bathroom

Movement/Physical Milestones

• Copy simple shapes
• Cut on a line with scissors
• Hop and stand on one foot up to 2 seconds
• Catch a bounced ball most of the time
• Ride tricycle
• Gallop

By 4 years, most children do the following:

Cognitive Milestones (learning, thinking, problem-solving)

• Count 10 or more things
• Recognize his/her own printed name
• Name at least 20 letters
• Print some letters or numbers from memory (without a model to copy from)
• Copy a triangle and other shapes
• Identify first, last, and middle
• Identify “half” and “whole” objects

Language/Communication Milestones

• Say full name and address
• Tell a simple story using full sentences
• Use past, present, and future tenses of regular verbs (cooked, cooks, will cook)
• Use many irregular verbs and irregular nouns, but sometimes mixes up the correct form (“He falled down”)
• State similarities between objects (How are juice and milk alike?)
• Identify rhyming words
• Understand most of what is heard at home and in school
• Follow directions with multiple steps (“Change into your pajamas, brush your teeth, and choose a book)
• Carry on a conversation

Social/Emotional Milestones

• Like to sing, dance, and act
• Want to please friends and to be like friends
• Play cooperative games
• Ask before using another’s belongings
• Is sometimes demanding and sometimes very cooperative
• Talk about own feelings
• Offer help to others
• Tell what is real and what is make-believe

Adaptive/Self-Help Milestones

• Use the toilet on his/her own
• Know which shoe goes on which foot
• Select own clothing appropriate for the weather
• Brush teeth without help
• Put dirty dishes in sink or dishwasher

Movement/Physical Milestones

• Color within lines
• Cut a straight line
• Use a fork and spoon and sometimes a table knife (with supervision)
• Stand on one foot for 10 seconds or longer
• Hop and may be able to skip
• Swing and climb