Sheena is a three-year-old little girl who began attending a daily half-day preschool program in the middle of the year. She is a petite, only child, and this is her first experience in a group setting. She is in a combination three/four year old classroom with seventeen other children and two teachers. Sheena is very soft-spoken, and her speech has a rather rhythmical quality to it. Sometimes her classmates ask her to repeat herself, and sometimes her classmates and teachers have a difficult time following Sheena?s train of thought. Sheena spends a good bit of time in solitary pretend play, and does not always accept her classmates? attempts to engage her. She has a difficult time leaving an activity and making transitions, especially when they involve the whole group of children. Sheena has been having frequent meltdowns and crying spells since starting school, often with no warning or obvious trigger, although her mother reports that Sheena expresses eagerness and excitement over going to school. This behavior upsets Sheena?s classmates and is challenging to her teachers.
The preschool director and teachers have been meeting regularly with Sheena?s parents to problem solve and work on supporting Sheena. Together they decided to have Sheena attend school only on Monday, Wednesday, and Friday mornings, thinking that she may benefit from having time to recover from being in a high stimulation preschool environment. After a few weeks of the three-day schedule, there appears to be no change in Sheena?s behavior. The decision is made to bring in an early interventionist with social inclusion training who can work with Sheena one-on-one, as well as facilitate her play with classmates.
The early interventionist gets to know Sheena, and spends her first few days in the classroom observing Sheena?s play and interactions with her classmates. She notices that Sheena enjoys imaginary play, especially when she is in charge of constructing the scenario. She does not always respond to classmates? attempts to join in her play, although there is one little girl in particular, Melba, who is persistent in her interest in playing with Sheena. Melba makes repeated and consistent attempts to engage Sheena, regardless of Sheena?s level of response. The early interventionist notices that Sheena becomes quickly disorganized, and often distraught, when there is a high level of noise in the classroom, and when there is activity involving the entire group of children. She also observes Melba frequently taking Sheena by the hand during transitions, and trying to comfort Sheena when she gets upset. Even sitting in the large group circle appears to stress Sheena, and Melba seems to intuitively position herself next to Sheena. On the playground Sheena can usually be found playing alone on the periphery, often shadowed by Melba.
The early interventionist works with Sheena on turn taking in imaginary play, and models verbal responses to peers who want to join in. She also sets up small group activities that include Sheena and then facilitates Sheena?s interaction and engagement within the small group. The early interventionist includes Melba in the small group activities. She also meets with Melba separately and asks her if she would like to be Sheena?s ?buddy? at the times Sheena seems to most need support, like during free play, group circle, snack, for special activities (yoga, music), and when lining up to go on the playground. Melba readily takes on the role, and as the weeks progress she and Sheena become more interactive and inseparable.
While Sheena?s meltdowns and crying do not totally stop, they become much more infrequent. Also, Sheena becomes less resistant to transitions and more fully participatory in the classroom, especially in small groups that include Melba. The early interventionist is able to begin consulting with Sheena?s teachers, instead of working one-on-one with Sheena regularly. She also recommends that Sheena receive occupational and speech therapy evaluations. Sheena?s parents follow up, and by the end of the school year Sheena is receiving sensory integration based occupational therapy twice a week, and speech therapy once a week.
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