Free Older Infants and Toddlers (Age 1 to Attainment of Age 3) - Wisconsin


File Size: 11.0 kB
Pages: 1
Date: August 18, 2008
File Format: PDF
State: Wisconsin
Category: Health Care
Author: DHS
Word Count: 484 Words, 2,976 Characters
Page Size: Letter (8 1/2" x 11")
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http://dhs.wisconsin.gov/forms1/f2/f20851B.pdf

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DEPARTMENT OF HEALTH SERVICES Division of Long Term Care F-20851B (Rev. 08/2008)

STATE OF WISCONSIN

B. OLDER INFANTS AND TODDLERS (AGE 1 TO ATTAINMENT OF AGE 3) Review each of the areas of functioning listed. Based on your assessment and pertinent records, determine whether or not a child has substantial limitations of functioning in a given area. If a child has substantial needs in that area, check the box. 1. Self care - Ability to help or ability to cooperate with others in taking care of personal needs, in adapting to environment and in learning new skills such as self feeding and dressing. Child typically feeds self with spoon, uses cup, is able to open doors and cupboards, takes off clothing, begins to dress self with help, pushes arm through sleeve or leg in pants, begins to be aware of being wet or soiled, resists being diapered, is willing to sit on potty chair. 2. Receptive and expressive language - Ability to communicate by understanding, imitating, and using an increasing number of intelligible words or signs and eventually forming two to four word sentences. Understands simple instructions, names pictures in book, understands and uses words or signs to engage others, uses language to make things happen, takes turn as speaker and listener, begins to develop concepts of more abstract words or signs like actions and feelings, makes creative utterances (combines words in new ways which shows understanding of language). 3. Learning - Ability to understand by responding to increasingly complex requests, instructions or questions, by referring to self and things around by point and eventually name, and by copying things or imitating actions shown by others. Child is typically able to show some ability to wait for needs to be met, searches for an object that was seen and then hidden, imitates songs or adult actions, points to body parts, tries to solve problems, puts puzzles together or shape sorter, asks questions, is able to respond to a request to get something / someone from another room, finds an object. 4. Mobility - Ability to move in environment using body with steadily increasing dexterity and independence from support by others, and ability to use hands to do something desired or get something needed. Child typically walks, climbs, is able to go upstairs (older) and downstairs (older), is able to throw a ball, build with blocks, scribble, turn pages of a book. 5. Self-direction - Ability to express normal dependence upon, and emotional bonding with, primary caregivers as well as increasing independence. Child is typically able to wait for some needs to be met, helps with simple household tasks, shows affection toward another child or extended family member, seeks out caregiver if hurt or scared, asserts self in response to adult directions, has a familiar possession, understands some safety hazards such as open stairs, the road, insists on doing things independently, plays next to or with other children.