ASSESSMENT REPORT

Identifying Data

Name: Anika Bhardwaj

Age: 2 years 1 month
Sex: Female
Date of Assessment: 28/03/2023
Chief Complaints: Excessive hitting, tantrums, lack of empathy

Initial Observations:

The assessment was conducted by the psychologist and occupational therapist at Asha Hai. Anika
presents as a healthy, well-built, well-groomed girl. She was accompanied by her parents for the
assessment. She was able to initiate and maintain eye-to-eye contact. She has appropriate name response
but the mother reported that many a times she doesn’t respond to her name. The parents reported that she
engages in simple instruction following but it can be inconsistent at times. She gave a social smile and
was trying to engage with objects around the room. She was excessively clingy towards her mother. It
was observed that she was oblivious of the objects lying on the floor and was able to avoid simple hazards
while walking.

The following psychological assessment tests were administered, aside from clinical observation and
interview:

 Developmental Screening Test (DST)

 Vineland Social Maturity Scale (VSMS)
 Children Autism Rating Scale (High Functioning)
 Occupational Therapy- Sensory Profile

DEVELOPMENTAL SCREENING TEST

Developmental Screening Test (DST) is a checklist that includes gross motor, fine motor, cognitive skills
as well as the independence of the child in terms of her daily lifestyles and activities.

Interpretation:

Anika’s Development Age (DA) indicates that she has mild delays in social, emotional, and physical
aspects. The Developmental Age of the child was found to be 1 year 6 months. On the other hand, the
chronological age of the child is 2 years 1 month.

Developmental Quotient is 72 % which reflects Mild to Moderate Delay.

 VINELAND SOCIAL MATURITY SCALE

An Indian adaptation of the Vineland Social Maturity Scale (VSMS) to assess children aged 0-16 years in
the areas of Self-Help General, Self-Help Dressing, Self-Help Eating, Self- Direction, Locomotion,
Communication, Occupation, and Socialization was used. The scale consists of 89 items grouped into
year levels. The scale yields a Social Age (SA) and a Social Quotient (SQ), which can be considered to be
an approximate Intelligence Quotient. This test is found to have a correlation of 0.85 to 0.96 with the
Stanford-Binet Intelligence Scale.

Profile Analysis: Social Age (SA) and Social Quotient (SQ) in the 8 areas of Social Maturation

SOCIAL AREAS SOCIAL AGE (SA) SOCIAL QUOTIENT (SQ)

Self-Help General 14 Months 56%

Self-Help Eating 19.2 Months 76.8%

Self-Help Dressing 16.8 Months 67.2%

Self-Direction NA NA

Occupation 21.6 Months 86.4%

Communication 21.6 Months 86.4%

Locomotion 21.6 Months 86.4%

Socialization 16.8 Months 67.2%

Results:
Social Age: 1 year 7 months
Social Quotient: 76%

Interpretation:

Anika’s Social Age scores in the areas of Self-Help General, Self-Help Eating, Self-Help Dressing, and
Socialization are good. Her scores on Communication, Locomotion and Occupation are average.

The Social Quotient of 76 %, indicates Mild Delays in Social Intelligence of the child which indicates
that sometimes the child may have difficulty in following and understanding social rules.
 THE CHILDHOOD AUTISM RATING SCALE (HIGH FUNCTIONING)

The report is based on observations made by the therapist through direct observation and interaction with
the child as well as from the parents' interview. There are 15 items all together which have detailed
description, according to which the child is rated. The case of a 2.1 year-old girl had been referred to
Asha Hai by her parents.

Social-Emotional Understanding: 2.5

The child shows an understanding of facial expressions, tone of voice, and body language in many
situations but it was reported that these responses can be inconsistent.

Emotional Expression and Regulation of Emotions- 2

The child faces difficulty in regulating her emotions. Restricted range of facial expressions observed
during the assessment – they were mostly neutral (flat) and her expressions did not change in response to
change of expression of others.

Relating to People: 2
Initiates interactions to get obvious needs met or around special interests. Some give-and-take observed
and reported but it lacks consistency or fluidity. Aware of others in her environment but minimal
initiation observed for purely social purposes that does not involve special interests.

Body Use: 2
The child was observed to be restless and bodily on the move. Some minor peculiarities such as agitation
in the body, repetitive move, and had difficulty in sitting still while completing activities (undesired).

Object Use: 1.5

It was observed that the child engaged in using toys and objects in a meaningful manner. However, her
play was restrictive, mostly directed towards seeking sensory input.

Adaptation to Change: 2.5

The child required some prompt for change of activity. She also continued the same activity when the
assessor tried to introduce a new one. Rigidity and tantrums have been reported by parents on regular
basis.

Visual Response: 2.5

The child’s eye contact is not consistently integrated with verbalizations.

Listening Response: 1.5

It was observed that she appropriately responded to her name being called. However, it was reported that
she does not respond to her name on several occasions. Receptive communication is appropriate however,
the responses are delayed.
Taste, Smell, and Touch Response and Use: 2.5
It was observed that the child is engaging in sensory seeking behaviours such as hitting, head banging,
putting painting on her face and hands.

Fear or Nervousness: 2.5

It was observed that the child does not show fear of falling. However, she is excessively clingy to her
mother.

Verbal Communication: 3
Able to communicate however, the rate and pace of speech is slow. The tone and pitch are also atypical
when compared to children her age. Her responses are delayed.

Non-verbal Communication: 2
Non-verbal communication is reported and observed to be typical. Facial expressions were observed to be
flat and neutral. It was also observed that she does not understand the non-verbal cues of others in her
environment.

Thinking/Cognitive Integration Skills- 1.5

The child may be mildly restless. The child’s activity level interferes only slightly with her performance.

Level and Consistency of Intellectual Response: 1.5

The child has at least average intellectual abilities. She presents good level of intellectual understanding.

General Impressions: 2
Anika shows a few characteristics of High Functioning Autism, including difficulties with Emotional
regulation, excessive sensory seeking behaviour and lack of empathy.

The overall score is 31.5 indicating Mild symptoms of autism spectrum disorder- (HIGH
FUNCTIONING)
 Occupational Therapy Report

Anika is a playful child. She came for Occupational Therapy assessment for behavioural and sensory
based concerns. She was able to get involved in activities and was showing interest in toys and activities
given to her.

Occupational Therapy Observations and Concerns: -

 Anika reportedly displays aggressive behaviour towards others; she pinches, bites others even
without any antecedent.
 Anika takes longer than usual to respond to name call and to pay immediate attention.
 She generally withdraws self from the immediate environment and perceived as ignoring others.
 She enjoys looking at moving objects.
 She may be oblivious to the environment and may bump into things.
 She seems to seek vestibular (movement -based) sensory inputs.
 She seems to have low threshold for auditory inputs coming from environment.
 She has difficulty in generating appropriate behaviour, social and emotional response associated
with sensory processing issues.

Diagnosis:
Summary Table:

Tools Raw Score Interpretation

Developmental Screening Test 72% Mild-Moderate Delay

Vineland Social Maturity Scale 76% Mild-Moderate Delay

Childhood Autism Rating Scale 31.5 Mild High Functioning Autism

Occupational Therapy Sensory Difficulties

 RECOMMENDATIONS:

Anika is 2 years 1 month old and on the basis of Self-report measures of the informants and Clinical
Observation, the child’s developmental age is 1 years 6 months which indicates Mild delays in
developmental milestones and her social age is 1 years 7 months which indicate Mild delays in social
maturity that means in certain situations the child has difficulty following and understanding social rules.

 Social Communication and Behavior Therapy- for working with rigidity, emotional,
behavioral, and physical regulation. SCBT is recommended a minimum of 3 times a week.
 Occupational Therapy for the sensory needs of the child is recommended 3 times a week.
 We are recommending certain play strategies for the child to improve her overall development-
Parents and caregivers should engage with the child at home. The following activities shall be
extremely instrumental in enhancing the overall development and interaction of the child-
a. Books- Read story books to the child every day to enhance attention, imagination and
expressive skills.
b. Bubbles– Use bubbles- blow them, asks the child to pop them. You can add words like 1-
2-3 pop or blow. Take turns while blowing the bubble, wait for turns while the other person is
blowing.
c. Engage in Sensory Play- Using rajma/pasta, water, sand. Sensory play includes just about any
activity that stimulates a child’s senses through new and exciting experiences. It helps build
neural pathways that will be needed for more complex learning tasks as your child grows.
d. Mirror Play- Make the child sit in front of the mirror and you sit behind the child. Make
various faces, do different actions. Let the child copy you.
e. Engage in free dancing with rhymes. You do the actions of the rhymes and let the child copy
you.
 No Screen Time- There should be zero screen time for a child.

Rashi B. Tandon
Founder, President – Asha Hai
Visiting Consultant Psychologist - Child Development Clinic (Sitaram Bhartia Institute of Science
and Research)
Registered Dance Movement Psychotherapist (ADMP-UK), Child and Adolescent Rehabilitation
Psychologist (CRR No. - A59992)