Kate is a 4 year, 6 month old African American female. She is the third born child in her family of six. She has brown hair and brown eyes. She enjoys spending time with her dad, drawing, and coloring. Background Information Kate's parents are worried about her skills and development because she was born with a minor cleft palate at birth. Although, she underwent surgery to correct it, she has some scar tissue remaining. She is also reading at a lower score than her peers. Family Information Kate has a very supportive family. She is the third of four kids. Her parents have been married for approximately 11 years. Her dad is a military officer and her mom works part-time as an interior designer for a local furniture and decor company. All surgeries were covered by her parents' insurance. Kate attended a quality child care center and now attends the public school preschool three blocks from her house. Kate's family is classified as middle class. Her parents have a healthy marriage and Kate has positive relationships with her siblings. Kate's dad is very strict and follows rules and routines religiously. He loves his children very much, but rarely shows affection

wards them. Kate's mother is more nurturing and sometimes breaks the rules/routines that the dad has set, but reminds the children not to tell their father. They are also very spiritual and attend church together as a family each week.

Child's Health Kate was born with a cleft palate. She had three surgeries after birth to correct her lip line. She has small scars from the surgery, which will fade with age. Otherwise, she is normal height and weight for her age. She has no signs of illness or disease. Child's Behavior Kate has a shy, withdrawn personality when interacting with peers. She typically engages in solitary play and parallel play while at preschool. At home, Kate frequently plays with her sibling. Her oldest sister, who is 12, frequently babysits Kate. Kate almost always follows the rules and directions at preschool. She frequently asks for clarification relating to rules and worries that she is not going to follow the rules correctly. Overall, she is quiet and well-behaved. Kate feels self-conscious when other children frequently point out her scar on her lip; therefore, she is sometimes slow to join friend groups and play with peers. She also has some language delay. She only says about . She does not read aloud basic picture books, like the other children. Every week, she sees a speech-language pathologist, to help with sounds. The surgeries around her mouth resulted in a delay of sounds and accurate pronunciation of basic words.

Parent Concerns Ava's parents are concerned because they feel Kate is socially withdrawn, shy, and struggles to communicate her needs and wants. At home, Kate is very outgoing and interacts with her peers, although, she becomes very quiet at school. She is also very concerned about following the rules at school and home. She becomes very nervous when the routine does not go as follows or other students do not follow the rules.

What is important to note about Katie's growth in the following areas:

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• Emotional:

What are Kate's strengths and risk factors:

• Strengths:
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• Risk Factors:
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What recommendations do you have for Kate's parents to support her growth and development:

• Recommendation #1:
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