Notes

Camilla Zoë Cuddy PsyD BCBA-D LBA
39 East 78th Street
Suite 501
New York, New York 10075
917-912-6667
[email protected]
czcuddypsychology.com

Child’s Legal Name: Delainey Davidson Child’s Nickname:
Date of Birth: 10/6/12 Gender: female

Parent(s) name(s): Maria Moss, Mark Anderson (stepdad)
Handedness (R/L/Both): R

Sibling(s) (age/ name/current school):
Daniel Davidson, 14yrs, Quad Prep
Avery Anderson, 5 yrs, PS 29

Home address (please specify if more than one): 176 Richards Street, Brooklyn, NY 11231

Tel/Cell Numbers: 718.614.5605 (Maria), 917.420.8397 (Mark)
Parent(s) email(s): [email protected], [email protected]

Child lives with: Maria, Mark, Daniel, Avery, and Lili (au pair)
Current school: PS 29
Grade: 5

Primary language: English Languages spoken at home: English

Race/ethnicity of parents/child: White
Religion: none

Diagnosis (please list any prior or current diagnoses): ADHD

Referred by:









Reason for referral:
_________________________________________________________________________________________________


What are your goals for this evaluation?
Finding ways in which we can better support Delainey, and finding proper placement for middle school

DEVELOPMENTAL AND EDUCATIONAL HISTORY

DEVELOPMENTAL MILESTONES AND EARLY CHILDHOOD

1. Pregnancy and birth (please describe; concerns and/or issues, complications, etc.) I was on Lamictal during the pregnancy. I had acute preeclampsia and had a c-section at 37w 4d.

2. How would you describe your child’s temperament during early childhood?

- _______ Calm
- ____x___ Hyperactive
- ____x___ Sociable
- _______ Withdrawn
- _______ Happy
- _______ Unhappy
- _______ Alert
- _______ Sleepy
- ____x___ Affectionate
- ____x___ Frequent crying
- _______ Difficult
- _______ Irritable
- ___x____ Hypersensitive
- _______ Angry
- _______ Fearful
- ____x__ Curious
- __x_____ Playful
- _______ Other (please specify) ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________




Other than the checklist above, please describe your child’s temperament and disposition during infancy and early childhood:



3. When did your child develop physical skills such as sitting, crawling and walking?

- ________ Do not know
- ________ Earlier than most children
- __x______ At about the same time as other children
- ________ Later than most children
- ________ Other (please specify) ___________________

Additional information (use this space if needed):



4. How would you describe your child’s language development (e.g., first words, talking in sentences, vocabulary, etc.) during early childhood?

- _______ Do not know
- _______ Advanced in comparison to most children
- ___x____ Average in comparison to most children
- _______ Slow in comparison with other children
- _______ Tended to express needs nonverbally
- _______ Other (please specify) ____________________

Additional information (use this space if needed):



5. How would describe the child’s motor development and skill acquisition (e.g., toilet training, running, jumping, throwing a ball, catching, etc.) during early childhood?

- _______ Do not know
- _______ Advanced in comparison to other children
- ___x____ Average in comparison to other children
- _______ Slow in comparison to other children
- _______ Other ___________________

Additional information (use this space if needed):





6. How would you describe your child’s social development (e.g., development of friendships, relationships with peers, relationships with adults) during early childhood?

- _______ Do not know
- ____x___ Advanced in comparison to other children
- _______ Average in comparison to other children
- _______ Slow in comparison to other children
- _______ Other (please specify) __________________

Additional information (use this space if needed):
Especially during pre-k, Delainey was extremely outgoing and social. It was very easy for her to make friends. She loved to compliment others and start conversations.


7. How would you describe your child’s cognitive development (e.g., counting, knowledge of alphabet, doing puzzles, understanding concepts, etc.) during early childhood?

- _______ Do not know
- _______ Advanced in comparison to other children
- ___x___ Average in comparison to other children
- _______ Slow in comparison to other children
- _______ Other (please specify) _____________________



CURRENT LIVING SITUATION
(where/with whom/for how long does child live. Please list any living situations including custody arrangements, etc.)
Delainey lives with Maria, Mark, Daniel, Avery, and Lili at our home in Red Hook, Brooklyn. We have lived here for 6 years. She used to go to her father’s (who is now deceased) every other weekend. Her father died last June.













EDUCATIONAL HISTORY

1. Which one of the following did your child attend prior to his/her current setting?

- _______ Infant day care
- __x_____ Preschool
- ___x____ Kindergarten
- _______ Head Start
- _______ Other (please specify) ___________________


Preschool:
Please provide the name of the preschool your child attended, amount of time per day/days per week, age during preschool years, and if there were any problems/issues/concerns during your child’s preschool years.

Preschool of America – 8hrs/day, 5 days a week, from ages 2-4
NY Kids Club- Pre-K, 6 hrs/day, 5 days a week, ages 4-5
At NY Kids Club, they did at one point think Delainey was falling behind a little, but we chose not to have her evaluated at that time.

Kindergarten:
Please provide the same information as above.
PS 29 John M Harrigan, 6.5hrs/day, 5 days a week – this is when Delainey started to catch up academically.

School Age Child: previous School(s)/current School (if applicable):
Please provide information related to school(s) attended other than those mentioned above, number of years attended at each one, and number of years at current school and any concerns or issues noted in any of these settings.
PS 29 – K-5th grade (present)


Educational interventions:
Please provide information regarding any educational interventions your child may have received (speech therapy, occupational therapy, physical therapy, applied behavior analysis services, psychotherapy, etc). Please include approximate duration of these therapies (dates started/ended) and frequency (hours/days per week), both past and current.






Delainey has speech 2x a week at PS 29. She also gets counseling at PS 29. One one-on-one, and one group session per week. Both started in second grade. She gets math help at PS 29 twice a week. That started in 4th grade. Delainey had psychotherapy from May 2021-May 2022. She had it again beginning February 2023-present.

Additional information – please describe any relevant issues pertaining to your child’s experience of school (separation from parent(s), attitude towards school, peers, teachers, homework, etc.

Delainey struggles with her ability to focus in school. With the help of medication, she is able to focus some, but it is exhausting for her. She tends to be very tired after school. When Delainey was younger, she was much more outgoing than she is now. At school, she has one best friend, and that is the only person she really spends any time with.

HOBBIES/INTERESTS/EXTRACURRICULAR ACTIVITIES
Please list any of the above-mentioned activities that your child enjoys
Dancing, acting/improv, painting, drawing, crafts


BEHAVIOR CHALLENGES/CONCERNS
Delainey has a lot of meltdowns at home. They last for some time and are hard to help her get through. It primarily happens when we’ve set boundaries that she doesn’t agree with (screentime for example). However, this is never a problem at school.

MEDICAL HISTORY
Please provide any relevant medical information (serious illnesses,surgeries/hospitalizations, allergies, vision/hearing impairments, medications, etc.) – Delainey is on Adzenys once a day, she takes 2.5mg of melatonin at night. She is allergic to milk.

FAMILY HISTORY
Please provide any relevant family history (developmental delays, mental health issues, disabilities, etc.)

Please do not include this in your report:
Mother – bipolar disorder
Father (deceased)- Substance Use Disorder






What do you believe are your child’s greatest strengths? Challenges?
Delainey is curious and extremely creative. She is funny and fun to be around. Her primary challenges are her ability to focus and her emotional health.




Below please provide any additional information you believe would be important to add.
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