534 นางสาวนภาพรรณ อุ่นคำมี ห้องเรียนบ้านจำลองทักษะชีวิต2

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( lri )

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.................................................. ๗๙ ๒๕๔๗
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// .........................................
// /

// /

Y ✓ ยา

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(....................................................)

126

i

ต(ฉน"บดป%mบปm&งm) (mท๔ธ+กราช ๒๕๖๔

:

-

IEP / IFSP

127

IIP/FCSP
✓ส

✓
✓

✓

✓

✓

128

IIP/FCSP

:

129

IIP/FCSP

ะ

130

IIP/FCSP

r

✓ส

-

131

IIP/FCSP

r

132

IIP/FCSP

ฒ๊

๛

133

134

IIP/FCSP

✓

✓

✓

✓

✓

✓

๛

135

-

1. General appearance

2. Motor Function
2.1 Gross Motor

-
2
-

3

2.2 Crossing the Midline

2.3 Laterality

2.4 Bilateral integration
2.5 Motor control

Mobility

Tremor

Chorea
Athetosis
Fluctuate

Ataxic Gait

Finger to Nose Test Dysmetria

Diadochokinesia

2.6 Praxis * *

-

-

2.7 Fine coordination Normal

136

eye contact
eye following

Reach Out
Grasp
1. Power grasp

Hook
Spherical grasp

Cylindrical grasp
2. Precise grasp

Carry hold
Release

eye-hand coordination

Lip Closure
Tongue
Jaw control

Sucking
Swallowing
Chewing

1. Tongue thrust
2. Tooth Grinding
3. Drooling
4.
5.
6.

137

1.

2. Sensation N=Normal I=Impaired L=Loss

- Tactile
-
- Light touch :
-
- Pressure :

Temperature :

Pain :

Vibration :

Proprioceptive :

Vestibular :

Visual :

Auditory :

Gustatory :

3.
Stereognosis
Kinesthesis
Pain Response
Body Scheme

- Right-Left Discrimination
Form constancy
Position in space
Visual-Closure
Figure Ground
Depth Perception
Spatial Relation

138

Position in space, Form constancy, spatial relation

13

-

Visual perception - -

- - -

39
- - --

140

-

Chief complaint
-

141

..
..
..
..
..

142

143

144

+
+
+
+
+
+
+
+

145

+
+
+
+
+
+
+
+

146 +
+ +

147

. Loss Poor

Fair Good
Normal

148 Loss Poor
Good
. Fair
Normal

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

149

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Loss
Poor
Fair
Good

Normal

Zero Poor
Good
Fair
Normal

Zero Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

150

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Loss Poor
Good
Fair
Normal

Zero
Poor
Fair

Good

Normal

151

152

Denver II

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ICT

7/08/2549

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Paint

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