Patient Name: Gideon

Patient Information:

Patient ID: 9954
Patient First Name: Gideon
Patient Date of Birth: 11-25-2025
Gender: male
Assigned Office: NB2 far east side
Primary Care Physician: Brianna, Garza
Patient Status: Active

Primary Attendance / Assigned Therapists:

ST - Speech Therapy:
FD - Feeding Therapy:
OT - Occupational Therapy: Solis, Bertha
PT - Physical Therapy:

Patient Primary Authorizations:

Auth. IDStatusStart DateEnd DateInsuranceST-UnitsFD-UnitsOT-UnitsPT-Units
23386Active02-23-202608-20-2026Blue Cross Blue Shield00570

Occupational Therapy Evaluation:

IDDateTypeEvaluation Diagnosis
417802-12-2026Occupational Initial EvaluationQ90.9
Occupational Background History: Gideon is a 2 month and 18 days old boy who was seen on this date for a scheduled occupational therapy evaluation in order to obtain current level of function. Parents, were present in order to serve as the primary informants throughout the evaluation. Per parent's report child was born at 38 weeks gestation via natural birth. Child did not experience any complications at birth, does not have any visual or hearing deficits. Mother reported oculomotor skill concerns, reflex integration, decreased strength due to potential low tone globally and guidance in steps to reach milestones due to potential of developmental delays secondary to Down Syndrome diagnosis.
Occupational Medical History: Per parent report, medical history is not remarkable
Occupational Medications: None at this time
Occupational Behavioral Observations: Attending Skills: Adequate, Response Rate: Mild delays, Level of Activity: Active, Awareness of Others: Adequate, Reliability of Scores: Good, Awarencess of Environmental Events: Usually, Prognosis for Improved Communicative Functioning: Good,
Occupational Communication Strengths: Endurance, Grasp,
Occupational Communication Weaknesses: Visual Motor Skills, Body Awareness, Eye-Hand Coordination, Postural Stability/Trunk Support, Sensory Process/Mod, Tone, UE Strength, Upper Limb Coordination, Visual Perceptual Skills,
Occupational Background Summary:
Occupational Diagnosis/Impressions: Gideon was assessed via: PDMS-2 Standardized Assessment, Clinical Observations and Parental Report PDMS-2 - Per standardized assessment scores Gideon falls below average in 2 subtests assed on the PDMS-2 evident by below average age equivalency scores ranging from 1 month to 2 months compared to his chronological age of 2 months and 18 days, placing him at least (-2) standard deviations behind his peers. Primitive reflexes acting and appropriate for developmental age, to continue monitoring integration and presence of all reflexes, palmar grasping diminished ~ 3 MMT and and UB strength at ~3 MMT- ROM of neck, shoulders and BUEs at ~10 degree limitation; limitations to neck rotation noted, more specifically L rotation and lateralization with stiffness noted on R side, possible cranial asymmetry ~2-3 degrees from left frontal quadrant to R posterior cranial quadrant, to increase ROM and stretching via myofascia release and manual therapy. Gideon demonstrates deficits in visual motor integration, manual dexterity, ROM, UB strength, low tone , which have impaired his ability to complete activities of daily living and instrumental activities of daily living that compromise his routines and roles at home and in the community. Child would greatly benefit from skilled OT interventions in order to address their established delays and facilitate functional independence and performance. Home programming alone is not sufficient to make the needed progress, direct one to one services are required for progress to be achieved. Results of the evaluation were reported and explained to parents, along w/ the diagnosis, prognosis, including the frequency, time and duration of treatment and contents of the plan of care. Family will be provided w/ a verbal report of progress noted along w/ any homework for the household and/or pt. as part of a home program (if applicable) at the end of every session. Parents verbalized understanding of treatment plan and agreed to the initiation of skilled therapy.
Occupational Recommendations: Occupational Therapy: 2 time(s) a Month for 45 to 60 minute sessions

Occupational Therapy Plan of Care:

IDPlan of Care
5282
Plan Date: 02-12-2026
Occupational Assessment Summary: Gideon was assessed via: PDMS-2 Standardized Assessment, Clinical Observations and Parental Report PDMS-2 - Per standardized assessment scores Gideon falls below average in 2 subtests assed on the PDMS-2 evident by below average age equivalency scores ranging from 1 month to 2 months compared to his chronological age of 2 months and 18 days, placing him at least (-2) standard deviations behind his peers. Primitive reflexes acting and appropriate for developmental age, to continue monitoring integration and presence of all reflexes, palmar grasping diminished ~ 3 MMT and and UB strength at ~3 MMT- ROM of neck, shoulders and BUEs at ~10 degree limitation; limitations to neck rotation noted, more specifically L rotation and lateralization with stiffness noted on R side, possible cranial asymmetry ~2-3 degrees from left frontal quadrant to R posterior cranial quadrant, to increase ROM and stretching via myofascia release and manual therapy. Gideon demonstrates deficits in visual motor integration, manual dexterity, ROM, UB strength, low tone , which have impaired his ability to complete activities of daily living and instrumental activities of daily living that compromise his routines and roles at home and in the community. Child would greatly benefit from skilled OT interventions in order to address their established delays and facilitate functional independence and performance. Home programming alone is not sufficient to make the needed progress, direct one to one services are required for progress to be achieved. Results of the evaluation were reported and explained to parents, along w/ the diagnosis, prognosis, including the frequency, time and duration of treatment and contents of the plan of care. Family will be provided w/ a verbal report of progress noted along w/ any homework for the household and/or pt. as part of a home program (if applicable) at the end of every session. Parents verbalized understanding of treatment plan and agreed to the initiation of skilled therapy.
Occupational Progress to Date: Initial POC- Baseline 0%
Occupational Rehabilitation Potential: Good. with consistent Occupational Therapy and parental support
Occupational Treatment Plan:
Occupational Long Term Goals:
CategoryGoal Description
Bilateral CoordinationIn 6 months, Gideon will demo spontaneous crossing of midline during self­ help tasks, with MOD assist, to increase bilateral use of hands and ADL participation, 4/5 trials. Baseline-­ MAX assist
Motor Planning/PraxisIn 6 months, Gideon will demo hand-­to-­mouth movements for 3 minutes with BUEs during feeding task, with MOD assist, to increase eye-­hand coordination and self­-care participation, 4/5 trials. Baseline­- MAX
BalanceIn 6 months, Gideon will push up onto forearms and hold the position for 20 seconds during tummy time with MOD tactile cues, to increase shoulder stability and core strength, 4/5 sessions. Baseline­- MAX tactile cues
Occupational Short Term Goals:
CategoryGoal Description
Bilateral CoordinationIn 3 months, Gideon will demo spontaneous crossing of midline during self­ help tasks, with MOD assist, to increase bilateral use of hands and ADL participation, 3/4 trials. Baseline-­ MAX assist
Motor Planning/PraxisIn 3 months, Gideon will demo hand-­to-­mouth movements for 3 minutes with BUEs during feeding task, with MOD assist, to increase eye-­hand coordination and self­-care participation, 3/4 trials. Baseline­- MAX
BalanceIn 3 months, Gideon will push up onto forearms and hold the position for 1 0-­20 seconds during tummy time with MOD tactile cues, to increase shoulder stability and core strength, 3/4 sessions. Baseline­- MAX tactile cues

Occupational Therapy Soap Note/Visit:

IDSoap Note
147410
Note Date: 03-19-2026
Subjective: Patient was eager to participate,Patient was friendly and cooperative,
Assessment of Goals/Response to Treatment: Targeted bilateral coordination, motor planning/praxis and balance: pt demo emerging prone reaching with weight-bearing through forearms and improved cervical extension; pt particpated in lateral movements and rotation to increase neck ROM and stretch due to stiffness on R side, with presentation of shortening of neck muscles, to support reduction of positional cranial asymmetry; pt demo holding toy at midline with MOD assist to position then held IND during side-laying positioning and 2xs in supine position; pt demo hand to mouth movements spontaneously 4xs throughout with MIN assist for movement; pt particpated in righting reaction and midline positioning during sitting, during side laying on B sides and during assisted sit ups (6 total) with demo of chin tuck IND, demo MOD compensations due to head lag and ROM limitations, however limitations decreased after myofascia release at cranial area held ~3 minutes; demo increased scanning to both sides in supine and in prone, with increased limitation to scan in prone position; parent received printed rhythmic/reflex integration worksheet to increase movements precursors for rolling, sitting and crawling; to continue symmetrical stretching and decreasing of stiffness at neck to increase motion and head-neck control
Plans: Continue with current Plan of Care,Continue with Occupational Therapy,
Additional Notes:

Completed Appointments:

IDPlan of Care
Appt-IDServiceStart-DateEnd-DateTherapistLocationStatus
88975897167: OT Evaluation02-12-2026 08:00 AM02-12-2026 09:00 AMBertha SolisNB2 far east sideCompleted
899096OT-VIS: OT Visit03-05-2026 08:00 AM03-05-2026 09:00 AMBertha SolisNB2 far east sideCompleted
906268OT-VIS: OT Visit03-19-2026 08:00 AM03-19-2026 09:00 AMBertha SolisNB2 far east sideCompleted

Scheduled Appointments:

Appt-IDServiceStart-DateEnd-DateTherapistLocationStatus
914238OT-VIS: OT Visit04-02-2026 08:00 AM04-02-2026 09:00 AMBertha SolisNB2 far east sideScheduled

Payments History:

DateService Description$Credit$Debit$Balance
2/12/26Patient visit charged - OT Evaluation: OT Evaluation0.0050.00-50.00
2/12/26Patient Payment Received (Stripe)50.0050.000.00
3/5/26Patient visit charged - OT Visit: OT Visit50.00100.00-50.00
3/5/26Patient Payment Received (Stripe)100.00100.000.00
3/19/26Patient visit charged - OT Visit: OT Visit100.00150.00-50.00
3/19/26Patient Payment Received (Stripe)150.00150.000.00

Billing History:

DateService DescriptionUnits$Amount$Status
2/12/2697167: OT Evaluation1220.00EDI Submited
3/5/2697530: Therapy Activity4220.00Unbilled
3/19/2697530: Therapy Activity4220.00Unbilled

Paient Notes:

DatePosted ByDescription
02-17-2026Patsy GuajardoPatient has only 35 visits per year with a 50 dll co pay

Paient Messages Admin:

DatePosted ByMessage
02-05-2026 05:50 PMAsbel GuajardoPlease fillout the form https://patient.newbeginnings-elp.com/Registration/default.aspx?sid=2603
02-05-2026 06:34 PMAsbel GuajardoPatient Registration: When you are ready to pick up where you left off, click this link https://patient.newbeginnings-elp.com/Registration/step1.aspx?sid=2603
02-06-2026 10:43 AMPatsy GuajardoGideon has been added to our Occupational Therapy wait list. To send us a message at any time, just respond here. To check the status of the wait list, click this link https://patient.newbeginnings-elp.com/Schedule/waitlist_status.aspx?pid=9954&type=3&wid=546
02-06-2026 06:30 PMPatsy GuajardoWAIT LIST UPDATE: Gideon's placement has changed on our Occupational Therapy wait list. To check the current status, click this link https://patient.newbeginnings-elp.com/register/waitlist_status.aspx?pid=9954&type=3&wid=546
02-07-2026 06:30 PMPatsy GuajardoWAIT LIST UPDATE: Gideon's placement has changed on our Occupational Therapy wait list. To check the current status, click this link https://patient.newbeginnings-elp.com/register/waitlist_status.aspx?pid=9954&type=3&wid=546
02-08-2026 06:30 PMPatsy GuajardoWAIT LIST UPDATE: Gideon's placement has changed on our Occupational Therapy wait list. To check the current status, click this link https://patient.newbeginnings-elp.com/register/waitlist_status.aspx?pid=9954&type=3&wid=546
02-09-2026 06:30 PMPatsy GuajardoWAIT LIST UPDATE: Gideon's placement has changed on our Occupational Therapy wait list. To check the current status, click this link https://patient.newbeginnings-elp.com/register/waitlist_status.aspx?pid=9954&type=3&wid=546
02-10-2026 06:30 PMPatsy GuajardoWAIT LIST UPDATE: Gideon's placement has changed on our Occupational Therapy wait list. To check the current status, click this link https://patient.newbeginnings-elp.com/register/waitlist_status.aspx?pid=9954&type=3&wid=546
02-12-2026 07:32 AMPatsy GuajardoNew Beginnings just sent you an invoice for Gideon Adame. Click this secure link to make your payment online https://st-pros.com/newbeginnings/stripe/default.aspx?transId=39244. Payment is due at the time of service. Thank you for allowing us to serve your child! 🙂
02-17-2026 09:28 AMPatsy GuajardoHi, Gideon as been assigned a therapist for Occupaional therapy. Here's a link to learn more about Bertha https://st-pros.com/newbeginnings/reports/welcomefromtherapist.aspx?id=9954&tid=119
03-05-2026 07:32 AMPatsy GuajardoNew Beginnings just sent you an invoice for Gideon Adame. Click this secure link to make your payment online https://st-pros.com/newbeginnings/stripe/default.aspx?transId=39774. Payment is due at the time of service. Thank you for allowing us to serve your child! 🙂
03-09-2026 07:23 PMStephen TulliusPlease join us for the next New Beginnings free Parent Training: Sensory Play. In this session learn how to create safe, engaging sensory experiences that help hypersensitive children regulate their responses to touch, sound, and movement. Register here: https://patient.newbeginnings-elp.com/trainings/default.aspx?id=20&pid=9954
03-11-2026 05:41 PMStephen TulliusHello, for anybody who would like to attend our Sensory Play parent training today but can't, we will be attempting a webinar version. You can register to see it online at https://webinar.getresponse.com/JvvC9/sensory-play/
03-19-2026 07:32 AMPatsy GuajardoNew Beginnings just sent you an invoice for Gideon Adame. Click this secure link to make your payment online https://st-pros.com/newbeginnings/stripe/default.aspx?transId=40413. Payment is due at the time of service. Thank you for allowing us to serve your child! 🙂

Paient Messages Therapist:

DatePosted ByMessage
02-11-2026 06:30 PMBertha SolisHi, this is a just a reminder that Gideon has a Occupational Evaluation appointment scheduled tomorrow at 08:00 AM. See you soon! - New Beginnings 🙂
02-12-2026 07:45 AMBertha SolisGideon Adame : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=889758
02-12-2026 07:54 AMGideon AdameGideon is CHECKED IN for:
8:00AM-2/12/2026
97167: OT Evaluation
02-12-2026 08:03 AMBertha SolisHi, this is a just a reminder that Gideon has a Occupational Evaluation appointment scheduled today at 08:00 AM. See you soon! - New Beginnings 🙂
03-01-2026 04:01 PMBertha SolisHi, this is a just a reminder that Adame, Gideon has a Occupational Therapy appointment on 03-05-2026 at 8:00 AM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
03-01-2026 04:03 PMGideon AdameGideon (Prim) Replied: Yes
03-01-2026 04:03 PMBertha SolisHi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-04-2026 06:30 PMBertha SolisHi, this is a just a reminder that Gideon has a Occupational Therapy appointment scheduled tomorrow at 08:00 AM. See you soon! - New Beginnings 🙂
03-05-2026 07:45 AMBertha SolisGideon Adame : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=899096
03-05-2026 07:45 AMBertha SolisGideon Adame : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=899096
03-05-2026 07:57 AMBertha SolisHi, this is a just a reminder that Gideon has a Occupational Therapy appointment scheduled today at 08:00 AM. See you soon! - New Beginnings 🙂
03-10-2026 12:17 PMGideon AdameHi Bertha! Are we going to set Gideon''s appointment for Thursdays at 8?
03-10-2026 01:26 PMBertha SolisYes, if that works for you all!! It will be biweekly, so I will see you all next thursday at 8 am (:
03-10-2026 01:36 PMGideon AdameGideon (Prim) Replied: Sounds good! :)
03-15-2026 04:01 PMBertha SolisHi, this is a just a reminder that Adame, Gideon has a Occupational Therapy appointment on 03-19-2026 at 8:00 AM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
03-15-2026 04:32 PMGideon AdameGideon (Prim) Replied: Yes
03-15-2026 04:32 PMBertha SolisHi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-18-2026 06:30 PMBertha SolisHi, this is a just a reminder that Gideon has a Occupational Therapy appointment scheduled tomorrow at 08:00 AM. See you soon! - New Beginnings 🙂
03-19-2026 07:45 AMBertha SolisGideon Adame : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=906268
03-19-2026 07:45 AMBertha SolisGideon Adame : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=906268
03-19-2026 07:57 AMBertha SolisHi, this is a just a reminder that Gideon has a Occupational Therapy appointment scheduled today at 08:00 AM. See you soon! - New Beginnings 🙂