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Length of Unconsciousness or of Altered State: Not applicable. Rehabilitation Program(s) [In/Outpatient Since Injury]: She was initially transferred from North Broward Medical Center to Broward General Hospital on March 24, 1999.She remained in Broward General until the end of April, when she went back to North Broward Medical Center where she remained for approximately one week.Her sisters and brothers can write their names, while Melissa can spell her name, but she can’t even trace her name. She has her regular physician visits scheduled and those will continue. Mother indicates she gets along with peers in school. CHRIS EVERT CHILDREN’S HOSPITAL: 5/18/99 – 8/17/99; 1/6/01 – 1/7/01; 2/23/01; 3/18/01; 3/19/01 – 3/24/01; 8/8/01 – 8/13/01; 8/18/01: 8/23/01; 2/27/03; 9/15/03; 12/12/03; 2/11/04; 2/20/04 - 2/21/04 Chris Evert Children’s Hospital: 5/18/99 – 8/17/99 Transferred from Broward General Medical Center.Her siblings can color in the lines, but Melissa simply can’t. She feels she is social and has friends in school and daycare. History indicates Melissa was born via C-section delivery for quadruplets.She is on the edge of hyperactivity, but her parents note that she is no more active than the rest of her siblings and in fact tends to tire more easily than her siblings. Fluoroscopy was performed and showed no movement of the left hemidiaphragm.She tends to be somewhat stubborn and defiant with her parents and is inconsistent with inhibit on command. Voluntary purposeful movements (upper & lower extremities): Yes. She was asymptomatic on unassisted room air with oxygen saturations in the mid to high 90’s.The purpose of this evaluation is to assess the extent to which handicapping conditions impede her ability to live independently, handle all activities of daily living, and to assess the disability's impact on her vocational development status.

She had eye muscle surgery done in December of 2003. As for the developmental delays, no one has been able to tell us what that will really mean and only time will tell.With some of her gross motor skills, she shows a problem with her balance. Follow simple 1 or 2 step instructions: She does best with one step instructions. She has a strong curiosity about what the other children are doing. Nebulizer used during colds and seasonal allergies only. Physical Stamina (average daily need for rest or reclining): She tires much more easily than her siblings. Apgars were 7 and 8 at one and five minutes respectively. Significant maternal history included maternal blood type A and Group B Strep positive.In hopping on one foot, riding a bike, using the trampoline, she has balance problems. With serial instructions, she will need things repeated. She has some difficulty with siblings such as when they are coloring and she can’t stay within the lines and they don’t want her to color with them. She finds them difficult and is resistant to things that are difficult for her to accomplish. Mom estimates episodes requiring Nebulizer treatments about six times per year. Pregnancy was significant for invitro fertilization with multiple gestation and a prenatal ultrasound that revealed hydrocephalus in quadruplet B. Melissa was transferred to Broward General Medical Center at 1-2 days of age with VP shunt in place.She has a VP shunt in place and is developmentally delayed.She was conceived by invitro fertilization and implantation procedures.

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All therapies converted at age three to IDEA with the school program. The doctor created a flap to prevent this from happening.