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Candidate Data:
First Name: 
Last Name: 

Date of Birth:









Beaver Meadow School



Guardian Info:

First Name:


Last Name:



39 Rex Drive




Guardian/Family Phone:

Guardian/Family Email Address:

Living Situation:


Mother and step father

Financial Situation:


Free/Reduced Lunch:




How many live in the household?


How many work and/or provide income to support the household?


Household Situation:

Kayden lives with his mother and step father and two younger siblings. Has a close relationship with younger brother though is constantly looking for attention from mom and step dad. Parents have asked for advice on balancing negative attention seeking behaviors within the home, and providing opportunities to give positive attention. At this time, Kayden describes his relationship with his biological father as nonexistent and mother has shared her own concerns for sexual abuse within the fathers household when Kayden was young. Kayden has also experienced trauma from losing a close family member.

Organizations / Mentor Programs:


Special Assistance:

Kayden does have a new 504 plan and has recently qualified for special education services. Does not have a one-to-one aid, but does utilize special education staff for writing and math support.

Health Concerns:

His current diagnosis include: ADHD, Anxiety, Other specified trauma and stressor-related disorder. Also, his ADHD medication keeps him from feeling hungry throughout the day and therefore impacting his growth and weight. The family currently wakes Kayden up at 4:30am to administer his ADHD medication, so that he feels hungry by dinner time.

Victim of Sexual Abuse:

Mom has shared that she suspects Kayden to have experienced sexual abuse by his biological father. We do not know for that to be true, but Kayden often expresses fear and hatred for his father.

Perpetrator of Sexual Abuse:

Not at this time

Victim of Physical Abuse:

Not that we are aware.

Threatening or Aggressive Behavior:

Mild aggression towards others. He often reacts before thinking and his actions don't often correlate to the size of the problem. He has shown higher level aggression involving defending/protecting his siblings.

Required Physical Restraint:


Personality / Social Standing:

Kayden has a couple of close friends in the classroom and is very social with them. However, is indifferent with classmates. Kayden can be a leader when he is confident in what he is doing and shows pride, however can also be a follower often when he makes poor choices (he often is following others). Kayden does not have respect for administration and adults that he does not have a trusting relationship with. His lack of respect for administration comes from his families display of lack of respect of administration and authority. Generally has good self esteem. When Kayden is on his medication he remains mostly control of himself and aims to please. He is remorseful after making poor decisions. When unmedicated, Kayden is out of control, does not consider consequences, or show any signs of remorse for his actions.

Behavioral Patterns:

Kayden is very close with a couple of other boys in the class that exhibit similar behaviors and attention difficulties. Kayden ranges from off task and goofy with his friends, to super focused and working very hard to get his work done and to please his teacher. He is often asking how his day is perceived by the teacher to be going. Daily communication goes between school and home ranking effort, expected behaviors, appropriateness, and work completion. Kayden is very motivated by this strategy and the family has been very supportive in rewarding his success. When Kayden plans and processes with his teachers for unexpected behaviors he often has many excuses and trouble with seeing his behavior as a problem. Kayden benefits from motor breaks and has shown improvement in taking these breaks when he needs them independently. He thrives in a small group setting or 1 to 1 setting.


Kayden works very hard at school, but are not connecting at home. Kayden would benefit from positive relationships with boys his age and older trusted adults. Kayden would benefit from meeting peers his age that are more positive role models. Engaging in activities other than video games would benefit Kayden greatly. He would benefit from physical, social/emotional challenges that are experienced outside of the home. The Mayhew Program would benefit from regular mentor visits from the staff. This carryover would be beneficial, especially as he transitions to the middle school next year.