Back to My Referrals
Back to My Dashboard
Candidate Data:
First Name: 
Last Name: 

Date of Birth:









Pleasant Street School



Guardian Info:

First Name:


Last Name:



59 Summer Street




Guardian/Family Phone:

Guardian/Family Email Address:

6035200009 (Mom)

Living Situation:


James is with his mother during the week and father on the weekends

Financial Situation:



Free/Reduced Lunch:



How many live in the household?


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


Household Situation:

James lives with his mother, Abbie, during the week and his father, Richard, on weekends. He has an older brother who goes back and forth as well. He has a younger sister at his mothers house and a stepfather. The relationship seems strained with this stepfather but he doesn't talk much about him. He seems to get along well with family members for the most part. His parents are extremely different and have different rules. When he is struggling behaviorally he typically stays with dad more often. Dad has more clear cut boundaries that James responds better to. He is very close with his maternal grandmother. She has always been a calming and stable presence in his life. He had a really difficult time when he moved to Laconia because he was no longer living with her in Concord. He idolizes her.

Organizations / Mentor Programs:

He is not involved in any programs at this time but was involved in scouts and misses it.

Special Assistance:

James has a 504 for his diagnoses of CP. He has a bathroom plan in place. He spends a lot of time with our behavior specialist as they have a great relationship. He is on an behavior incentive plan. While he is very bright and can do any of the work presented to him he spends more time avoiding it.

Health Concerns:

Yes, James has Cerebral Palsy. It is From Dad: On a daily basis, the most difficult problem for camp staff might be his frequent/daily bowel accidents. When he was in Cub camp at Carpenter dad was there as a leader for the entire week in both years. Thus, he was able to handle the changing and cleanup to keep him in acceptable condition. Dad believes we would need to inform staff and establish some guidelines on how to handle this in a sensitive manner consistent with child protection protocols. He typically denies having accidents at school.

Victim of Sexual Abuse:

He does not have a history as a victim of sexual abuse

Perpetrator of Sexual Abuse:

He does not have a history as a perpetrator of sexual abuse.

Victim of Physical Abuse:

He does not have a history of physical abuse.

Threatening or Aggressive Behavior:

I don't think of James as a violent kid but he has hit students on occasion. This is from his father: The other primary concern is not an impediment, but rather a manageable physical/behavioral issue. At Carpenter when he became physically exhausted or stressed from vigorous activities, occasionally there would be a type of emotional meltdown. He becomes upset, defiant and withdrawn, and occasionally physically lashes out at fellow campers. He also has some minor coordination issues and tends to tire more easily. When this happens his actions become slightly uncoordinated and uncontrolled, which makes him more accident-prone.

Required Physical Restraint:

He has never required physical restraint.

Personality / Social Standing:

James really likes to joke around and says he is "snarky" at times. He is good natured and means well. He's a funny kid. He's very smart. He is more of a follower but also beats to the tune of his own drum. He has an easier time interacting with adults than he does his peers. When his behaviors are unexpected, sometimes he shuts down and gets upset and other times he tends to argue and become a little rude. He has a hard time identifying emotions and triggers behind his behaviors. He really tries to fit in with his peers but struggles at times. He is an extrovert. He has the ability to get along with anyone but doesn't always pick up on social cues from his peers. Sometimes he doesn't know when to end a joke and doesn't have the social understanding of "enough is enough" and when to drop things. His self esteem is low but he comes across as he doesn't care. He has a lot of negative self talk more recently. He worries small issues are going to become really big issues.

Behavioral Patterns:

James has no filter and blurts out without thinking. He will question adults and not know when to stop his sarcasm. He will try to talk his way out of everything and anything (and is also very insightful while doing it).


James is a hands on learner and enjoys STEAM activities. He loves to read. James has been working very hard at playing cooperative sports outside at recess. He's been trying soccer, football and kickball. He enjoys gaga ball. He loves thinking puzzles and brain teasers as well as riddles. James would be a good candidate because he would benefit from the opportunity to interact and socialize with peers with a positive role model to guide these interactions. This is the biggest struggle for him. He would really love the outdoors and has not had many opportunities in his life to do so. This would be an experience for him that would last a lifetime. When I think of a kid who would benefit from Mayhew, James is it.