Monday, April 4, 2011

10 Month Assessment

So, it is all said and done now, and Joshua actually did better than expected.  It is possible that I am a hard marker, but he also did decide to start doing a few random things like saying Dadada in the past couple of days that worked in his favour.

So, the results are:

Fine motor skills and problem solving-  Delayed
Communication, Gross Motor Skills and Personal/Social-  Borderline/Requires monitoring.

By borderline, I mean, if they were a point lower, they would also be delayed, but they just scraped by into the grey area instead of the black!

When I scored him, I got all of them in the black except for one of them!

It is important to know that the points are allocated according to whether a child can do something all the time, only sometimes, or not at all.  Joshua scrapes through with a lot of "sometimes".  Like, he might have done it once or twice in his life, but that still counts.  Also, the things he gets a "Yes" for, are still very hard for him.  Such as sitting unassisted.  He can do it.  He can sit up straight for at least a few minutes, so he gets a Yes.  But when you look at a typical baby sitting up, they are relaxed and carefree, and playing.  When you look at Joshua sitting unassisted, you can tell that it is still very much hard work for him.  As his PT put it, he has many skills that are "emerging" but we want to work towards them becoming commonplace for him.

So, what does this all mean?  Well, first of all, it means that he doesn't need to be referred to Carpentaria Disability Services.  They don't consider him to be that severe that he would need their service.  She said he would need to be right down low in the black areas in at least three areas for a referral there.  So that is one weight off my mind that we can stay where we are.

In terms of his speech, he is starting to put speech sounds together (now, as of a couple of days ago!), but his receptive language is unclear. He doesn't follow any kind of instructions such as "Give me the toy", and when you ask him a question like "Where is Daddy?" he makes no attempt to look for Daddy.  In other words, he doesn't outwardly show many signs of understanding speech.  The only exception to this, is that when you sing "If you're happy and you know it clap your hands" he will sometimes clap his hands.  Oh, and if I ask him if he wants milk, he starts to cry!  So, he is being referred to the speech therapists at the Children's Development Team also.  They have long waiting lists though, but his PT thinks the lists for babies are not as long as for older kids, and that his referral date goes in as being the date he started at CDT and not todays date, so that will also help him jump the list a bit.  She is also going to speak to them and ask if they have any ideas or resources that might be useful in the mean time before we actually get to see them.  She said she is also going to try and have the speech therapists attend baby group periodically.  She tried to arrange this for last term, but they both had other things on during baby group, but she isn't sure of their schedule on Monday's this term.  He has his hearing test on Friday, so that will also rule out any hearing related problems.  

He has achieved many of his goals that were set last time, such as sitting unassisted, using his right hand more, and rolling.  So now he has some new goals.  They are to independently move into and out of sitting.  This is going to take a long time and be a lot of hard work to achieve.  Using his right hand more is likely to be an ongoing thing, though he has made improvements.  Another goal is for him to be pivoting on his tummy (which he has also made improvement with over the past couple of weeks!) and to start gain mobility through crawling (be it on hands and knees, army crawling, whatever).    The other goal is for standing.  We need to try and encourage him to take weight equally through both his legs and ensure proper positioning to ensure that his feet don't start to roll in.  He tends to bear most of his weight on the left leg and when you try and shift it to the right, the right leg starts to buckle a bit, so he needs to work on that.  In addition, it is still very important to practice those skills that he has gotten a tick for, such as sitting and rolling, so that he might start to find them easier.

The occupational therapist is going to be providing some more input into his fine motor skills also, but his PT said "I doubt she will tell you anything you don't already do with him though" LOL.

In terms of his muscle tone, there has been overall improvement, but the biggest problem right now is being noted with his right leg.  There is an obvious difference in how tight it is compared to the left leg.  The positive thing is that it still has full range of motion when moved slowly, so this indicates that it is not a physical problem with the muscles, but an issue with the nerves, which are of course, controlled by the brain.  It is really important to stretch that leg regularly to ensure that it maintains full range of motion.  I've been concerned about the possibility of muscle shortening, and I discussed that with the physio today and she said that it is a possibility but that she doesn't think that Joshua is at high risk of that happening because he does still move his leg, and when the leg is at rest, it is usually fully extended.  It would be a bigger problem if he kept the muscles contracted all the time.  But we definitely want to keep working it, stretching those muscles all the time so that no long term problems can develop.  In terms of his right arm, she feels that muscle tone is no longer a significant issue, and that the problem he has with his right arm is more to do with control than tone.  It no longer feels much tighter than his left arm, he just has a harder time making it do what he wants.  It CAN do everything, it is just a lot more difficult.  He uses his two hands together quite well now in his play, so she is really happy about that.

Overall, she is really pleased with him and said that I am one of her favourite Mums because I work so hard with Joshua.  She said she loves it when I come in every week and tell her all of the things I have been trying with him, while some parents unfortunately make minimal effort in working with their kids.  

1 comment:

  1. I know im a little late reading this... but im so glad it went so well, and that he IS making progress! I will say in my experience, it is sooo nice when you have parents who are very proactive! I dont understand the ones who arent...