Thursday, May 22, 2014

Joshua is 4

Wow.  4 years old.  There is something about being 4 that sounds really KID like.   You can still pass a 3 year old off as a toddler, but 4......  it is something else!  He definitely isn't a baby anymore.  It is hard to believe I have a 4 year old.  Because whoa, that sure went fast, but also because in many ways, I really don't have a 4 year old.

Apparently 4 year olds know their own name and age.  They can answer questions and speak clearly in sentences.  They tell stories and sing simple songs.  They can correctly identify common colours, they know when things are the same and different, they can sort items by colour and shape.   They can do puzzles.  They have an understanding of basic time (morning, afternoon, night time etc).   They can follow three part instructions.  They can count and understand the concept of it.   They know how to pretend.  They can throw and catch balls and ride tricycles.  They can use scissors to cut paper.  They can copy simple shapes like circles and squares.  They can draw people.  They can draw a few capital letters.  Build towers with 9 or more blocks.  Dress and undress by themselves.  Use the toilet.   The list could go on and on......

Joshua does none of those things.   And to focus on that could really get a person down, so, for the most part, I don't.  Instead, I look at where Joshua is actually at, and how far he has come.  Joshua isn't on track developmentally, and at this point, it is unlikely that he will ever be.   Of course, in the earlier days, we did still hope that he might be able to "catch up" and all would be fine, but that is not what has happened, and you know what?  It is still fine.  Continual progress is the most important thing we can hope for, and we have got that.

A year ago, Joshua was able to say around 30 words.   Now he is able to say over 100 words.  He is starting to put 2 word sentences together.  He says things like "Mummy Car"  "Big Truck"  "All Gone"  "I do"  "Get Down".   Last week he even put 3 words together.  "I do Bubble".   He is a quiet boy (well, speech wise...  he is actually really  noisy!!) But the speech is coming...  and we couldn't be more thrilled.  He is able to answer questions with "yeah" or "no" now.  So that helps a ton with communication.   He is trying to copy words a lot more.  The words are just coming a little more freely.  I have always known in my heart that he would speak eventually, just like I always knew that he would walk.  So its nice to actually see some evidence of being right.  Hah!  It is slow, and it can be unbelievably hard not being able to communicate properly with your child, for both of us, but we will get there.   We have also started using a PODD Communication Book.  This is a picture based communication system and Joshua has shown some really good progress with it.  He understands what a lot of the pictures mean now, and it is particularly helpful in situations like when he is having a tantrum and I can show him the "Something's wrong" page and he can point to the grumpy picture etc and it really diffuses him when he is able to express that he is upset.  During therapy we also use it during activities, such as bubbles, or playing with cars or dolls, a lot of it right now is me telling him his story and pointing to the pictures, but he does look at them intently and there has been times when he has pointed at the pictures to us and its been genuinely in context.   You may have seen that I posted quite some time ago about making Joshua a communication folder.  We tried sign language too.  He just never picked up on these things before now.  But now he is ready.  He is ready to start talking and communicating, so I really think the next year is going to be a great year for Joshua when it comes to speech and communication.

Physically, Joshua does very well.  He walks, runs, climbs particular types of equipment, he is getting good at stairs.   He falls over easily and often.  But he doesn't let it bother him.  He just gets right back up and carries on like it didn't happen.  I guess you get used to it after a while!  It doesn't take much.  If you have ever walked past someone and bumped them with your body accidentally then you will know how easily it is for that to happen.  Unfortunately when I accidentally do that to my son it knocks him to the ground.  Luckily he is a trooper and doesn't let it get him down.   Gross Motor skills are now his strongest area.  Fine Motor, not so much.  He does do some nice things though.  He uses both his hands for two handed tasks.   For one handed tasks, his left hand is still very dominant and he will cross his body with that hand to reach things on his right side to avoid using his right hand, but it is very good that he will use both hands to do things when he needs to use two hands.  He feeds himself pretty well.  But there are lots of fine motor tasks he struggles with.  For example, wooden food.  The kind that sticks together with velcro and you cut apart with a wooden knife. It is very hard (almost impossible) to him to angle the knife properly in-between the two pieces to cut them apart without help.  He can't do things like zips on clothing or bags etc.  Lots of small things that you really don't think about a great deal are hard or impossible for him.  But we are very lucky that Joshua is able to do a lot of basic fine motor tasks for himself that other children with Cerebral Palsy can really struggle with, like eating, opening door handles, pressing buttons etc, so you gotta count the blessings where you find them :)  

Along with speech, Cognitive ability is one of Joshua's biggest struggles.  I often amuse myself by thinking (or saying to someone else)  "Look how smart he is" because he has done something like Pointed at a familiar person when asked where they are, or found a familiar object from a place where it is always kept.  I get impressed when he does things like that.  Because it shows he knows what objects are, who people are.  He is aware of things going on in his environment.  The other day I asked him something and he said "No" and started having a tantrum, and I said to Rod "It makes me happy that he did that because it shows he knows and has an opinion".   But when you compare Joshua's "smart" moments to what kids his age are "supposed" to know, they don't seem all that smart anymore.  Oh well!   I'm well aware that my 22 month old daughter understands me better than he does, that she can carry out instructions better than he can (its pretty handy to be able to ask someone to get the new toilet paper off the table for you if you find yourself stuck in the toilet without any....  Hah!  But Joshua isn't the one to ask!)  And yet, I still get excited about how "smart" Joshua is.  They say "Comparison is the the thief of joy".  And it is.  So best not to compare and just celebrate the good things, whatever they might be, and not worry about what other people's good things might be!  We have to really focus on teaching Joshua a lot of basic concepts that come easily to most children.  Things like "Under",  "Behind", "big"  "Little", "wet", "dry", These are all things that kids generally just pick up naturally in life.  But not Joshua.   We have to go out of our way to really teach these things, lots and lots of repetition.  It takes time.   But the fabulous thing is that he does learn.  It takes a lot lot lot longer, but he does eventually learn things.   Yippee.  We believe has learnt big now.  I used to always say 'Big Truck" to him and he started to say it, but I wasn't sure he really knew what big meant.  But in the last couple of weeks he has said things like "Big Kick".   "Big Bubble"..  And according to his speech therapist, when a kid starts applying a word across different contexts like that, you know they have nailed it.  He also knows "Hot".   Currently we are working on "Under" and "wet".  

Socially, I have noticed Joshua is playing much better around other children lately.  His play skills are not age appropriate.  He doesn't understand the rules of games that children his age play.   They can get frustrated with him for "ruining" their games, but overall I feel he is getting better.  I don't have to hover over him quite so much in social situations as what I used to.  A year ago, I would have to be there to "manage" his interactions with other kids all the time.  But lately I have been able to sit back and watch a little more and be a little less ready to pounce.   Some children at day care have said things to me like "Joshua can't play with us because he is a baby, he can't talk".  Or "I don't want him to play here, he always plays silly and wrecks our stuff".  Which is kinda sad.  Another common scenario is that when he tries to stand up from sitting on the ground he will put his hand on another child to support himself to stand up, or when he gets up he can't manage his legs well and accidentally kicks them into someone as he is trying to swing them around to get up and that will inevitably result in the other child whining "He hit me!" When of course, it was an accident, and he just has trouble getting up.  It is a little depressing, but at the same time, he still has friends.   His special "girlfriend" who he has been going steady with for a couple of years now (Hahaha) and I have been told by his day care teachers about some other friendships that are beginning to develop with him.  So that is nice.  
Joshua and his special friend, Olive. 

It is heart warming to see the love between these two despite Joshua's challenges.
Like all couples, they have their fights too though!  :)   

Recently, we have started pursuing some private therapy in addition to our government funded early intervention.  We are now doing some private Physiotherapy, and have just started private Occupational Therapy.  We are still in the assessment process for that, so I will have more of an overview and plan from that soon.  In ordinary circumstances, Joshua would have started preschool at the beginning of this year (Children who turn 4 before June 30 can start preschool at the beginning of the school year).  However, in light of Joshua's developmental delays and his late May Birthday, we elected to delay Joshua starting preschool until next year.  Our focus now, is on getting Joshua as ready for preschool as we can.  I had really hoped he would be toilet trained by the end of the year, but we will see.  The Physiotherapist helps us with Joshua's gross motor skills, but the Occupational Therapist is who is really going to help us with Joshua's preschool skills and I feel that this is a fabulous time for us to have started pursuing additional therapy as Joshua is really coming along at the moment and showing us he is "ready" to start doing more.  So I will definitely report back once we have a plan of action there!  

I am really excited to see what the next year is going to bring for my little man, and while it is hard to know what is going to happen in the future, I do know one thing, and that is that he will keep being awesome :)  

This is one of my favourite recent photos of Joshua.  

Joshua, heading home from Day Care.  He looks like such a grown up boy here :)  

And in case you missed it....  Joshua's annual Birthday Video!

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