Thank you Shawn!

Thanks again to Shawn for pointing out things that I do not see when dealing with Julia's issues on a daily basis and with so much emotion involved since her injury. She is doing better and I just need to be more patient! The serenity prayer always comes to mind but in the midst of everything, I lose sight of those things.



Attention Span
Previous: No focus at all. Would go from toy to toy and activity to activity without joy or recognition, nor looking at you or seeking reassurance; no action to get you to engage with the playing. No apparent interest with anything in particular.

Current: Dramatic improvement. She still has trouble sitting with you in your lap or similar situation, but she does play with her toys individually and will watch TV (especially if it’s something she really likes) for minutes at a time. Has very specific toys that she will play with for several minutes unprompted and enjoys them, indicating such with a smile, laughing, or repetitive motion. Much less need for an adult to “hover” and shadow every movement for fear of injury; often times can now go upstairs, to the restroom, laundry room, etc. with little fear of major incident.

Dexterity
Previous: Unbalanced, difficulty walking for extended periods of time, very limited use of left hand, “wobbly” at all times, unable to activate many toys or “open” things. Constant worry about walking on uneven ground, stairs, steps, etc.

Current: Is now attempting to “run” and often “hops” which seems to be very enjoyable for her. She can open many “child proof” containers and frequently activates many toys in a consistent fashion (especially noise-making). Can easily navigate the stairs; can now (just recently) get in and out of the bathtub unassisted. At a recent therapy appointment, Erica indicated that Julia was trying to use her left hand to take off her zippered sweatshirt; this behavior was not prompted nor taught before this. Has navigated snow and rock beds outside the home without falling.

Affection
Previous: Little or no affection, mostly bordering on indifference.

Current: Often seeks physical contact and “play” as well as unprompted kisses. When changing diaper at night or getting pajamas on she will “hug” for seconds at a time. Now uses a “pat” to say “hello” or just to let you know she’s there. Actively seeks some kind of contact from anyone she knows; seeks physical play and can get annoyed if it is not returned.

Problem Solving/Advanced Function
Previous: Struggled with the most basic “cause and effect” and was frustrated with these things; often became irritated. Little advanced actions shown; was content just generally throwing things or moving things around.

Current: Displaying common two to three year old behavior: not liking the word “no”, asserting some independence, and trying things on her own. She is opening doors, cabinets, appliances, etc. all the while testing reactions and results. She can open most of the aforementioned plus “child proof” and “spill proof” containers using unusual resourcefulness (i.e. using leverage or teeth or persistence). There is a story to highlight her recent strides: In the car on a return trip from therapy, she was getting irritated and threw her favorite singing toy on the floor. I picked it up, precariously, as I was driving (sorry but you know how that goes!). Well, of course she did it again. I picked it up one more time, putting it on the back seat atop the dog’s blanket just out of her reach (unintentionally), saying “If you throw it again, then it stays there!” Much to my delight, she looked at me quizzically and proceeded to pull the blanket towards her to get the toy! She thus got the toy into her hands and played with it the rest of the drive home. In retrospect, this was one of the most rewarding efforts I have witnessed, as it displayed problem-solving, resourcefulness, and determination.


Speech
Previous: Incoherent noise, screaming, droning, “yodeling” or whining.

Current: Obvious effort at verbal communication. She knows some signs and uses them for common things such as “more”, “done”, “please”, etc. She has repeatedly, although without an apparent pattern, used the words “mama” and “baby”. At times, she seems to be trying very hard to speak, often times screaming or moaning between words; I interpret this as her perceived and real frustration at really wanting to, but not being able to, completely verbalize her emotions. Just today, she pointed at a small, white whiffle-ball and clearly uttered “BA!” This just happened, but in looking at it again and sharing it with many people I think it reaffirms my complete belief that within 6 months we will be saying “remember when she didn’t talk all the time?” She consistently appears to be trying to talk, and exhibits all typical behavior that accompanies learning to speak – she watches mouths, she mouths words, babbles, etc.

Word Recognition/Reaction and Direction Recognition
Previous: Indiscernible.

Current: Usually now she will readily react to your promptings and directions. “Get the ball”, “where’s the baby” and similar commands are usually met with a positive response now (including one night where she correctly accomplished the task “get the red ball”). She constantly wants one to join her in pointing out things in her favorite books. She frequently will point out, when prompted, certain items in such books – the butterfly, the ball, the crab, “Swiper” (her favorite), “Dora”, “Boots”, etc. This is a marked change from previous behavior. She has recently begun to want to and assist with feeding the dog, including opening the closet where the food is, holding the bowl, pouring the food, picking up spilled food and placing it in the bowl, and now going back to the closet when the dog is done (presumably because she usually wants more than the first serving!).

Behavior/General/Misc.
Previous: Indeterminate. When I first met Julia I had little idea about her affliction or what would go along with that. In all honesty, I had not dealt with a situation like this so I had no assumptions and thus no judgments.

Current: Julia exhibits typical behavior for a two-year old; I feel this is outstanding given the physical and physiological effects that Julia experienced. The daycare provider indicates now that the very mention of the word “No” inspires a tantrum and undesirable behavior. We have seen this at home when shutting a door that she wishes to open, saying she can’t have something, etc. There is a definite challenge with trying to understand what she wants; she will point at and make noises at things she seems to want or need. Julia is exhibiting the tendencies and behaviors of a child from 24-36 months, despite the non-verbal issue. Julia, although obviously behind in development, is very intelligent, aware, and receptive to everything that those who interact with her provide. She is very aware of negativity, tension, and frustration; she seeks understanding and patience.