Children's Hospital report

The short version is that he's doing great.

Some of the highlights:

* They recommend that he be placed in a regular preschool program next year. We spoke with his current preschool teacher, and after a little brainstorming we hit upon the idea of John going to 2 preschools - a regular one in the morning and a special one in the afternoon. See, at his day care, there is a regular preschool in the mornings now, but Burrito misses it because he goes to his special program. Next year, the idea is that he can have both the regular program where he can interact with "normal" kids, and the special one where he can continue to get speech and occupational therapy. Children's thought this was a great idea, and endorsed it. So, anyone out there who thinks school is bad, my kid's going to school TWICE next year! Just wait until he's grown up. HIS kids will LOOOOOOVE that one!

* John's verbal comprehension and recall of numbers is just above the 5-year-old level. For a kid that's approaching 4, this is, well, advanced. His abilities in vocabulary, picture/object similarities and pattern construction were all appropriate for his age.

* "Language skills are progressing nicely and are now close to age appropriate."

* "Social foundations are much improved, and John's social communication and relatedness is much stronger now."

Sounds great, right? Well, it is. However, there are still areas for improvement:

* John scored between 2.5 and 3 years in fine motor skills. (His physical age at the time of the test was 3.8 years). This is something his occupational therapists address constantly. On a positive note, John tends to demonstrate capabilities in bursts. What this means is that he will refuse and refuse and refuse to try something, then all of a sudden he will try it - and get it right. He seems to have a low tolerance for trying and failing, and when he is unsure that he can do something he prefers to not do it. Subsequent to the testing, we are seeing some signs that we might be on the cusp of a fine motor skill breakthrough (he's become much more interested in coloring, for instance). However, breakthrough or not, there is plenty of work that remains to be done.

* "He tends to get 'stuck' at times on certain details or one perspective in understanding information in his environment. He has a hard time shifting his way of thinking about problems or stimuli, and tends to become overwhelmed easily when a task requires such cognitive flexibility." This is a hallmark trait of autism. The report adds that, "he also is fairly quick to sense that a problem may be challenging for him, and his anxiety around possible confusion or failure increases quickly."

* The report repeats this theme in the Temperament section: He "continues to struggle with anxiety and frustration around challenging and less predictable situations."

* Adaptive and self-help behavior, though is labeled "Immature but improving". In the month since the evaluation, he has made some solid progress in terms of dressing himself (which he can now do completely, including socks and shoes which have velcro straps). He has trouble with the fine motor aspects of dressing, though, like buttons and snaps. Zippers, though, are not a problem.


All in all, John's progress is steady and accelerated. In most areas, he is catching up with what is considered "age appropriate." Social/temperament and fine motor are the two obvious exceptions, as we all knew previously. The recommendation to place him in a typical preschool program is based on the fact that he notices and mimics other children. Simply put: let him mimic "typical" kids. Also, a normal preschool will be less tolerant of his unwillingness to do something that he doesn't want to do (like drawing or other fine motor tasks) and this will help him to understand that he cannot avoid those activities. Once he realizes he HAS to do something, he usually manages to do it.

We are very pleased with the report, and hope that you are too.