Medical & developmental update

Audiology - 21 July - behavioural audiogram to re-assess Reuben's hearing loss after his PE tubes op in April. He hears speech (20-40db) clearly without his bone conduction aid but we want to ensure he hears all frequencies so I don't feel we'll be saying bye to the aid just yet. Previously his loss was recorded as 50db plus left ear and 90db plus right ear but the fact he can hear speech suggests an improvement.

Urology - 1 July - 1st of 3 urology surgeries. Reuben will be admitted as an inpatient but hopefully for only a short stay.

Communication - 12 new signs in July Lion, Thank you, Bye bye, Nurse, All done/Finished, Ball, Play, Head, Teddy bear, Pajamas, Bed, Knee making 30 signs in all. No rhyme or reason to the signs I choose to teach him, just whatever I fancy and whatever he's motivated by! However, he's learning his manners early on and I'll always get him to sign Thank you and Bye Bye to his therapists as they're leaving. He's also learning his A B C rather nicely. When Jason first bought the Signing Illustrated book, I felt truly overwhelmed about learning sign language and eventually put it aside in favour of an ASL Baby Signs book which was much more accessible. It's lovely to add the date within that book when he first learnt the sign. It's part of our morning routine, a sign review. He has a great memory; he'll remember the signs we learnt yesterday and add them to that maze of active brain cells. He'll sign along to his videos or pick up ambient speech and sign when he recognises a word. Lovely listening skills when you think he's not listening. He's a bright young thing.

PT/gross motor - Reuben will no doubt always be challenged by his low muscle tone in his torso and yet the strength of his legs, those which encourage him to stand, stand stand! is wonderful. He now sits comfortably for long periods, stretches for objects, thoroughly relishes rolly pollies (as of May 25 in Scotland) in both directions. His torticollis (crook) of the head is a constant feature of our therapy. Due to the malformation of his ear canals, his vestibular causes him to be constantly off balance which means he's always working against gravity, against a diagnosis of walking like a drunken sailor. Yet I have great hope he'll be standing unaided within the next few months. It just takes a lot of patience and a lot of muscle building therapy.

OT/fine motor - One of Reuben's big strengths. Within seconds of being shown a toy with an open/close function by his Every Child Achieves therapist, he'll be happily closing and opening the door having found the latch. Sonal came two days in a row this week and using the same toy, he's now able to put the giant coins in the big pink piggy bank, requiring a certain dexterity and of course the need to balance his body whilst undertaking the action. Although initially hindered in his fine motor by his gross motor delay, he's caught up, having learnt to take objects in and out of a bucket, push objects through shaped holes, stack and unstack rings.