I mentioned in my last blog post that Nathaniel had a number of doctor appointments recently. I am always learning new things about my son when I talk with his doctors. I learn about things that happened medically before he joined our family. I learn how they anticipate him continuing to grow and change.
Nathaniel had a brain bleed on the left side of his brain around the time of his birth. Within a minute of walking in the exam room door, Nathaniel's neurologist was teaching his residents by pointing out movements and lack of movements connected to the bleed. I sat there a bit shocked because while I have know about the brain bleed since before Nathaniel joined our family, if someone had recently asked me if Nathaniel still had differences between the use of his right and left arm, I probably would have said no. He has done so well the last six months in his gross and fine motor development; it is easy to overlook and even forget the lingering evidence and impact of this brain injury.
I recently took a video of Rich and Nathaniel playing ball. It was only after the neurology appointment and watching the video a few times that I noticed how little he uses his right arm and hand independent of the left.
Immediately after seeing these differences, it struck me how important it is to give Nathaniel plenty of options for augmented communication. Sign language can not be our only tool when the pathway from his brain to his right arm/hand has been altered.
The collective experience of recent doctor appointments has given me a lot to process. During our visit to the ENT last week, I learned Nathaniel's trachea reconstruction surgery will probably not be until he is three or four years old. He will stay nonverbal until that time. The neurologist stressed the importance of good evaluations and developmental testing for Nathaniel because, he warned, nonverbal children can sometimes be misdiagnosed with cognitive and learning difficulties when in reality it is simply their lack of an expressive language.
Everything is pointing to the importance of Nathaniel's understanding and use of language.
On a very positive note, I spent an evening recently scoring Nathaniel on the MacAuthur-Bate Communicative Development Inventories again. In May, he understood forty-eight words and said one with sign language. This month he understands one hundred words and says six with sign language. That is a huge growth in two months. It makes me want to read more and talk more and spend more time helping Nathaniel find ways to express himself.