B has ongoing input from paediatric physiotherapy, speech and language therapy and is under the care of consultant paeditrician. He started nursery on 20 September 2010 and has also started input from Portage.
Ensure B has all the appropriate input to meet his fine motor and sensory development needs both at home and within the nursery setting.
Assessment took place at home using a variety of non-standardised and informal observations. B has recently learned to walk. He previously mobilised for a long time by walking on his knees. He requires close supervision due to his decreased ability to employ saving reactions when he falls. B demonstrates an unusual dyskinetic movement patterns. B is able to independently stand up in the middle of the room and will squat to pick up objects off the floor. He is less confident outside and tends to hold an adult's hand.
We are using the Mclaren Major special needs buggy outside which is working well to meet his outdoor mobility needs. B frequently w-sits and sacral sits (sitting back on his pelvis). B is able to ascend stairs on all four limbs but does not yet attempt to step. Nor does he attempt to descend stairs.
B engages in fine motor skills very well. B plays parallel to others. If he wants something he will make eye contact but this is minimal. He can use a shape sorter and puzzle. B's sense of exploration has improved. He posturally tires more easily than his peers and this is due to his low tone. We go over some self care - eating, drinking etc.
B uses vocal sounds to communicate but does not yet use words. He turns when his name is called but not consistently. He smiles and laughs. He displays hand-flapping movements when excited.
B presents with mild delay in his fine motor and perceputal skills. B's gross motor skills have improved however he still struggles to negotiate stairs, walk outdoors and experiences regular falls. These are secondary to an ongoing decreased core stability.
Recommendations going forward occupational therapy to continue. Provision of a Heathfield chair to promote posture and functional development.
