27 January 2023

Nathaniel started new intense communication and occupational therapy twice a week. The facility is a far drive, and the days are long, but the therapists are excellent, and they think he has potential to progress.

Nathaniel has an iPad for communication. We made screens of pictures of various topics for Nathaniel to choose as a way of letting us know what he wanted or how he was feeling. It hasn’t been so successful as a way of communicating for a variety of reasons. Recently, we opened a keyboard app. WOW! He is much more effective in communicating what he wants by typing. He still has a hard time with eye-hand coordination and pointing to the correct letter each time, but he is getting better. We asked whether he wanted chicken or beef for lunch. He typed (in Hebrew) בסר.. It's a spelling error, but it is phonetically correct. Last night I wondered if he knew the letter ע, which is the first letter of chicken, because he always chooses beef.

He is also learning new hand gestures to communicate. At this point, we have to remind him to make the gesture before we do what he wants.

He is starting to be able to bend his right knee and push with his right leg. He still needs help to completely straighten his leg, but it is a start.

Recently he has refused to do some of his "homework" therapies. Although this is very frustrating for us, it seems like a sign that he is actually improving. People with traumatic brain injuries often go through a negative, confrontational stage before returning to themselves. I hope this stage won't last too long or be too difficult. He was a good teenager, so there is hope.