Josh/2007/care

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Josh details

Ironically, Josh is in many ways the easiest of the three. At home, he normally keeps to himself and is almost self-sufficient. He never comes in the office, gets into screaming matches with his brothers, chases the cat, or demands things in a whiny tone of voice. The only things he needs (from day to day) that a normal 13-year-old wouldn't need are:

being cleaned up after a number-two in the toilet (relatively easy; see below)
food and drink preparation
when he's in one of his rare bad moods, keeping him from hitting his brothers (see #Bad moods).

Main issues

Toileting

We keep a supply of surgical gloves on hand – 2nd drawer from the right in the kitchen. Josh is very cooperative; he stands calmly, will hold his shirt up out of the way on request, and let you clean until you say "ok, Josh, all done!" and pat him on the back. Fresh underwear is in the laundry room in the blue basket labeled "Josh" (change once a day should be fine). He only goes about every other day or so.

Bad moods

Sometimes (several times a year, but not on a regular or predictable basis) Josh will get agitated, and it may be difficult to figure out what he needs; if you suggest food, he may run away to indicate you've guessed right... or you may just have to try a few things and see what solves the problem. Probably the best general way to calm Josh down, if you can't see anything obvious that can be fixed, is to just play one of his musicals (Mary Poppins is probably his favorite) on the TV (some are VHS, some are DVD).

Sometimes he seems to get headaches (holds face/forehead, face looks flushed/droopy), and a little neck-massage seems to calm him down. Sometimes he is just hungry, and will calm down once he gets a little food into him.

Feeding

Drinks

Josh's main drink is orange juice, shaken (not stirred) and diluted approximately 50-50 with filtered water from the fridge. (If it is too diluted, he will either ignore it or pour it out in the sink.) He also will sometimes take water from the blue spray-bottle. When going on outings (visiting other houses, going to the park, etc.), he drinks Sprite-like drinks (usually "Mist") which are kept in the basement; he only likes them warm. We've been trying to wean him off these and onto using the blue spray-bottle of water, and it's probably ok at this point to only bring the sprayer unless the outing is longer than 1-2 hours and the sprayer might not be enough.

Snacks

Josh sometimes snacks on veggie-chips, which are kept above the chest freezer in the laundry room. The bag needs to be opened just a little and he can open it the rest of the way; these can be left out on the dining table for him to munch on in passing, and he will throw away the bag when it is empty.

At the moment, though, he seems to be off these; you might try getting him a fresh bag anyway if you're not sure whether he is hungry. Popcorn is also a good fall-back snack (kept in laundry room on vertical wire shelves).

Meals

His fall-back diet, for meals when we're not preparing something he likes, is now Quinoa pasta (dead simple: boil for 8 minutes, drain, and serve).

His default meal used to be hot dogs, which he seems to have gone off lately, but here are the instructions anyway:

take frozen pack from the chest freezer (laundry room)
microwave at 10% (careful not to accidentally select 70%!) for 8:88 (a.k.a. 9 minutes 28 seconds)
open the pack, take out half of the dogs (usually 5), put on a plate and microwave on Defrost for 2:22 (usually I rinse off the ice first; they cook more evenly that way, and you don't end up with as much loose water)
wait until Josh finishes, and repeat for the other half of the pack (he has been known to eat too fast and end up coughing up hot-dog chunks on the floor if given too many at once; 5-6 at a time seems to be okay)

Josh will also eat chicken in almost any form, as long as it is recognizably chicken and doesn't have too much other stuff mixed in (rice is good, though; he also loves chicken grease, if it's available, to be dunked all over everything). He also likes hamburger (no toppings) without the bun, and provolone cheese (either on burger or separately).

He also likes pizza; he generally starts by stripping off the cheese and leaving the tomato and bread. If he eats that too without pausing, that means he is really hungry and will need more (more pizza if available, or something else if not). We generally let him wait a little while for seconds if he doesn't finish the bread, but if he's in a bad mood it may be wise to just feed him until he feels better. (We also try to avoid letting this develop into a pattern of rewarding him for behaving badly, but I'm not even sure that his cognitive development is such that it makes a difference as long as there is some delay or disconnection between the bad behavior and the "reward".)