Billy is described as having an affectionate bond with his caregivers and those around him. He smiles easily and often when shown affection or cared for, and loves to be held. He babbles and needs help walking. Billy is not yet two and imitates and interacts with others, shows initiative in walking, manages to hold more than one object at a time, grasps small objects and expresses pleasure in contact with different textures, he is learning to put figures in their corresponding place, however, with help they can carry out this activity. On the other hand, he is responsive when asked to hand over a toy, and is cooperative when dressed and fed. He likes to play with other children, interacts with adults, shows a social smile and is interested in having stories read to him.

Billy is alert and recognizes when he is called by name, maintains adequate periods of attention to different types of stimuli, both visual, tactile and auditory, and monitors them, responding assertively to environmental demands.

Although Billy is behind developmentally, he has and is making strides in his overall development. Billy is alert to his environment and recognizes facial features appropriately in terms of modo, and he cries or smiles appropriately. He recognizes things that bring his discomfort such as wet diaper, being hungry or tired, or  an injury, and responds appropriately.

He has diagnosis of Imperforate Anus, neurodevelopmental disorder and intellectual disability as evidenced in his intellectual and developmental delays. He has had previous urinary tract infections caused by E. Coli and Klebsiella Pneumonia, Imperforate Anus, possible Trigonocephaly, trend to microcephaly, may have other associated conditions.

Update 2022: He had surgery to repair his imperfect anus and his colostomy removed. Surgery was successful and he is eating and eliminating well. We also now have a brief video of Billy.