First of all, let's give some things names. Call the five 4s, in "reading order", NW, NE, SW, SE, S. We'll also use these names for the regions containing them, and for their tetromino shapes. I'll call the tetromino that's often called "S" "Z" instead to avoid the name-clash with the S region.
Now
the region-adjacency restriction forces the S region to be either T or L. Then one of the regions must be I, and in fact it can only be the NW region, with two possible horizontal positions for the I. We can shade some squares either because they are adjacent to, and can't be part of, known regions, or because they need to be shaded to let other shaded squares connect out, or because they aren't reachable from the 4s.
+---------------+
|# # # # : : : :|
|: 4 : : 4 :|
|# # # # : : : :|
|: : : : : : : :|
|: : 4 # # 4 :|
|: # # 4 : : :|
+---------------+
Now
the SW region has to extend leftward from its 4 in order to put an unshaded cell in the SW-most 2x2 block, and then we can fill in some more shaded cells to let the ones on the bottom row connect out. After this the remaining cell in the centre-left 2x2 block must be unshaded, which forces the SW region to be an O:
+---------------+
|# # # # : : : :|
|: 4 : : 4 :|
|# # # # : : : :|
|# # : : : :|
|# 4 # # 4 :|
|# # # 4 : : :|
+---------------+
Now, is it possible
that the isolated shaded cell near the SE connects out downwards rather than upwards? If so, we must have this:
+---------------+
|# # # # : : : :|
|: 4 : : 4 :|
|# # # # : : : :|
|# # : : : #|
|# 4 # # 4 #|
|# # # 4 # # #|
+---------------+
but this is impossible because now
we don't have enough space for both the S and SE regions. So no, that cell must connect upwards:
+---------------+
|# # # # : : : :|
|: 4 : : 4 :|
|# # # # : : : :|
|# # : # : :|
|# 4 # # 4 :|
|# # # 4 : : :|
+---------------+
At this point, consider
the cell in the SE corner. If this is shaded then it must connect out somehow. If it connects upwards then there is no room for the SE region. If it connects leftwards, we have this:
+---------------+
|# # # # : : : :|
|: 4 : : 4 :|
|# # # # : : : :|
|# # : # : :|
|# 4 # # 4 :|
|# # # 4 # # #|
+---------------+
after which
the only tetrominoes there's space for in the SE are O (already used) and Z:
+---------------+
|# # # # : : : :|
|: 4 : : 4 #|
|# # # # : : # |
|# # : # |
|# 4 # # 4 #|
|# # # 4 # # #|
+---------------+
This would force
the S region to be an L, and the shaded cell near the NE corner to connect upward:
+---------------+
|# # # # : # # #|
|: 4 : : 4 #|
|# # # # # : # |
|# # # |
|# 4 # # 4 #|
|# # # 4 # # #|
+---------------+
but now
there is no room for the NE tetromino. So the cell in the SE corner isn't shaded after all. What is the SE region, then? If it includes the cell immediately below its 4 then (1) the S region is an L and (2) the SE region can only be L or O, both already used. So that cell is shaded; it must connect out leftward, so in fact the S region is an L and we have this:
+---------------+
|# # # # : : : :|
|: 4 : : 4 :|
|# # # # # : : :|
|# # # : :|
|# 4 # # 4 |
|# # # 4 # # |
+---------------+
Now let's see whether the SE region
can be a Z. It would have to look like this
+---------------+
|# # # # : : : :|
|: 4 : : 4 :|
|# # # # # : # #|
|# # # #|
|# 4 # # 4 |
|# # # 4 # # |
+---------------+
and then
the NE region is forced, and then so is the NW region, giving
+---------------+
|# # # # # |
|# 4 # 4 #|
|# # # # # # # #|
|# # # #|
|# 4 # # 4 |
|# # # 4 # # |
+---------------+
which is in fact legal. So this is our solution, but we haven't yet proved it's the only one. The other possibility would be
a T in the SE region:
+---------------+
|# # # # : : : :|
|: 4 : : 4 :|
|# # # # # : : #|
|# # # # |
|# 4 # # 4 |
|# # # 4 # # |
+---------------+
and this is impossible because
now the cell in the NE corner can't be covered by, but must be disconnected by, the Z-shaped NE region.
So we're done.