Tag Archives: autism

A Missing Purse, A Crisis Averted, and a Lesson Learned

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Today is World Autism Awareness Day. It’s the one day out of the year when skyscrapers and other monuments around the world are bathed in blue light as a way of raising awareness of the growing epidemic of autism spectrum disorders. And our home will be no exception. After work tonight, I’m going to swap out the light bulbs over our front porch and on our garage doors so that our house will be set apart by a soft blue hue all month long.

So it’s only appropriate that I started out Autism Awareness Day with a little episode that made us aware of the challenges of ASD—and that gave us a brief lesson in how to help.

The Case of the Missing Purse.

My twelve-year-old daughter, who has Asperger syndrome, wouldn’t go to school this morning. At least not until she found her purse. Why? Because her purse contained her spare set of earrings. And she was deathly scared that the ones in her ears would start bothering her in the middle of the day, and she wouldn’t have anything to replace them with.

Never mind that her earrings were perfectly fine. Never mind that her ears were perfectly fine. She had got the idea in her head that something bad might happen, and she couldn’t let it go. Typical aspie behavior: Your brain gets stuck on something, and it’s nearly impossible to get it unstuck.

Lord knows I tried this morning. I looked in all the usual places. Nothing. I looked in all the unusual places. Nothing. I suggested even more unusual places where my daughter could look. But she had become so frustrated and anxious at the thought of not finding her purse that she had curled up on our bed, tense and sobbing. I tried reasoning with her. “Why don’t you go to school, and Mom and I will keep looking. When we find it, we’ll bring it to you.”

“You don’t understand. I can’t go until I have that purse!”

“But you’ve already missed a lot of school, and you have exams this week.”

“I don’t care. I need that purse! I won’t go without it!”

A Fresh Start.

Not wanting to have two kids tardy, I took her older brother to school and came back home. Katie, in the mean time, took on the task of getting the other kids ready for elementary school—and dealing with a couple of minor ASD-related crises from them.

When I got back, I laid down next to my daughter and stared at the ceiling for a couple of minutes. “Let her get used to me being here. Just breathe. Don’t push her too hard, or she’ll melt down, and then all bets are off.”

After a short while, she uncurled a bit, and began verbally retracing her steps from the last time she had the purse. It’s something Katie and I had tried to get her to do before, but she had to decide to do it herself. “Okay,” I said. “Let’s look around all those places.” This time, she actually got up and began searching on her own—and far less agitated, too.

It took nearly an hour, but we found the silly thing. It was one of those “hidden in plain sight” things that makes you embarrassed you hadn’t seen it earlier.

Problem solved. Crisis averted.

A Lesson to Be Learned.

But here’s the really quirky part. Once she found her purse, she immediately changed her earrings, put the purse down, and gathered her books. “I’m okay now,” she told us. “I can go to school.” No spare set. No need to carry the purse. No fear of irritation or infection. She had forgotten why she needed the purse. Her brain had gotten so stuck that she didn’t even know what the initial problem was!

Neither Katie nor I wanted to argue with her at this point. We were just glad that the episode didn’t escalate beyond general anxiety and obsessive thinking.

We were also glad that we were able to stay relatively calm—a key ingredient in helping her avoid a full-scale melt down. Episodes like this don’t always end so pleasantly. Especially if we parents lose our cool.

So on this day when advocacy groups everywhere are raising awareness, my little girl contributed to the cause. She made us aware of how unpredictable ASD can be. She told us to expect the unexpected. And she showed us that a little kindness and empathy can go a long way.

If only the rest of the world could learn this lesson!

Pint-Sized Prophets?

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Pope-holding-Dominic

Just this morning, I came across a story written by Paul Gondreau, a theology professor at Providence College in Rhode Island. He and his family happened to be in St. Peter’s Square in Rome on Easter Sunday and were present when Pope Francis toured the Square in his popemobile. The picture you see here is of the pope embracing Gondreau’s eight-year-old son, Dominic, who has Cerebral Palsy.

It was a moving sight, and it made its way to the Internet and numerous news outlets around the world. (Not unlike his first popemobile ride, when he also had the car stopped so that he could give a special embrace to a disabled man in the crowd.)

In so many ways, the picture speaks for itself. But Gondreau’s brief article on the event makes a couple of moving and important points.

First, he relates a comment that a woman in the Square made to his wife afterward: “You know, your son is here to show people how to love.” Gondreau talks about how this comment turns our everyday thinking on its head. Parents of children with disabilities are called to give more than the usual amount to their kids: more help, more guidance, more advocacy, more money, more time, more therapy, more of everything. And we often focus on all that we have to do or all that we have to give. But what Pope Francis highlighted—and what Gondreau picked up on—was how much our children give to us. While we’re busy giving our children all they need, they are busy giving us huge lessons in what it means to love. They’re teaching us how to give and give and give—not by demanding it of us but by drawing it out of us. Just as Jesus gave himself for us not because we stormed heaven and demanded our rights but because his heart warmed at the sight of us, and he couldn’t help but become one of us and share in our pain and need.

Second, by framing the whole thing in terms of a vocation, Gondreau finds a way to answer the “why” question that every parent of a special-needs kid asks. Why did this happen? Why him and not someone else? What did he (or we) do to deserve this? In my very first post on this blog, I wrote that asking “how” is far more helpful than asking “why.” Well, I’m not so sure any more. I think you need to be working on the “why” if you want to know “how.” And to say that it happened because God wanted more professors in the art of love is clearly one very encouraging, hope-filled answer.

Of course, that raises the possibility that God actually gave your child autism or cerebral palsy or some other genetic disorder. In fact, it almost pushes you toward that kind of conclusion. I don’t want to get into that really thorny question here (perhaps later), but my own experience tells me that when I look upon my kids—specifically with their challenges and disabilities—as God’s gracious gift to me and to the world, my heart softens. I find more patience, more peace, and a renewed willingness to fight for them. I find myself, too, looking upon other people—especially those who don’t get my kids—with more kindness and compassion. Bitterness recedes, and fear diminishes. Hope grows, along with a little more wisdom and clarity on how to proceed through each challenge that we face.

Early in his article, Gondreau referred to Mother Teresa of Calcutta, who talked about performing “small acts with great love.” That’s one way into this vocation. But I like another saying of hers even more. She called it the “Five-Fingered Gospel.” Carefully counting out each finger on one hand, Mother Teresa would tell people, “You. Did. It. To. Me.” Everything we do, especially for the poorest and most vulnerable and most needy among us, we are doing to Jesus. She spoke often of meeting Jesus “in the distressing disguise of the poor.” For her, that was the heart of the Christian message, and I’m beginning to agree with her. I can’t tell you how helpful it is to know that in caring for my kids, especially in the midst of a huge melt-down or in some other difficult moment, I have the privilege of meeting almighty God. If my heart is right and my mind is clear, I imagine myself caring for Jesus at that moment, just as people in the gospels washed his feet; wrapped him in swaddling clothes; and took his exhausted, wearied body down from the cross and laid it in his mother’s lap.

None of this diminishes the pain and the difficulties, of course. But maybe it will help us learn how to love and accept the situations we are in rather than try to run and hide from them or get swallowed up in anxiety or anger. Imagine the kind of world it would be if the least and the most challenged among us were treated as gifts and not glitches—as prophets and not problems.

Happy Easter, everyone.

Why We Cry. . .

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kiss_cheeseburgerRecently, a friend at work sent me this story about a girl with autism who was treated very well by the staff of a Chili’s restaurant in Midvale, Utah. Apparently, the Facebook post that this story was based on has gone viral, with nearly 50,000 comments. And I can see why. If you have one or more kids on the autism spectrum, you don’t expect people to go out of their way to help you or your kid. Instead, you get used to the baffled stares, the cluck-clucking, and the occasionally mean comments about your children and your parenting skills—or lack thereof.

For Katie and myself, whenever we contemplate going out to dinner, we have to include a few questions that most families wouldn’t bother to ask. Questions like: “Is the place too dark? Too bright? Is it noisy or quiet? Is there plenty of space between the tables? Do we know if the staff is flexible? Is there more than one way out in case of a melt down or in case one or more of the kids needs to take a break and get some fresh air?” So as you can imagine, we don’t go out that much, and when we do, it’s usually to our local McDonald’s, where many of the people already know us.

Anyway, as I said, I read this piece about a week ago, and it kept popping up on my Facebook account. Friends messaged me about it, or posted it to my wall, or shared it on their own walls. Clearly, it moved a lot of people. And one of the best reactions to this story I have read comes from a man in Canada who has a son with autism. His name is Stuart Duncan, and he writes a blog called “Autism from a Father’s Point of View.” Check it out, and see what you think.

What a Difference a Day Makes

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IMGP3797So the past couple of weeks have been pretty rough. By my count, I spent six hours in IEP-related meetings at two of the kids’ schools. And two of those meetings were both tense and emotionally draining.

Not to mention, those six hours required at least twelve hours of preparatory meetings with psychologists and IEP coaches. And part of those twelve hours consisted of conflicting, or at least confusing, input from the various parties.

Oh, and those preparatory meetings either required or resulted in about another twelve hours of preparation and homework so that we could get our information and our strategies straight.

That makes thirty hours right there.

Then there was my nightly routine of going over my two oldest kids’ school binders and homework assignments and making sure they did the work they had forgotten to do—a routine that is not without its conflicts and occasional melt downs.

Then there were the increasingly dramatic tantrums that our seven-year-old began having right around the dinner hour—often starting a domino effect with a few of the other kids.

Then our four-year-old’s ADHD, perseveration, and stimming suddenly began shooting up like a Roman candle.

And finally, there was the fall-out of all of this in my job. Lots of time off for meetings, melt down management, and homework duty translated to a string of late nights just so I could keep up with the deadlines.

A Sudden Escape.

All these factors combined to produce a pretty dark cloud over my head. Everything seemed bleak. There seemed to be no end to the challenges. And I couldn’t see any sign of progress. All I could see was a long, difficult road ahead, and I was getting tired of trudging down it.

So I was pretty demoralized by the time last Tuesday rolled around and I remembered an engagement I had the next day. It was an autism symposium at the University of North Florida. I had been to previous meetings like this and found them very helpful, and this year seemed really promising. The topic was genetics—something that I have a vested interest in!

But I just couldn’t face the idea of going. “If I hear the word autism one more time,” I told Katie that night, “I’ll explode.”

So what did I do? I got up Wednesday morning, helped Katie get the kids going, and drove my two oldest to school—the regular routine. Only instead of heading for the symposium or going into the office, I got onto I-95 South and headed for Orlando.

I escaped for the day to Disney World.

Me Time.

Actually, this has become a regular habit of mine. As a Florida resident, I am able to take advantage of discounted park tickets, so it turns out not to be too extravagant an expense.

What do I do there? I don’t always go into one of the theme parks. Sometimes I wander the grounds of one of the resort hotels that are part of the property. I ride the monorail. I walk around one of the lakes. I sit on a swing or lie on a hammock. I take my camera and shoot pictures. Or I explore some area in one of the theme parks that I hadn’t visited in a while. One time, I splurged a bit and got a haircut at one of the high-end resorts. (Decadent, right?)

But what do I do? I pray. I think. I unwind. Disney is very good at creating immersive environments, so it’s easy to lose yourself and enjoy the scenery. And that experience of being somewhere else, even if it is mostly make-believe, helps me reset my brain.

I did a bit of everything that day. I walked around a couple of resorts and ended up in Epcot, where I strolled around the World Showcase. As the day progressed, I noticed a few things.

First, my pace grew more relaxed and my breathing became deeper and more even. Even my face felt more relaxed, and it became easier to smile. My shoulders lost their hunch, and my often fisted hands opened up. I hadn’t realized how tense I had become, and how I had been holding that tension in my body so much.

Then, I noticed that my thoughts were slowing down. With broad vistas stretching out in front of me as I walked around the lake in the Coronado Springs resort, I began to let go of the confining, cramping concerns that had been overshadowing my mind. The tyranny of the urgent receded, and I found myself taking a longer, more hopeful perspective.

To Dream Again.

All the things that had to get done, all the issues that remained unresolved, all the glitches that my children need to work through—they were all brought down a peg or two. The kids came into sharper focus, with all their fun quirkiness and golden hearts, and the autism receded. It was still there, mind you. (It never leaves.) But it was dethroned.

The other thing that receded was fear. I didn’t even known I had been under its shadow, but I had. Actually, it was more like a low-level panic over all the what-ifs for the kids’ futures. So many things could go wrong. So many forces could overtake our family and make our life together a ton worse. All these ominous possibilities were making me feel claustrophobic, helpless, trapped.

But getting away for a day of relaxation and prayer raised me above the fear. Being in a place that was built on dreams helped me remember my own dreams for my family and for each of my kids. I knew that some of them might not come to pass. But by letting fear entrap me in some kind of tunnel vision, I began to believe that none of them would ever come true.

I forgot that all the work we are doing with our kids is geared toward the goal of giving these dreams a chance. I forgot about all the progress that we’ve made the past few years—progress that will build a better foundation for these dreams. And worst of all, I forgot that my kids have their own dreams. I had become so focused on addressing their challenges that I forgot about their gifts—the gifts God had given them, the gifts that they are to our family, and the gifts that they will be to the world as they grow and develop and find their footing.

No Difference?

When I came home that night, not much had changed. Our seven-year-old hadn’t miraculously overcome his melt downs. Our twelve-year-old hadn’t stopped fixating on the new toy she wanted. Our four-year-old was still so hyper that he couldn’t stay in his bed . . . even though it was past 9:00 at night and he had woken up at 5:00 that morning. And so on and so on.

No, not much had changed at all. But I had changed. And that was all that needed to happen.

Words I Wish I Never Heard: Comorbidity

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When a parent receives the news that his or her child has an autism spectrum disorder, only one word sticks in the brain: autism. It’s a scary word, filled with mystery and foreboding, and it takes a while for parents to wrap their brains around what it means for their child.

But over time, the parents do get used to the word and the various ways it is used—autism, autistic, autism spectrum, ASD, etc. They also get used to the way their child manifests the various social, language, and emotional symptoms that are part of the autism spectrum. More or less, they begin to make peace with the diagnosis. They learn how to reorder their lives to accommodate their child’s special needs, and they do everything they can to help their child grow and thrive. They grieve the loss of what might have been, and begin to look forward to what will be—with all of its highs and lows.

That’s all well and good. But over time, other words begin showing up and demand entry into their vocabulary. Words that bring with them a host of new challenges, fears, and road blocks. Words like stimming and perseveration become part of the parents’ everyday conversation. They are part of the universe of autism spectrum disorders, and every child touched with ASD manifests these behaviors in one way or another.

But there’s another word that shows up, whether early or late, and it has the potential to eclipse all its rivals: comorbidity. Even the sound of the word is chilling, with its hints of gloom and even death—to be morbid with, or something like that.

But while comorbidity is not a pleasant word, neither is it fatal. The definition runs like this: “the simultaneous presence of two chronic diseases or conditions in a patient.” It means that a person may carry two or more psychological or developmental diagnoses, as in the following sentence: “Bobby has a primary diagnosis of attention-deficit disorder, and a comorbid diagnosis of obsessive-compulsive disorder.”

ASD and Comorbidity.

According to a recent study done at Boston University, the rate of comorbidity in people with ASD is frighteningly high. The study found that:

44% of children with autism also had some kind of specific phobia, like fear of crowds.

37% had obsessive-compulsive disorder

31% had ADHD, and

25% had depression.

In fact, according to the researchers, “Seventy-two percent of the children in our study had at least one DSM-IV Axis I psychiatric disorder in addition to autism.”

More than 30% had two disorders comorbid with autism.

And nearly 10% had three comorbid conditions.

Even more chilling was this statement:

The frequency of multiple comorbid diagnosis we report is likely to be an underestimate. Parents were less likely to complete the later sections of the interview when multiple types of psychopathology were present in their child because it typically took longer to complete the interview.

No one knows exactly why the comorbidity rate is so high among people with ASD. Is it a brain chemistry problem? Or does dealing with ASD cause other disorders like depression and OCD? The jury is still out on this, and it may be for quite some time.

So not only do people with ASD have to navigate the troubled waters of autism; most of them also have to deal with other challenges. And what’s worse is that these comorbid disorders don’t just lurk in the background. They can often become the primary concern.

Paralyzing Depression.

This has definitely been our situation for the past few months. One of our sons has been diagnosed with depression, general anxiety disorder, and executive dysfunction, along with an inattentive type of ADHD. And as I said above, these comorbidities have a way of overshadowing the ASD deficits.

In this boy’s case, his depression and anxiety have become so strong that they have affected him physically, not just emotionally. A couple of months ago, for instance, he became so anxious that his legs literally shut down. He couldn’t walk. He couldn’t feel anything in them. He couldn’t move them at all. Two days in the hospital, an MRI, and a neurological work-up revealed absolutely nothing organic at the root of his paralysis. It was completely stress related, “all in his mind,” but not in a conscious way at all.

So here’s the challenge: do you treat the depression? Of course you do. But what if the stress is caused by the challenges this boy faces because of his ASD? You have to help him deal not just with his stress but also with the ASD issues that caused it in the first place. In this boy’s case, he has a hard time coping with all the noise and chaos of the crowded hallways in his school. It’s such an assault on his senses that it turns him into a jittery mess.

He has to deal, as well, with the social awkwardness that comes from his communication deficits. Classmates just don’t get him, and he doesn’t get them, so he feels his otherness deeply. All he needs is a couple of thoughtless remarks from his adolescent peers, and he’s off to the races. No wonder his body shut down last November! It’s as if his legs were telling him, “We can’t take any more. Please give us a break!”

So here we are, two months and nearly three thousand dollars in medical bills later, hoping that we’ve got a handle on things. We’ve increased his time with a counselor. We’ve taken more steps at home to help him accept his ASD challenges. We’ve gone out of our way to make sure he knows how much we love him and enjoy him. Anything to help him extinguish the negative thoughts that are constantly seeking entrance into his mind.

A Box of Chocklits.

But there’s another thing about these comorbidities. Once you’ve got one under control, another one pops up. In this boy’s case, the depression seems to be staying in the background, but the ADHD has now taken center stage. Homework assignments are being missed. Important papers from school are not making their way to us. Simple things like hygiene and general self-care are being forgotten. Now, instead of managing his mental-health issues, Katie and I have become his surrogate frontal cortex—that part of the brain that manages organization, short-term memory, and executive function.

Every week seems to bring a different challenge, another selection from Forrest Gump’s box of chocklits. And all the time, the ASD remains in the background, a kind of cantus firmus that shapes every aspect of his life. Bit by bit, we’re helping him make sense of it all. Bit by bit, we’re giving him the tools he needs to face down these challenges. And bit by bit, he’s making progress. But it’s slow. It’s arduous. And it’s sometimes painful.

It’s also no wonder that he seeks escape in his video games—to the point of them becoming almost and OCD issue. Yup, another comorbidity!