I’ve come down with an early case of the “Bah Humbug” this year. I can’t imagine why, but I’m very short-tempered these days. In spite of my inner voice coaching me to be cheerful and merry and show my fellow citizens tidings of joy, I end up immensely irritated by something an innocent bystander has done while I wait for my latte at the barista counter. Maybe I should try decaf? No … it’s more than that. I catch myself watching other grumpy people with scowls on their faces, wondering if I look like they do. I catch myself beginning to scowl as I start to worry about scowling.
I really want to be pleasant to others, make them smile, and possibly turn someone’s day around by a random act of kindness. So what’s getting in the way?
As I started to ponder my own funk, the recent news about oxytocin caught my attention. I remember hearing a radio story on the topic, and the autism link wasn’t what piqued my interest. What I honed in on was the real need humans have for socialization and the effect that socialization has on the brain. Cognitive functioning may be impacted by how we humans socialize. So maybe the Bah Humbug is caught by spending too much time alone. Maybe I’ve been spending too much time at home behind my computer, and not enough time in the company of others.
This experience with my own socialization woes has me thinking about Cameron’s social health. I wonder if the Bah Humbug I’m experiencing is similar to what Cameron experiences on an ongoing basis. Maybe, like me, Cameron wants to be the cheerful person who brightens a stranger’s day with a kind word, but his frustration tolerance gets in his way, and he shuts down at the first sign of annoyance. Maybe Cameron tries to suppress his snappish and snippy responses to people, but he doesn’t have the ability to edit his attitude before it’s too late. Does he reflect back on his poor social interactions, and wish they had gone differently? I certainly reflected back on the interaction I had yesterday with the insurance call center in my effort to get my daughter’s same-as-always, life-long medication refilled. Maybe, in hindsight, I shouldn’t have shouted at the representative when she suggested that perhaps this time the medicine was different when I asked why the claim was being denied. Sometimes things that are meant to stay in the thought bubble accidentally get said out loud. I’m afraid that’s one of the side effects of the Bah Humbug.
So the one benefit of my struggle with the Bah Humbug is that I better understand Cameron’s social challenges. I understand now what it’s like to want to be one way, and end up acting in an entirely different manner. It’s frustrating, to say the least. But does Cameron really want to be social? Or am I projecting my own desires for him? He’ll soon be at a point in his life where it will become abundantly clear. His potential move from home to join a postsecondary program will certainly give him the opportunity to grow socially. Let’s hope the Bah Humbug isn’t contagious.
Last Tuesday my sister Connie had to have a surgery.
When they wheeled her away, I went to the waiting room with my oldest sister, my brother, Bill and various other family members. While we were there my oldest sister’s work supervisor came into the waiting room to offer moral support and see how all was going.
The supervisor is a young mother of two boys, ages 8 and 9. The 9-year-old resembled Cody so much at that age it was uncanny. And as it turns out, he also is on the autism spectrum. I couldn’t stop staring at him. He had so many of the same characteristics and behaviors that Cody exhibited all those years ago.
My sister Pam had told me a little bit about this young woman and the challenges that she and her son were experiencing. Violent outbursts—aimed at both himself and others—were a problem. His predisposition to restlessness was very obvious. I could see the agitation growing in this child and the more fidgety he grew, the more anxious Mom became.
I watched how many times she turned her attention away from conversation to make sure her son was still holding it together. As time went on her glances in his direction became more frequent. Dad was there as well. It almost appeared as if Mom and Dad were taking turns watching the boys—that look of angst on their faces—the one that just speaks so loudly and clearly to the fact that these parents were on alert for that one spark that could light the fuse that would detonate the fiery explosion they were so dreadfully anticipating.
Then Dad confirmed my suspicions:
Dad: “Well we’re going to go.”
My Sister: “You don’t have to go just yet on our account.”
Dad: “No we need to go before the meds wear off.”
Mom: “We have this visit perfectly timed.”
How well I remember those days. Oh my heart went out to them!
How I wished I could have had a chance to talk to them about the struggles they were going through and to express my compassion and understanding.
Cody had many of those same battles. And while there were no meds that helped subdue those battles, what it did take was time, dedication, patience, and repetition of loving methods of discipline.
It took many reminders that he had to be in control of his behavior. It took reminding him over and over that outbursts would not achieve any goal he wanted to achieve. It took restraint to remain calm, but firm. There were times when Cody would go into meltdown mode and I would sit him on the sofa. For hours he would yell, cry, hit, kick and scream obscenities at me because every time he attempted to get down I sat him right back up there. And for a while that fueled the fires even more, but it’s what I had to do.
I would tell him in the beginning that when he could behave appropriately, and speak to me calmly and respectfully we would talk and then he could get down. Until then I sat in front of him and would not look at his face or speak to him. I deflected his physical attempts to lash out by blocking kicks and punches with my hands and arms. The verbal ones I ignored. After what seemed like an eternity he eventually became calm and we were able to come to a peaceable resolution to whatever it was that had set his rage in motion.
Was it difficult to do that? Absolutely! Was it exhausting, frustrating and heart wrenching? Yes, yes and yes! Did I want to just break down in tears? Oh yeah! But as the years passed these episodes began to happen less often. Cody hasn’t had one in years now.
Conquering those behaviors was by no means easy. There were times it took me to my knees. But there is hope through resolving oneself to help a child or even an adult overcome those behaviors with simple techniques like these. It does require great tenacity when it comes to simply standing your ground with love and determination. But for us, the amazing results were worth every moment of trial.
Here's what really gets to us about the holiday season. It's not the way advertisers assault us, though that's troubling. It's not the way radio stations insist upon playing the most grating seasonal songs they can get their hands on, though that's annoying. It's not even the pressure put on us by others—to send Christmas cards, to show up to holiday brunches, to decorate with splendor and style—though those obligations weigh on many. Instead, here's my theory: the real problem with the holiday season is what I like to call the disconnect. First, there are the surface disconnects, such as the disconnect between our table and Martha Stewart's table. Or the disconnect between our humble decorations and the neighbor's light show spectacular. But that's not where it really hurts, not for most of us. What really hurts this time of year is the disconnect between people. Be it distance or time or hurt feelings or simply atrophy, the disconnect between us is what stings. The disconnect between our relationships as they are and as we wish they would be.
Why? Because the holidays are a time of gathering. And I'm never so lonely as when I'm about to set off on a long trip to visit faraway friends and family. Thrilled as I am to reunite with beloved people, the thought also brings pain. On most days, I can push aside how much I miss them, how much I long for a sense of home and belonging. I can focus on my work, on tasks I need to accomplish. But during the holidays, it's harder to forget the distance between us. The cozy scenes on TV, the soaring holiday carols … we want to share these things with someone else. We don't want to watch “Home Alone” or “Little Women” by ourselves. We don't want to go ice skating or candle-lighting or tree-hunting or basement-foraging-for-long-lost-decorations in solitude. We want to participate in these activities together. Not just physically together, to be sure, but together in spirit, together in heart.
With this in mind, I'm thinking about an unexpected moment of connection I shared with Willie last week. On Black Friday, I woke early in the guest room of my parents' house. After a moment of disorientation, I registered the unmistakable sounds of struggle and loud noises coming from downstairs. Given my brother's history of aggressive and self-injurious behavior, my mind filled in the blanks: Willie is having a meltdown, our parents need help … though at this volume, he's probably roused our aunt and uncle, who are sleeping on the pull-out couch in the living room. That's unfortunate, but at least it means that our parents will have help. I rose slowly, trying to steel myself for what I might find downstairs. Willie's door stood ajar; his bed empty. I descended the stairs with a solid lump of dread in my stomach.
Imagine my surprise, then, when I found the family dogs, Chevy and Chance, scuffling and play-fighting. Confusion was soon eclipsed by relief: for once, it wasn't Willie going crazy! For once, he wasn't wrapped up in a rug, trying to calm himself. There was nothing to fear. In fact, Willie was in a fine—albeit sleepy—state when I found him. He'd escaped to the finished basement, curled up next to the space heater, and put on Disney's “The Jungle Book.” I sat down next to him, and he leaned right into me, ducking his head in the way that always speaks to me of trust. To be sure, I knew that he was cold, that he wanted to be closer to me in order to get warm. I knew that, but I also knew that this unarmored, early-morning time was a gift. And so we watched the movie for about half an hour before I headed back upstairs, humming along to, “The Bare Necessities” as I went. “Look for the bare necessities, the simple bare necessities, forget about your worries and your strife ...”
And for that time, I could forget about worry and strife. I could inhabit that pocket of peace, knowing that I'd received everything I needed and more.
By the time you read this, I will have returned from a week’s vacation in Florida with my family. I will have celebrated Thanksgiving with my parents and uncle and, if the weather permits, spent some time visiting Disney World. Before getting on the road, though, I was given the responsibility to complete the tricky task of scheduling what we would do at Disney. It is not a task that I looked forward to doing, but a bit of hard work on my part before I left with my family would mean a very organized schedule for us all and more time for relaxation when we reached our destination.
My parents had already figured out the dates when we would be traveling, where we would stay while traveling, how long we would stay with my uncle, and when we would head back home. They indicated that we would have three days to spend at Disney, leaving us the rest of the week to spend with my uncle, including Thanksgiving Day. Since our excursion to Disney World was mainly for my entertainment, my parents left it up to me to determine how I wanted to spend my time there. This decision was totally mine.
To say that I found this decision-making to be intimidating would be an understatement. I would be heading further outside of my home state than I had ever been, so I had a bit of anxiety to start with. Now I was in charge of planning our activities at Disney. In addition, it played into my ongoing concern of having everything in my life be in a perfect, uncluttered state, or at least as close to that state as possible. I have stated many times that I work best when things go smoothly and are organized, which is calming to me. However, I realized that forming a plan was necessary for our vacation to go well. I wanted this vacation to be as organized as the Disney parks are clean (not a speck of dirt or trash to be seen).
To make the planning process easier, I purchased two guidebooks on Disney World which contained very helpful information about the parks and their attractions. After reading both, I determined that it would be best for us to visit the parks earlier in the week in order to avoid the crowds and long lines. I then looked through the guidebooks and chose which rides, attractions, and other features of the Disney parks I would most like to check out. After much consideration, these were my choices: the Disneyland-like Magic Kingdom, the technologically-focused Epcot, and the movie magic of Disney’s Hollywood Studios. With the schedule we had worked out, we could spend a day at each of the three parks.
Finishing the schedule took some time to complete, but I knew that it was an important step to enjoying our time in Florida. It gave me some much-needed experience in determining how to best spend valuable time, a skill which I feel is essential to my life. I knew that we could not do everything during this vacation, so I had to figure out what I wanted to see the most this time around. For a person that loves everything Disney, I can tell you that I really had to consider my feelings regarding the features of each park to determine my choices.
Even though it took some time for me to do the research and choose from the many options Disney offers, I am glad that my parents gave me this task and included me in the decision process. Not only has it helped me to learn new skills regarding time management and vacations, I also know exactly what we will be doing each day because I was part of the planning. I feel glad that I put the work into my part to make this vacation possible, and I hope it will be enriching and fun!
First published on July 3, 2012.
“Annie,” I called, cupping my hand to the phone. “We are making no progress. I am so sorry.”
It was my second call to the school. We were late, very late, and I worried how it would affect Madison and our visit. The interstate had been shut down, rerouting us to a two-lane road that doubled our hour-long drive.
“I think you should go ahead and give Madison some lunch,” I told her. “Maybe we will just have ice cream this trip.” Hunger is never a friend when Madison is “brittle,” or prone to upset. And we didn’t need any more complicating issues given our delay.
Like many children with autism, Madison does not wait well. We tell her that I am coming for lunch just before I arrive. We’ve learned that if for some reason I cannot make it that day, the change in her schedule can be disastrous. So, “Lunch with Mommy” is never in the early morning schedule; it is only added after I call to confirm.
Schedule-based living, however, can be a tricky proposition. On the one hand, a schedule orders the day, the expectations, and is comforting to Madison who has difficulty with transitions. Knowing “what’s next” is sometimes all it takes to calm her. Yet, routine schedules can also create a false sense of predictability that does not allow for exceptions. And life is just not that predictable all the time. If the schedule is too rigid, we both become trapped, unable to respond to other opportunities.
Even though Madison has an intellectual disability, uses only scripted speech, and cannot read nor write, she understands far more than she shows. In her limited speech, her number one phrase is, “Schedule, please.” And her next favorite is, “And then.”
When her schedule is given to her, she will often prompt the speaker, saying, “And then” multiple times, until she hears an activity that satisfies her. On Tuesdays, although she has no concrete understanding of the calendar or time, she seems to sense my visit, often requesting “Lunch with Mommy” before I have called.
Although poignant, I realize the “Lunch with Mommy” is also a break from work. And, hey, who doesn’t like a predictable break from work?
So, how do we keep my visits a “treat” instead of an “expectation?”
“Broaden the activity,” said Dr. Kathy Niager, owner and Executive Director of Trellis Services, Inc., Instead of, “Lunch with Mommy,” she suggested redefining the time as “Family Time,” and offer Madison other options, such as a phone call to Mommy or other family member, looking at a family photo album, or making a card to send to a family member.
Perfect! Well, probably not for Madison, but at least it keeps some structure in her day—and flexibility in mine.
On that Tuesday, “Lunch with Mommy,” finally made it to the schedule board. But it’s nice to know that “Family Time” is a new choice that will give us both more options.
The search for a postsecondary program for a student like Cameron is not much fun. It’s actually pretty awful. In my case, this search has caused much anxiety. There have been many prime sleep-time hours lost staring at the ceiling, wondering what next year will entail for Cameron. It makes my stomach hurt to think about it, and yet it’s all I can think about. But as it turns out, the search is not the worst part of finding a program. Actually the worst part of the postsecondary hunt (so far) has been finding an ideal program, and now having to wait to receive the admissions decision.
After much deliberation with Cameron, family members, friends, trusted advisors … basically anyone who would listen, I’ve decided that the last program Cameron and I visited would be a great fit for him. Sure, there will be challenges, but what would postsecondary education be without challenges? This program checks all the items off the “must have” list, and I’m convinced it will be a tremendous growth opportunity for Cameron. But did I convince the admissions committee? Did Cameron’s surliness during the interview kill his chances?
I was discussing my conviction that this program was “the one” with my mother. And my mother, like no one else can do, brought me down to earth quicker than a pin to a latex balloon. All she said was, “It reminds me of how you felt about The Lab School.” (I envisioned it as a red balloon, flailing around my living room, landing in a tumbleweed of dog hair the vacuum missed.)
Ah yes ... The Lab School. This was the school that was going to be the perfect place for Cameron. We were relocating to Washington, DC from London, and The Lab School was going to put a smile on Cameron’s face each and every day that he entered their hallowed halls. Only Cameron wasn’t deemed an appropriate fit for their program. I later learned that The Lab School was a program for a vastly different type of learner than Cameron, so of course it was the right decision on the school’s part not to offer him a coveted spot. But I was so convinced that it was the right place for him.
So now I wait. Convinced again of an ideal setting for Cameron, but reminded that my convictions aren’t always the best solution. I’ll put my trust in the professionals that are running this “most ideal” postsecondary program, and readily accept their decision. One bright side is that the decision will be made within a few short weeks. If things don’t go in Cameron’s favor, we’ll have plenty of time to formulate a Plan B. Which also gives me plenty of time to revise my “worst thing about postsecondary searching” award recipient. I suspect that I will be well-acquainted with every nook and cranny of my bedroom ceiling before this process is complete.
Last week I had the opportunity to head to Washington, DC to attend the “Autism Speaks to Washington” summit. This was one of my first times in Washington since 2011 when I went to DC to meet with New Jersey Senator Robert Menendez to discuss the Combating Autism Reauthorization Act (CARA). It was a huge moment for me when I found out that not only would I be doing social media for the summit, I would be introducing Senator Menendez before his keynote address.
I have to say that the three-day event was a life-changing experience. As a self-advocate I believe passionately in the need for a national agenda and to get over 300 participants to share a collective goal for that was amazing beyond words. I could share a million high points from the summit, but something happened on the way home that both shook me up and reminded me of how far I’ve come personally. I was leaving early from the summit to get on an Acela train to head back to New Jersey in time for a book signing. I had to go back to my hotel to pick up my belongings, and then head quickly to the train station.
This is when my nightmare began. I ended up making it back to the hotel in plenty of time, but on the way to the train station got caught in a massive traffic jam. I was devastated to find what should have been a 20-minute taxi ride take over an hour. With a heart that was beating what seemed like a thousand times per second, I swung my luggage out of the back of the cab and ran inside. When I got to the Acela stand I read the time: 3:03 p.m. I had missed my train by two minutes!
These types of situations are always a bit tough for me. In the past I’ve never gone on a long train ride by myself. So I slowed down my breathing, rubbed my hands together (which I sometimes do in stressful situations), put on my headphones and listened to some music, and decided on my next move. I went to the information desk, found the front desk for ticketing and was able to get on a 3:30 p.m. regional train instead. Fortunately that train had no delays and I showed up to my book signing only 10 minutes late.
I think I learned an amazing amount about myself. If I were thrown into a situation like this a few years ago, I would have panicked and lost my cool. One of my mantras growing up was “No problems, just solutions.” I would chant this over and over to calm myself down. Public transportation will always be hard for me due to the uncertainty of situations, but I think some self-soothing skills I’ve developed helped me out in a tough situation. I encourage everyone—not only those with autism—to try to discover such coping strategies for yourself. Stressful situations will always come about in life and it’s how you act that will decide how it will go.
Always give yourself the upper hand by preparing and knowing how to deal with any problematic situation that may occur. When a problem arises look around, consider your options, ask for help if needed and find a solution. Not only will you solve the problem, but you will take another step toward self-sufficiency.
This hasn't been a peaceful time in the autism community. What with Suzanne Wright's highly controversial post at Autism Speaks and John Elder Robison's subsequent resignation from Autism Speaks' boards, we've seen our fair share of conflict. And with good reason, too; we're talking about core issues, getting to the heart of what it means to support people with autism. The claim I've heard repeated most often is that Autism Speaks—with its motto, “It's time to listen,”—has not listened well. As such, it was all the more important for me to take time to listen closely before writing a response.
Here's the first thing I heard, when I stopped to listen: This latest turn of events is upsetting, yet it doesn't mean that Autism Speaks is “all bad.” (That's exactly the kind of black-and-white thinking that we found so upsetting in Suzanne Wright's letter.) Disturbing as that letter was, it doesn't erase the good Autism Speaks has done … and they have done a great deal for our community. Their website alone is an incredibly rich resource, a veritable treasure trove of toolkits. I have friends among their staffers, exceptional people dedicated to supporting people with autism and their families. I've contributed to Autism Speaks' blog, and volunteered for a “Light It Up Blue” campaign too. I did so because I wanted to make a contribution, however small. I wanted to help create a better world for my brother.
And like so many of us, I felt my heart sink as I read Wright's call to action. As I read, I thought, There's so little hope here. I feel a terrible sadness that this was the message sent out on the eve of Autism Speaks' national policy and action summit. That fear and despair and exhaustion and emergency were chosen to describe the lives of families like mine.
To be sure, it's important to acknowledging the realities of autism. I know what it's like to live some fear and despair and exhaustion and emergency, and I suspect that you do too. It is hard to keep your chin up when your brother has a black eye from self-injury, and might give you one at any moment. The challenges of autism are real, and they impact family members. We do get tired. We do get scared. We're only human, after all.
But here's the bigger truth, the TRUER truth, the truth that was notably absent from Suzanne Wright's letter: We are strong. Our sons and daughters, our brothers and sisters, our husbands and wives who have autism … THEY are strong. They are brave. They face difficulties every single day, it's true, but they also bring light and laughter and innovation and creativity and so many priceless gifts. And we family members are strong too. We are brave. We walk amongst ambiguities and impossible choices, and we keep going.
And you know what makes us strong, don't you? Of course you do. We are strong because we love each other. And that love is more powerful than millions of dollars. More powerful than fear. More powerful than anything.
In this week of controversy, I appreciated Laura Shumaker's respectful, heartfelt piece, “Who Does Autism Speaks Speak For?”
She wrote, “My son Matthew was a very challenging kid to raise, and at times I felt hopeless and depressed. But he is now a delightful, earnest, quirky and loving 27-year-old … He had a reputation for being aggressive and even violent, but as he has grown and matured, [he] is a sweet gentle soul. He is currently attempting to get in touch with everyone who knew ‘the old Matthew' and tell them he is sorry. I admire him so much.”
I wonder: Why wasn't a story like that chosen for Wright's letter? And I join Laura Shumaker in asking Autism Speaks to apologize for their words, for leading from a place of fear rather than a place of love. Because that's what I've learned from my brother, my friends, my family members on the spectrum: how not to give up, how not to give in to fear. It is from them that I have learned to carry on.
The "Battle of the Bulge" was one of the most infamous conflicts of World War II. It has—regrettably in my view—inspired a more informal usage of the name to describe some people’s ongoing struggles to maintain a healthy weight. I have been working on reducing my own waistline, which has taken on a particular roundness from years of sitting while completing my college education (my father has given me a creative nickname of “Buddha Belly”). The latest tool in my ongoing crusade to better my physical being is a new DVD exercise program with which I hope to get some promising results.
The program consists of a series of 10-minute workouts, each honing in on different areas of the body. A person can do from one to three of these workouts (with warm-up and cool-down periods) each day. Some of the exercises require the use of a mat and elastic bands.
Due to my current stamina level, I am concentrating on one 10-minute workout per day, but I hope to add more workouts in per day as time goes on. Each workout is made up of 10 to 20 exercises which target specific muscle groups for the area of my body that I am working on in a short span of time. I watch the exercises being carried out on a DVD and then perform them myself.
I do the best that I can, but sometimes I do not notice certain nuances of the exercises and assume a bad form. I usually start out concentrating on one important detail of the exercise while missing finer details and my form reflects that. My mother acts as my coach and spotter, helping me to maintain proper form and to properly utilize my equipment. Her help and encouragement has made these workouts much more bearable for me. If I am using bad form or missing an important component of the exercise, my mother stops me, and I watch the DVD again to see where I have to correct myself.
When first trying a new exercise, it is hard for me to concentrate on its multiple aspects. However, after watching the exercise again on the DVD and with my mother’s verbal instructions, I eventually gain an understanding of what I am supposed to do. My moves smooth out and my frustration level lessens as I see that I am moving along with the instructors. I also like this particular DVD program because there are modified moves for beginners—something I really need right now. I know that as I work with the program more everything will come to me easier and the workout will go much smoother. The workouts do place some strain on my body, which is something that I do not normally physically feel very often but notice right away when I am experiencing it. The exercises can be quite grueling for me because of my weak muscle tone, gross motor issues, and very tight hamstrings. Not being able to motor plan as well as most people my age is a disadvantage for me, and I can become very frustrated when I cannot move the way I want to, especially when I see the instructors moving well and doing the exercises perfectly. I have to remember that I am just learning and nothing is perfect in this world. My mother also reminds me that I can do the modified moves and as long as I am trying and doing the exercises as well as I can, I am benefiting.
I am still at the beginning stage of figuring out my new exercise program, but I do like it. I work up quite a sweat, and I feel that all my hard work will better my overall health. After all, this program is helping me set a new precedent for good healthy habits for the rest of my life, so I feel it is well worth pursuing.
One of the first things people ask me about my 21-year-old son Mickey is, “Is he high functioning?”
I hate that question.
Are they asking his IQ score? If he speaks? Whether he will be able to live independently? I don’t know how to answer.
How well does anyone function all the time? Isn’t it circumstantial? Mickey does well socially when he feels comfortable and safe with people he knows. He has learned to ask such appropriate questions as, “What did you do today?” or “How was your weekend?” although he has a limited amount of small talk in him. He still struggles to sustain a complex conversation. When he doesn’t feel like interacting, he’ll say, “Leave me alone, I don’t want to talk.” Not exactly polite, but still functional. But put him in a room teeming with noisy, unfamiliar people or loud music? He’ll be out the door so fast he’ll leave skid marks.
All people are high functioning in some ways, less so in others. If you ask me to write an essay, I’d say—modestly—that I am fairly high functioning in that regard. But if you depended on me to rappel down the side of a cliff or navigate a raft through white water, you’d be putting your money on the wrong gal. You’d never make it out alive.
As students, we’re all expected to do well in every subject. In reality most of us are not good at everything. As we grow, we tend to narrow our focus. We specialize. We seek out work in areas where we can excel. Autistic or not, everyone has a mix of strengths and challenges.
If you can do calculus but can’t tie your shoes, are you high or low functioning? Does high functioning mean you can live independently but low means you can’t? Mickey can’t yet safely turn on the stove to cook for himself. But he is adept at making his own sandwiches and reheating food in the microwave. He won’t starve. Where does he fall on the continuum? Just because an autistic person can speak, make great eye contact or perform academically doesn’t mean that he doesn’t also have major social and behavioral challenges. Where is the arbitrary cut-off point between high and low? Who gets to decide?
When Mickey was 19 months old he saw his first speech therapist. She said he had a “mild” delay. Several months later, a different evaluator told us the delay was “severe.” She said, “It’s possible he may never speak at all.” Mickey hadn’t changed; he was still the same loving, lovable little boy with the megawatt smile. Nor had his challenges changed. What had changed? The evaluator.
During Mickey’s first year in a self-contained high school class, teachers gave him work that was too challenging. Mickey became disruptive. He distracted other students with jokes, off-topic remarks and such questions as, “Do brown cows make chocolate milk?” My husband and I asked for a Functional Behavior Assessment.
After observing him, the consultant they’d hired noted that Mickey was anxious and frustrated because the curriculum wasn’t geared to his needs. They’d expected him to comprehend ninth-grade reading materials even though he was reading at a fifth-grade level. She developed a behavior plan for the school to follow.
Privately, she told us, “When they called me to come in, they told me I’d be observing a low functioning child. But your son is verbal and socially connected. That’s not low functioning.”
It’s human nature to want to categorize people and create hierarchies, but labels can be dangerous. They can so easily be used to dismiss people, to see them as “less than.”
How should I respond when someone asks me where Mickey “falls” on the autism spectrum? His development isn’t linear; you can’t measure it with a yardstick or clock.
Maybe the only truthful answer to the question “Is your son high or low functioning?” is simply, “Yes.”
Cameron and I embarked on our second college road trip together last week. If you’ve ever seen “Planes Trains and Automobiles” or “College Road Trip,” you will understand when I say last week’s trip was truly worthy of Hollywood. I found myself looking over my shoulder to see if there was a camera crew following us, because the comedy of errors might actually be funny … if it hadn’t happened to me.
In an effort to minimize the time spent away from school, Cameron and I were flying out in the morning, and back the same evening. It was a short, 90-minute flight, so it seemed like a perfectly rational travel plan. We left our house at 7:15 that morning, and made it to the airport an hour before our flight. (Which, for the record, is unusual for me. I’m more of a from-security-line-to-boarding-line, cutting-it-close-so-as-to-minimize-waiting-around kind of person.)
When Cameron and I arrived at the security checkpoint, I asked if it would be possible for him to keep his boots on because of his broken foot. I was told they would need to pat him down, so I didn’t think that would be a problem. We waited for a male TSA officer to pat him down, and as part of protocol, he tested for certain chemicals used in explosives. For some unknown reason, Cameron’s chemical swab came back positive, so we had to wait for a supervisor. A female supervisor showed up on the scene 15 minutes later, calibrated the equipment, and said Cameron would need to have an enhanced pat down by a male supervisor. (At this point, I’m really regretting not having Cameron just take his boots off, but it was too late for that option.) A male supervisor eventually showed up, and when all was said and done, final boarding call for our flight was being announced by the time we left security an hour after arriving at the airport. We made the flight, but it was unnecessarily stressful, and all because I wanted to save Cameron the effort of removing his shoes from his injured foot.
While in flight, I informed Cameron that we would be arriving home at 11:00 that evening. This did not sit well with Cameron. He grumbled that he probably would do terribly in the interview he was scheduled to have with the admission committee that afternoon because he was in a bad mood from knowing he wouldn’t get enough sleep for school tomorrow. This did not sit well with me. I took the opportunity to conduct a mini-lecture about being an adult and being perfectly capable of functioning even when missing his usual bedtime and the need to, basically, suck it up. Surprisingly, this “suck it up” speech did little in the way of changing Cameron’s mood, so I finally offered to drive him to school so he would be able to sleep longer. I decided this was the only way to clear his mind of the distraction. I figured there was no sense in going to the effort of visiting an out-of-state program, only to have him tank in the interview because of a grueling travel schedule.
As it turned out, Cameron’s bad mood was the least of my worries. We arrived at the airport rental car desk at 11:00. The campus was a 45-minute drive, and the Open House program began at 12:30. We should have plenty of time for lunch along the way. Our last college road trip entailed complicated travel as well, and there was no time for lunch. This is an even more serious infraction for Cameron than a late bedtime. I didn’t want to make that mistake again. Only … due to a computer system outage, we didn’t get behind the wheel of our rental car until 12:04. And it was a Prius, so it took me another five minutes to figure out how to start the car, and make it go forward. I began to swear like a sailor in my search for the seat adjustment controls and ultimately decide the fully-reclined position is fine. Okay … I called the program coordinator, and explained that we were running late. But still … we had to eat. I decided a five-minute fast food stop was a good idea ... Only it took 20 minutes. The Open House program was well underway, and we still hadn’t made it off the airport property. And the Prius didn’t go as fast as I like to drive in these situations. (Maybe that’s a good thing.) I called my mother from the car, and broke into tears. She told me not to cry and hung up without saying good-bye, because her contractor was at the door. Why did I call my mother? She’s in the middle of moving, and even more stressed out than I am. This was bad idea number 72 of the day, and the day was still young.
Cameron and I made it into the campus auditorium in time for the concluding question and answer session. We didn’t have time for the student-guided tour because he had an interview immediately following the Open House. The interview lasted about an hour, and this may come as a great shock, but Cameron was grumbly and borderline rude during the process. When we left the building, we both agreed that it had not been a shining moment for him. He said he was bored and tired. But having shared space with me all morning and my giant ball of stress and anxiety, I can understand Cameron not being himself. I know I certainly wasn’t at my best.
On the way back to the airport, someone else had an accident, which gave us an extra 30 minutes to reflect on the day. Once at the airport, our 90-minute flight delay gave us even more opportunity for reflection. Based on my emotional state that day, I’m not sure I am capable of assessing whether or not the program we visited is the best fit for Cameron. But I am certain that I want to minimize the number of these trips we make!
When Cody was younger he could become agitated at the drop of a hat. This usually led to an all-out tantrum. I tried many things to calm him. Back then, verbal communication did little because he could not communicate to me what had triggered his outburst. So if the trigger was not obvious to me I had no way of knowing what it was. Therefore, I couldn’t remove it.
Sometimes even when I knew what set his rage in motion it was too late for pre-emptive action. Loud noises were often the catalyst for a sudden occurrence of fury. But I couldn’t always prevent another driver from honking the horn, or another child from screaming, or accidentally dropping a metal pan on the floor. So damage control was essential.
If we were at home, and it was apparent what had precipitated Cody’s outburst, I could usually hold him on my lap in a bear hug and we would rock while I whispered assurances to him that all was well. It usually only took a few moments before he was ready to resume his day. But if the trigger was not apparent then I had a multi-step system, which I had developed over time by trial and error, to ascertain what the problem was and then provide a solution that would make the world right again.
Through experience I learned that self-injurious actions were most always brought on by anger and frustration with himself. Screaming and running and hiding were usually the result of something that frightened him. And lashing out at someone or something was an expression of anger with that person or object.
When it was a matter of self-anger or frustration, I found distraction to be a good tool. I would take him to another room and offer options of different activities to do. Listening to soft music was particularly effective.
A fearful situation was usually pretty easily rectified. If I saw what made him afraid then a visual demonstration of why he didn’t have to be afraid would work if his fear was unfounded. But if his fear was valid then removing the thing that caused the fear, such as a spider, would do the trick. However if it was unclear to me what caused the fear, then removing him from the area and using the rocking bear hug method would resolve the matter pretty quickly.
In the case of anger at another individual or object, separating Cody from the individual or putting the object up out of sight and sitting with him in a quiet area for a few minutes would usually work quite nicely.
These methods worked in public with a little planning ahead and some slight adaptations. For instance, if we went to the grocery store, making sure Cody was engaged in the shopping process was key to a smooth, uneventful trip. But if another child were to cause a ruckus then finding a quieter area of the store for a few minutes would work.
Cody is an adult now and he is able to express himself much easier than he could in his youth. And it’s much easier to alleviate building tensions now than in the past. But he still has times when unpleasant stimuli will cause agitation. Now, many times he takes care of the matter on his own.
Distraction is rarely a part of our comfort repertoire anymore since he’s able to at least tell me what will make him feel better even if he can’t tell me what made him feel bad right away. I don’t use the rocking bear hug method now but Cody will ask me to sit on the sofa so he can lay his head on my leg and have me lightly rub my hand over his hair. And now if he becomes angry with a person he knows to walk away, and most times he will put an object of anger up out of sight himself.
But these are just different versions of the same techniques I used when he was a child. Cody has just modified them according to his own abilities. I’m glad I was able to find these simple techniques worked back then, and very happy that they still work for Cody now.
From one sibling to another, I hope that you never have to deal with this. I hope that you never have to watch your brother or sister melt down over and over for a decade. If this does happen to you and your family, I believe that you'll make it through, but it will not be easy. It will make you question everything you thought you knew. It will take away your basic sense of stability in the world. Because if someone you love—someone you know has a good heart, a good mind—can just disappear like that? Can just vanish into a haze of rage? Then you'll start to think that maybe everything is illusory. Maybe nothing is certain. Maybe anything, and anyone, can be lost at any moment. And that's true enough. It's true that the vulnerability involved in being human is terrifying. But it's not true that we're alone in it. Everyone has to face this awful reality; no one is exempt. You just had to face it earlier than most, honey.
Maybe you're like me, and you've listened to your parents tell stories like this one: “Your brother had a hard day yesterday. We were on a walk, and he was getting agitated, getting too heavy-handed with the dog's leash. But he wouldn't let go. We were walking by the playground of your old elementary school when he hit me, and tried to tackle me. Yes, I'm fine physically, honey—it was just … traumatic, that's all. And then he kicked the backpacks—these little children's backpacks that were piled up by the side of the playground. Their parents were upset … ”
If your parents are like mine, they'll tell you these stories as quietly as possible. They'll say, “I'm just thankful it wasn't worse.” But if you're anything like me, you won't understand that. You'll be in shock. For the life of you, you won't be able to see how they're being so … calm. It will get worse after you hang up, after the emptiness passes. Feelings will arise—fear, anger, grief—and you'll wish you could go back to being numb. A wonderful line of Anne Lamott's will run through your mind: “She told me to feel the feelings. I did. They felt like shit.” And they do. But you'll know better than to think you can skip over these feelings. It would be great if you could stuff them down with food or alcohol or exercise or compulsive productivity, but you can't, not for long. The futility of it will be too clear. The feelings always win.
Friend, I'm sure you've already figured out that parts of your experience mirror that of families who deal with addiction. In some ways, it's like your sibling is in and out of rehab. They're always trying to get their life together, yet they relapse again and again. Only in your case, the truth is blurrier than that, because you don't know what drives your sibling's behavior, or how much control they actually have over their actions. It's an awful ambiguity, really. And there isn't anyone to blame. Everyone—including your sibling—is just doing the best they can.
So here's what I hope for you: I hope that, when you feel that you can't take it anymore, someone steps alongside you. I hope that when you say, aloud, “My heart is just so heavy,” you'll have someone wrap their arms around you and say, “Then I'll carry it.”
I hope you have someone to carry your heart.
The person who says those words to you may not know the eponymous ee cummings poem, but you will. You'll hear the verses in your mind, and they will quiet you:
here is the deepest secret nobody knows
(here is the root of the root and the bud of the bud
and the sky of the sky of a tree called life; which grows
higher than soul can hope or mind can hide)
and this is the wonder that's keeping the stars apart
i carry your heart (i carry it in my heart)
The biggest part of my job is knowing all the individuals on my caseload and what they are capable of doing. A lot of the time it is trial and error, frustration, and ultimately, success once we find out what skills the individuals have. The end goal for me is always to find employment for all the individuals on my caseload, and learning what they are capable of is a great starting point. Sometimes the best way to learn about a new individual is just sitting with them and seeing what they do during the day, and sometimes it is listening to other people who have been around that individual.
When I was first hired as a Supported Employment Manager, the first part of my job was to receive a lot of training on how to handle the individuals and how the company works. After training, I spent most of my time during the first few months reading behavior plans and looking at files. The behavior plans gave me insight into the past of the individuals, things they like and dislike, and ways to help them learn new job skills. I quickly learned that there was only so much I could learn from a behavior plan, so I spent some time just sitting with the individuals and talking with the staff. Most of the staff had been with the same individual for years and was my best source on learning about the individual as a person, rather than simply seeing an overview of behaviors.
I had to put a lot of trust into the staff and their knowledge of each individual when I first started out, and it did help. Over time, I got to know my individuals and also got to know some of the other individuals that are not on my caseload just by sitting with them. Every time a new individual comes into the company or comes from the school we work with, it is a chance to meet someone new and learn new ways of interacting with them. Just recently I added a new individual to my caseload from the school our company works with. In reading up on him, I came to find out that he is the grandson of our founder, which most people seemed to think put a lot of pressure on me. In my head I was thinking, “Well, I must be doing something right to get the founder’s grandson and no one else got him.” So I spent some time sitting with him at the school to learn all about him and the staff he had been working with. I came to find out that even though the individual cannot speak and uses an iPad to communicate, he is very intelligent and picks up on things right away.
Once this young man was in our program, it was easier for me to spend some time with him, and in that time he actually got to know some things about me. I got to learn that he likes jobs where he is putting things together and does not like to get dirty. He would ask me questions about football on his iPad and ask me how my day was going. It is the little things in getting to know someone with autism that sometimes matter the most to them. So for anyone in the business of working with people with autism: Take the time to just sit with an individual and talk with them. I guarantee that you will learn about that individual and maybe even something about yourself you did not know.
The positive result of Reilly's recent “break” from school was that I had a chance to have a long talk with his counselor at NYIT about how he is doing in general and what our next steps might be.
While the Vocational Independence Program has been a productive experience for Reilly, we were wondering if he is outgrowing it, and what comes next. We were concerned that he might be “spinning his wheels,” getting too comfortable and not making progress toward a life plan.
Happily, my conversation and subsequent email communication with Erin, his counselor, have given me confidence that we/they are on the right path, moving forward.
I told Erin we weren't certain if staying in the VIP program another semester would be productive and the best use of our resources. We don't know if Reilly can (or needs to) complete a four-year degree, or whether it would be worth the price tag in any event. If we got him trained for a job, we could use the money we would spend on tuition to help him with living expenses. Erin argued that academics is one of Reilly's strong points. He's taking two college-credit classes this semester, and many of his peers aren't able to do that. So maybe we shouldn't give up on college just yet.
Reilly's personal goal is to work as an equipment manager for an NFL football team. It's not as crazy as it sounds. A few years ago, his goal was to be a football player at the University of Hawaii and then get drafted into the NFL. We pointed out the unlikelihood of that happening, since he doesn't actually play football, though watching it is an obsession. He reconsidered his career goals and thought maybe he should be a team owner. If only he had a spare billion to buy a team. But he was lucky enough to spend two summers interning at the Washington Redskins Training Camp—his idea of heaven! Interns work under the team's equipment manager, doing things like folding towels and collecting practice uniforms and equipment when the team comes off the field. Reilly also got to operate a machine that snaps the ball for the kickers at practice. One day he got to drive a golf cart around the field, picking up players and returning them to the locker room.
So a sports equipment manager or assistant might be doable, right up his alley. Even if he can't work in the NFL, there are likely other sports facilities or recreation programs that might be a good fit for him. We visited a school in Connecticut that has a sports management program, which, if he could complete it, would be useful for getting a job in the field. The question is whether Reilly is ready for that, and whether he can handle a full course load. The jury is still out.
Meanwhile, Erin said the academic director at VIP had found a Principles of Management course Reilly could take next semester at NYIT. They are working on getting him an internship in the school's athletic facility, which could give him good hands-on experience. Some very positive steps.
For his part, Reilly agreed that he needed to work on some personal goals: hygiene, organizing his schoolwork better, improving his “reciprocal conversation skills.” Probably good things for most college-age boys to be working on! So now the question is whether to focus on the school in Connecticut, work on next steps at NYIT, or both. Oh, and of course getting everyone home for Thanksgiving and preparing for the holidays. Always plenty of items on the “to do” list!
But it was nice to hear that NYIT is working on a Reilly-specific plan, to help him take the next step. We're not alone. We're not wasting time and resources. Good to know.
I am constantly reminding myself that "Cameron will be okay." This phrase has become somewhat of a mantra (and I'm actually starting to believe it.) My mantra came in handy while sitting in the ER with Cameron last weekend after his accident on the way to work. The mantra rang true when Cameron rejected my suggestion that he take the following weekend off from work, so as not to have to hobble around the restaurant on his broken foot. Cameron was adamantly opposed to taking two weekends off in a row, and soldiered on, big clunky orthopedic boot and all. With his desire to work, Cameron may very well indeed be okay.
But then I think, "Will he be okay? Will he really?"
Since the beginning of the school year, Cameron has been happily participating in his third internship in as many years. This internship is part of his regular school day and is arranged for by the school's Transition Department. These internships have been great for many reasons beyond the obvious work experience he is gaining. Cameron has already built an impressive resume, with three work experience entries of 9 months or more. I'd say that's impressive for any 18-year-old, regardless of his learning profile. I don't think my own resume at that age would reflect such longevity. And let's face it: for the type of employment opportunities Cameron will likely be seeking, length of time with employer is a key consideration for hiring managers. But I always worry that not only does Cameron need the right kind of job opportunity, he also needs the right kind of manager. I worry that not all employers will be as sympathetic to Cameron's challenges, and that he's just been lucky so far.
The school recently asked Cameron's current internship manager for an evaluation of Cameron's performance. Cameron's transition teacher immediately shared the results with me via email. Cameron received the highest rating in every category, and the manager made glowing comments about Cameron's work ethic. So, yeah ... maybe Cameron actually will be okay. I mean ... yeah, Cameron will be okay. (Deep, cleansing breath.)
Many of my fears about Cameron's coming of age have already been tested. I had feared a medical emergency situation in which Cameron had the right to make his own decisions, and made the wrong ones. Last weekend in the ER, no one tried to shut me out of the decision-making process and I was still the person whose signature was sought. But even if Cameron had been left to his own devices, and I had been told that it was Cameron's signature they needed, I'm confident that Cameron would have made the right choices. And when given the opportunity to stay home from work, not only does Cameron not take the opportunity, but he avoids missing work at all costs.
So, yeah. Cameron will be okay. I am firmly convinced of It ... At the time of writing ... As I push troublesome scenarios from my head while I try to close this column on a happy note. No, really. I mean it. Cameron will be okay.
Every time it happens, I can't help but smile; there's something about the sight of a half-dozen children flinging themselves onto the playground that makes me happy. As the late October daylight fades, I watch David* and Darcy* race around the jungle gym. Keeping up with the twins at the monthly respite night is a workout.
After their burst of energy subsides, I walk over to Darcy; she's sitting by herself, meditatively picking up pieces of playground flooring. She gave me a big smile earlier, but now she's turned into herself, her usual radiance dimmed.
I'm a supersibling too, so I know how it is: We smile and help calm our siblings down and pitch in with diaper changes until we just can't anymore, until we have to take a break from it all. At such times, it helps to look at simple things, like pieces of flooring or books we've read a hundred times. It helps to be with people, but not have to say anything.
After a few moments of quiet, Darcy digs a piece of bright purple flooring out from among the dingier colors. “Isn't this one pretty? Purple is my favorite color,” she says.
“Very,” I reply. “It's my favorite too. It's the color of royalty, did you know that? Here's another one.”
We assemble all the purple pieces we can find in a companionable quiet. “You know, this is like looking for sea glass,” I tell her. “Do you know what sea glass is?”
She shakes her head no.
“It's pieces of glass—usually broken bottles—that have been tossed by the ocean until they're smooth. It's easy to find green and brown pieces, but I used to love to hunt for rare colors—aquas and blues—when I went to the beach.”
“I've never been to the beach,” she says, longing in her voice. I've forgotten how far inland our Alabama town is; having grown up in New Jersey, I take it for granted that children have been to the shore. “I have sea glass at home,” I say, “I'll be sure to bring it for you next month.”
She smiles, her usual radiance returning. Just then, David throws himself onto the climbing wall next to us, calling out, “Help me! Mom, help me!”
“I'll help you, but I know you know I'm not Mom,” I laugh. “I'm Caroline. Could you call me that instead?”
“Caroline,” he repeats, clear as a bell. With several boosts (and several shrieks which seem to combine joy and fear), he makes it to the top level of the jungle gym.
“Awesome!” Darcy and I call up.
“It's awesome!” he echoes, smiling down at us.
“Five minutes, everyone!” the respite leader shouts. Of course, this prompts half the kids to stand by the door, trying to push their way in. So I pull out my most reliable distraction strategy: “Let's race! On your mark, get set … ”
“GO!” David cries. Several kids take the bait, and together we race. (Everyone wins.)
After things have quieted down, Darcy asks me, apropos of nothing, “Who's your favorite songwriter?”
“I'm not sure,” I say. I could be wrong, but I think that what Darcy really wants is for me to pose the same question to her. So I do. “Who's yours?”
“Taylor Swift!” she grins. As soon as she says it, I know what her favorite song will be: “22.” It's my favorite Swift song too. Most of Swift's songs are about romance, but “22” is about a night out with friends. It's about being young and carefree, leaving the weight of responsibilities behind. It is, in short, everything a supersibling wants but feels she can't allow herself. Plus, it's really catchy. The first time I heard it, it was stuck in my head for a week.
“'It feels like a perfect night …'” I say, quoting the song’s opening line. And it does. Being here with Darcy, I feel less alone in the vast, unfathomable ocean that is life as an autism sibling. And it seems to me that we are like sea glass, shaped by our siblings as well as our own choices, becoming something new.
My autism greatly affects the way I perceive the world and interact with it. Simple tasks such as climbing up and down stairs, navigating crowded places, or even tying my shoes can be considerably challenging. My parents and I are always trying to learn new ways for me to more easily carry out these tasks. We also continually work on adding new skills to my repertoire. One such activity is cooking, and it is much more involved than a lot of the other tasks I do daily.
I am able to independently prepare some foods for my breakfast and lunch and have made these foods for myself for many years because they are simple recipes with few steps and do not involve utensils or equipment more complicated than butter knives and toasters. I know their ingredients and compositions by heart. For many years, these foods were among the very few that I ate daily.
I am very sensitive to the textures and tastes of certain foods and when I was younger, I would have extremely negative reactions to these tastes and textures when I tried new foods. I would gag and, at times, vomit as I attempted to eat. Even the thought of certain foods could drive me over the edge. As I have gotten older and my tolerance has increased, my diet has greatly expanded. As a result, I have added many more foods and much-needed nutrients into my life. I am pleased with the progress I have made with my diet, but I am always working to expand it even more.
Now, with my mother’s help, I am starting to learn how to prepare my own dinners. I have worked with my mother on learning the art of cooking in the past, but these new meals that I will be tackling will be more difficult for me to do because they contain many more steps than I am used to and many utensils and pots and pans that I am not familiar with. I also have fine motor issues that make it difficult for me to actually hold and maneuver utensils. In an effort to help make it easier for me, my mother has purchased a whole cabinet’s worth of specialized utensils and instruments for me to use. I even have my own utensil holder on the kitchen counter, full of new and exciting gadgets just for me.
One dinner meal that I really enjoy is tuna salad sandwiches. I have eaten them for years, but my parents have always made them for me. Recently, with my mother supervising, I made one for myself. My mother taught me how to use and hold each tool as I completed the steps for my sandwich. I enjoyed putting the sandwich together and figuring out how everything worked. Again, my fine motor issues did make a few steps a little more difficult for me. I had trouble applying pressure with my hands to my new can opener as I opened the tuna can, squeezing the can to get the excess water out, and spreading the tuna salad onto the bread with my new butter knife—but I did accomplish my goal and completed my sandwich. It tasted great!
My mother also helped me make my own pancakes. I followed a classic recipe which resulted in some great, fulfilling flapjacks. The recipe had a few more steps than my tuna salad sandwich, so I was glad that I was able to follow and complete it with no major problems. I was able to try out more of my special tools including a whisk, liquid and dry measuring cups, a spatula, and a placemat which kept the mixing bowl in place as I stirred the batter. They were tremendously helpful. My mother also showed me how to turn the stove on and off, regulate the stove’s flame, and reviewed safety rules with me.
My new cooking abilities are still developing and I have many more meals that I need to learn, but I am glad that my repertoire is growing. My new tools are very well-made and an enormous help, and I am excited to try them all out. Cooking is a skill that has challenged me for many years, but now, with my new equipment and my mom’s help, I am ready to take it on. Step by step, I will follow a recipe for success.
She stuffed the fries back in the box, shoved it into the McDonald’s bag, and stood up midway in her meal.
“Madison, are you finished?” I said.
She flashed a smile and lumbered over to my wheelchair.
I could tell that her words weren’t with her that day. “Are we ready to say goodbye?” I prompted. “Already?” I looked up at her and saw her mission-driven eyes. I wasn’t sure what was next, but finishing the lunch I’d brought into school that day was apparently no longer on her schedule. “Well, okay, then, Madison. Give Mommy kiss.”
I lifted my cheek to her, but she dodged me, and instead went around my outstretched arms to the back of my wheelchair.
“Madison what are you doing?”
“She’s trying to push you, Becky,” Rachel, our family caregiver, said.
“Oh my, she hasn’t done that in years,” I said as I twisted around to try to see Madison’s eyes again. I knew she couldn’t push me as she had when I was first paralyzed 16 years ago and used a manual wheelchair. Madison was 5 years old and in lieu of words would often push me where she wanted me to go, including almost sending me over the edge of a six-inch drop into my family room to get a Barney tape. I quickly learned to keep her in front of me, read her eyes, and lock my brakes at all times.
“One minute, Madison,” I said to her then told the others who’d joined us for lunch, “She’s not going to be able to push me in this power wheelchair. It weighs over 300 pounds. I guess I better anticipate where I think she wants to go.”
I moved my joystick forward and we went to the lobby. Madison was behind me, clutching my push handles.
“Give mommy kiss,” I said, thinking she would dismiss me at the lobby door.
But she persisted, trying to push me out the door.
“Maybe she misses going out for lunch,” I suggested and the others agreed. So Rachel brought my van around and sure enough Madison let go of my push handles, marched up the ramp into my van, and plopped into the back seat, snapping on her seat belt. Her one-on-one joined us.
“Let’s drive around the parking lot once,” I said. “Maybe she just misses time in the van.” We made one pass in the parking lot loop and tried to say goodbye again.
She wouldn’t budge.
So we drove farther, several miles. Again, she wouldn’t budge. She guarded her seat belt buckle with one hand, forcefully pushing away anyone who tried to release it with the other.
“What do you want, Madison?” I asked. Often she would say, “Schedule please,” or “McDonald’s,” or “Cheetos.”
But her words continued to fail her.
I got out of the van and coaxed her. “Come see Mommy, Madison. Want to watch Mary Kate and Ashley? Barney? Want Cheetos?”
She sat there, buckled in tight. She started to get antsy, a pre-upset warning, and I started to get worried. Her one-on-one went into the school and came back with three staff members and a large pillow. They approached Madison from each of the sliding doors and from the hatchback door in the rear.
Parked in front of the van, I clasped my hands across my heart, shut my eyes, and prayed. After what seemed like forever, I heard her heavy footsteps on my ramp. Hand in hand with a staff member, she headed into the school. I dared not break the momentum with a goodbye.
“How did they get her to go in?” I whispered to Rachel once they were inside.
“I think they asked her if she wanted to read her Baby Bop book.”
“My word,” I muttered. “Baby Bop beat out Barney? I would have never thought of that.”
And we left, grateful for creative caregivers who knew how to help Madison when her words failed her.
There are certain phone calls you never forget. Those are the calls that elicit such an emotional response that the memory is forever fresh in your mind. You are able to distinctly recall where you were, what you were looking at, and even the sounds and smells in the room. I have received three such phone calls from Cameron’s phone. The first one was the summer when Cameron was 15 and he went on his bike to explore the National Mall while I was at work. A nasty storm blew in, and I repeatedly tried calling Cameron to check on his whereabouts. When my phone finally rang, I was relieved to see Cameron’s number on the screen, and answered, “Hi Cam!”
The reply was, “Actually, this is Officer Smith with the US Park Police.”
I was awash with panic before I was able to process that Cameron was fine, but had been caught in the storm and the police were evacuating the Mall. They wanted to make sure someone knew where Cameron was.
The second call I will never forget happened last summer at the precise time Cameron always called to say he was leaving work. Again, “Hi Cam!”
… and “Mrs. van der Poel, this is Ms. Johnson. Cameron has been [assaulted] at work by another employee.”
I shared this event in my “Eyes Wide Open" column, but the memory of that experience is as fresh as if it happened yesterday.
Speaking of yesterday, this brings me to the third phone call from Cameron I’m sure to never forget. An hour before deadline for this column, I was sitting at my PC trying to think of something new to share. I was wishing for a compelling topic beyond my current obsession with trying to find a postsecondary program for Cameron. I took a break, and decided to push the deadline. My phone rang at exactly Cameron’s start time for work. I’m so used to these phone calls, I often don’t answer, and (most of the time) I later listen to the voicemail that Cameron has arrived safely. Because my phone was in my hand when it rang, I answered as soon as it started to ring. “Hi Cam!”
“Mom, I’ve been in a bit of an accident.”
Cameron was riding his bike on the sidewalk of a busy street, and came to an intersection. Cars from the busy street were turning left into the side street, and cars from the side street were turning right onto the busy street. There’s no light at this intersection so it is a bit tricky at rush hour. There was a line of cars on the side street, and the first car in line had pulled through the crosswalk. Cameron started to cross behind the first car, but the second car in line began to move forward as the first car moved forward. Cameron was caught between the two cars. The driver of the second car said he never saw Cameron.
This happened less than a mile from home, and my husband jumped in the car as soon as Cameron gave us the location. I kept talking to Cameron and could tell he was rattled, but not terribly injured. To keep him focused and distract him from his growing anxiety, I told him to call work and let them know what happened, and to call me when his stepdad arrived. Cameron called me back within three minutes.
The entire time this was happening, my inner demons were reminding me of Cameron’s driver readiness screening I wrote about in my last column. When the driving instructor asked me if Cameron could safely to cross the road alone, I was shocked and incredulous. But as the reality of this incident began to settle, I couldn’t help but ask if we had just been lucky that a much more serious accident hadn’t happened sooner. Was Cameron really not capable of processing everything that one needs to process in order to navigate traffic? Of course, I didn’t want to blame Cameron for the accident, but I needed to know if he was safe.
Cameron rode to the hospital in an ambulance. I arrived at the ER, and the first point of contact for the hospital was with someone filling out paperwork at her desk. I said, “Excuse me. My son was hit by a car and brought by ambulance. How can I find him?”
She gestured to the man at her desk and said, “This is the patient. You’ll have to wait.”
I stood there for 45 seconds and said, “I’m sorry, but can I go back to the nurses’ station and ask for my son?”
She turned to the triage nurse and (clearly annoyed) asked her to help me, and the triage nurse muttered that a lot of people had been brought by ambulance, as if Cameron would be difficult to find. Luckily, that was the beginning and end of poor treatment. When I finally found Cameron, he was being triaged by another nurse, in a private room, and the nurse was very compassionate. The nurse asked about existing medical conditions, raising his eyebrows as he offered, “Autism?” It probably shouldn’t make me happy that people immediately label Cameron as having autism, but in this case I felt somewhat relieved.
Cameron was doing a self-assessment of his injuries to his left foot and right leg. He predicted that he would need surgery or they would have to “cut these things off.” The nurse and I assured him that nothing would need to be cut off. Later, while we were waiting in the hall for X-ray, I started to think that what Cameron was referring to being cut off might be the bandages he had received in the ambulance. Surely he didn’t think his injuries warranted amputation! So I asked him if he meant the bandages, and he said no, he meant his leg and his foot. I asked why he thought they would need to be cut off, and he said because they might be broken. I explained that when bones are broken, they heal. There’s no cutting off of arms and legs. To which Cameron said, “So I guess it’s just a crazy idea of mine that they’ll cut off my hand if these warts don’t go away.”
The X-rays showed a small break on the top of his left foot. His left leg and knee were badly bruised and swollen, but nothing time won’t heal. Cameron apologized for forcing me to miss the movie my husband and I were going to see. He was worried that I had wasted my money by pre-purchasing the tickets. I assured him that I had gotten a refund. Cameron lamented that he had “ruined everything” because he had volunteered for a pet adoption event that he would now not be able to attend. I assured him that it was not his fault and that everyone understands that accidents happen and plans must change.
The police officers that responded to the accident also came to the ER. They inquired after Cameron’s well-being and gave me a card with a case number. I couldn’t stop myself from asking them if they felt Cameron was at fault in the accident. From what I’ve been able to gather, the driver of the second car was looking left to turn right, and apparently never considered the crosswalk in his actions. Cameron admitted that he was worried about being on time, so in his effort to hurry, he probably opted for speed over caution. I can see this accident happening to anyone—both from the driver perspective and the bike rider. This could have happened to anyone, regardless of the neurological processing abilities. But it didn’t happen to just anyone. It happened to my son. And as much as I’d like to be able to, I’ll never be able to see the world from his eyes and truly understand what he understands … and what he doesn’t understand. But I just can’t see myself clipping his wings in the interest of protecting him. I guess instead of managing Cameron’s every move, I’ll have to devote my energy to managing this knot in the pit of my stomach. And by the way, I don’t think I’ll find myself wishing for compelling column topics ever again.
First published on October 18, 2011.
Bat lollipops, gummy eyeballs, sticky popcorn—Halloween is that most delicious of holidays when the candy and treats are flowing freely. But what if you are one of the thousands of teenagers and adults on the autism spectrum following a special diet?
In preparation for the holiday, I decided to taste test various products with a few discriminating friends and family to see which items pass muster. I have divided the products into two loosely defined categories: Crunchy and Sweet.
Please note: If you are following a special diet, you need to check ingredients carefully and consult manufacturers before trying something new to make sure any product described here meets your dietary needs. Ingredients and manufacturing practices change frequently and labels can be confusing.
Hands-down, the number one gluten-free pretzel is the Bachman Gluten Free Puzzle Pretzel. This pretzel is shaped like the autism-awareness puzzle piece symbol. Taste testers liked the superior crunch. According to one tester, this gluten-free pretzel “does not crumble the way some gluten-free snacks do.” An added bonus is that the Bachman gluten-free pretzel is manufactured in a dedicated gluten-free and casein-free factory, but the product does come in contact with sesame seeds. By way of full disclosure, I had no idea while testing this product that Bachman donates 5% of sales of these puzzle pretzels to Autism Speaks.
For those of you allergic to or avoiding corn, I discovered a tasty substitute for popcorn. Mini Pops are made out of sorghum. According to the company, sorghum is more nutritious anyway, with fewer calories and more protein and fiber. Mini Pops really do feel like popcorn in your mouth and in your hands. My testers only sampled the Subatomic Sea Salt flavor and the raves were unanimous. Some flavors contain milk or milk products, but the manufacturing facility is dedicated gluten-free, organic, and kosher.
I discovered during this review process that a number of companies make excellent candies and other treats that are suitable for a variety of diets. Everything tested was delicious—so first prize can’t go to one single company. Instead, I narrowed in on a few treats from several companies.
If you are just looking for treats to pass around at a party or to hand out to trick-or-treaters, all my testers said YummyEarth lollipops are the best. And while my testers acknowledged that they enjoyed the allergen-free gummy bears, gummy worms, and jelly beans from several companies, most voted for Surf Sweets when asked to pick only one brand. As my neighbor explained, “Surf Sweets are sweet and fruity, but not too sweet, and definitely fruity.” Some Surf Sweet products are listed as vegetarian and not vegan because they contain Confectioner’s Glaze, which is derived from an insect—but all products are gluten-free, casein-free, and dye-free.
One other item that caught my eye: organic licorice laces by Candy Tree. These long strings of black licorice are dye-free, organic, and the ingredients are gluten-free. (Please check with the company if you require items manufactured in dedicated gluten-free facilities.) With a bit of innovation, you can tie and twist these laces into cob webs, bats, and witch hats. Imagine—allergen-free edible Halloween decorations! Now that takes the (gluten-free) cake!
A Few More Tips
Of course, you can find many other products that are suitable for special diets. Potato chips and corn chips, for example, are usually gluten-free and casein-free, and you can find these at any supermarket. A number of popular food manufacturers make candies and treats that are also free of allergens. But be careful. I tried a few types of gluten-free, casein-free chocolates only to discover that these items contain artificial flavors and artificial colors. Manufacturers are pretty good these days about disclosing ingredients and manufacturing processes if you call them up on the phone. You can also find a plethora of information on the web, but you should always verify Internet data.
Sometimes treats made in dedicated factories with carefully selected and monitored ingredients cost a lot of money. But often you can get free shipping if you order products from distributors online. Also stores like Whole Foods will usually give you a case discount on items the store carries. Talk to an accountant to determine if food products purchased in order to comply with a medically-required diet can be deducted from your yearly taxes as a health expense.
Luckily, for those of you following a special diet or interested in trying one, finding yummy, nutritious, and safe options is much easier today than it was even a few years ago.
Best wishes for a spooky and deliciously allergen-free Halloween!
I never thought I would be so happy to hear my child argue with me. I know that sounds odd, and if many parents were to hear me say that they would be looking at me like I may have come from Mars. But they don’t understand what it is like to have raised a child who could not express his likes and dislikes, emotions, physical pain and discomfort, personal opinions and individuality in general through the use of speech. It can be a trying road to travel.
But finally at the age of 27 Cody is making huge strides in overcoming his language barriers.
Last Friday night one of my sisters became gravely ill and had to be taken to the emergency room. It was clear that she had respiratory issues of some sort but tests had to be performed to determine what those issues were. After a CAT Scan was done doctors told her that she had a large mass in the base of her right lung that could quite possibly be lung cancer.
When I learned of the news I told Bill I was going to the hospital to see my sister. He really didn’t want me driving alone so he decided that he and Cody would drop me off at the hospital while they went and did a bit of grocery shopping.
Cody had already showered, was quite comfy in his pajamas and had plans to snuggle under his favorite blanket and watch some TV. When Bill told him to get dressed and that we were all going into the city, he had no trouble verbally expressing his displeasure about the idea.
Cody: “Well I’ll just stay home!”
Bill: “No, you need to go with us.”
Cody: “We’ll just stay home!”
Bill: “No we have to go into town.”
Cody: “I’ll just stay home and stay in my pajamas!”
Bill: (Smirking) “Cody, get dressed and get your shoes on.”
Cody: “I’ll just stay home and watch TV on the sofa.”
Bill: “Do you want to stay home by yourself? Nana will be here but she will be asleep and you’ll be all alone.”
Me: (Trying not to laugh.) “Ok. The argument is over. Let’s go get dressed now.”
Disgruntled, he complied.
We had never heard him be so verbally argumentative in such an appropriate way. There was no guesswork involved in ascertaining what he wanted.
While my sister is still in the hospital, doctors no longer believe she has cancer, but a complicated pneumonia which is much more easily treated, thank God!
It was only a couple of days later when I saw Cody’s new-found assertiveness in action once again.
Sunday, we went to the store to buy a get well gift for my sister. While we were there Cody saw a sweatshirt with a picture of a semi-truck on the front. He made a bee-line over to it and shouted, “That’s a semi-truck shirt!” He made this exclamation several times. He kept looking at me and then back to the shirt as if to say, “Mom! Do you see this?” Numerous times he held it up and ran his hand over the graphic. I sort of just stood and watched in awe for a moment. Finally, I asked, “Cody would you like to have that shirt?” Immediately with no hesitation in his voice he answered, “Yes!” Of course, I bought it for him.
His excitement was undeniably evident in his tone of voice. His actions were clearly demonstrative of his enchantment with this item. His facial expression was one of longing and not the flat affect we were used to seeing. And his verbalization was distinct and concise.
It is such a blessing to see this kind of self-expression coming from Cody. This kind of decisiveness and this kind of assertiveness is an indication to me that those kinds of verbal and non-verbal communication processes are present with him and he is now learning to articulate them in a concise and well-defined way which can be easily identified and understood by others. So don’t be surprised if you see me smiling while my child is arguing with me. I’m just happy to know my son is finally able to make his voice heard.
“Supersibling” is a term made popular by Karen Olsson in a 2007 New York Times feature which refers to siblings of individuals with autism who are particularly responsible and mature for their age. Supersiblings are often perfectionistic high-achievers, deeply devoted to their families and their siblings' care.
1. Your life experiences frequently call to mind these lines of dialogue from the movie "Juno":
Dad: “Hey … where you been?”
Juno: “Oh, just out dealing with things way beyond my maturity level.”
2. You are kind and compassionate, a fierce advocate for people on the margins. You may be too scared to speak up at times, but you are always loyal to the underdog.
3. You have this solemn rule buried deep within you from early childhood onward: Thou shalt not, under any circumstances, add to your parents' troubles and difficulties. And if thou doest, thou shalt at least feel very, very guilty for doing so.
As adult sibling Graham Seaton says in a 2004 New York Times article, "[As a child], I was so aware I couldn't make a big deal with my family … My parents already had enough on their hands." Likewise, in another 2004 New York Times feature, author Jane Ross notes, “Even when parents give them explicit permission to vent about an autistic sibling, many children choose silence, experts say, one of many ways they may try to protect their overburdened parents.”
4. The sole exception to the aforementioned no-venting, no-making-a-big-deal rule comes when you're under such stress that your (ordinarily strong) sense of self-control snaps. In such cases, you may be astonished to find yourself smashing a guitar, screaming at a stranger, or running away from home.
5. You have a tendency to take responsibility for other people's feelings. If something goes wrong, it's your fault. If something goes well, you take a moment to feel relieved, and then you start preparing for the next thing that could go wrong. You pray the Serenity Prayer because you are prone to forgetting what, exactly, you can and cannot change.
6. You are attuned to your sibling, able to read his or her expressions and moods. Often, adults rely on you to “translate” your sibling's vocalizations. For example, my brother Willie is obsessed with giving incorrect answers, even when he knows the correct response. Several times a day, he'll call out to our parents, “Is the capital of Spain Barcelona?” or, “Is two minus one four?”
The appropriate response to these questions is a gentle, playful one, something like: “Barcelona? I thought it was Istanbul!” or, “Two minus one is … ten?” This gives Willie the chance to deliver a punchline, saying, “Oh, no, I mean Madrid!” or, “No, it's one!” Such exchanges may be confusing to non-family, especially as Willie can become agitated if his questions aren't answered, or if the answer isn't what he expects.
7. You try to predict the future, because you often end up worrying when you sense the presence of overwhelming possibilities before you. For example, you probably know the estimated genetic odds—numbers, percentages, the whole bit—that your children (or your children's children) might be on the spectrum. You think to yourself: So, the odds that my kids would have autism are high … and the odds that I'll be the one caring for my brother/sister on the spectrum in the future are also high. What do I do? What's the right choice? What if I don't have kids and then end up regretting it, or what if I do have them and end up in some kind of untenable situation of constant caregiving?
At times you feel caught between having a “life of your own” and contemplating a life of caring for your sibling. Eventually, though, you realize that these categories are moot. A life of your own means caring for your sibling in some way, and caring for your sibling in the best and truest way also means having a life of your own.
I think it's only fair to report that I didn't have all the facts when I filed my last column about the shoplifting incident involving Reilly's friends. While it was true that he hadn't stolen anything, he was aware and complicit during the event. This came to light a couple of days later in a meeting between Reilly and school staff. The decision was made to suspend Reilly for a week, along with the kids who had been caught with stolen goods.
Reilly had planned to fly home for the long Columbus Day weekend. The suspension meant I had to change his plane ticket to move his flight up from Friday to Tuesday. While I was happy to have him home for more than the original three days, I was, of course, disappointed in him. And he was disappointed in himself.
When I texted him with the new flight details, he responded, "It sucks that I have to come home by suspension, but it will help me learn not to do anything bad anymore." He wanted to know if our weekend plans would still go ahead. A good high school buddy was to come for the weekend, partly to watch the big Cowboys versus Redskins game with Reilly. I decided I would go ahead with the plan—I didn't want to punish his friend, who was terribly excited to spend the weekend with us.
I got some of the details about the incident from Reilly's school counselor, who had talked the police officer out of arresting the kids. She was quite upset about the whole thing, and disappointed in Reilly, who she thinks is a great guy. I thanked her profusely for saving his bacon, though whether he would have been arrested with the other kids is unclear. I imagine she told the officer that the students all had disabilities and that the school would punish them.
For his part, Reilly had no explanation for his or his friends' very poor judgment. He said he knew what they were doing was wrong; he didn't know why he didn't say so. Another friend who is part of Reilly's group wasn't with them and had warned them that shoplifting was wrong. Why didn't they listen? Reilly had no explanation.
One of the students who was involved was not suspended. Reilly said he didn't think she had told the truth. We asked how he felt about that and whether he had reported that to the staff. He said he didn't think it was fair, yet he didn't tell on the student. But the fact that she wasn't punished didn't matter; it didn't excuse what he had done. I found that insightful and encouraging.
He seems to "get it" now. But of course, his dad and I are worried about all the possible ways his judgment could fail him in the future. Young people on the autism spectrum have trouble making generalizations, taking a lesson learned and applying it in a different situation. And Reilly holds on to a sort of magical thinking that is common in younger children. When I remind him to buckle his seat belt, he says, "Oh Mom, we aren't going to get in accident." When I ask him how he knows that, he tells me it is because we haven't been in an accident yet. So because something bad hasn't happened yet, it never will? I think that's a common belief system among teens, but at some point most kids start to understand the potential consequences for their actions or inaction. Don't they? Or am I attributing something completely normal to Reilly's disability again? As usual, I have no idea.
And it raises the bigger worry about young people with ASD living and interacting in a world that might not be so forgiving of their stupid mistakes or failures in judgment and reasoning. NYIT staff won't always be there to save them from themselves. And neither will Mom and Dad. I made him promise me that if he is in another situation where friends are using poor judgment he will call his brother or sister for advice. And take that advice. They've done their share of stupid things. Maybe he can learn from their mistakes, too.
I've heard it said before that aging out of free and appropriate public education is a lot like getting an initial diagnosis of autism all over again. When your son or daughter with autism leaves the protection of the school system, there's an abyss before you. And yes, it's a very similar feeling to when you received the first professional evaluation that officially says "something is wrong." There’s a lot of hand wringing and desperate need to take action without knowing what action to take. It feels almost as if someone has dumped a bucket of ice water over your head. (But definitely not in the celebratory, “We just became World Champions and we’re going to Disney World!” sort of way.)
As if facing life for Cameron after high school hasn’t been stressful enough, I’ve recently had a fresh bucket of ice water dumped on me. Cameron’s instructor from this summer’s driver education course recommended he participate in a driver readiness screening before we schedule any behind-the-wheel lessons. Based on his behavior in the classroom, she had concerns about Cameron’s ability to handle everything he would need to process while driving. I had been giving Cameron driving lessons in a parking lot, and while I knew it would be a long process to get him to a competent driving level, I had no doubts that he would eventually get there. Realizing that the instructor had only known Cameron for a very short time, and that the classroom setting is very different from being behind the wheel, I felt confident that the screening process would be a mere formality. Boy was I wrong! When I sat down with the instructor for her review of the screening, I had emotions bubbling up that brought back the distinct 14-year-old memory of being told the amount of supports Cameron needed in an academic setting, and that the short bus would be coming for him to take him to special needs Pre-K.
There’s nothing quite like having someone tell you your son isn’t capable of doing something you’re convinced he can do.
I received a six-page report as a result of the screening assessment. There were several areas of skill that were assessed, and the report contained many occurrences of phrases such as: “Cameron has poor skills in this area,” “Cameron was not able to …,” and “Cameron became anxious …” By the end of the review session, the instructor asked me if I felt Cameron was safe as a pedestrian crossing the street without assistance (!). Cameron and I left the meeting and I doubted nearly every instinct I had ever had when it comes to his upbringing. Were my visions regarding Cameron’s capabilities and reality truly that far apart? How will this effect Cameron’s self-confidence? Has this led him to doubt his abilities as well? The most proud I have ever seen Cameron was when he passed his learner’s permit exam. I think we both convinced ourselves that the written exam would be the most difficult step in his obtaining a license. Now we’re faced with the very real possibility that Cameron may never drive.
Not to worry. I haven’t lost all hope. But that dousing of ice water certainly has my attention.
I was recently asked to host a fundraiser for a nonprofit organization that provides employment services for adults with mental illness, addiction or autism.
If you’ve ever read a column I’ve written before, you probably know that I spend a great deal of time trying to figure out where my son will go and what he will do ...
I wanted to take some time in my column this week to commend the job being done by the Wall Street Journal in covering the topic of employment and autism.
One of the reasons I love spending time with Willie is his refreshing lack of pretense. I'm not good at polite deception, and neither is my brother.
There is an old stereotype associated with people on the autism spectrum which states that we lack feelings or, more specifically, have no empathy.
She wouldn’t let go. It had already been a Plan B day for me.
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