Tag Archives: children special needs

Preventative Measures

The New York Times published a piece in August of this year about the role the environment plays in the rise of autism.  It begins with the question asked by many people who are hoping to become parents  - What can we do to decrease the risk?

I have often thought about what I would have done differently, knowing what I now know.  There are a number of things, things I didn’t know to do or not do when I was pregnant with Emma.  There are a few things that appear to have some scientific basis to them, such as taking prenatal vitamins at least three months before getting pregnant and continuing to take them for the duration of the pregnancy.  I began taking them when I learned I was pregnant with Nic, though interestingly, with Emma I was taking them before I became pregnant with her and continued throughout the duration of my pregnancy.  I would not have eaten any fish of any kind during any part of my pregnancy.  I ate grilled swordfish a couple of times in my second trimester with Emma.  I also used fingernail polish remover a couple of times and had my hair highlighted once during my third trimester.   I would have stopped using all artificial sweeteners and I would have been more careful after the 9/11 attacks by not going downtown to Richard’s office in Soho to work.  Beyond those incidences, I did not take any drugs of any kind, not even aspirin, I didn’t consume caffeine or alcohol, I did not have an amniocentesis, avoided all and any invasive procedures, had two sonograms and gave birth naturally in a birthing center.  It seems unlikely that anything I did while pregnant contributed to her autism, but who knows?

After giving birth I would have done a number of things differently.  From the moment she took her first breath I would have eliminated all onion, garlic, dairy and wheat from my diet while I was breast feeding.  During those first few months when she was so uncomfortable and “colicky” I would have kept a food journal to see if there were other foods I was consuming that upset her and then eliminated those.  Since Emma seemed so uncomfortable when I breast fed and much preferred drinking breast milk from the bottle, I would have tried different techniques in swaddling her or having some sort of soft cloth between us so our skin to skin contact wasn’t so uncomfortable for her.  I would have started brushing therapy (click link for more detailed information on brushing) with joint compressions (see link for a detailed description of joint compression exercises) during this period as well.

Then there are the things I wish I had done much sooner such as  Dr. Marion Blank‘s literacy program instead of all those hours spent doing ABA.  I wish I had discouraged Emma from sucking her thumb.  I would not have introduced corn, soy, wheat, dairy or any foods that are thought to be problematic for some children.  I would have obtained an evaluation much sooner as well as taken her to a neurologist and had an MRI done before she was 18 months old.

Had I done all of those things, would any of it made a difference?  Except for introducing Dr. Blank’s program right away, which I am convinced would have made an enormous difference, who knows?  How much of a role does the environment play?  How much is due to genetics?  I have questions, lots of questions.  None of which will likely be answered any time soon.

For more on Emma’s journey through a childhood of autism, go to:   www.Emma’s Hope Book.com

Emma’s Story

This is the story Emma made up and wrote this morning before she went to school.

I had to give her support a couple of times when she would say a word, such as “the” or “to” but then would forget to actually write it and wrote the next word (always a noun or verb) instead.  According to Dr. Marion Blank, the woman who created the literacy program we have been using with Emma for the past nine months, children on the spectrum dislike non-content words.

Emma then took her story over to her dad and read it to him!

We first met Dr. Blank almost a year ago now.  Before that first meeting we both read her book “The Reading Remedy” and were impressed by it.  In January of 2011 we began implementing her program with Emma.  During those first few months we worked on the beginning of letter formations and sequencing.  In April Emma was able to form all the letters of the alphabet and we began the first level of the literacy program.  Over the last seven months Dr. Blank has added other elements to the program, specifically designed for Emma so that we now are working on a spoken language program in conjunction with the literacy piece as well as the Phonics Plus Five and Reading Kingdom programs.

For more on Emma’s journey through a childhood of autism, go to:   www.Emma’s Hope Book.com

Amanda Boxtel

Last night Richard and I went to a launch party here in New York City of Ekso Bionics with a live demonstration by Amanda Boxtel.  Amanda was in a skiing accident over 20 years ago, which left her a paraplegic.  For more than two decades Amanda has lived her life from a wheel chair.

This photo is out of focus and does not do Amanda justice.

Amanda demonstrates the power of Ekso Bionics

This quote is from Amanda’s website.

“Imagine wanting something so badly for years and years—fluctuating between acceptance of what is and hope for something better.  Imagine if that one thing you longed for is to stand tall with your legs supporting your full body weight, and then taking your first step.”

When we took Emma to Costa Rica for her first stem cell treatment, fluid seeped from her spine into her blood stream.  Suddenly she was in excruciating pain and Richard and I were terrified.  Amanda wrote me and her letter, one of many I have kept, was a calm voice of strength and reassurance.  Amanda has been to India six times for stem cell treatments.  She is an inspiration and source of hope for all.

Watching Amanda stand and then walk last night was a visual confirmation of what is possible in this world, if we never give up.  I think of Amanda often as I work with my daughter, Emma. Writing is difficult for Emma, it does not come easily.  But then walking does not come easily to Amanda either and yet she has never allowed that to slow her down.

Emma’s writing from this morning

For more on Emma’s journey through a childhood of autism, go to:   www.EmmasHopeBook.com

Having a Daughter with Autism

Someone asked me the other day – What’s it like having a daughter with autism?

The flippant response would be – I don’t know what it’s like to have a daughter without autism.  But the more thoughtful answer is a bit longer and more complicated.  My own experience of being a daughter to a mother with whom I feel deeply connected to, a connection that many, I have learned over the years, do not have certainly plays a role in my answer.  I have always felt my mother and I share something that goes beyond the usual feelings of responsibility and gratitude toward someone who gave so much in order that I might have a good life.  It is as though we share something much more than the history and past of living under the same roof for the first 17 years of my life, something I cannot adequately put into words.  We have a closeness, a bond and yes, a friendship that only a few of my female friends can relate to regarding their own mothers.  I have often said that if my mother were not my mother, I would wish she were.  I don’t actually know many people who can truthfully say that about their mothers.  I am lucky.  I get that.

So when I was pregnant with Emma, I fully expected to have a similar experience.  I knew right away she was a girl.  Don’t ask me how, I just knew it.  For one thing I began to wear pink, a color I never liked until Emma entered my being and for another I craved spinach and blue cheese during my first trimester, as opposed to steak and all things meat when pregnant with Nic.  Okay so I’m not being completely serious – though all of this is true – the pregnancy was different with Em, it just was.  Without meaning to or even consciously trying to, I visualized my soon to be daughter.  I knew she would have blonde hair, blue eyes and broad shoulders, as both Richard and I share these things, but beyond that I couldn’t know. I sang to her, just as I did when I was pregnant with Nic, I talked to her, read to her and dreamed about her.

While pregnant with Emma, I was walking on Fifth Avenue one afternoon, when I passed The American Girl store.  It reminded me of my first and favorite doll, Maribelle, a gift from my mother to me when I was little.  Maribelle came in a blue and grey striped trunk complete with shoes, gowns, dresses, she even had a fur coat!  (I still have Maribelle – she and her trunk reside upstairs in my mother’s house.) I saved her, intending to give her to my own daughter, were I fortunate enough to have one. Looking through the large windows of the store I fantasized of the day I would bring my daughter there and how she would choose a special doll.  A doll that would be like Maribelle was to me – a companion, a doll she would whisper secrets to and spend hours upon hours playing with.

Richard and I were not the kind of parents intent on placing our yet-to-be-born children on waiting lists of the most coveted New York City preschools, looking to the day we could sit listening to our child’s speech having graduated  from Harvard Summa Cum Laude.  Ours was a more unconventional approach – at one point we fantasized about putting all of our belongings in storage and traveling the world for a few years.  We spent many an evening discussing the places we wanted to travel to, which included Tanzania, Lebanon, Egypt, Brazil, Morocco and Laos.  We poured over guide books and vowed that once both children were out of diapers we would make our fantasies reality.  We had no way of knowing that Emma wouldn’t be out of diapers until she was eight and a half years old.  We couldn’t know that once she was out of diapers we would be scrambling to cover the staggering cost of her care, making any dreams of extensive travel abroad impossible to seriously contemplate, not to mention the sheer logistics of traveling to a foreign country with a child with special needs.

(To be continued.)

For more on Emma’s journey through a childhood of autism, go to:   www.EmmasHopeBook.com

Autism’s Murky Future

Yesterday the New York Times ran a front page piece entitled – Autistic and Seeking a Place in an Adult World.  I am always so grateful when I see anything on autism, even when I am not told anything I don’t already know.  I am particularly grateful when I see something on autism on the front page of the New York Times.  For those of us who are parents of a child with autism, the looming question of what will happen when our child becomes an adult is something we do not have the luxury to ignore.  Yet, the answer is not readily available to us, either.  There is no road map by which we can look to.  The future of our children is very much up in the air.  It is a tricky balance keeping the fear at bay, while also being practical and realistic about ones child’s future and how we might ensure she is taken care of should she not be able to hold down a job and live independently.

My message of hope on The Hope Installation at the entrance to the High Line

The truth is we cannot know what Emma will be like in another eight years, all we can do is continue to work as intensely and extensively with her as we currently are.

So this evening when I come home from work, I will work on the word – does.  After we spend an hour or so going over the word, both using it in hand written sentences and as well as typing sentences with it, we will also use the word verbally as when I lay out a frog, a boy, a bus and a dog and say, “Hand me the one who does not eat.”  After we have done all of that we will play some games using the word “does” and finally we will go over a list of words she has already learned and review them.  Somewhere during all of this – dinner will be prepared, Nic’s homework will get done, stories will be read and everyone will eventually go to bed.

For more on Emma’s journey through a childhood of autism, go to:  www.EmmasHopeBook.com

Gymnastics – Autism

Because Emma has a wide variety of sensory issues and because she is so active, we are always trying to find things she can do that might give her some of the sensory input she so craves as well as help her focus while doing something she enjoys – moving.  Finding someone willing and able to teach her is often challenging.  It requires a special person who can keep her focused without using a great deal of language, who also has the patience and desire to continue to work with her for more than one of two times.

When we finally found Brett, a gymnastics instructor, we leapt at the chance to make this into a weekly affair.  So on Sundays Emma and Nic have an hour of gymnastics – or they did until Brett hurt his ankle.  But now Brett is back and off they went last Sunday to their first gymnastics class in almost four months.  Emma was very excited and kept saying, “Oh, Brett’s ankle is broken.”  ”Brett hurt his ankle.”  ”Ankle all better now.”

To which we would answer, “Yes, Brett hurt his ankle, but now it’s much better!”

When we arrived and Brett came out to get Nic and Emma, Emma bent down and gently patted his ankle.  ”You hurt your ankle,” she said, sadly.

“Yeah, but it’s better.  Thanks Emma.”

“Ouch!  Have to get a bandaid,”  Emma said.  Because to Emma, anything that hurts requires a bandaid and will feel better if a bandaid is applied.

Emma and Nic stretching with Brett

Since it’s been awhile since Emma had gymnastics, I was curious to see what if anything was different.  Would she be able to stay more focused?  Would she attend more?  Would she be able to follow instruction better?

During their stretching period, Emma managed to keep up.

And while her form wasn’t great, she did do all the various stretches as best she could.

Later she was able to do straddle jumps on the trampoline and forward and back rolls on the mat.  She became a bit distracted when a birthday party took place in another part of the gym, but for the most part she attended and tried to listen.

Waiting for her turn on the trampoline.

All in all she showed progress, slow but steady progress.

For more on Emma’s journey through a childhood of autism, go to:  www.EmmasHopeBook.com

A Work In Progress

As we have added more work to Emma’s already busy schedule, I have had to adjust my own schedule to accommodate.  Since her new school year began this week, I am now doing her literacy session before the bus comes to take her to school in the morning, while Richard gets Nic ready.

This morning we worked on the word “boy”.  Emma wrote this in answer to my question – “Are these boys?”

“What are they?”

Wait for it…

Yes, they most certainly are!

The beauty of this is that all of it is done non-verbally.  Emma is able to concentrate fully on answering the questions posed by either writing or typing the sentences on the computer.  Today she learned how to use the shift key while hitting the appropriate letter to create an upper case letter to mark the beginning of a sentence.  The grin on her face when she wrote:  ”Here are some boys.  They are sitting.” complete with punctuation and upper case letters for the “H” and the “T” was as close to euphoria as one can get.  She even giggled when she was finished and beamed at me with pride.

This is the dress Emma chose to wear to school today.

For more on Emma’s journey through a childhood of autism, go to:   www.EmmasHopeBook.com

Hope – Autism

For those of you planning a trip to New York City, you must take in the High Line, New York City’s most creative and interesting park, built on the old elevated tracks on the west side of downtown Manhattan.  The High Line spans more than twenty blocks and eventually will end at 34th Street.  Last Sunday we came upon this art installation at the bottom of one of the High Line’s many entrances/exits.

On each of the little red and yellow tags people had written what they hoped for.  One said, “Cure Ann of her cancer” another said, “I hope I will love Miquel forever”, and still another read, “Please make Mom get better”.

Love and health were the most popular “hopes”.  I would have written one of my own had I’d thought to bring a pen with me – Let Emma live an independent, happy life, filled with loving relationships.  I guess the thing about hope is it keeps us moving forward.  Hope allows us to get through tough times.  I am reminded of the prayer of Saint Francis of Assisi:  ”Where there is hatred, let me sow love; where there is injury, pardon; where there is doubt, faith, where there is despair, hope…”  Regardless of ones beliefs, these words have given solace to a great many, myself included.

For more on Emma and her journey through a childhood of autism, go to:  www.EmmasHopeBook.com

My Emma

A mother with her little girl, about Emma’s age stand patiently in line for the bathroom on our flight to Denver.  Methodically her mother braids her daughter’s long, blonde hair, then places her arms around the child’s upper body.  Her daughter puts her own hands on top of her mother’s, tilts her head up and smiles at her mother.

I marvel at how such a simple gesture, probably gone unnoticed by either of them, is utterly foreign to me.  I long for such a simple exchange with Emma.  I get them, but they are rare.  When they do come, seemingly out of nowhere, I am usually caught off guard and brought to tears, tears of relief and joy and something else, something closer to grief.

I think of Emma, standing in a similar line, on this same airplane route flying from New York’s La Guardia to Denver several years ago.

“Potty?” Emma says, anxiety rising in her voice.

“Yes, we have to wait in line,” I say.

“Potty?!” Emma says again, her voice slightly louder, the anxiety has crept up a notch.

I count the number of people in front of us, there are four, but one’s a couple so maybe they don’t both have to go, perhaps they’re just keeping each other company I reason.  Five minutes, tops, I think.

“We have to wait,” I say again, grim determination steeling into my tone.  I take a breath when another person vacates the only bathroom, reducing our line to three.  I look behind me at the two bathrooms at the back of the plane, the line snakes up the aisle, at least half a dozen are waiting.

“Have to use the potty,” Emma says now close to tears.

The woman in front of us turns to look at the whining child, my child.  “She can go ahead of us,” she says kindly.

“No she can’t,” her husband, counters.

“Scott!  Of course she can.  Go on, go ahead of us,” she glares at her husband who is shaking his head in annoyance.

Grateful, I thank them, ignore the husband’s irritated glare and go to the head of the line, pulling Emma ahead of me.   Anxiety, stress – will she wet her pants?  Did I bring enough pairs of underwear and a full change of clothing if she does  Embarrassment, humiliation… it’s all there.

I return my thoughts to the little girl with her mother behind me, looking for any sign that she might be uncomfortable.  There are none – mother and daughter, utterly relaxed standing close to one another, as though this were the most natural thing in the world.

“Compare and despair,” a friend of mine once said to me.  And it is true, though I cannot always help myself.  Whenever we are with friends with small children, whenever we are at a playground, any time I see a child I find myself asking – did Emma do that when she was that age?  Did Emma ever to do that? And then the inevitable follow up question, which serves to slam the door shut on all further questions – will she ever do that?

Who knows?

I am away for the next four days, yet my children and husband are here with me, everywhere I go.  I find there’s great solace in that.

Two Steps Forward…

Emma had another melt down Saturday night.  It went on for well over an hour and it began with wanting to eat whipped cream though it was time for bed.

“Whipped cream?”  Emma cried repeatedly.

Joe and I tried to use the following; it’s time to go to bed, it’s dark outside, which means it’s time for bed and you’ve already brushed your teeth, as reasonable explanations.  None of these statements made a difference nor did they serve to appease her.  When she realized eating whipped cream at 9:00PM wasn’t going to be allowed she said, “Vanilla milk?”

We repeated the same logic to a mind in lock down mode.  It was futile and we knew it.  Weather the storm, I kept thinking, but had a tough time being calm about it.
Eventually I raised my voice, “Emma!  You cannot stay in my room and scream.  You can scream in your own room.  Where do you want to be?  In your room or Mommy’s room?”

The fact that I was now raising my voice while telling her to lower hers was not lost on me.  Nor was the idea I was having a difficult time controlling my own emotions, yet was demanding she control hers.  It reminded me of once during a parent/teacher conference at our son, Nic’s school.  It had been a rave review and finally as things were coming to a close I asked, “Is there anything he needs to work on?”

“Well he has trouble controlling his impulses sometimes,” his teacher said.

“His parent’s are still working on that one too,” I responded.

To which his teacher laughed, “Yes, I suppose we all are.”

It was with this in mind that I was able to say, “Let’s take a deep breath, Em.”

“Stay in Mommy’s room,” she cried.

“Okay.  But you can’t scream, take a deep breath,” I said.

“Whipped cream,” Emma cried.  And on it went.  In many ways it was worse than the other night when she was crying for the four-wheeler because this time her screams were even louder and she went on even longer.  And then she began hitting herself in the head.  Hard hits with clenched fists, curled in frustration, seeking to cause pain.  I can only assume the physical pain from hitting herself lessened the emotional internal pain and frustration she was feeling.  I had to hold her wrists so she couldn’t hurt herself and thought of all those young women who seek solace in cutting themselves.  It is a terrible thing to witness your child causing injury.  That it is their own body they are inflicting the injury to makes it all the more upsetting and baffling.  Other than physically restraining her and trying to speak in soothing tones, I felt unable to help her.

Eventually she calmed down enough for me to let go of her wrists.  “It’s going to be okay, Emma,” I said.

“Whipped cream?” she whimpered.

I thought of how when Nic was a toddler I would try to distract him when he was upset.  “Hey Em, do you want to see some photos?” I asked, pulling out my iPad.

“Whipped cream?” she said, looking at the pictures.

“Look!  Here you are with Toni riding Beau,” I said.

“Beau,” Emma said, flipping through the photos.

“Wait, look here’s Nicky riding Beau.”

“Toni,” Emma said.  Then she added, “Whipped cream?”

“Oh look Em!” I said, hoping to keep her distracted, “what about this?  Who is that?”

“Joe!” Emma said staring at the picture of Joe two Christmases ago.

After ten minutes or so Emma said, “No more photos.”

“Okay.  Do you want me to talk to you?” I asked.

“Yes,” she said, surprising me.

I decided to do something I use to do with Nic when he had trouble falling asleep.  I would use a soft sing-songy voice about walking through a meadow and finding a trail that wound through a field of wild flowers.  I would go on making it up as I went until Nic would eventually fall asleep from the sheer monotony of it all.

“Your walking along a path,” I began.

“Whipped cream,” Emma whispered.

“There’s a field of wild flowers all around you,” I went on.

“Emma stop talking,” Emma said quietly.

“The wild flowers are so beautiful, pink and purple and blue.  There are lupine and poppies and Johnny jump-ups,” I continued.

But before I had gone through five or six wild flowers, she curled up as close to my body as she could without actually being on top of me, pulled my arm so it was wrapped tightly around her waist and immediately fell asleep.

Later as I was thinking about how upset she had gotten, how inexplicable it all was, I remembered how Emma often has terrible upsets in the evening after a day or days of amazing progress.   It’s two steps forward, one step back, the unsteady progress of a mind trying desperately to make sense of it all.

When we were in Panama waiting for Emma to wake up from the anesthesia after her second round of stem cells, the attending physician said to me, “It’s never like this,” he held his hand up at an angle pointing his fingers upward.  “It’s more like this,” he waved his hand up and down steadily raising it up.  “There’s progress but it’s up and down.”

“As long as she’s showing progress, you’re on the right track,” a neurologist once said to us early on after we’d received her diagnosis.  “Just don’t let her get away with too much,” he added as we left his office.

That Emma is progressing is something no one would dispute.  She is making progress, however shaky it may be, it is still progress.