Tag Archives: autism and parenting

Emma’s School Bus

Emma came home this evening and said, “Sad.”  This was in answer to my question, “How are you?”

“Why Emma?  What happened?” I asked.

“Emma have to go on the school bus.  Emma make you sad,” she said, frowning and nodding her head.

“What do you mean?” I asked kneeling down so my eyes were on the same level as hers.

“You have to wait!  You have to sit!  Emma cry.  Emma bite yourself,” Emma looked directly at me as she said this.

“Why do you have to wait, Emma?” I asked.

“Want to go to Becky’s class.”

“Did your bus come to school early?”  I asked trying to piece together what Emma was trying to tell me.

“You have to wait.  Want to go to Becky’s class.”

“Did someone tell you, you had to wait?” I asked.

Emma nodded her head.  Shouting and pointing her finger she said, “I told you! SIT DOWN!”

At this point I was more than a little alarmed.  “Emma, who said that to you?”

Emma didn’t answer at first, then nodded her head.  “Yeah,” she said in a sad voice.

These kinds of responses from Emma only highlight how difficult it can be to communicate with her and understand her.

“Did the bus driver say that to you or the bus matron?” I asked, knowing these were the only two people on the school bus.

“Bus driver said – I told you NO!  Sit down!”  Emma said in a loud stern voice.  Then in a quieter voice she said, “Emma cry.  Emma so upset.”

I think it was at this point in the conversation when I went to the computer and wrote an email to our lawyer, ccing Richard and Emma’s head teacher, the head master and social worker.  I have no idea what kind of recourse is available to us and so we need advice.  What I do know is that we have had to deal with the Office of Public Transportation since Emma began going to school five years ago.  Emma’s bus arrives between 7:20AM and 7:40AM to take her some fourteen blocks to her school, which begins at 8:30AM.  When I called to complain about the early pick up time, insisting that it cannot possibly take an hour to drive fourteen blocks even if three of them are cross town blocks, I was told the bus picks up many other children who go to several nearby special education schools before Emma is eventually dropped off at her school.  In other words, Emma is driven around the city for close to an hour.  For years now I have questioned the logic in this and have been:  hung up on, yelled at or told this is the way the route is mapped out and there’s nothing that can be done.

A few years ago I was determined to have the bus change their pick up time from 7:15AM to something later.  For two months I went back and forth with various people at the Office of Public Transportation, sometimes calling three and four times in a single day.  By the time they finally agreed to change Emma’s pick up time the semester was coming to an end and we started anew with a new bus company and driver after the break.  Which is another bizarre thing.  Are special needs children the only ones who have a new bus company, new bus driver, new bus route every three to four months?  How is it that neuro-typical children in New York City have the same bus for the entire school year, often for several years in a row?

In the past few weeks I have noticed when the bus pulls up that there seem to be only one or two other children on the bus as was the case Thursday morning, no other children.  Emma was the only child.  So unless the bus is picking up children after Emma, it is driving fourteen blocks (which should take about ten minutes depending on traffic.  If the bus arrives early, (picks Emma up at 7:25AM drives ten minutes to her school, getting there by 7:35AM) it sits idling outside the school until the school’s doors open at 8:25AM.  Which means (if I am correct) Emma is waiting in the bus alone for almost an hour.

What makes all of this particularly horrifying to me is we put Emma on the school bus and cross our fingers she will be treated well and with respect, she will arrive safely at her school in a timely manner, but we cannot know what really goes on because Emma cannot tell us.  We have to trust.  And at this moment I no longer trust.

Emma’s Language

Emma’s language continues to fascinate.  What follows are a number of examples demonstrating Emma’s creative use of the English language.

This morning she said tearfully, “ Rope?”

I now know she was asking me to help her find Merlin’s cat toy, which Emma has become particularly fond of.  It resembles a fishing rod, only it’s plastic and at the end of a thinner plastic “line” is a cat’s version of a fishing fly.  The “fly” has feathers in royal blue and black though ours, or I should say, Emma’s no longer has any feathers.  Just a few defeated bristles are all that remain.  I tried to get Emma to call the toy “Merlin’s cat catcher”.  Emma repeated the words and then said, “rope,” in a matter-of-fact tone.  Fair enough, saying rope is certainly easier than the tongue twister I was suggesting.  Emma’s interest in Merlin’s toy is not to engage Merlin in any sort of play.  She likes to hold it and chew on the thinner plastic line.  Merlin, under the misguided impression it is still his toy, leaps at the bristled end and tries to grab it in his mouth.  Emma ignores him unless prompted by one of us to use it to play with him.  At which point she will whip the thing around her head so violently Merlin runs away.  Mission accomplished.  No one can accuse Emma of not being able to creatively problem solve.

“Leash?” Emma said the other day.  “Leash” is short hand for any number of things:  tape measure, jump rope, belt or dog’s leash.  It began out in Colorado where she loves to hold the leash attached to one of my mothers’ two German Shepherds.  She is actually terrified of most dogs, including my mother’s.  Giving her the leash to hold is one way to calm her when we are taking the dogs for a walk.  But since we do not own a dog in New York City I know when she asks, she is looking for my tape measure or less frequently her jump rope.

This morning Emma sat on the floor and looked at some work sheets that had been sent home in her backpack.  There were a series of numbers referring to corresponding red dots.  Emma looked at the number and said, “What’s that letter?”  She then counted the red dots, ” One, two, THREE!”

“What’s that number, Emma?”  I said.  “It’s a number.”

Dutifully Emma repeated, “What’s that number?  One, two, three, four.  FOUR!” She looked up at me and smiled.  “What’s that letter?”  She said pointing to the number 6 on the next work sheet.

“It’s a number, Em.  Look these are numbers and this,” I drew the letter A, “is a letter.  Can you see the difference?”

Emma nodded her head.  “A”, she said.

It was not clear she understood the difference.

As I watched her counting and naming the numbers I thought about how it must all seem so arbitrary to her.  A number, a letter, a rope, a leash, a toy…  All things we learn to identify at a very young age and never think about again.  But for Emma this is not the case.  Why would the symbol for a quantity – say the number 3 – be any different than the letter G if one does not understand quantity?  If one continues along this line of thinking all the names we apply to letters in the alphabet must seem incomprehensible.  Why is the letter H called “Aich”?  It’s phonetic sound doesn’t offer any clues either as it’s the sound one makes when hit in the solar plexis or something resembling a whispered “huh”.   As anyone knows who has attempted to learn the English language, for every rule there is an exception, making it an exceedingly difficult language to learn.

The other night Emma was recounting our trip to Costa Rica, something she often does.  She tapped her stomach and said, “Now go bang-bang!”  Which means she was remembering how her stomach hurt.  “Now see thunder.” She added.  Meaning she remembered her headache.  “Make you cry.”  She said and proceeded to pretend cry while looking at her reflection in the mirror.

We have an African Senufo Bird in our loft which is a primitive statue carved from wood.  It stands about five and half feet tall and Emma refers to it as – “giraffe”.  I have corrected her on numerous occasions, but she remains unconvinced.

Yesterday, seated next to Emma while she ate her breakfast, she looked at my upper arm and said,  “Ahhhh… you bit.”  She made a sad face while pointing to three scars on my arm, which I received when I broke my shoulder about 14 years ago.  The doctors inserted three metal rods into my arm to facilitate the mending of the broken bones.  Emma has never mentioned the scars, so it was interesting that she took notice and then showed genuine compassion for what she imagined must have happened – that I bit myself.  Something Emma does to herself when her frustration becomes unbearable.  That Emma was relating the scars on my arm to an action she often takes and was identifying with it was remarkable and very hopeful.

I have come to appreciate Emma’s use of language.   I would like to become fluent in it.

Emma’s Language

I am lying in bed reading.

Emma comes running in looking for me.  She stops when she sees me.  Huge smile.  In her hand she has two pieces of what are left of her blanket she calls“cokie”.   She drapes the smaller piece on my arm and says, “That one Binky, mine!  Ohhhhh!” She runs to the other side of the room.

“Emma!” I say in an animated voice.  “Are you letting me have your cokie?!”

“Wait a second.  That one cokie,” she says holding the larger piece of her old blanket in her hand.  She jumps up and down.

“Is this piece mine?” I ask.

“That one Binky.  Awww…” She says in her sing-songy voice.

“I have Binky and you have Cokie?” I ask.

Emma twirls around holding her blanket.  “What’s boy?”

I put my ipad away and sit up.  “What is boy, Emma?”

Emma seems to not hear me.  “What’s ee- day? Boy gone.  Yes!” She says while continuing to twirl in place.  “Booooooy..” She says the word as though it were several syllables.  Her voice rising in the middle of the “o” sound and coming down at the end, stretching it out, playing with the sounds.  She pauses and stops twirling.  “Ee-day is gone.” She begins to twirl again.

“Who’s ee-day? “ I ask.

“Ee-day move away.  Ee-day is gone.”

“Emma, do I know ee-day?

“Ee-day move away.”  She begins to jump up and down.  “That’s right.  Boooooy, ee-day gone.  Ee-day is gone.  Ee-day is gone.”  Emma stands still and continues twirling a piece of her hair around her finger.  “What’s watch your finger?  What’s boys?  What’s watch your?  What’s watch, wash your finger?”

“Are you saying watch or wash, Emma?”

“Booooy – wash your finger’s gone,” Emma sings the words.

“Emma, is it wash – like washing soap or watch, like you watch Elmo?”

Emma says nothing.  She stands still with her head cocked to one side and twirls the lock of hair. Twirl, twirl, twirl.   She stares at the piece of hair as she twists it around.

“Or are you saying watch out!” I ask.

Emma looks at me, “WATCH OUT!  WATCH YOUR FINGER!  BE CAREFUL!!”  She shouts while jumping up and down.  Then she begins to laugh.

“Did someone at school tell you to watch your finger because it might get caught in something?” I ask.

“You have to be careful.  Watch your finger!” Emma says.  She runs over to me and yanks away the piece of her blanket still draped on my arm.  She runs away and then comes back and gently places the scrap on my head.  “Ahh, it’s your Binky.”

Earlier that day Emma was taking a shower.  “Emma make sure you use the soap,” I tell her.

She dutifully washes her body with soap.

“Now make sure you rinse your body off.”

Emma stands just to the side of the spray, soap covering her.

“Wash the soap, Emma,” I say.

Emma holds the bar of soap under the water.

Okay, that makes sense, my mistake, I think.  “No not the bar of soap, the soap on your body,” I explain.

Emma moves under the spray and proceeds to wash the soap off of her body.

I don’t know what Emma hears or what goes on for her when she is being spoken to.  I do know she takes things literally, as when I told her to wash the soap, meaning wash the soap off her body.  Often, as in the first conversation, Emma seems to be working through something, though it’s not clear to me what.  Either that or she likes the sounds and is playing with the sounds of the words and their various meanings.  My guess is there is much more going on than I am able to figure out.  I am almost always perplexed by Emma’s language.  It is foreign to me and while I am learning to speak a little of it, I have a long, long way to go.

Soma Mukhopadhyay’s Workshop

A number of people contacted me regarding the documentary – A Mother’s Courage – the documentary about an Icelandic woman’s search to help her autistic son.  The documentary tracks the journey of a mother who interviews many and eventually goes to Austin, Texas where Soma Mukhopadhyay has created the Halo Clinic.  Soma is the mother of a non-verbal autistic child, Tito.  (Tito is no longer a child.) Soma developed a program, Rapid Prompting Method, to teach her son to read and write.  Tito has gone on to write several books, despite being non-verbal.

Joe, Emma’s therapist and I drove out to the Bronx this past Saturday where Soma was leading a workshop.  Soma described RPM as a method to “empower the student and express himself.”  Soma’s method takes a non-judgmental view of self-stimulatory behaviors.  She believes they are clues that can help us interact and teach the autistic child.  Soma never once implied nor does her website that her method is a “cure” for autism.   RPM is a means by which autistics can learn to communicate.

For those of us who parent an autistic child, that is an amazing and wonderfully hopeful prospect.  There is not a day that passes when I do not have the thought – I wish I knew what Emma was thinking.  I wish I had a window into her world.  The idea that Emma might one day be able to read and write is something I have hardly dared to wish for.

Toward the end of the workshop, Soma’s son Tito wrote on the large pad of paper Soma had propped up on an easel:  “I think you are talking too loud.”  Soma had been speaking into a microphone.  She held the microphone to his mouth so he could hear how he sounded as he made a noise into it.   It was a light hearted moment, a moment of a teenager commenting on his mother.

Tito writes in his book – The Mind Tree:  “One day I dream that we can grow in a matured society where nobody would be ‘normal or abnormal’ but just human beings, accepting any other human being – ready to grow together.”

I have ordered Soma’s book describing in detail her Rapid Prompting Method.  I am guardedly optimistic.

For more information on Soma and her work with her son Tito, go to:  www.halo-soma.org

Rules

Emma can be very strict.  She is a stickler for rules.  Merlin (see yesterday’s post) is not supposed to jump up onto the counters or dining room table.  If he does, Emma shouts, “Merlin!  Get down!”  Even if he hasn’t jumped up on the counter (yet) Emma will remind him, “Merlin!  You may not get up on the table.”

If we have a vase of flowers on the dining room table Emma will repeatedly warn Merlin (whether it applies or not) “Merlin, kitty, you cannot eat the flowers!”  Then she’ll laugh.

These are all things she has heard us say at some point and Emma is a terrific mimic.  She will not only repeat the things she hears us say, but she will mimic the tone.  There’s a word for what she does.  It is – echolalia – common among autistic children.  Echolalia is the parroting or echoing of sentences and phrases heard.   Emma does not make the sorts of linguistic mistakes commonly heard in young children.  She does not say things like – I bringed it to her – something often heard from young neuro-typical children as they try their best to navigate the English language.  On the other hand Emma will say – Bye Emma! When saying good-bye to someone, whose name is definitely not Emma.  It is what she hears them say to her when they or she is leaving.  Why would she say anything else!?  To Emma “Bye Emma” means a parting of ways.  Or, as in the case of a dinner party we had a few months ago, Emma felt it was time for everyone to leave, she announced – “Dinner is all done!  Bye Emma!”  When our guests, understandably confused, said, “Oh!  Are you going now?” but did not themselves show any sign of leaving, Emma began bringing them their coats, saying, “Bye! Bye Emma!”  while vigorously waving her hand good-bye.  Needless to say she cleared the place out within minutes, despite our reassurances that it was not time to go yet and wouldn’t they like to stay and have some coffee or tea.

For Emma, however, we had eaten, she had patiently waited while this occurred.  She knew there would be dessert after which she would be allowed to blow out the candles on the dinner table while singing “Happy Birthday” (Any party is a birthday party and remarkably some guest almost always is about to have or has just had a birthday – so it confirms Emma’s ‘party = birthday party’ theory.)  Once Emma has sung Happy Birthday, usually several times and with all of us joining in for the third or fourth “last time” rendition – it is time to go to bed.  Emma has a difficult time understanding that we may not be ready for bed.  We may want to move into the living room to talk, have some tea or coffee and enjoy each other’s company.  This, for Emma, is not how it should be, it is her bedtime now and so it should be everyone elses too.  This sort of flexibility does not fit into her “rules”.  The guests should leave and if they do not, then Emma must remind them.

When Emma was beginning to talk she did not say single words, but whole sentences.  See previous post – “Emma at Ten Months Old”.  As Emma grew older, she would repeat things she heard others say.  But the things she latched on to were things said with a great deal of emotion, or, as Stanley Greenspan used to say, “high affect”.  Sometimes these comments were in context, but other times they were arbitrary.  A dear friend of mine who has two children just a bit younger than mine admonished her son in the playground one day while we were there.

“Rogan NO!”  She shouted, as her son dashed toward the gate leading out onto 10th Avenue.  Emma, for the next four years mimicked her in all sorts of situations.  Often it was when she wanted to go somewhere, but knew she shouldn’t, but just as often it was arbitrary.  Emma would shout, “Rogan NO!”   Sometimes she would add  “You have to come back!”  And sometimes she would just use the short hand version  “NO!”  But we knew from the way she said it, the tone she used who she was mimicking.  She had captured the voice perfectly.  A few years ago we ran into my friend with her children in the park and Emma upon seeing her, immediately said, “Rogan, NO!”  Fortunately my friend has a good sense of humor and didn’t take offense.

Emma does the same thing with another friend of ours.

“Jack!” Emma will shout in a stern voice.  Then “Jack!  Jack!  Jack!”  Said in rapid succession.  She captures the child’s name and the anxiety ridden pitch perfectly.  At Nic’s birthday party a few years back, Emma, upon seeing Jack’s father, started shouting – Jack!  Jack! Jack!

“I guess that’s how I sound, huh?” The father said, looking slightly embarrassed.

How to explain?

For Emma, rules help her cope in a world run riot.  Rules provide sameness and from that, Emma derives comfort.  Though Emma has been known to question some of the rules she does not like.  “We cannot make pancakes,” Emma will say, knowing it is a school day.  She hopes maybe we will make pancakes anyway and this is as close to a question as we often get.  But once confirmed, “No we cannot make pancakes this morning.  It’s Wednesday,” one of us will say, Emma will begrudgingly accept this.  It is our rule after all.

“Sleep, wake up, sleep wake up, sleep wake up, pancakes!” Emma will respond.

“Yes.  That’s right.  Pancakes on Saturday and Sunday.”

“Make pancakes with Mommy?”  Emma will say with a sly grin, trying one last time to see if this ‘rule’ can be suspended if for only one day.

“Pancakes with Mommy on Saturday.  Today is Wednesday.”

“Okay,” Emma will say.

Sunday in the Park with Emma

Most Sundays we all play around the house until noon and then Ariane will do something with Nic while I take Emma on an outing, usually to the “big park” – Central Park. Emma knows what she likes and likes her routines, so most of the time our forays are predictable, except when I try to mix things up deliberately just so she doesn’t get too OCD about it. In the Spring, Fall and Winter months, the routine begins with a visit to the “big carousel” followed by the zoo, the children’s zoo, FAO Schwartz and the Apple store. Sometimes we start with a trip to the Natural History museum and then do one or two items on the other itinerary.

In late Spring, Emma will begin talking about how “the ice skating’s all gone…ice skating over”, in a very sad voice with a very concerned frown. In truth, she’s much more excited than sad, because she can’t wait for Memorial Weekend when an amusement park opens up where the ice skating rink used to be. It’s called Victorian Gardens and Emma has been talking about it and going over to the rink to see if it’s open every weekend for the last month.

Hooray! It opened this weekend and she went on Saturday with Lee and Sunday with me. We spent a few hours there and then we changed into her bathing suit and went to one of the playgrounds inside the park that has a nice sprinkler and a series of little pools she can sit in. We spent a couple more hours there, Emma playing in the water and in the sand and climbing and sliding.

When it was time to go home, Emma did a really good job of rinsing the sand off as soon as I asked her to – something that used to be incredibly difficult to get her to do without a complete tantrum. On the way to the train we stopped for a snack and sat on a park bench. While she was sitting there, happily munching away on her Pirate Booty, she pointed to a butterfly and said, “butterfly.” She pointed again when a woman walked by pushing a carriage and said, “baby asleep in the stroller.”

This is the second weekend in a row that she has pointed repeatedly at different things and labeled her sightings. I’m sure this won’t seem very significant to most people, but it was her lack of pointing and labeling that finally ‘clinched’ her diagnosis with ASD and cut through our last shred of denial. To see her pointing at things while looking at me for my reaction fills me with great joy – and hope.

Years ago we started a diary book that we called Emma’s Hope Book, where we listed every little advancement she made as a way to focus on the positive aspects of her recovery and to bolster our spirits as we repeatedly slid into despair at just how slow her progress has been compared to normal children her age. “Compare and despair” is a recipe for hopelessness and so we still cling to every new achievement as a victory flag placed on top of a mountain.

Emma’s Hope Book is alive and well here (and now open to the public) and more than ever does it serve it’s intended purpose for us – to cut through the other side of our denial — our denial of her gradual but indisputable progress. She is getting better, slowly but surely, more slowly than we would want of course, but moving forward one day at a time. We have hope – and the evidence documented on these pages – that she is getting better a little bit at a time, day after day.

This Morning’s “Conversation”

(Showing Emma this photograph)

Emma splashing

A:  Hey Emma!  What do you see?

Em:  He putting on the sprinkler.

A:  Who’s “he”?

Em:  He putting on his feet in the sprinkler.

A:  Who is that?

Em:  Emma.  Emma putting he feet in the sprinkler.

A:  Her.  Her feet in the sprinkler.

Em:  Her.

A:  You’re putting your feet in the sprinkler.

Em:  Yeah.

A:  Was that fun?

Em:  Yeah.

(I show her this photograph)

Me:  What about this?  What’s going on in this photograph?

Em:  Dr. Halper.

Me:  What’s he doing?

Em:  Just Toni Karlsrud.

Me:  Is that Dr. Karlsrud?

Em:  Nooooo!  (Laughing) Dr. Halper.

A:  What’s happenig to you?

Em:  (Touching photograph.)  Goes beep, beep, beep, beep.

A:  You’re having a QEEG done.  It measures your brain waves.

(Emma gets up and walks away.)

A:  Emmy!  Come back!

Em:  Where are you going?

A:  Emmy!  Come back!

(I follow her into the other room where Richard is.)

A:  Hey Em, do you know why you’re having a QEEG done?

Em:  Now goes beep, beep, beep…  (while she says this she is touching various points on her head where the electrodes are placed.)  beep, beep, beep, beep… (she touches her arm) beep.

A:  They don’t put one on your arm!

Em:  (Laughs) Beep!

A:  Do you know why this is being done to you?

Em:  Beep, beep, beep, beep.

A:  It’s looking at your brain.  It measures your brain waves.

Em:  Beep, beep.

A:  Do you like going to see Dr. Halper and having a QEEG?

Em:  Yeah!

A:  Should we go pick out what you’re going to wear today?

Em:  Yeah, sit for one more minute.

A:  Okay.

The Search

One of the things I realized early on in my search to help our daughter was, there are a number of people who believe they know what causes autism and many more who believe they can cure it.  There is also a tremendous amount of money to be made from desperate parents, like myself.   I cannot tell you how often I took Emma to an alternative “healer” who claimed, if I just kept going and paying them their enormous fee, Emma would be cured.  I do not believe these people meant to deceive, I think they really have convinced themselves their method will cure a child and if it does not, it is because we didn’t give it enough time.

In many ways Bruno Bettelheim’s refrigerator mom is alive and well even if it has taken on a new twist in today’s world.  While no one came right out and said – You are to blame for her autism (and to blame if whatever method they were pushing didn’t cure her) – it was inferred by the questions they asked.  What follows is a sampling of a few of the questions I have been asked over the years.

Did you drink caffeine during your pregnancy?

No.

Did you or do you drink alcohol?

No.

Did you take any sort of medication during your pregnancy or labor?

No.

None?

No.

What about aspirin?

No.

Did you sun bathe?

No.

Did you have an epidural during labor?

No.  No drugs, natural childbirth.

How long did you breast feed?

9 months.

Just nine months?

Yes.  Emma didn’t want to breast feed, she weaned herself.  I wasn’t going to force her to breast feed when it clearly distressed her.

Ahhh…  Did you eat fish?

A couple of times.

What kind?

Grilled swordfish.  I didn’t know about the mercury levels in fish when I was pregnant with Emma.  It was only a few times when we were in Cape Cod.

Uh-huh…

There it was, finally, the answer they were waiting for.  Depending on the practitioner, the questions changed and as a result, my answers, but there always came a point when I gave the “wrong” answer. It always ended the same way with the same look – eyes downcast, a slight sad shake of the head.  I came away from these ‘interviews’ feeling angry, but I also wondered if there was any truth to it.   Maybe the two times I ate grilled swordfish while we were in Cape Cod, really was enough to cause her autism…  I think as a mother, it is second nature to wonder if something one did during pregnancy horribly effected the baby.  To this day I feel tremendous guilt for having unwittingly eaten swordfish during my pregnancy with Emma.  I honestly did not know how toxic our oceans had become.

I have become particularly wary of those who are adamant autism is caused by any one thing.  My guess is, it’s multi-causal, but who knows?  I am also wary of those who speak with absolute assurance they know how to “cure” autism with diets, behavioral therapies and alternative remedies.  Autism is a neurological disorder and while all of these things may play prominent roles in children getting better, I have yet to meet a child who has been cured, in fact, I have yet to meet anyone who has met a child who has been cured.

Mother’s Day

Every year when Mother’s Day rolls around I think about buying a trophy for Ariane. But if you’ve ever seen the kind of “World’s Best Mom” statuettes they sell in gift shops, you’ll understand how easy it becomes to resist that impulse. To do full justice in honoring her ceaseless sacrifices, her boundless commitment, and her indomitable courage in the face of repeated heartbreak, I’d have to commission a giant gold statue of her in full Viking Goddess mode, hair blowing in the wind, fist outstretched in an upward and onward call to arms as she stands atop a mountain of diapers, empty vanilla milk cartons and pancake batter, Emma perched on her shoulder with her thumb in her mouth, her other hand clutching her blanket Cokie as it flutters behind them like a triumphant flag.

Maybe next year. God knows she deserves it.

It’s hard being a mom. It’s hard being a mom for a normally developing child. Harder still raising two normally developing children, which is what we both thought we were doing in Emma’s first year of life. She logged in countless hours in countless playgrounds, bookstores, zoos and museums – with more than a gazillion trips to the Museum of Natural History alone — which Emma still calls the Snakebite Museum because she obsessively goes up to the third floor on each visit to see the diorama of a boy laying on the ground that’s been bitten by a snake.

And it’s hard…really, really hard…to be the mom of an autistic child. It’s hard being the dad of an autistic child too, but not as hard as it is for Ariane. For one thing, Emma can only bond physically with one person in the world, and that’s mommy. She might sit next to me, or lay in bed next to me, but we can’t cuddle. She likes to stroke my arm and she really likes to slap it. But I cannot hug her for more than a few seconds, I cannot hold her in my arms, I cannot sit with her in my lap in the rocking chair, not for long anyway.

She is not daddy’s little girl. She is mommy’s little girl. And along with the joys of that affection comes a world of responsibilities that are extremely difficult to bear when they rest on one person’s shoulders. Only mommy can comfort Emma when she stubs her toe, or gets a cut. Only mommy can hold her and say, “It’s okay.” I cannot count how many times I’ve run to Emma’s assistance when I’ve heard her screaming, only to have her run right past me and into mommy’s arms. And when Ariane is out of the house and she injures herself, there isn’t much I can do but try and calm her while I get a bandaid.

This next part is difficult to talk about, but I think it needs to be said in order to fully appreciate what this has been like for Ariane. Emma has only been able to poop in the toilet by herself for the last year. She has had chronic constipation we have tried everything to relieve for as long as I can remember. Ariane, being the only one who could really hold her, had to hold her on the potty while Emma screamed in agony, trying to relieve herself. This could go on for more than an hour. Every day. For years. Think about it. Now add to this the fact that Emma screams louder than a jet plane on takeoff. Nuff said.

Mothers of autistic children have to cope with another burden that never seems to fully go away, not that I’ve seen anyway. Guilt. Ariane is not alone in this respect, every mother of an autistic child that I’ve ever spoken to about this has said pretty much the same things: “I shouldn’t have eaten so much fish when I was pregnant. Or exercised. Or done those leg lifts the midwife told me to do because they said she was breached – and she wasn’t. I shouldn’t have gone down to the World Trade Center after they blew it up and all that smoke was in the air. I was too old to have another child. That’s what did it. That’s what made her this way.”

I’ve never heard the father of an autistic child wring his hands over his role in ‘causing’ their child’s autism, even though some studies have said that one possible factor in the disease is the age of the father, not the mother. But the mother bears the child and that seems to lead to countless recriminations and self-blame that doesn’t even end after the child is born. “I shouldn’t have given her that MMR vaccine. I shouldn’t have given her any vaccines.” And so on.

I once said to Ariane, “If you were talking to another mom with an autistic child, would you blame her? Would you tell her it was all her fault?”

Of course not. But I wonder how much these thoughts have faded even after all this time.

As soon as we got the diagnosis, Ariane must have read every book on the subject. While I consider myself to be a pretty good dad, equally concerned and committed to healing our daughter, I have still never read a single book on the topic, not cover to cover. Maybe I’m just being a guy, but my initial response was to Google everything I could discover about possible causes and treatments in the most concise descriptions possible. I couldn’t take the pain of all those details, of all those suffering voices. “Bottom line it for me.”

Ariane tried every possible treatment she had heard about on the internet – from other mothers, of course. She has documented many of these efforts on these pages. For example, she mentioned here that she once baked a casein-free/gluten-free cake for Emma’s birthday that took her hours and hours to make. No flour, no yeast, no dairy, no sugar. I couldn’t believe how good it tasted. “What’s in here, fairy dust?” I asked, reaching for a second slice.

Emma never took a single bite of it. That trophy I was talking about should have been awarded for this feat alone. I might have to commission one after all.

Happy Mother’s Day Ariane. I love you. Nic loves you. Emma loves you.

You are amazing.

Tests

We took Emma and Nic to a center specializing in hearing tests.  The tests for Emma came back negative for hearing loss, though the center did recommend hearing therapy for Nic.  Nic was sensitive to loud high pitched noises, like the fire truck’s sirens from the fire house across the street from where we lived.   He would run away from the sound covering his ears and crying.  Emma didn’t seem bothered by noise, in fact, Emma seemed to enjoy noisy situations, loved parties, the more, the merrier, it seemed.  Up until we received the results from the hearing tests I convinced myself this was the crux of the problem.  I remember telling my mother about a book I’d read regarding hearing loss and how it can lead to a variety of behavioral problems.  Surely this was what ailed Emma.

When the hearing tests came back negative, I had to modify my thinking.  Okay so her hearing was fine, this was good news, right?    It didn’t feel like good news.

We set up an evaluation through Visiting Nurse Service of New York.  VSNY is a not-for-profit organization providing health care in New York City.   There were pages of paperwork to be filled out prior to the evaluation.

Some of the questions were:

Does your child look at or turn to sounds?

YES!

Does your child respond to favorite people, making happy sounds or smiling?

YES!  She’s very happy with a jubilant, infectious laugh.

Does your child imitate you when playing a game, such as peek-a-boo?

YES! Another bull’s eye.  Maybe things were going to be fine after all.

Does your child engage in “make-believe”, such as playing with a doll or truck or playing house?

Okay, no, but she’s not interested in dolls, she’s more of a tom-boy.  She likes to run around and be outside.

Does your child indicate when she wants something?

Well no, but Emma never seems to want anything – so it’s not applicable – right?

Does your child interact with peers?

No.

Does your child use one or more words to ask for what he/she wants?

She did… sometimes, okay, not often.  She said “chase me” when she was about 16 months old, but as her language regressed, “chase me” went the way of all the other phrases – into the great abyss.

Does your child look up when you call to him/her?

Well, no.

And so it went.  Each question – like a nail being pounded into a plank – shutting out the possibility she was going through some sort of freakish delay which would right itself if left alone and not questioned.

For more information on Visiting Nurse Service go to:  www.vnsny.org

For more information on Emma’s evaluation see earlier posts:  The Beginning  and Hug Witness.

Emma At Ten Months Old

I sat in the pediatrician’s office with Emma squirming on my lap.  “She’s not really talking.  I mean she says words grouped together, but not single words.”

“Like what?” the pediatrician asked.

“Ba-bye, Da-da, Ah-done… things like that.”

“Smart kid,” the pediatrician said, checking Emma’s reflexes.

“So there’s nothing to worry about?” I asked.

“She looks great,” the pediatrician laughed, as Emma scooted across the room one leg jutted out in a crab-like crawl.

Thirteen Months

“So I shouldn’t worry, right?” I asked the young master’s degree student, studying speech therapy, who was Nic’s ‘teacher’ at his pre-school.

She nodded, “Some kids, especially the ones who are more athletic often have delayed speech.”  She looked at me with a smile.  “And her brother is pretty precocious, sometimes their younger siblings are slow to speak.  I’m sure it’ll come in time.”

I was turning into one of those neurotic New York moms.  It was classic.  I needed to stop worrying, Emma was fine, I told myself as Nic and I walked home from his pre-school.

Twenty-two Months

“Do you think she might have a hearing problem?” I asked my girl friend.

“But she looked up when that siren went by,” she reasoned.

“Yeah, I know,” I said, watching Emma push an empty swing.  “Watch this.  Hey Emma!” I called out.

No response.

Louder, “Hey Emma!”

Nothing.

Now shouting, “Emma!  Emma!  Look at Mommy!”

But Emma continued to play with the empty swing.

“Okay, but half the time my kids don’t look at me when I call them either.  Kids do that,” my friend said.  “Don’t they?”  She looked at me with half a smile.   “Anyway who wouldn’t be mesmerized by that swing?” she added, putting her arm around me and giving me a squeeze.

Thrity-One Months

“When was the last time you heard Emma say, Chase me?” Richard asked.

I thought for a few seconds.  “When was the last time you heard Emma say anything?” I asked in answer.

This was the conversation that poked the final hole in my bubble of denial.   It was August and we had rented a house in Cape Cod.   I remember standing in the living room, looking outside, watching the children.  Nic and Emma were on the porch in their ‘swimming pool’ a make-shift plastic tub we’d filled with water.

The mask I had so meticulously constructed for myself and my family fell away revealing something I couldn’t identify and could not understand.  I remember telling myself to breathe through the rising panic that threatened to consume me.   And then I remember feeling the feeling that I would feel many times in the ensuing years.  Failure.  Something was terribly wrong with my child and I had failed to see it, failed to do something about it.

As often happens when I feel overwhelmed, I began to make a mental list of actions I would take the instant we returned to New York.    The first two items on my list were:  get a hearing test done and get an evaluation.

Mommy & Me Class

One of my girlfriend’s and I decided to enroll our daughters in a Mommy & Me class at the Children’s museum.  Emma was walking, so it must have been when she was about eighteen months old or so.  Our daughters were born four weeks apart and it was a way for us to see each other in a city where one routinely must make appointments months ahead to see even close friends.

During the first class Emma became fixated with the guitar, which the young woman who was leading the class played periodically through out the hour and fifteen minutes.  When Emma wasn’t trying to grab the guitar out of her hands, she was dashing up the wooden ladder, crawling through a series of tunnels and sliding down the inflated slide, over and over and over again.  Meanwhile my friend’s daughter was listening to the stories, happily creating all sorts of “art”, interacting with the other children and seemed content to go along with what was being offered.  I laughed it off at the time, but I remember on the subway ride home feeling ashamed and lonely.  They weren’t feelings I could logically explain.  I mentioned to Richard when he returned home from work in the  evening that Emma didn’t seem to like the mommy and me classes.  Beyond that I was unable to put the feelings into words.  I just felt an inexplicable heaviness.

As was typical, I persevered, hoping she would grow out of it, whatever “it” was and kept showing up for the weekly classes that spanned three months.  While other children seemed to develop relationships with one another, albeit rudimentary ones, Emma continued to show no interest in any of the children or adults, for that matter.  I remember clinging to the idea that she was independent.  Looking back to that time, even now, is painful.  I realize we were in limbo, a sort of odd “in between” place which I was unable to recognize, much less express.

The Kiss

Last night, after Richard and I realized Lost was NOT airing a new episode, we decided to watch the amazing documentary “A Mother’s Courage”, which a number of people saw and contacted me about.  Emma was sitting in bed next to me, (she does not go to sleep much before 9:00PM, despite waking at around 6:00AM).  I was propped up on some pillows with my knees bent.  Emma ran her index finger up and down my arm, saying, “You may NOT hit Mommy.  You have to be gentle.”

Emma wants to hit the people she is most fond of.  All of us tell her when she does this, “You may NOT hit, Emma.  You have to be gentle.”

Sometimes I’ll add, “Look, Emma.  Like this,” and then I’ll stroke her arm or face.  So last night Emma was parroting this and, it seems to me, practicing.

I laughed when she ran her finger up my arm.  “That tickles,” I said.

Emma laughed, “Be gentle.”

I nodded my head, watching the television as the documentary began.

And then Emma leaned over, with a enormous grin on her face and kissed my left knee.  Emma has never initiated a kiss like this.  She kisses me good-bye or when I get home from work.  She’ll kiss me back when I kiss her or when I ask her to.  To kiss me as she did last night, for no apparent reason other than because she wanted to – it was one of those moments – a indescribably beautiful, touching, magical, moment.  I looked over at Richard.  “Did you see that?  Did you see that!?  She kissed me!”

I looked back at Emma, “Thank you Emmy.  I love that!”

She beamed at me and said, “Kiss Mama.”

And then I held her and I wept.

The Playground

I use to take the children to a number of playgrounds in the city when they were young.  We went to Union Square Park (before the renovation), Washington Square Park, Seal Park which is way over on 10th Avenue between 22nd & 21st Streets, Madison Square Park and Triangle park (a little playground nestled in the triangle created by Hudson becoming 8th Avenue.  There were others, but these were the ones we went to more often than not.  Washington Square was a particular favorite because of the large sand box and there was a smaller playground close by for younger children, where we would stop, on our way home.  In addition there was the huge water fountain in the center of the square and when the weather was very hot, the children loved to splash around in it.

One summer day while at the playground in Washington Square, Nic was playing in the sand box with his trucks and Emma wanted to swing.  Typically there were lengthy lines for the swings, particularly in the mid morning and mid afternoon.  I learned to repeatedly remind Emma she would have to wait for the swing, something she seemed increasingly unable to do.  More and more frequently I would have to pull her from the ground where she had crumpled in a sobbing heap and strap her into her stroller kicking and screaming to leave the playground with Nic, reduced to tears, in tow because she refused to wait in the line.  Anyone who has spent time with small children in a playground knows cutting in line for the swings is tantamount to declaring war on the other parents and children.

On this particular day we were waiting I counted each time a child vacated a swing.  “Okay, Emma, five more children ahead of us.  Remember we have to wait.  Let’s count. “  And then I would count while Emma stared fixedly ahead.  Eventually when it was Emma’s turn she leaped onto the swing and waved me away so that I couldn’t push her.  I stepped back, wondering what she would do.  Then with her feet scuffing the ground she pushed off and began to pump her legs.  It was amazing to watch such a little girl able to swing herself.  A small crowd of moms and caregivers gathered around, watching.  One of them asked, “How old is she?”

“Eighteen months,” I replied, as Emma soared high in the air and back down again.

Much later I learned many autistic children have what are termed splinter talents.  Things they are good at, though they remain delayed in most other things.  Emma has always been coordinated even though she began walking late – at fourteen months – and needs more time than a normally developing child to learn things.

But on that warm summer day, Emma found something she was able to do, and do really well.

Misconceptions Regarding Autism

Denis Leary made a stir in 2008 when he made public his belief that autism was caused by “inattentive moms and competitive dads”.  His comments echoed Bruno Bettelheim, who in the 1950’s posited autism was caused by emotionally distant mothers whom he referred to as “refrigerator moms”.   While Bettelheim’s theories were largely rejected in the 1960’s, there remains confusion by many people when confronted with an autistic child.   My guess is many people believe autism is a psychological problem as opposed to neurological.  As my mother so beautifully wrote in her post From Emma’s Granma autism is largely invisible.  Because of this, people often assume the child is behaving badly because they are spoiled and the parents are unaware or worse, condone the bad behavior.

Several years ago, Joe, Emma’s therapist, was with Emma in the park when she fell to the ground screaming she wanted to ride the carousel one more time.  Joe, knowing Emma needed to be back home, told her it was time to go.  Emma refused and sat in the mud in her pretty dress crying and screaming.  A group of women stood nearby, watching with looks of shock and concern.

Emma continued in full melt down mode repeating over and over again, “I want to ride on the carousel!”

One of the women asked Emma if she was okay.  When Emma didn’t respond, Joe tried to physically pick her up, thinking she might calm down once he was holding her.

Another woman in the group yelled at Joe, “Don’t touch her!”

“You have no idea what’s going on here,” Joe said, trying desperately to get Emma to cooperate.

“I’m calling the police,” the woman said, pulling out her phone.

Figuring there was nothing he could say or do to make the women understand, he finally was able to pick Emma up and carry her out of the park.

The group of women followed Joe for the next ten to fifteen minutes.  At which point Emma was calmer and Joe was able to get her into the subway and home.

When Joe arrived back at the house, he was visibly shaken.

All of us who have spent time with Emma over the years have experienced versions of Joe’s experience.  I remember being in a playground in Central Park with Emma one weekend.  It was crowded and Emma was having a tough time waiting for her turn on the swing.  Each time one became empty she rushed forward, trying to grab it.  I ran after her, explaining that it wasn’t her turn yet.  Finally one of the father’s of another child turned to me and said, “Hey!  Can’t you control your kid?”

“She’s autistic”, I said.

Before I could explain further he interrupted me and said, “Yeah?  Well my kid likes to paint too.  Who cares?!”

Confused, I said nothing, but as I led Emma back to her place in line I realized he had misunderstood me and thought I’d said, “artistic”.

It became a running joke at our house whenever any of us didn’t want to do something we’d say, “Hey, I’m artistic.”