Tag Archives: autistic behavior

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!”


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.

A Tribute To Stanley Greenspan

We first heard of Dr. Stanley Greenspan and his work through another parent who had seen some success using his DIR/floortime methodology with their autistic child.  I read his book:  The Child With Special Needs, which led to our appointment for a floortime training session with Emma.  We drove to Bethesda, checked into the hotel, took Emma swimming and hoped we might all get a good night’s sleep for what we guessed would be an exhausting day.  In preparation for the meeting, Richard and I watched some of Stanley’s training videos.  We felt we had a vague idea of what was expected of us.  Whether we would be able to engage and interact with Emma in the DIR way or not, we were not so sure.

So it was with some trepidation that we were ushered into Stanley’s office – a small dingy room with some toys, a few broken, Stanley’s desk and piles of papers and books.  Stanley asked us a number of questions, all the while watching Emma intently.  “Okay.  Mom, why don’t we start with you?” He said, still watching Emma.

“Hey Emma!” I said, huge smile, high affect.  “What should we play with?!”

Emma ignored me and wandered over to the couch where Richard was sitting.  I ran over to her, tried again to engage her, “What do you want to do?  Do you want to play with this,” I asked, thrusting an armless doll at her.

The office was hot. I could feel perspiration beading on my upper lip.  After about twenty minutes Stanley said, “Okay Mom.  That’s fine.  Now I need you to take that energy and up it by about 100%.

“You’ve got to be kidding!” I exclaimed.

Stanley smiled at me,  “You have a nice connection with her. “

As he spoke, Emma was busy trying to open the door to leave the office.  I tried to pull her away.  “No, no Emmy, we can’t leave yet, “ I said.

Emma resisted me and continued to turn the door’s handle.

“Em, it’s not time to go yet.  We have to stay here,” I said, pulling on her arm to come with me.

“Block her!  What will she do if you put yourself in the way?” Stanley asked.

I wedged my body between the door and Emma.

Emma tried to reach around me.

“What do you want me to do?” I asked.

Emma tried to push me out of her way.

“Oh!  You want me to move?”

“Don’t make it so easy for her.  Make her tell you what she wants!” Stanley coached.

“Emma, what do you want?” I asked, sure that this was leading to a melt down.

“Open it!” Emma said.

Richard and I gasped.  WOW!  We hadn’t heard Emma say that since she was 13 months old.

Stanley was brilliant.  Keenly observant, unfailing in his critique, he encouraged us to follow Emma into her world.  To interact with her, “playfully obstruct”, “entice her”, were a few of the things he encouraged us to do.  “The worst thing you can do is nothing at all,” he said, as our session came to a close.

When we returned home his insight and words stayed with us. We enrolled Emma in the Rebecca School in New York, which uses the Greenspan DIR approach. It is the only school in New York City using this model.  Richard and I undertook additional floortime training sessions at the Rebecca school and hired their DIR training specialist to work with us at home.  Alex trained Emma’s therapist, Joe as well.  Hence the “Zen Master of DIR” label in the last post.

Dr. Greenspan had a consulting relationship with the Rebecca School and we were privileged to have two sessions with him over the last three years. The entire school faculty was in attendance and Stanley was conferenced in by telephone. Richard and I began each session by updating everyone on Emma’s home life, her progress and problems and our questions on what we could do to help her.  This was followed by her teachers’ review of how Emma was doing at school. Whenever they addressed an area of difficulty, such as Emma’s self-injurious behaviors like biting herself, instead of giving his recommendations immediately, he asked the faculty for their ideas. He listened patiently and then offered his own suggestions, which were always so intelligent and insightful that Richard and I would look at each other with an expression of awe – and gratitude.

Dr. Stanley Greenspan’s ideas and methodology changed everything for us.  His belief in the intelligence and abilities of each and every child were a profound change from the kind of rote “training” we had heard and received in the past. To say that his presence and guidance in our lives will be missed is a vast understatement. It is a great loss for us and for all the parents and children who will never have the opportunity to experience his keen analysis and problem solving ability on an individual basis.  Yet his legacy will live on through his books and videotapes, his DIR Support Services under the brilliant stewardship of his son Jake, a floortime genius in his own right – and with schools like Rebecca School, which have adopted his teachings as their principle therapeutic model, helping countless autistic children and their families like ours move forward one day at a time.

For more information on Stanley Greenspan and his work with Autism read:  Engaging Autism & The Child With Special Needs and go to his web site:  www.stanleygreenspan.com

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.

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.”


As Emma began to regress, starting at around 13 months old, it was not just what I believed to be typically “autistic” behaviors – lack of eye contact, delayed speech, obsessive-compulsive behavior, rigidity – that regressed, but things I didn’t expect, such as the restriction of  foods.  Slowly, just as her speech began to disappear, so did her ability to try new foods and after a few years, a paring down of foods that were a staple to her diet fell away as well.

The following is a list of the foods Emma will eat.  Anything else she refuses.


Mango Fruit Leathers

Red Grapes



Wheat toast with Organic Raspberry Jam (must be the red labeled wheat toast from Whole Foods & The Organic Raspberry Jam from Whole Foods)

Horizon Vanilla Milk – occasionally she will drink the Horizon Chocolate Milk

Stonyfield Chocolate Yogurt (She use to eat the caramel yogurt as well, but they discontinued it.)

Motts Apple Juice (this was an issue in Costa Rica as they had a different brand and she refused to drink it, though eventually did, cut with water)

Pirate Booty

Baby Bel Cheese

Grated Cheddar Cheese – must be orange


Maple Syrup

Chips Ahoy (she will not eat any other kind of cookie)

As a baby Emma was a healthy eater and tried just about anything I put in front of her.  At 9 months she ate a mushroom-barley soup I made.  I recorded this milestone in her baby book.

Many people believe that autistic children are unable to process gluten and dairy, others believe that their child has food intolerances which adversely effect their behavior and some believe that a gluten free/casein free diet has cured their child of autism.  While I have never met a cured autistic child or personally know anyone who has, I do know of one child who clearly functions better without dairy in their diet and a number of autistic children who are allergic to a variety of foods.

In October of 2004, we began working with a DAN (acronym for Defeat Autism Now) doctor who was also a pediatric nutritionist/allergist.  We removed all dairy and wheat from Emma’s diet.  At that point she was eating a limited, but varied amount of foods such as scrambled eggs with cheese, a wide variety of fruits, all flavors of yogurt, ham, turkey, chicken, dried fruits, carrots, etc.  In retrospect her diet seemed limitless in comparison to what she whittled it down to.

Once on the gluten free/casein free diet she refused to eat any new foods to substitute for the old.  I stayed up, often until after midnight, baking wheat-free breads made from rice flour, almond flour, and almond butter.  I found web sites that specialized in casein free/gluten free products and recipes.  I developed a way to make my own organic pureed fruit leathers, which I spread onto baking sheets and dried in a low heated oven for 10 hours or over night.  To celebrate her third birthday I made an entire menu of gluten free/casein free foods.  Emma would not touch any of it.  Even refusing the birthday cake I made, which everyone else seemed to like, including Nic.  Though he confided in me later that he didn’t like it as much as a ‘normal’ cake, but didn’t want to hurt my feelings.

After three and a half months and no change in her behavior, other than a 10% loss of body weight, we took her off the diet and slowly introduced her old foods that she once loved.  Only now she refused to eat most of the old “fail-proof” foods too.  It was as though she never liked them to begin with.  The DAN doctor advised us to introduce one food we knew she liked – we chose cheddar cheese – and to give her a great deal of it and then wait to see if we saw a discernable change.  I gave her several ounces of cheese, which she ate and then waited to see what would happen.  After several days and no change, the nutritionist advised us to introduce yet another food.  We repeated this exercise over and over again.

Occasionally now Emma will take a ‘bite’ of some other food – say grilled chicken – with great reluctance and protest.  I remember a friend telling me about her sister who refused to eat any foods that were not “white”.  I was horrified by the story and remember thinking I would never have a child like that, as I prided myself in being an excellent cook and would never tolerate that sort of “behavior.”  I have since come around to the pick-your-battles way of thinking.  The food battle is one I am just not willing to engage in any longer.

Late at night when I am caught in a cycle of worries, I console myself with the idea that there are certain indigenous populations that survive quite well on extremely limited foods, such as a group of Eskimos who survive on whale blubber and little else.  For now that consolation will have to do.