Tuesday, February 15, 2011

Two confessions

Here are a couple of things that must sound dreadful. My day started with me just flattened by the emotions stirred up during S's "mini-assessment" yesterday. I became more convinced that the psych's suspicions were right, that I had just been interpreting things with an inadequate framework for understanding AS. I was sobbing before I was out of bed. I felt incredibly bleak. I had to start adjusting to the new reality taking shape before me.

S didn't want to go to kinder as usual, and P was fighting going to school. I had nothing in the tank; I told them there would be a new toy if they went. Immediate change of attitude; S even went and got himself something for "show and tell" (no-one has discussed this with him, he must be copying his brother's routine from school last year). He apparently had a terrific day, played really well with a new boy, and when I arrived he was happily playing with a girl he knows quite well, even if he was telling her she was dead for not following some crucial instruction (so he was mimicking a computer game like P does). He told me he'd played with everybody. He seemed relaxed, happy. I should have been happy, and I was really, but here is the dreadful-sounding part; I almost would have found it easier if he'd been the unhappy, mal-adjusted child that I'd braced myself for. At school pick-up, I found myself with another lovely son. We had to bring home a friend of his whose father couldn't get there on time. All 3 boys were happy and well-behaved together.

I do not know what to think or feel. On top of this, Q has had to go to a work function tonight, and I always pace myself carefully on such evenings. The boys had a lot of computer time, a lot of leeway to play, were up a bit later so that they'd be just that much more tired when I tried to get them to bed. The next dreadful-sounding bit; sometimes I feel almost too nervous to do things with them. They are so unpredictable, I get confused, I get drained, I get frustrated, I get angry. I don't know what to expect, and sometimes I just hold back and try to make it to the end. On nights when it's just me like this, I wonder how single parents cope, I wonder if I make more sense to them, or if maybe I'm not as alone as I feel.

Monday, February 14, 2011

Sentencing postponed

It felt like I was going to be sentenced; for guilt, for failing to understand what was in front of me. And a sentence for S too; a label, a life of problems that I thought he would not have to know as his brother does.

In that mood I drove to the psychologist's. S was at his worst. For the half hour of driving he repeated incessantly 2 "jokes", barely pausing for breath. I turned up the radio, I sang loudly, to stop myself from screaming at him. By the time I found a carpark we were late, and I was frazzled. S was at his worst, blocking the psych's every attempt to engage him, although she made modest progress. Pretty much everything she saw and everything I told her seemed to confirm the likelihood of AS, but the fact that he also seemed unrelaxed, combined with a conversation she'd had with the OT who feels he's probably not, meant that she couldn't be sure. And so she decided to do a full assessment in 2 weeks.

I had to do some shopping this afternoon and set out with the lowest of expectations of him, only to discover him to be enthusiastic, co-operative, and fun to be with. I feel like I am going around the twist.

Wednesday, February 9, 2011

S's question

"Mummy, what do birds know?"
"Uh, they ah (how am I going to get this wrong?) know how to build nests, how to find worms and juicy berries, and they know how to fly!"
"No, I don't mean that!"
"Oh. What do you mean?"
"I mean can you tell them to do things?"
"Not really, birds don't think like people do ... well, some birds you can teach a little bit, but not very much."
"What about gorillas?"
"Yes, you can teach gorillas some things. You can even teach them to point to pictures on a board so that they can tell you what they are thinking, but they can't do this as much as people can".

This seemed to satisfy him. So many of his questions range between being bizarrely metaphysical and just plain bizarre. I really don't know what to make of them. Does it support or negate the ASD hypothesis?

While I am here, yesterday, the kinder orientation, went better than expected. Once S prepares himself to do something, he really does just get on and do it. He accepted being there, and he seems to have enjoyed it. Was delighted to see me, but it quickly became a melt-down that lasted all the way to school, where I added another over-tired, fragile boy to my party. They were so tired that even the tantrums were a little muted, but they did trigger in me a mild panic about returning to the fraught days of P's kinder transitions. It felt so familiar, even though the actors have shuffled a bit. I can barely stop wishing that the visit to the psychologist would happen. The only thing that distracts me is the sheer number of appointments at the moment; meetings with teachers, therapies, extended family obligations (frail elderly parents, to be precise, which is especially draining for Q of late). I hardly know how to juggle it all. But this morning at least, S and I are going to have a picnic at a children's farm a short drive away. I should have already mentioned that once the stress and worry of the drop-off had passed, I dissolved into tears for all the usual reasons; my little boy was away from me for most of the day, and I missed him! I really missed him, and surprised myself a bit because there is so much difficulty involved in looking after him, I have been so desperate for a break. So today will be special for us, and so far the signs of it going well are present.

Monday, February 7, 2011

Poised on the precipice

Ever since I woke up this morning, all I could think about was S starting kinder tomorrow, heavy with dread. When I crossed paths with a friend taking her daughter to the kinder class that S attended last year, I felt an unanticipated wave of relief. Yes, at this time most of last year, I would have been shepherding both boys to school and then rushing to arrive only a few minutes late to kinder. The distances are short, but the journeys could be so fraught, so easily degenerating into a muddle, a tantrum, a transition meltdown, at any step of the way. I often find that it's those unexpected emotional waves in response to other people's experiences that make me aware of how much of a tightrope I walk every day with these 2 boys.

Off his own bat, S asked this morning when he was to return to kinder; I was grateful indeed that he brought it up. Tomorrow I told him; predictably he was resistant, and upset that I would not stay there, but I am optimistic that by telling me this himself today, he understands that it is inevitable and he is trying to process it. One the way home from school he asked for a fidget toy that I bought him last week, and I reminded him that it was for kinder, for when he needed quiet time. He immediately smiled, asked if he would have to share it, and I said no, it was just for him when he needed some time to himself. He looked really happy, and I felt a little more reassured.

On an different note, trying not to take it personally, I went to give P a kiss this morning and he stiffened up. When I asked if he wanted one, he said "no thanks"! Oh it's hard not to touch that soft little cheek with my lips before I say goodbye. On the plus side, I've been getting a lot of cuddling from him at night. He wakes up at almost the same time every night and calls out. I didn't get up to him last night, knowing that he would come in anyway. I've always been a happy co-sleeper but for at least 6 months we've been making more of an effort to keep them in their own beds, as Q has become something of an insomniac and their tossing & turning & kicking of covers is indeed very disruptive. Because we explained this to them, they have at least been coming in more quietly & generally responding more positively to requests to move heads etc., knowing that the alternative is to go back to their own beds.

Well, P is installed at school, S, is relaxed and cooperative this morning. Please can it last ....!

Friday, February 4, 2011

It only took an hour

School started today. No problems from P; he was co-operative and relaxed, so that was a relief. S seemed accepting, although I wasn't lulled, as I knew that any trouble from him would probably start once we were out of the house.

It was a wet morning, and there were people everywhere in the schoolyard. A toddler splashed in a puddle behind us and some landed on S, which is always a problem. I immediately responded to his request to pick him up and he huddled into me tightly. He managed to stay calm while I put him down to give P his bag and a hug. He wanted to be held throughout the brief assembly, and despite my groaning back I was determined to be as supportive as I could, and get our day off on the right foot. We farewelled his older brother as he headed off to class and were invited for a cup of tea at a cafe nearby with another mother whose daughter he knows well. All was fine while there was a biscuit to eat, and then he became predictably restless. That was still fine. We left and walked home, him calmly by my side, which felt good. There were a few brief exchanges about nothing consequential, then out of the blue, he said, "Mummy, you're garbage", and then, "you're a stinky banana", which he & his brother have been telling each other for a few days. I immediately felt weary; it wasn't the first non-sequitur of the day, but it seemed a particularly blatant departure from the reasonable dynamic that we'd had, so I decided to tackle it. "How do you think that makes me feel? Does it make me happy?" Yes, he claimed, so I let him know that it didn't. He tried to contradict me but seemed to lose interest. I started to suggest other things that he could say that would make me feel good. As we got closer to home, I suggested, "Mummy, can I bring in the garbage bin?" Unfortunate that the garbage theme was resurrected, but the empty bin was in front of us and he always seems to enjoy both the activity and the sense of helping. He tilted it towards him; a trickle of water ran from it onto his hands and shorts. He let go and got upset. I confess my patience was already eroded; I felt that I'd been working pretty hard already just to keep things on an even keel, and I quickly tipped it again to get rid of the rest of the water. We sort of misread each other's body language I think; he looked interested but uncertain, and I tried quickly to get it back in his hand before he could get more upset. He took it but wasn't quite prepared, lost his balance and fell over. And I lost him. He sobbed, upset rather than angry, but I was already worn out. I'd been picking him up, cuddling him, humouring him, tolerating him and guiding him all morning, on the tips of my toes for the better part of an hour. I paused for a minute, then ploughed on with both bins myself, continuing to push as he tried to hold me back, shrieking now at the top of his voice (hello neighbours! We're home!). Once inside he started to hit me so with a horrendous sense of familiarity I held him seated in the bedroom till he calmed down. It was 10.10 when I looked at the clock.

And now it's out of his system, and he is watching a DVD while he eats his lunchbox; back to the routine. The funny part is the DVD; it's The Transporters. I got it out yesterday to see how he went on the quizzes. He did pretty well, and not badly again today when we did one. He loves the show, and keeps talking about it very coherently. He just asked me why P stopped liking a certain kind of cracker that he was about to eat. He seems to me to be competent at least in organising his thoughts ... time will tell. We had another session with the OT yesterday. It went surprisingly well, in that he was persuaded to join back in whenever he opted out. But she now wants to join in the assessment process and have the SP there do the same, as she felt he was struggling with his pragmatic language, and that a speech assessment would at least "eliminate" an ASD diagnosis, if that is in fact how it plays out. We both mused about our observations at the end of the session; she said he seemed to her very much in his head, and commented on him nearly losing his balance at one point. I'm not totally sure what she was driving at, but she seemed to be suggesting that his body and speech were not keeping up with his thoughts. I also mentioned the CARS scores Q & I came up and she said she felt she'd come up with something similar.

So it's all very perplexing; he does indeed seem to have some strong ASD characteristics, but somehow, that doesn't seem to be the whole story, not yet at least. Well, I suppose for me, I have moved from that agonising confusion about what is going on; clearly, something is. But the days are going to feel very long till we get back to the psych, make some calls, and actually start addressing what is going on.

Wednesday, February 2, 2011

and down I go again

Since the possibility that S has ASD was raised yesterday, it has been impossible to shut it out of my mind. I did some gardening yesterday evening to take a break. As I was finishing, I caught myself realising that I had in fact been successful and thought about dirt and water for a while; that was the beginning of the end. The worries slid back like a landslide and I found myself hurrying to the computer to look up the CARS questionnaire online. I did it, and got Q to do it, and we compared answers; both in the low 20s, having both picked the same items to give higher scores, and yet, in neither case did he even nudge the cut-off score for autism (30). We know that's not the end of the story, but we did take some comfort from the consistency of our viewpoints.

But I ended up writing yesterday where I do end up so often; my never-quenched thirst for reciprocity. I should have known that today would be a bad day. It was to be a warm day, and feeling a strong and apparently unrealistic desire to connect with my children, I decided to risk an early trip to the zoo. P has disliked the zoo for a long time, has never really seen the point of animals, but because it had been a while, I thought it time to try again. S does like it, but being the handful that he is, trips can still be hard work, and I was worried that the 2 of them would just go into clown mode and it would be a disaster.

It wasn't quite that bad, but I think with my yearnings heightened, I had little tolerance. With these new suspicions about S and ASD as my companions, I tried to guide the 3 of us around together, but instead was dismayed at P's aimless gait, something I recognise in other ASD kids, and S torn between following/imitating him and staying with me and whatever else was distracting him. A woman with a pram & kids in tow nearly mowed S down at one point. I was rather cross, but really, how could she avoid us? Slow moving yes, but sprawling and utterly unpredictable. Her own kids were bunched in a group like a school of fish by comparison.

And so I could not but notice that at every opportunity, my boys tried to opt out of the moment. They each tried to engage each other in acting out computer games. I put my foot down and tried to keep them present with me. We were in the dark underground seal-viewing area, and they ignored me. I was trying to rustle them towards the exit. S's head narrowly missed a display case; I put my hand out and felt a surprising sharp, hard point at the corner. I was just processing the shock at how close he'd come and wondered if it would have resulted in a trip to the hospital when P hit his head on the handrail and burst into tears. I got angry. I marched away as fast as I could. They opt out, turn every environment into something meaningful only to themselves, and it always ends badly, and I feel so incredibly alienated.

But I pressed on with the program, forced them to see the other animals we'd agreed on. P complained bitterly, but I couldn't just give in and let them "win". This was the zoo, they'd agreed to come, and this is what one did at the zoo. Surprisingly, P had some good moments. There is one gibbon that always comes up to the window for a good look at the humans. P was very taken with her, and wouldn't come away, as he found it "interesting". That's big stuff for him. But on the whole the rewards were thin on the ground. During the wait for hot chips at the cafe, S forfeited a substantial amount of his computer time by snorting like a pig (copying a TV show and thus heightening my anxieties about what we are now officially calling his echolalia) and generally falling into the dreaded clown mode. I don't like punishments like that, I usually try to reward good behaviour, but I think that whenever I feel their responsiveness slip to a low, it brings out a sternness in me. Perhaps one good thing resulted from it; many apologies from S in the car. I thanked him but said it would not bring back his computer time. He said "I know" and moved on. He seemed genuinely just to be sorry, to be showing empathy, and something more sophisticated; contrition. Those are the kinds of moments that I have seized on when I tell myself that he does not have autism. How realistic am I being?

The joys continued; P lapsing back into silliness & getting hysterical when he landed in bird poo, S's final tantrum for wanting to beat his brother out and then failing to get back through the one-way gate to leave with his brother as well. They both enjoyed the reptiles, they always do. And to my amazement, P said he'd had a good time. Too little too late; I was not very gracious, and let them both know that I had not.

Tuesday, February 1, 2011

Progress of a sort

Finally, S was seen by a psychologist today. I think she will suit us well, but I have learnt not to be effusive after only 1 visit. Nevertheless, she did nothing disconcerting, and seemed to understand my concerns, and my reasons for thinking he is not on the spectrum. All the same, the responses I gave to some of her questions were clearly cause for concern along those lines; his rigidity, his literal imitation of his brother, as well as all the other stuff... Next time she will do a "mini assessment", as she says, to find out what they are dealing with and get him "more functional". Sounds like a plan to me.

It's a funny thing; I am in the 2nd month of a 3-month experiment where I have to keep a mood chart. Having suffered from debilitating pre-menstrual headaches for years before pregnancy and breastfeeding, I have found that with children, these headaches are overwhelming and I often cannot cope with parenting demands when I have them; I fill myself with painkillers, if I am lucky it coincides with my regular helper's visits, or when it's really bad, I have been known to call Q for emergency relief. For a year I have been experimenting with oestrogen patches with mixed results, but this itself has resulted in more research and more awareness of the other symptoms; the headaches may dominate, but I seem to go through significant mood disturbances at the same time every month. So I'm keeping the chart to verify this, and then I have an experience like this one, not at that time of the month. It hasn't exactly wiped the floor with me, because I have been worried for so long, but it has laid me pretty low. So I put that on my chart, and what will a doctor make of it? What a ridiculous world we live in.

On the positive side, this is my 2nd session with a professional in the past few days that has felt like something I've wanted for a long time. But it has been ridiculously difficult to arrive at this point. A few days ago P saw his new speech pathologist for the 3rd time, & she had prepared all sorts of activities designed to help him ask and answer questions. During the session she noticed other things that she said she would also get him to work on. This is what I expected to happen. How, over the previous 18 months, did I end up having not one but 2 therapists go all expansive on me & tell me there wasn't much to work on? And with S, what about the psychologist I spoke to for the better part of the year about my family circumstances, who always deflected me from bringing him in & sent me out with specific advice on discipline, instead of looking at the whole picture? I'm struggling with some anger towards her for delaying this whole process for a substantial time, very substantial when talking about preschoolers who might need intervention. And that when I went and made arrangements to have him seen by an OT, she high-handedly told me that if I was to do something "like that", in her experience it was only worthwhile if they could see the child in the home environment. I really don't understand what her problem was. She seemed sensitive to many things, but why did she think she could address my concerns long-distance and then express something close to disapproval when I found someone prepared to actually look at how he behaves?

In my own, unscientific way, I have come to believe that most (neurotypical) humans are in some sense hard-wired for reciprocity. I get so little of it in my parenting life that I am quite disoriented. I find myself constantly surprised when I see how straightforwardly other kids express themselves, other families get on with things. Even when I can see and accept a problem, seeking assistance has proved an experience worthy of Kafka.