Nathan

I have the most precocious three-year-old boy you could imagine. He gets into more mischief than Curious George. He likes trains and his favorite color is green. His name is Nathan, and he attends a preschool program for autistic children.

I took Nathan to the preschool for an evaluation a few months before he turned three years old. I had concerns about his language development. He didn't speak in sentences yet and he would say "nnn" for water. As Nathan played in the preschool, lining up toy cars, I talked about my son and my concerns to a group of specialists: the director, who's also a child psychologist, the speech therapist, the occupational therapist, and a few others. I explained how Nathan hated haircuts, how the sight and sound of the clippers would send him screaming out of the room. I talked about his sensitivity to loud noises -- car engines and the blender -- and how he would cover his ears or run from the room. I talked about how he did not engage with the other children at play group who were more verbal; he wandered away from the slides to the basketball court or dashed across the grassy field. I told them about Nathan's difficulty in transitions, how he threw tantrums when leaving a place he liked or when I tried to put him in a shopping cart. I related instances of spending minutes figuring out what my son wanted, such as wanting me to reheat his chicken nuggets. The words tumbled, poured out of my mouth as a dam that bursts to relieve intense pressure. The specialists nodded their heads, asked questions, and before long the evaluation was over. We would meet again and they would inform me of their recommendations at that time.

Nathan participated in The Learning Center (TLC) after he turned two years old. He attended a sensory play group and we received home visits from one of the teachers. I wanted Nathan to receive visits from a speech therapist, but the center didn't hire one until Nathan was about 31 months. She gave me excellent support in the little time we had left at TLC, visiting our home three times a month until Nathan turned three years old. We also had visits from TLC's occupational therapist, and we discussed Nathan's food issues (he wouldn't eat real food -- he only wanted crackers, juice, milk, peanut butter, grated cheese, and CANDY). A child psychologist paid us a visit when our rep came, and after spending an hour in my home observing Nathan and talking to me, I received this punch-in-the-stomach verdict: "I'm sorry to say this, but your son has a disorder. He does not seem to relate to others in normal ways. It's not because of anything you've done." While I appreciated the help and services from TLC, I also felt frustrated that there were no clear-cut answers about Nathan -- why he's so loud, why he's delayed in speech, why he has sensory issues. I wanted answers and instead I got a pat on the back.

Nathan's TLC rep came to our meeting with the preschool. The director and the head teacher of the Applied Behavioral Analysis (ABA) program both said they would categorize Nathan as either developmentally delayed or autistic -- they could go either way. Well, there may not have been much difference to her, but the two distinctions are on separate sides of a chasm in my book. Autism? My son? My son who laughs and looks at me and right into the camera with that beautiful smile since he was a few months old? My husband and I weren't so sure about the "A" word, so we decided to put down "developmentally delayed" in their records. The TLC rep and the preschool evaluators recommended Nathan receive full-time preschool services Monday through Friday in the ABA program. This meant he would receive one-on-one sessions with teachers in the class designed for autistic children. He could receive bus services. I tried to picture my little boy on a big school bus and I almost cried. However, we were willing to do whatever necessary to help our son learn and grow.

Nathan boarded a yellow school bus for the first time in August 2007. He eagerly climbed on the bus with Mom and Dad and got in the car seat, but when I climbed down, he started to cry. I went to observe at the preschool. A teacher tried to place Nathan on the chair. He resisted and fell to the floor. She calmly helped him up and tried again. I watched this a few more times and had to leave. I sat on a couch in the front of the preschool and nearly cried as I heard my son crying from the classroom. One of the employees came up to me and handed me a book, Let Me Hear Your Voice: A Family's Triumph Over Autism, by Catherine Maurice. She said it would help me understand the ABA program and why it's so important. I thanked her, and after hearing my son scream and cry for another twenty minutes, I left the building. When I reached my home, I got a phone call from the school: Nathan had settled down and started his sessions. Later I learned that was his first and last tantrum at the school.

It's hard to send your only child to a school because he's behind. I felt a range of emotions and wondered if we were doing the right thing. Nathan's such a happy, fun-loving child, and I wondered if this applied behavioral stuff would quash his budding personality. I came to observe Nathan -- the head teacher said I was welcome to visit -- and I was slightly offended at their methods at first. "Do this," the teacher would say, raising her arm. Nathan just looked at her. "Do this," she'd repeat with the same gesture. He's not a puppy, I indignantly thought. Are you going to ask him to beg and roll over too? I did not like seeing Pavlov's work played out on my child. I decided to remain patient and have a wait-and-see approach, and I started to read Maurice's book.

I'm so glad I did. The mother in Let Me Hear Your Voice had similar doubts and concerns about the ABA method -- it seemed too cold and clinical to use on her daughter. She decided to look into alternative therapies for her daughter, such as holding therapy, in which the mother engages in forced hugging sessions with her child to establish a bond. The holding movement claims that the mother needs to reconnect with the child, blaming the mother for the child's autism. It's incredible that an educated woman such as the author would buy this method -- especially with the insidious blame-the-mom theory -- but I can testify parents who have children with special needs are very vulnerable. (Unfortunately, some people will exploit them because of that.) This book is a moving account of a mother's determination to wage a war against the autism that inflicted her daughter. There were not many experts in autism in the 1980s, so she hired a graduate student to employ the ABA method in her home. She also had a speech therapist come into her home. The sessions were difficult for her at first, but little by little she could see how the direct instructions and positive reinforcement drew her daughter out of the shell she had slipped into. Her daughter did recover, and then her baby boy had the symptoms too. She employed the same methods -- ABA with trained teachers and a speech therapist -- and her boy recovered as well.

Nathan did not have autism like the girl in Maurice's book. The girl in the book avoided eye contact, stared at her hand, and had a very limited vocabulary. Nathan doesn't avoid looking at people's eyes, he doesn't sit there transfixed by one thing, and he knows many words. While I gained confidence in the ABA method for treating autism, I started to doubt whether Nathan was really autistic. I decided to talk to the preschool head teacher and director about it. I went in and explained how Nathan is not like the autistic girl I read about or other examples I've heard of or even like some of the other kids in the class. They heard me out and the head teacher told me they recognize Nathan has great abilities to learn and is smart, but he is high-functioning autistic. She said that his cognitive abilities in language and social deficits place him in the autistic spectrum. This spectrum ranged from those who can easily mainstream into schools, from those who have Asperger's syndrome, to those who are severely autistic. He has an ASD -- autism spectrum disorder. The director concurred.

Although I'd heard it before, the weight of their informal diagnosis hit me like a punch in the gut. This is real. This is something I have to deal with. I have to find out all I can and do all I can for my son. I also need to stand strong and look this enemy in the eye to overcome it. Maurice shares a sonnet by John Donne in her book:
Batter my heart, three-personed God, for you
As yet but knock, breathe, shine, and seek to mend;
That I may rise and stand, o'erthrow me, and bend
Your force to break, blow, burn and make me new.
I, like an usurped town, to another due,
Labor to admit you, but oh, to no end;
Reason, your viceroy in me, me should defend,
But is captivated, and proves weak or untrue.
Yet dearly I love you, and would be loved fain,
But am betrothed unto your enemy:
Divorce me, untie, or break that knot again,
Take me to you, imprison me, for I
Except you enthrall me, never shall be free,
Nor ever chaste, except you ravish me.
Maurice explains, "I let Donne's prayer become my own cry to arms; it did more than 'sustain' me, it galvanized me to begin what was to become an assault on my daughter, an assault of love ... I read that poem as a metaphor for Anne-Marie's voice, could she but speak to those who loved her. ... I wrote some statements in my journal, the first draft of a battle plan. 'She will not sit in the corner. She will not play with strings. She will not not look at me. She will not be mute. She may want it. I will not have it. She will be dragged, kicking and screaming, into the human condition.' " (Maurice 80-81) My battle would not be as imminent and urgent as the author's; Nathan meets my eyes, says, "hi, Mommy," and chooses to engage with people. My battle will be a long, drawn-out affair, navigating the best options for Nathan's language and social delays and fighting the good fight for improvement each day.

The ABA method works like this: The child is given a prompt to master, and if the child doesn't do it or looks away, the prompt or request is repeated. When the child responds successfully to the prompt, he receives praise. The child moves on to the next prompt and builds from one skill to another. Even though Nathan did not exhibit obvious signs of autism, he did share some similarities with the author's daughter. She talks about working to get the child to "pay attention" and to vary the activities so the child wouldn't be "locked into" one activity (Maurice 172). Nathan needed to learn how to learn. He had to be taught how to sit still and focus and pay attention. He likes routine and wants to keep things set and orderly in his little life, but they shake things up at the preschool so he will learn to adapt to change. (There are excellent program suggestions on pages 193-194. The preschool employs these ideas in its ABA program.) Another red flag Nathan shared with the autistic girl was his failure many times to look at me when I called his name. I usually attributed his behavior to his stubborn side, but he did it often enough to worry me. He also echoed what I would say, and although echolalia can be a normal stage of speech in little children, he mimicked me for a long time -- he still does.

I read another book during this time as well entitled Late-Talking Children by Thomas Sowell. I wanted to balance one book with another perspective. This author is a professor and had a late-talking child. While many parents would rush their child in for services, his instincts told him his son was fine. His son went on to major in computer science at a university, and Sowell argues that many specialists want to pigeonhole children and apply diagnoses in a rash, biased manner. He said these specialists immerse themselves in pathology and that is all they see: "To a hammer, everything is a nail." This really made me rethink Nathan's placement all over again. I thought those who observed him may want him in the program -- they need more kids to receive more funding, after all, and they probably over-analyze the children's behavior. Is it so bizarre for a boy to line up cars? That's what boys do! My husband felt this was going on, but I had to admit Nathan made great strides since starting preschool. I couldn't dismiss the test results: He scored under 20 when he started, and several months later, he scored 80 out of 100. Also, Nathan did not know how to respond when I asked, "What did you do at school today? What did you play? Who did you play with?" I couldn't leave his future to fate. I have hope and faith in the preschool program.

Nathan talks in sentences now. He likes to run and play with other children. He's learning how to engage in pretend play, such as dressing up like a fireman to put out a fire. He's still the delightful, energetic kid he's always been. I work to notice the triumphs and focus on what he can do rather than worry about what he can't do. Every day after school, we greet each other with a question: "Did you have fun at school?" (Nathan says it right along with me.) I believe Nathan will one day happily prattle away an answer to my follow-up question: "What did you do at school today?" Nathan is the brightest light in my life. He is a shining star who craves attention when he sings the ABC's song. He likes to wear a hat to cover his hair at all times ("No brown hair!"). He loves the outdoors and will scour hiking trails with me for years to come. He is a sweetheart who doesn't want to see his Mommy cry ("No Mommy sad."). He greets his baby sister jubilantly every morning. His place in my heart is engraved forever no matter where he is on the autism spectrum or whether he reaches certain developmental milestones. I will work to help him acquire the skills he needs in life, and I believe he will achieve anything he sets out to achieve. I'll be there every step of the way. And I'm sure the day will come when he'll be two steps ahead of me.

Rave Reviews

I watched Stranger than Fiction last weekend and LOVED it. I knew I would -- how could I resist falling for a film featuring Emma Thompson, Will Ferrell and Dustin Hoffman? I don't watch movies as regularly as I used to (something about canceling Netflix and taking care of two children affects that), so I'm more selective now about the ones that I see. It's so refreshing to pop in a movie and have it meet and even exceed your expectations. Especially when other things in life fail to do so. I so enjoyed Thompson as the disturbed, eccentric writer, and it was nice to see Ferrell play a more serious role. Hoffman's character was the icing on the cake. Hey Hollywood, can you hear me? Make more clever, fun films like Stranger than Fiction!

Another reason that I lag in the movie watching department is that I've started to watch more television. But it's not entirely my fault -- my husband's a TV show junkie. I was never one who cared about new shows of the season or someone who couldn't POSSIBLY be expected to do ANYTHING on such-and-such night because such-and-such show is on that night. I would NEVER be one of those people. Would I? Hmmm . . . I'm going to write a book entitled Confessions of a Television Watcher: From Loather to Lover. (What a horrific title.) The truth is I AM one of THOSE PEOPLE now. And here are a few of the reasons why:

1. Lost. A fantastic drama -- Great writing and interesting characters are my prereqs for a good show, and this show doesn't disappoint. I enjoy the flashbacks for providing rich character development, and I don't mind all the mysteries. Rather than frustrate me, it gives me a reason to watch; it's not worth my time if it's the same show every week (i.e. Everybody Loves Raymond) or too easy to figure out (all the sitcoms from the '80s).
2. The Office. I start to laugh when I just think of the characters, let alone when I watch the show. I experience giddy anticipation as the episode starts to see what major faux pas Michael will commit next. And then there's Jim and Pam -- what to make of it? (OK, yeah, they'll probably get together, but at least they're throwing in really good obstacles and make it believable.) I used to work as a receptionist, so when she looks kind of bored out of her mind and needs to pull office pranks to maintain her sanity -- I can relate.
3. Battlestar Galactica. Yes. It's a sci-fi show. And no, this isn't my husband's list. Once again, it meets the criteria in the writing and characters department. I also like tragedy -- I can take Hamlet and Julius Caesar in one sitting and ask for more. I admit I was drawn to a story about the fight for human survival after the Cylons shattered their planet with nuclear weapons. The survivors were so few, the hope of reaching a new planet so slim -- who could pass up a plot with such desperate needs? This show has mysteries as well, such as who are the other Cylons, and I enjoy the intrigue as well. This series better not get canceled! Give them enough time to make it to Earth!
4. 30 Rock. This show rocks! I had seen Tina Fey on SNL a few times, but she shines much brighter as the writer and star in this comedy. I give Fey props for smart, funny dialogue and amusing antics. One episode featured a sketch of an impersonation of Barbara Walters, and it made my day -- my day, my week! It was hilarious! I'm so glad Fey found her niche. You go, girl!

There's the list. They're worth watching. I watch other things on TV too, like the news or decorating ideas from HGTV or documentaries from the History channel, but these are shows I don't want to miss. Oh, there's one more show I watch but can live without: Gilmore Girls. It's a girly show with witty banter, and I'm pretty sure that Lorelei character is on drugs since she talks so fast and is always chipper, but there is a certain sweetness to that whole mother/daughter vibe, and the other characters are a hoot. (Did I say "hoot"?) So there really is television worth watching these days. You just have to know where to find it.