Mourning does not become me

Your child with autism is not the child that you thought you would have.

Following a twitter link, I came across a book, “Following Ezra” by Tom Fields-Meyer, that deals with how he has approached his child who has autism.  There are also interesting comments on his blog.

The question posed is whether or not you should mourn for the child you did not have. The author of the book has a refreshing view; he tries to celebrate the child that he does have, instead.

After many years of effort, I have been able to approach that attitude with some success.

When you give birth to a baby that is, from the start, not quite right in some way, you can grieve, accept and move on to face the challenges ahead.  However, if your baby seems quite lovely and intelligent and you lose her to autism at the age of 1 or 2, then it seems as if the child she was has died.  You have no time to mourn her death because you are thrust into dealing with enormous challenges.  You push the feelings aside and try to keep your head above water searching for answers and trying therapies, dealing with the day-to-day.

Once in a while you can glimpse that former child in the child you have; there is always the hope that you can get her back.  So you put off the mourning and accepting a bit longer.

When I have allowed myself to mourn, (or wallow in the grief more like), it can be paralyzing.  My thoughts become circular and pointless and I am unable to productively deal with the crisis at hand.  And there is always a crisis.

That is the challenge: to break the attachment to the hope that you will get the first child back and relish the rewards of who she has become.  Or not become.  Not riding around in cars with boys, not taking illicit drugs,  not doing the scary things we associate with teenage girls.

And when you do follow her around you find someone who is quite lovely indeed.

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Eating with Autism-2

There is controversy around the various ‘bio-medical’ treatments of autism and one of the most controversial areas is diet.  Many parents and physicians think that their children with autism are helped by restrictive diets of one form or another, the most common variant being the gluten-free/casein-free diet. Others include Feingold diet, the Specific Carbohydrate diet and the low-oxalate diet.

A recent study of the nutritional issues in autism can be found HERE.

When my daughter was  in her late teens she developed symptoms of anxiety: pacing, increased tantrums, aggression toward some of her teachers and upper GI symptoms of regurgitation and belching.  The neurologist recommended trying medication with risperidone.  I was not ready to make that leap at the time and the school did not approve of medications for behavior control anyway.

The school did not approve of  restrictive diets and supplements either.  Their method was to increase the student’s tolerance for a variety of foods by slowly encouraging new tastes, smells and textures.  Many children with autism are undernourished because of multiple food aversions and self-restriction.

After I attended a conference on the bio-medical treatment for autism put on by the group Defeat Autism Now! (DAN!),  I thought that it could not hurt to try some diet and supplement changes to see if it would help.  The school was willing to try the gluten-free/casein-free diet for 3 months and we also gave her some vitamins C and B as well as a balanced fish oil supplement.

The short story is that her behavior and happiness level improved immensely with this small change in what she ate.  Even her teachers admitted that she was able to control herself more easily and that she was able to concentrate longer in class. We added some digestive enzymes and things continued to improve.   When the neurologist mentioned trying a low-glycemic index diet for seizure control we instituted that as well.   Her last year at school was her best ever.   Her noise aversion disappeared and she was able to enjoy bowling for the first time.  She began learning to use a communication device and was more connected with people and more social.  Her gastrointestinal symptoms improved and she was more purposefully energetic.

The longer story is that when she transitioned into the adult world they refused to continue her diet  and despite many attempts to change things we have been completely unsuccessful in instituting even a reasonably healthy diet at her house.  We think we are making headway, we get nutritionists and dietitians involved, we get a commitment from the Agency to provide the diet (which is prescribed by a physician), then the staff at the house changes and all is lost to the wind.

Now, sadly, we have been forced to go the medication route anyway and are dealing with yet another set of side effects.  We are also changing seizure medication; tapering up and tapering down.  And we have yet another house manager to educate about food.

I am in constant awe of the parents who have been able to keep their children at home, who have control over what  their children eat and how they are treated.  It is extremely difficult to maintain these restrictive diets even at home and it takes maximum dedication and caring to do so.

So stop making fun of those over-protective moms who won’t let their kids eat the birthday cake; support them instead and be glad you do not have to do it at your house.

Choosing life for you and your child

In this Age of Autism piece,  a parent bravely shares the experience of making the decision to send his child out of the home to live elsewhere.  As I was reading, and crying, I was also remembering the time I had to make the same decision.

LL was 11 years old and I was trying to work full-time as an Obstetrician, including over-night call, while my husband lived and worked in Russia.  I had a Nanny who would stay over when I was at the hospital and take LL back and forth to school.  We were on vacation in Florida, Lily was having a melt-down about something, going to bed, I think, and  Nanny said to me: “You should put her in residential school. She is autistic after all”.  I really blew up at her at that.  Nanny left to visit her boyfriend and she was supposed to meet us at the plane for the flight home; we never saw her again.

When we were home in Boston, I tried to hire another Nanny.  The agency sent me a girl with narcolepsy. At that point started to think about my life and LL’s life and how we were doing together.  When I was not on call at the hospital, I often did not sleep because LL did not sleep.  And she was getting bigger; always strong, she was able now to overcome me physically when I tried to prevent her from emptying the refrigerator at 3 AM.  When I was working at the hospital, I was not sleeping either.  Sleep deprived people tend not to have the same level of patience as they would like and do not often have enough energy to provide the teaching and guidance required for difficult children.  So she was really not getting what she needed and I was certainly not getting I needed.  We were both losing out.  After much agonizing and discussion, LL went to the residential part of her school.

Her teacher, who was very attached to her, told her that if she behaved really well Mommy would take her back home.  The school asked me to leave her there for 3 weeks before I visited (agony) and when I did finally visit LL was perfectly behaved and you would never have known that she had any behavior issues.  She kept looking into my eyes as if to say: “Now that I am so well-behaved, may I come home now?”

Every time I took her back to the residence I talked to her about how it was for the best;  every time we both were miserable.  But, I felt I had no choice. Teaching a child with the high level of needs that she had while trying to work is nearly impossible without an equally high level of support.  I could not do it alone even if I did not work.  I did not know how to parent and teach her at that level. I so admire the parents who do keep their children at home and are able to be both parent and teacher.  I wish I could have done that and feel guilt to this day that I was not up to the challenge.

We as a society need to give more support to our families; more training, more “respite”, and more understanding.  Parenting is hard enough with “typical” kids; when you add the sometimes life-threatening behavioral issues plus the speech and communication issues plus the medical issues it is most-times overwhelming.

 

Guilty Pleasures and Lost Weekends

Last night I wrote about how frustrating it is to hear that the people taking your place as the caregivers and safe-keepers of your disabled adult child have not kept their promises. Anyone in my situation knows that when you take time off for yourself or to care for someone other than your child or even to see if some independence might benefit your child…you almost always feel guilty. Even if your presence would not have made a difference or if you could not have done a better job, even if you know that you cannot handle your son or daughter when they misbehave, underneath it all, you feel guilty. When you cannot sleep at night the “what ifs” will run in your head like a chattering monkey. This is not rational but part of being a parent and is somewhat shared by the parents of non-disabled children.

I have often wondered what is different about having a child with autism that sets us apart from the parents of other disabled children. Perhaps I am mostly exposed to particularly pushy parents. Some parents are passive and accept what services they are offered and do not press for more. These families often end up over-extended with adult children living at home with aging parents who are less and less able to care for them. The most common concern of all the parents I speak with is the fear of who will care for their children when they cannot. Who will advocate for improved staff training and job coaching?  Who will see that their adult child is actually physically ill and not just “having a behavior”?  When we hear and read stories of mistreatment and indifference such as abuse in state-run  agencies we become even more terrified.

The problem with fear is that it often breeds even more paralyzing inaction; a terrified person cannot think what to do next. And when your rational discussions produce no results except lip-service, discouragement sets in. Then you have to pick yourself up and calm your thoughts to begin again the fight for what is right for your child.

This is what I will be doing tomorrow. I will attend the quarterly meeting and listen to the plans and hopes for improvement, all the while knowing that after 2 years little has changed. The staff changes and each new person is put forward as the answer to our prayers. Usually this person cannot actually deal with the reality and is gone within the month.  I will say again what should be done and will be assured that they have a plan in place that is going to make everything all right.

Then I will go home and feel guilty that I cannot do it all myself.