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Posts Tagged ‘advocacy’

If you ever doubt that nonverbal, seemingly “severely autistic” people don’t know what’s going on around them, I’d like to offer this for your consideration:

We saw a particular doctor, a neurosurgeon, several months ago to evaluate Nik’s “mildly tethered” spinal cord. During the appointment, Nik was very focused on the doctor’s stethoscope since he is enamored of all things medical. While Nik played, we discussed his symptoms with the doctor and plotted next steps including ruling out some things. We have not seen this doctor again (yet) since the initial visit.

Lately, Nik’s been having an upsurge of similar symptoms including intractable head pains. He’s also started using his device to ask to see this particular doctor. I, stupidly, assumed he was just randomly naming one of his many doctors.

Until this morning.

I asked Nik, after he had said this doctor’s name a few times, “What do you want the doctor to do?” Nik started answering with his self-scripted litany of the processes involved in taking vitals, etc. We see enough doctors that Nik not only knows the routine but has incorporated it into his play routines. It’s only recently that we realized he only engages in this routine when he feels “off” or needs to soothe himself somehow. Nik became entrenched in this line of pretend play and I didn’t know what to make of it. What was he trying to tell me.

He asked for the doctor by name yet again. Knowing how he might respond if I asked the question the same way as before, I changed my approach, asking him what he wanted the doctor to FIX. His reply blew me away,

“Fix head feel hurt.”

Always, ALWAYS presume competence and understanding. Even when you can’t put the pieces together, they are there. They have meaning even in their seeming randomness. Never give up.

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Doing the Write Thing

A milestone many, many years in the making. It’s still a work in progress (especially the letter k), but it’s finally happening!

My boy is so proud of himself, so happy when he writes his name. It’s his new favorite thing to do and he does it everywhere — with his fingertip on the side of the bathtub at night, on the playroom walls, tracing his name on the glass of the storm door as we wait for the bus. When he thinks I’m not listening, I can hear him softly trying to sound out the letters one by one. “Mmmmm, ihhhhhh, kuh.” (He cannot articulate the sound of many letters, including N.)

Waiting for the bus this morning:

“What does that say, sweetie? What does it spell?”
His nimble fingers fly to his device to answer — name.

He knows it is his.

“That’s right, love, it’s your name. Can you say your name?”  Knowing full well he cannot articulate the actual sounds into one fluid word, I have no expectation of a response, but he tries; he always tries.

Today, however, he voices an unexpected and enthusiastic “Guh!

Startled, I smile widely and feel the sting of tears in my eyes.  He knows he has surprised me and his face splits into an infectious grin as he claps with glee at his cleverness.

My boy is nine. I don’t expect that he will ever use his laborious manual writing for more than signing his name, but I am so incredibly proud of his efforts and his perseverance; both are –in spite of the continuing state of flux of his health and his daily challenges– such constant facets of my amazing child.

The only things more constant are the love and pride I have for him.

 ******************************

Today, Wednesday, March 6, people around the world will unite their communities to Spread the Word to End the Word®, as supporters participate in the 5th annual ‘Spread the Word to End the Word’ awareness day, aimed at ending the hurtful use of… the R-word (“retard(ed)”) negatively impacting people with intellectual and developmental disabilities (IDD). Language affects attitudes. Attitudes impact actions. Special Olympics and Best Buddies International encourage people all over the world to pledge now to use respectful language at www.R-word.org and build communities of respect and inclusion for all people.  I hope you will add your voice in support of these efforts. Your life may not be graced by a loved one with an intellectual disability, but I am sure you know someone whose life is touched on a daily basis. The next time you hear someone using the term as a slur, please speak up. For your friends, your loved ones… for my child.

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You may have noticed that my writing has fallen off here. Quite a bit. Yeah, I know, I know. I don’t need to beat myself up about it, it’s my blog, blah, blah, blah.  The truth is, I haven’t been writing because I haven’t known how—or what—to share about the changes happening with my son. The words are jammed up inside my head, warring with the feelings inside my heart. I have discarded multiple drafts in an effort to find the words I need. I wrestle with what I want to say and how much I feel comfortable sharing. I still don’t have the answer; I am outside my comfort zone.

The irony is not lost on me.  Ever the consummate over-sharer— not afraid to tell my story to anyone who will listen, I have struggled with what to reveal. I’ve been grappling with finding my own truth and having to confront my own biases all while trying to find a new equilibrium. I have been forced to examine and to reframe my vision for the life I thought we would have.

The life I thought he would have.

It’s very much a work in progress as we continue to redefine, reshape and work our way through the morass of emotions and information.

*******

When my son was born extremely prematurely, he was substantially smaller than his gestational age and had a number of identifiable health conditions in need of immediate treatment –either with medications or surgeries. Life—mine and his—became about surviving another day, making it through another crisis.

Over the course of his 209-day hospital stay, and even after he came home, the focus was on making it through; through another season, another health crisis—whatever curve-ball life threw our way.  At that point in time, there was no way to predict how the cards would fall and no way of knowing what his future might hold.  Many professionals told us there were still so few children like ours who were old enough to really have enough data to be able to predict with any degree of certainty. So, we simply hunkered down and did the best we knew how to do with the minimum of supports we had. All we knew was that we were not quite out of the woods but not quite fully in them.

“When we let go of hope fear wins.”

Through the years, there have been so many well-intentioned people –from health care professionals to total strangers—who confidently told us not to worry, our son would surely catch up. They patted our shoulders in sympathetic displays and told us stories of their cousin’s friend’s uncle’s daughter or their neighbor’s son who were “born early, too; they caught up by the time they were in elementary school.”

When you don’t know what you don’t know and the prospect of knowing certain things is, well, scary, it’s all too easy to want to believe the well-wishers and the miracle-sellers who predict your child’s miraculous growth and feats of development. So, you put on the blinders and tuck your chin down and simply soldier on—hoping for and working toward the best, whatever that turns out to be. In the absence of even a hint at the longer view, we simply clung to hope and pushed our worries aside, taking it a day at a time, an issue at a time.

When our son was ultimately diagnosed with PDD-NOS, it gave us something to hold on to and provided a new context through which to view everything else. As time progressed and some of the more emergent health issues began to resolve or remained stable, we hit a kind of developmental sweet-spot.  Our son began to make tremendous progress and was rapidly gaining many skills which had been so severely delayed. In a seemingly short time, he blossomed from the child who couldn’t even sit up or roll over and who relied on a tube for all his nutrition, to a child who could walk and run, climb and eat, and who had taught himself letters and was showing signs of spelling and early reading skills emerging.

With that swelling surge of hope, we began to really push for supports and look for signs of academic progress.  Some early literacy skills were emerging, multiple word sentences constructed on his speech device – there were glimpses; glimmers of dazzling progress.

Until there weren’t.

Which is where we have been for a while now. I’ve struggled to understand for myself and to try to articulate for others, the degree to which things have stagnated; there’s been some significant regression in some areas. It’s best summed up in a brief conversation I had with our developmental pediatrician this week.

ME: So, if I have three different evaluations, done by two different entities over a two-and-a-half year period – and not shared between each other—and they all show pretty much the same thing, including almost no change over time…

Can I pretty much assume that (1) my son doesn’t test well and the tests aren’t completely accurate and (2) that there’s probably *some* kernel of accuracy there which speaks to a larger issue? The one we think we are seeing?

DR: (wrinkling her nose in a sympathetic grimace, nods her head) Yeah, I would make that leap. Let’s make an appointment to talk about it and find a new way forward.

Hope is important; it is vital. But so is the ability to see beyond the heart’s desires, to peel back the thin veil over your fears and really look at what is in front of you. I’ve been in that process for a while now –none of this is new data; it’s just data my husband and I have finally been ready to see in a different light.  The process of getting to this point has been emotionally messy. It’s been painful to confront our own prejudices.

For years we have both felt like we were sort of straddling two different disability worlds and not feeling like we solidly belonged in either one. Was our inability to settle in, to identify with any one group, born of denial and shame? Why is it so much easier for me to say, publicly, that my child has “mild cerebral palsy and autism” yet I cannot bring myself to declare just as casually that he is intellectually disabled—mentally retarded?  (Yes, I know the term really isn’t used anymore; that’s my point—I’m calling myself out on my own biases and misperceptions.)

Different words will not change my beautiful, smart, funny, loving child. Nothing will.  And yet, the truth of those same words cuts me to the bone, laying bare the fears and grief I’ve held at bay for most of my son’s life; I am the one it changes. I am the one those words challenge.

I hope I am able to meet it with half the grace, determination and heart with which my son has lived his entire life.

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Nik’s IEP is next week. I have been in constant contact with his teacher (who gets him, thank God; she really gets him), writing goals and summaries, researching and ranting to friends about “stupid OT’s” who think my kid needs a handwriting goal… again; Nik’s teacher will set her straight.

A sample if Nik's ability to trace his own name after 8+ years of occupational therapy. There are reasons I keep pushing for assistive technology, folks!

A sample of Nik’s ability to trace his own name after 8+ years of occupational therapy. There are reasons I keep pushing for assistive technology, folks!

As far as IEP’s go, I think this one shouldn’t be too bad; Nik’s got a really great team working with him this year. They get him; they have seen the funny, smart, affectionate child I see. They know him well enough to recognize when he is having an off day which is not representative of his potential.

Still, I’m not going to lie; the anxiety is really running deep over this one. We are making big changes, big requests and, possibly, even adding some new letters to the already overflowing alphabet-soup of diagnoses and classifications which are a significant part of Nik’s educational record. We’re losing some services but gaining others…for now. We’re going to be asking for a minimum two-hundred percent increase in one of his services; I expect a lot of push-back on that (thus the reading and research). Over all, though? I’m hoping for good things and easy resolutions.  And yet…

He’s nine. NINE. The gaps between my child and his peers are growing so much wider and the fears I have for my his future are taking root ever deeper in my spirit. The emotions are hard to push down.

I see-saw between hope and despair, manic laughter and tears.

My fingernails have all been cut off to keep me from biting them to the quick.

I may or may not have indulged in some emotional eating lately.

It feels like so much is at stake in this particular meeting. This particular year. It feels pivotal and overwhelmingly, intensely…huge.

It’s too much. And I am foundering.

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Yesterday was a pretty tough day for my son. He’d been looking forward to the country-wide Special Olympics bowling event for weeks. His excitement was mostly about riding the school bus and seeing “friends” with whom he could play his wordless hand-clapping game. His expectations and the reality were so very, very far apart.

Don’t get me wrong; we love Special Olympics and all that it has opened up for Nikolas. It gives him an opportunity to learn new skills, to experience new situations, and to practice some of the very important listening and participation skills which challenge him greatly on a daily basis. I appreciate that he can participate in whatever manner meets his needs dictated by his physical limitations in both motor and visual processing and coordination. Frankly, I also love that Nik is often not the most obviously impaired child present – as it so often feels when we are at the park or even within Nik’s own wonderful classroom setting.

So, why was it such a tough day, you ask? Simple, really…

Take approximately 200 kids, each with an accompanying teacher, paraprofessional and/or nurse, add a family member for every other kid present, the staff and volunteers from Special Olympics, the requisite number of bus drivers to transport those children and school professionals from four different school districts and pack them all into a 32-lane bowling alley for three and a half hours.  I don’t have many sensory issues of my own, nor do I have any impairments which make it exceptionally challenging for me to process visual and auditory input like Nik does, but I can tell you that my brain was still buzzing from the tension more than six hours after the event was over.

Nik gets ready to bowl

Nik gets ready to bowl with the help of a ramp and his friends.

Nik didn’t even make it through the first of two full games before he was spent.  He went from a bubbly and exuberant boy when they first started, to a child who could not even pull himself together after the first five frames of the first game. He simply shut down. DONE. No amount of coaxing or cajoling would work. In fact, it made it worse.

If I had the benefit of today’s hindsight yesterday, I would have simply taken Nik home. It was shades of our Special Olympics soccer experience of a year ago when Nik was so utterly overwhelmed by the sheer volume – both in terms of people and noise, that he could do no more than throw himself on the ground and wail his outrage and frustration. Yesterday was deceptive in that he did not throw himself on the ground, but he made it crystal clear he was not going to bowl any more. Instead, we spent hours walking up and down and taking some breaks to sit and drink some soup or nibble at his bagel.

Nik has, clearly, had enough fun for one morning!

Nik has, clearly, had enough fun for one morning!

Given how crummy he feels right now between his infected ears and sore throat? It’s a miracle he didn’t throw himself on the ground and weep and rail at the world; I’m not so sure I wouldn’t have in his situation. Progress.

But at what cost? I watched as my beautiful boy flitted from place to place like a hummingbird –unable to fully alight and be comfortable or content for more than a flash before the compulsion to move on took hold. We walked and wandered. We tried to eat lunch and sing songs in the semi-quiet rooms near the back of the bowling alley. Still, it was all too much. I could see the perseverations rising like flood waters and I felt helpless to figure out where and how to draw the line. I wanted to hang in until the end so that Nik could get the ribbon for which he had worked so damn hard. He may not have finished his event, but he gave it his all and I was proud of him. I wanted him to hear the crowd celebrate his achievement, too.

As the awards were being given out, Nik’s para, Ms. M, and I realized that something was wrong; Nik’s entire group had been given their medals and ribbons and were making their way toward their school groups. There we stood, confused.  I know Nik didn’t understand the ramifications of what was happening, but Ms. M and I both did. I felt hot tears prick my eyelids. Ms. M adores Nik like he was her own son; she asked me to stay with Nik and strode off like a mama bear on a mission.

Ms. M returned triumphant but disgruntled. When Nik hadn’t finished his first game, a volunteer removed his name from the roster. On paper, it was as if my boy had never shown up, had never given every ounce of heart and energy he had. As Nik sat slumped against my shoulder and my heart was, figuratively speaking, on the floor wailing in frustration and outrage, Ms. M. simply made it right. (It’s one of very many reasons I am so grateful she is working with Nik!)

When the announcer called Nik up to get his ribbon, Nik was all smiles and fist-bumps with the police officer who gave him his ribbon. I, on the other hand was all sniffles and quiet tears. The oversight in such a setting where it’s all about inclusion, left me rattled.

My boy works so hard to make his way in a world which neither understands him nor fully embraces him for how he is right here, right now. As far as I’m concerned, he deserves a ribbon every day.

Emotional crisis averted, we made our way to the opposite end of the bowling alley to find Nik’s teacher and the three classmates who had participated in a different division. It was like watching a family reunion; Nik suddenly sprang to life and bubbled over with joy at seeing his friends.  They were also over stimulated and tired from the long morning. One of the boys can get very physical when he is in that state and I worried when Nik grabbed his hands to start to clap with him. I admonished Nik to use his “words” (his speech device) to ask the boy if he wanted to clap.

The way Nik spelled everything out was as if it were one long, breathless request. “Marcusclapplease.” Marcus has always made me slightly uncomfortable because he is so much older and bigger than Nik and has no concept of personal space. He also has a very flat affect so it’s hard to tell what he’s feeling or thinking at any moment. I watched, somewhat leery, as he put his hands up for Nik to clap.

Marcus pulled his hands away very suddenly and mumbled “clap done.” Nik persisted and Marcus tensed. I knew Ms. M and Ms. C (the teacher) were watching and ready to intervene, yet they didn’t seem at all anxious about what Marcus might do. Marcus reached out and put both of his hands on Nik’s shoulders and slowly pulled him to his chest. I held my breath as I watched in awe; Marcus slowly bent his head down and, with a tenderness I could not have imagined he could express, kissed the top of Nik’s head in the most affectionate and brotherly gesture I have ever seen. So simple, yet so profound.

The sting of the three-plus difficult hours which had come before this moment suddenly melted away. This…connection; this was the real prize for my son who gives his all every single day. This was what he came for.

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Nine? How did that happen? In the blink of an eye you went from my fragile little micro-preemie –fighting for your life over and over again, to my funny, engaging, affectionate monkey!

We still have so many miles to go in this journey of ours together, so many things to learn and so much teaching to do in the world around us. But the one thing I hope you will always, always know is how very much you are loved. How very much you are cherished and respected. And how none of that is affected one iota by the things you can or cannot do in this life.

Happy Birthday, baby. You are my life, my soul, my heartbeat. You take my breath away every single day. You fill me with pride and wonder, perspective and faith. Though our road together has been so very challenging from even before your birth, I wouldn’t change a single bit of it if it meant you were any different than you are today.

I love you so very, very much.

A day without you

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Sorry to disappoint, my friends. I don’t have a pithy, meaningful or otherwise significant post to share tonight. The demands of the day and the need to prepare for an early morning appointment with Nik have me recognizing my limitations and acknowledging that I need to take care of myself; Nik and I will be on the road at sunrise and, though he’s grown and changed in so many amazing ways, his needs still require a great deal of logistical planning.

I am grateful for my ability to recognize and honor my limits. Tonight, I will don my Oxygen Mask and bid you sweet dreams until tomorrow.

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