"He Just Looked at Me. He Doesn't have Autism"

We went to see a new pharmacologist to talk about medicine for my son's anxiety. I went through the usual 5 minute intro about our journey with PDD-NOS, anxiety and sensory processing disorder.

The doctor was nice and seemed understanding, but then he said it.

"He just looked at me. He doesn't have Autism".

I think I stammered. I told him I feel blessed that my son is high functioning and tries so hard to make connections with others.  I told him what we've worked on, and how far he's come, and then the challenges he (and we) still face. I thought he understood, but I left feeling uneasy that a neuro-psychologist just casually "undiagnosed" my son minutes after listening to me while watching him out of the corner of his eye.

A month later, we went back for the follow up.  The doctor looked at James, just a few minutes in the room but totally focused on putting together a magnetic game, asking the same questions over and over, and showing an uncanny memory at the placement of random objects in the Dr's office.

Then the doctor looked at me.

"You know what Autism is right?  It is lack of reciprocity.  DO YOU KNOW WHAT THAT MEANS?"

I winced.  It felt like he was yelling at me.

And then the bombshell:

"Are you really attached to that particular label?"

I think I said something like "you can call him a purple people-eater if you want, as long as he gets access to the services that are helping him so much", but I really can't remember because I was too busy screaming inside. 

Screaming at the doctor for not seeing what breaks my heart on a daily basis, but mostly screaming at myself for not standing up to him, and for allowing a person, after 10 minutes, to make me second guess myself and everything I've done to try and help my child.

Instead of slinking out of there feeling sick and guilty, like I just discovered I was either a Munchausen by proxy patient on an episode of "House" or the direct target of Denis Leary's next book, I wish I stayed in that office and said this:

REALLY? Do you think I actually want my son to be labeled with autism? Do you think it makes me happy to watch him struggle daily to fit in? To see how uncomfortable other children are around him when he tries to play with them?  To watch adults get frustrated when he gets in their face and asks them the same question over and over again even though they've answered it?  To have to repeatedly tell him to look at whoever is talking to him, or to continually tell him to answer whatever question has been asked of him?

Do you think I wanted him to realize at the age 8 that he is always going to be "different" from his brother and other kids his age?  To know things that are so easy for his little brother to do will always be challenging for him?  Playing sports, playing with friends, even telling jokes?

Do you think I dismiss the fact that he laughs when other people cry, or that he doesn't understand when people become annoyed with him, or are teasing him?

Oh, actually, yes.  After living this for just about all of the past 8 years, I guess I am "attached to this particular label".

I am attached to it because my son does exhibit that characteristic about reciprocity.   For my son, and many others with ASD,  lack of reciprocity is not for lack of trying.  Although some may try desperately, they are unable to reciprocate without constant assistance and significant effort.  Some of them, like my son, are able to achieve a basic level of back and forth, but they have to work constantly to recreate even a simplistic version what you and I do without even a second thought. 

I am attached to this label because it is a word that has meaning for people who are just getting to know my son, so that they can better communicate with him, and understand the support he needs to successfully reciprocate. 

I am also attached to it because I think it is going to be a very powerful word for my son as he grows, and I believe that he will be able to use the label on his own terms -- as a crutch if necessary when he feels like he is left out or lost, but hopefully more often to help develop relationships that are comfortable for him, with people who will understand and respect him.

As for me personally, I am attached to it because I can use it as a tool to teach others that people cannot be pigeonholed into a 3 word definition in order to understand them, nor can they be "figured out" by observation, and that anyone who tries to do so is lacking in empathy, respect and, yes, reciprocity.

Preserving Arts and Craps

I've been feeling nostalgic since Johnny finished Kindergarten last week, and have been thinking about all the things I'm going to miss as he gets older. 

I'm not sure why it is hitting me so hard, I never felt this way with James.  It could be (and I really hope this is not the case) that a lot of the cute things James did got lost in our memories b/c we were so focused on his progress and therapies, or maybe because Kindergarten lasted 2 years and we were emotionally ready for 1st grade by that point.

It might be that because James didn't speak until later on, and then couldn't verbalize thoughts or ideas at that age, so these Johnny-isms seemed the funniest things we had ever heard. It could be that I wasn't on Facebook and didn't keep a journal (which I totally regret!), so I didn't have the chance to look back and relive those moments.

Or, it could just be that I know I'll never have another Kindergartner in the house (unless he is left on our doorstep!).

Whatever the reason, I keep going back to some images and reminders of things Johnny has said and done, trying to preserve them clearly so I don't lose them like I lose everything else in that black hole I call my memory.

So, more for me than you, here are some of my favorite comments and status updates from the past 2 years:

Favorite Johnny-isms

 "Coughateria", "Chopped lips", "Arts and Craps" and things that "blow in the dark".

Fluffy and Kitty School Moments
- Playing Candyland w/ Johnny and his stuffed kitty. Fluffy is winning.


Fluffy at Kitty School



Kitty school is growing.
Each student has a desk, chair, pencil and eraser.

- It's Dance Party hour at kitty school. Johnny started a "Justin Beaver" chant. 

-There are about 25 stuffed animals in line to see the Vet. I think we have a kitty flu outbreak over here...

Johnny being Johnny

- Johnny: "Mom, how do you spell right?" me: "you mean like take a right at the light?" Johnny: "no, like when you tell your mommy something new that she's never heard of before, ever, and your mommy looks at you and says 'you know, you're right and you are very smart to think that' "



Johnny Multi-tasking

- Johnny just wrote his name in Australian. It is upside down...

- Teacher asked Johnny this morning what he wants to do when he grows up. His response: "I want to do everything, except be a priest".

- My favorite part of today was Johnny sitting down on the steps of the State House and singing "I'm just a Bill, yeah, I'm only a Bill, and I'm sittin here on Capitol Hill" (From the day we went to the State House to support the Autism Insurance Reform Act)

- Johnny Drama just came in the kitchen crying that he really hurt his leg. "What happened?" "I fell! ouch! It hurts!" "what did you fall off of? The couch?"
"NO! OUCH! The FLOOR!"

- Johnny started crying while changing into his pajamas. "Johnny, what's wrong, are you OK?" I yelled running from the kitchen.  "NO!  I got a rug burn putting the pajama pants over my knee!"

-Overheard Johnny talking to his new friend on the playground --
Johnny (in excited, squeaky voice): "Greg! We have exactly the same stuffed animal!"
Greg (confused): "You have a stuffed butterfly too?"
Johnny: "No, I have a gray kitty. But Greg (now using his serious teacher voice) you know why I said we have the exact same animal? Greg, wait. Do you LOVE your butterfly VERY MUCH?"
Greg: "YES!"
Johnny (excited again): "I LOVE my Fluffy VERY MUCH TOO! That is why I said we have the exact same stuffed animal!!"

-OMG, I just looked in the living room and Johnny is dancing to "DJ got us Falling in Love" - on roller skates!

 - Johnny saw something about Cupid and asked who he was, I told him that there was a story that people who got hit with Cupid's arrow fell in love with the person they were with. he said " OH, That is what happened! I got hit with Cupid's arrow when I met Kaydence!" (a girl he became good friends with in his pre-school class 2 yrs ago ;)

Johnny to James on the way to swimming lessons. "Wait, did you say "heart" or "hard"? Was it "heart" like "she stole my heart?"

- Johnny told Tony tonight he believes in God. And Fairies.
Religious Education successfully completed in the Macchi household.

- Johnny: "MOM! There is a BULLY on bus 3-5-9! We don't have a bully on our bus. The cooties come every few weeks though, so that is bad!"


Johnny's been playing with his new file cabinet all day.
I'm waiting for him to start calling the keys "my precious"...



- kids are playing fetch. Johnny is the dog as usual.

James: "someone said the 'S' word on the bus today."
Johnny: "was it the 'upid' or the 'uck' one?

- Umm, Johnny just told me he hears voices in his head that nobody else can hear. I'm wondering if I should take the File Cabinet of Fun story more seriously...;)

- Johnny just said "Mom, life keeps getting gooder".

And the moment that makes me appreciate "Johnny being Johnny" more than any other and realize I have a lifetime of these to come:
- Just watched Johnny lead James all the way around the pool club by the hand to show him where our chairs were. Possibly the sweetest thing I've ever seen.

He got his eyes from his Father. But who did the Autism come from?

Like all parents of a child on the autism spectrum, I continually struggle with the question of why he has it.

I had just gotten over the fear that I caused James' autism by "not nurturing him enough" when I showed him off to a friend of a friend at a party, who said "I just heard on NPR that autism is caused by letting your child watch too much TV".  I was so horrified I didn't know how to respond, I was completely floored that someone could even consider that plausible, and then say it out loud - AND SAY IT TO ME!

I have a very strong belief about what happened.  It has always been based solely on instinct, but there was an article this week suggesting that others have the same theory.  And although I'm nervous that people close to me are going to be upset, I need to talk about it.

I believe that toxins I was exposed to while growing up were passed on to my son, and these factored enormously into his having autism.  My toxins.  Not Tony's.

Salem, MA, soccer fields built on a dump were recently closed because dangerous levels of lead and cadmium were found in the soil.

I grew up playing soccer almost every day. 
I was lucky enough to live in a town with beautifully manicured soccer fields, and I spent as much time as possible on them.  I never thought about how the fields managed to stay perfectly green and lush at all times (while located within the town dump).
  
Chem lawn visited my yard regularly.  When we wanted to play in the backyard, we simply waited until the white spots dried up, and then we moved the little danger sign out of the way.  I didn't think anything of it until my dog got tumors on his rear end and back legs.

We regularly ate tuna fish (still one of my all time favorites) and vegetables (still not a fan) out of cans.

We didn't know any better. I'm not to blame, nor are my parents or community, but I believe that these and other toxins (maybe pesticides on that plant I did some, um, research on while in college) factored in to James' autism.

The article suggests a possible link between toxins that mothers were previously exposed to and autism (link to full article below):

"Studies have strongly suggested a genetic component in the cause of autism, but it's becoming clear that genetics alone isn't the whole story; there could be interactions between susceptibility genes and environmental chemicals."

My family is participating in a genetic research study at Children's Hospital Boston, and our DNA will be tested and compared.  It will be interesting to see what the research shows, but my instinct is telling me that my DNA is going to share something with James that his father's doesn't.  A "susceptibility gene" perhaps. 

It's just a hunch, and I don't have a study group like that fabulous TV watching research, but I do have the benefit of 8 years of around-the-clock observation, mental notes and self-reflection, as well as the vivid picture of the Chem Lawn sign ingrained in my head.

And now there are some in the scientific community suggesting a similar cause.


Here are the links to both articles:
http://thechart.blogs.cnn.com/2011/06/07/scientists-warn-of-chemical-autism-link/

http://www.boston.com/yourtown/news/salem/2011/05/salem_soccer_field_closed_due.html