Saturday, January 29, 2011

Read 'Em and Weep




For centuries, doctors and scientists grappled with the problem of infection. Hand-washing and boiling helped limit bacterial outbreaks, but once infection set in, there was little one could do other than throw a few leeches on the patient and hope for the best. Then, in 1928, Alexander Fleming left a petri dish uncovered, some mold grew on his culture, and the rest was history.

I wouldn't say I view competition as mold, but I do confess to being a little bit of a hippie. I always stress to Maddux that she shouldn't worry about what her friends are doing; she should try to do her best job, regardless. (I realize this may seem hypocritical coming from someone who expected from herself nothing less than perfect scores, but "Tiger Mom" I am not.)

Nonetheless, just like the mold that inhibited bacterial growth on those cultures at St. Mary's Hospital some 82 years ago, competition -- that thing I try so hard not to emphasize -- has proven to be the catalyst for my daughter's reading breakthrough.

At the beginning of this school year, Maddux couldn't read much more than her name. Perhaps it's part of the ADHD, perhaps she's a touch dyslexic, or maybe she's just a late bloomer, but for some reason the letters seem to mix themselves up before her eyes and she quickly gives up trying to decipher the text in front of her. Until this month.

For the past few weeks, Maddux' kindergarten class has been participating in a schoolwide "read-a-thon" in which the house teams compete, based on minutes read, for a gold medal. (At least that is what my daughter tells me. Whether there is an actual medal, I have no idea, but far be it from me to detract from her incentive!)

Because she is a superhero and a princess, Maddux feels that she should be the very best at everything. She wants to be the fastest runner, the strongest lifter, have the blondest hair, be the lead in the class play, lose the first tooth -- I think you get the picture.

For an entire semester, I was under the impression (based on her frequent bemoaning of the fact that "everybody else" was in a higher-level reader) that she was the worst reader in her class -- until her teacher informed me that, upon beginning her ADHD medication, she quickly advanced to perfectly average. I was also informed that she was a pretty darn good mathematician, which Maddux conveniently forgot to mention because she expects to be marvelous at everything.

Me: How are you doing in number work?
Maddux: (Shrugs) OK.

But since her reading contest began, Maddux has been strangely enthusiastic about reading. Gone are the days when getting her to complete her 10 minutes of reading homework requires threats and bribery. No sooner is her backpack hung on its hook on our return from school than I hear "Mommy, can we do some readin' now? I want to read for 90 minutes today so we can BEAT THE RED TEAM! They're CHEATIN'!"

We haven't quite made it to 90 minutes, but she has read aloud for about 30 minutes most nights ever since she realized her team wasn't in the lead. This weekend, she has a sore throat, but she still managed to log 34 minutes tonight without prompting.

Her hard work is paying off. On Thursday, her house team pulled ahead in the competition, thanks in part to the six stickers she earned for the "racetrack" on the wall in the school hallway. Apparently, she read more minutes last week than any other kindergartner -- despite the fact that she still painstakingly sounds out every letter.

Who would have thought that, like the mold at St. Mary's Hospital, the answer to our reading problems was lurking under our noses the entire time? I had tried everything with Mads -- phonics games, interesting books, conversations about phonics while driving to and from school -- to no avail. Apparently, for Maddux, learning is not its own reward. Gold medals are. (Perhaps we will start having room-cleaning contests and not-interrupting-grown-ups-while-they're-talking contests.)

I'm still not sold on competition as the sole motivator for learning (after all, that's how we get test-bank cheating and "ringers" taking the SATs), but for now, I'll take it. Like penicillin, it may not work forever, but it cleared up our reading issues quite nicely.

Saturday, November 13, 2010

Hooray for Band-Aid Solutions (or Why I'm Drugging My Kid)

You’d think I’m injecting my 5-year-old daughter with heroin, to hear some people talk.

“Drugs are just a Band-Aid solution,” they’ll say – these mothers of non-learning disabled children who believe all problems can be avoided by Good Parenting. (This is after I mention the ADHD and before I mention medication. After this quote, I never get around to mentioning medication, funny enough.)

“I can give you the number of a really great naturopath,” says one well-meaning acquaintance, who then tells me a 10-minute story about a former involving this wonderful “doctor” and some blood test (unavailable at the allergist’s office owing to that pesky thing called “a high rate of false positives"). The test proved the child in question was -- as are all people who get their allergy tests at a vitamin store -- sensitive to gluten, dairy, soybeans, carrots, anything yellow or beige, and oxygen. The child’s improvement was immediate and dramatic, of course. (Never mind any nutritional deficiencies or that giant bubble in which he now lives.)

Don’t get me wrong. I’m all for natural foods and positive reinforcement. We've done sticker charts and bribery positive reinforcement. Desserts are for holidays and chips are for computers. We use some natural supplements (like the newly-debunked fish oil chewables) while abstaining from others (marijuana as an ADHD cure? What are these people smoking? Er, never mind ...). Chris and I both have ADHD ourselves, and after I did the quick mental Punnett squares any woman does when considering a potential mating partner, I realized I’d better research solutions for raising kids with ADHD, as any given offspring would have a 50/50 chance of being jittery, distractible spazmazoids like us.

My suspicions were confirmed when, sometime in the middle of my first pregnancy, I read about “kick counting.”

“Who the heck are these lucky women who have to count kicks?” I thought to myself as the world’s tiniest perpetual motion machine pummeled my ribcage.

The pregnancy book suggested drinking orange juice if one wasn’t feeling kicks. I wondered what one might drink in order to sleep for five consecutive minutes without the sensation of being attacked from within by a badger.

The experts said to worry if you didn’t feel 10 kicks in a two-hour period. I was never worried. A quiet spell for Maddux meant only 10 kicks in two minutes.

And one warm May day, the hyperactive fetus became a colicky, hyperactive newborn. The newborn turned into a bright, playful, and curious baby who was remarkably resistant to naps and bedtimes. Soon, the baby crawled, climbed, and beat up all the other babies in her playgroup, and her swimming class, and library storytime. (Did you know that a dainty blue-eyed 8-month-old girl can use another infant as a climbing apparatus? Neither did I. Neither did the mom of the other baby, who stared at my lovely daughter as if she had chewed her way out of my chest rather than spent 11 hours coming out the normal way.)

There was never a time, from the moment our fetal daughter began the never-ending gymnastics routine, that were anything less than certain she shared our disorder. And although Chris and I had both done wonderfully on ADHD medication, I was determined that we wouldn’t Drug Our Child until she was old enough to make the decision herself.

Books directed at parents of children with ADHD unfailingly mention the importance of establishing a predictable routine. Because we spazmazoids are predisposed to chaos and general spazmazoidery, structure and routine are not innate and must be taught from an early age. So, in what felt like a crime against my own nature, I made my first schedule ever – planning out meals, naps, exercise and quiet play down to within 15 minutes (to allow for all the diaper changes, as her bowels were hyperactive too).

Foods were introduced with great care and were organic and hand-mashed (Maddux being my first child and all -- Thomas, being the third, eats a steady diet of dirty, expired Twinkies). Multiple books on pediatric allergies were consulted before I commenced Maddi's initiation to solid food at 7 months with a bowl of shredded and gently steamed organic Gala apples. Any food sensitivities (broccoli and, oddly, rice) were caught and the foods eliminated.

I like to think it would have been worse had I not been controlling her diet, keeping her on a predictable routine, and implementing organizational aids and bribes positive reinforcement. But truth be told, there was a lot of coloring on furniture, assaulting of playdates, shampooing with glue, and bringing cups upon cups of water into her room at naptime and pouring them all over the carpet.

We won’t even mention Poo-casso’s Brown Period. (OK, we will. It lasted from 10 months of age to about 17 months, and it happened at least once per 24-hour period. There was one horrible day when she painted once upon waking in the morning, once at naptime, and then again for good measure that night after bedtime, and I had to put her back to bed with no sheets because all the others were still in the wash. The next week, noting that I had lost the will to rise in the morning, I began taking Prozac.)

Despite all the challenges to my own well-being, I continued with the non-medicinal approach. Drugs are bad. Just say no.

“They” say to be sure you give your child with ADHD at least five praises for every criticism. Some of the praise came easily. The same genes that cause Maddux to feel like there’s a fire lit under her heinie every minute of the day also imbued her with insatiable curiosity and a remarkable hyperfocus. When other moms looked askance at Mads as she spoke (OK, yelled) out of turn at library storytime, I shamelessly boasted of her encyclopedic knowledge, at 3, of the human digestive system (while hoping she did not enlighten her playmates on the female reproductive system, as I was pregnant and she was very fond of telling people her new brother was going to be squeezed out of my birth canal, or be-gina). She also picked up preschool French easily, and was constantly singing made-up songs and telling imaginative stories. Her My Little Ponies had the most amazing dance parties ever (small consolation at 3 in the morning when most of them occurred, but fabulous nonetheless).

However, on days when she threw sand at preschool or used a contraband marker to decorate her very expensive dollhouse bed, five praises for each criticism seemed a tall order.

“Hey, Maddux,” the conversation might go. “I appreciate that you only hit your brother once and told the truth about putting all the hair elastics and barrettes in the toilet, but it makes Mommy and Daddy sad when you punch your classmates. But great work on remembering that we don't undo the deadbolt and leave the house at night, and we’re very proud of you for helping clean up all the yogurt cups you opened this morning!”

The same types of people who now act as if I’m pouring chemicals into my daughter generally let me know back then, in no uncertain terms, that I Had No Control Over My Child.

Had I heard of “1-2-3 Magic?” I was asked. “The Happiest Baby on the Block”? “Raising Your Spirited Child"?

I had. Endlessly.

Just as I’d heard of and tried swaddling, babywearing, natural foods, positive reinforcement, sticker charts, schedules, and 5-praises-for-every-criticism. I’d doggedly followed all the “best practices” for ADHD offspring because the people who sell self-help books to harried mothers insist that if their techniques aren’t working, it’s the mother’s fault because she didn’t “stick with the program.”

So I stuck with the program, and Maddux still met the criteria for combined ADHD, her pediatrician told me this fall when we brought her in. Because unlike pop-psychology parenting books, genetics is based in actual science and your kids’ genes don’t particularly care whether the baby food is hand-mashed organic fare or whether you keep doing the sticker chart even if it doesn’t seem to be working. What I had was the best possible outcome for my little spazmazoid. And she was a happy, confident, hard-working (well, as hard-working as could be expected) little girl.

This year, Maddux entered kindergarten. She had been behind the other kids in preschool phonics, but this year, the teachers really piled on the work.Maddi had only just mastered the most basic phonetic reading, and now she was coming home with diphthongs and “sight words.”

Some people eat when they’re stressed out. Some smoke. Kids with ADHD get into mischief. Maddux threw sand on the playground. She hit classmates. She escaped from storytime and methodically locked all the stalls in the little girls’ room from the inside, offering a shrug and an embarrassed “I don’t know” as explanation for her prank. At home, my adorable blonde pixie continued to draw on walls and shred paper like a gerbil and empty six pots of glitter glue onto the shag carpeting in her room and wake her brothers up at 6 a.m. on weekends for spirited furniture-jumping sessions. In short, her behavioral issues eclipsed James' autism in terms of parental worry. If only it were as easy as a spare set of clothes, extra planning and avoiding activities that involved jackets or strange footwear, we thought.

But those aren’t the reasons she started medication.

Every day at homework time, I quizzed her on her phonics. She did fine, as long as we sounded out one letter at a time. Putting the sounds together, however, required a level of concentration that kids with ADHD don’t have. At least not when the subject matter doesn’t interest them.

Maddux could proudly name the phonics sound for any letter you’d ask, but after a word or two, she’d lose interest. Her eyes would wander the room, searching for something more stimulating than a bunch of boring letters.

If you asked her to read the words on the clip that held our bag of Cheerios shut, she’d sound it out painstakingly. “Ch. Ee. R. Ee. Oh. Z.” Which would be great, if the clip said “Cheerios,” but it in fact said “Bag Clip.”

It didn’t bother me that James was well ahead of where she’d been at his age. It seems only fair that the universe should balance his difficulty adjusting to new clothes with the ability to sound out words he saw upside-down (not surprisingly, both autism and ADHD appear to be caused by large copy number variants on the 16th chromosome). But when Thomas – who is completely typical as far as we can tell – could rattle off as many phonics sounds at 25 months as Maddux did in her second year of preschool, I began to worry.

And then it came to me.

I’d had the same problems with numbers. To this day, if I'm not on medication, it takes me a good month before I can confidently tell you my latest telephone number. To me, 867-5309 might as well be 908-3567 or 866-3355. As a child, I’d wanted to become either a neurologist or a craniofacial surgeon, but I majored in journalism instead because I knew my sloppiness with numbers would bode ill for a future in medicine.

After realizing in my mid-twenties that journalism was incredibly unfulfilling, I rescheduled the follow-up appointment I'd forgotten about after my ADHD diagnosis in college (yes, you read that right) and availed myself of a bottle of Strattera. Suddenly, I was multiplying matrices without absentmindedly ignoring the order of operations. I was also cleaning my long-neglected kitchen and waiting for people to finish talking before I cut in with my own hilarious but completely unrelated anecdotes. ADHD medication enabled me to be me, but better.

As I reminisced, I realized that while medication shouldn’t be the first resort, I’d been foolish to write it off altogether for Maddux just because she was a child. Here we were, doing everything “right,” and Maddux still came home weeping because all her classmates were in a higher phonics reader than she was. We could praise her endlessly for her great science and French skills and her generous heart, but surely having to reprimand her 20 times a day for hurting playmates and damaging property was going to have some sort of effect on her self-image.

And for us, taking ADHD drugs had made a profound difference. My failure to follow a dream because of my math troubles paled in comparison, I realized, with the struggles my daughter faced if her ADHD gave her similar misgivings about something as fundamental as literacy.

Of course, we had reservations about pharmaceuticals. The children in the articles I’d read on medication always seemed to have complaints about stomachaches and feeling “fuzzy” and losing their creative spark. These were things the helpful moms of children with perfectly-calibrated dopamine receptors were certain I needed to know before I began poisoning my kindergartener with drugs.

Nevertheless, I couldn't bear allowing my daughter to develop a lifelong hatred for reading when one 10 mg pill per day could make all the difference for her.

Amazingly, within the first few days of beginning her daily 10 mg dose of Biphentin, a drug that one might compare with an extended-release form of Ritalin, Maddux was experiencing approximately zero of these side effects. Instead, she has listened to lessons and participated eagerly in class instead of tearing up pieces of paper and antagonizing whoever happens to be in the vicinity. Her reading has improved to the point that, three weeks after her poisoning by Big Pharma commenced, she was able to navigate, with little incident, a book titled “The Headache.” Not one pot of glitter glue or Sharpie has been abused in her room (although she and James did empty a third of a tube of AquaFresh into the toilet tank last weekend). And she is once again allowed to use the school bathroom on her own rather than suffering the ignominy of an adult escort.

When the other moms and the well-meaning naturopathy adherents tell me solicitously about the benefits of fish oil (she’s been taking it since she was tiny, thanks very much, and JAMA debunked the fish oil mythology this month anyhow) or how Supernanny does this wonderful star chart, I smile and nod.

Then I go home to drug my kid -- my natural-foods eating, fish-oil-supplemented, oft-bribed positively reinforced kid -- so she doesn’t cry over her schoolwork and endure dirty looks and cruel whispers from the same people who are telling me I’m poisoning her with pharmaceuticals. (And, yes, also so I don't feel the urge to throttle her for disobeying the no-toothpaste-in-the-bedroom rule yet again.)

Maddux doesn’t get stomachaches. She doesn’t feel "fuzzy." She’s not a dull-eyed zombie, but a sparkling, cheerful girl who invents delightful games for her playmates. She still makes up wonderful songs and stories, but no longer suffers from the impulsive and destructive behavior that made her a kindergarten pariah. Shortly after beginning her prescription, Maddux told Chris, "I never want to stop taking my medicine. It makes me so smart.”

Naturally, there are days when her mind still wanders during phonics lessons or she gives her brother a green foam-soap beard while the rest of the house is sleeping. And she misbehaved outrageously for an entire week following Halloween (thank you, chocolate). But so do “normal” kids, and that’s what pharmaceuticals have enabled her to be.

If drugs are a Band-Aid solution, I’m pretty sure people aren’t giving bandages enough credit.

Tuesday, October 26, 2010

Coat of Conduct

First off: Sorry, everyone, for not posting for the past six months or so. Owing to some personal matters (OK, a miscarriage, since I hate cryptic allusions to mystery crises in other people's online communication, but PLEASE let us never speak of it again even if it's just to tell me you're sorry!) I just couldn't bring myself to write blog posts for awhile. But now I'm back and ready to update you on all the boogers and poops of my so-adorable children.

Those of you who have read my blog will doubtless remember the School Pants Debacle. If not, let me fill you in. James needed two pairs of navy slacks for preschool last spring, which meant we had to try them on in a fitting room. For some reason, the stroller did not make it to the mall with us. The resultant 900-decibel tantrum by James and gleeful prison break by Thomas earned us some amount of notoriety at The Children's Place -- nay, at the very mall itself. The School Pants Debacle is the shopping disaster by which all shopping disasters are measured in our family.

Now, you may be asking yourself, "What does James hate more than school pants?"

"Nothing" is not the right answer.

Had you been there at the Big White Ski Resort Debacle, you would know that the correct answer is "jackets." James' hatred for parkas, coats, anoraks, hoodies, blazers, windbreakers, and anything else that goes over one's clothes and fastens in front is so intense that we have what I call The Negative Twenty Rule. If it is above negative 20, he may wear his shirtsleeves, since at these temperatures, the jacket plus the tantrum would provide the heat necessary for our son to spontaneously ignite. If it is below negative 20, he is forced to wear his coat and the rest of us are forced to listen to his No. 1 hit single, "I-no-wear-my-jacket-no-no-no-no-no-no-Mommy-no-jacket-aaaahhhhhh-ahhhhhhhh-ahhhhhhhhhhggghhhhhh!"

His size 2 jacket was a great jacket. He wore it for two whole years, or about four times. But alas, he is no longer a size 2. And what's worse than a jacket? Why, a new jacket, of course. James finds any new clothes disturbing. Even the new shoes he picked out himself for PE class, after much explanation about how he had to have clean new shoes to use in the gym, were the focus of a major meltdown the first day he had to wear them. So, as the weather has grown colder over the past month, I've been trying to warm him up to the idea of a new jacket.

"Boy, it's chilly this morning," I would say. "Look, your friend Andrew is wearing a jacket today."

"Andrew's wearing a jacket today," James smiled back.

"Pretty soon, it will be time for you to wear YOUR jacket," I commented cheerfully.

"I DON'T WANNA WEAR NO JACKET, MOMMY!"

"You can pick it out yourself."

"NOOOOOOOO JACKET!"

"You can choose whichever one you like, James" I continued (mentally adding, "As long as it's 50 percent off," because that's how I roll).

This conversation happened about five times, and the protests became quieter and less adamant each time. This week, since James was the only kid at school without a jacket and there was a sale at Please Mum (although, sadly, only 30 percent off), Chris and I toted the boys to the dreaded mall.

Yet again, we didn't have the stroller, but it never hurts to have a big burly dad along to scoop up errant tots. Did I mention it was already naptime? So we had errant tots aplenty.

James and Thomas have not been shopping at the mall in quite some time (not least because I'm terrified we'll be recognized at The Children's Place), so they ran happily amok among the clothing while Chris and I looked for boys' jackets in 4T.

"James, what jacket do you like best?" I asked.

"I don't want a jacket!" he yelled in his robot voice, laughing and running in a circle around a rack with Thomas in pursuit.

"How about a blue one? Or this one with dragons? Or the cool dinosaurs?"

"A blue one!" James yelled without looking at the jackets.

We pulled a blue parka out for him.

"I don't want that jacket!" he shouted, bug-eyed.

Then he picked out the same jacket, but in a much smaller size.

"OK, James, let's try it on," I said as Chris swapped the 3T for the 18 month.

"NOOOOO! I want THAT one!" James roared, pointing at a plaid number in a bid to delay wearing the dreaded jacket.

Unfortunately for James, the plaid jacket was also available in a 3.

I tried to make a game out of trying it on, putting my hand through the sleeve and tickling at him, but he was having none of it. He squirmed away from the jacket like a greased hog at the county fair. He flung himself on the ground and dared me to shove his limbs into the coat, as the world's most annoying salesgirl hovered asking if she could help. ("Why yes, you may. Do you have any tranquilizer guns on hand?") I knew I had to pull out the heavy artillery.

"James, if you try this jacket on, I will give you jelly beans in the car."

"NO."

"I will give you a LOT of jelly beans, James." (I'm not great at bribery.)

Then, in a flash of brilliance, Chris remembered that we had just bought some Rockets (or Smarties, in the states) for me to eat on the ride home trick-or-treaters.

And grudgingly, with tears in his little bug-eyes and his brow all furrowed with anguish, James agreed to let me stuff him into his new jacket and zip it up.

And for all that, it was this close to being too small. We needed to try the next size up. But James had tried on his limit. He was done.

"James, I will give you TWICE AS MUCH CANDY!" I said brightly.

James made a noise that can only be described as The Angry Robot and bolted. We bought the 4T assuming that if it didn't fit yet, it would soon enough. Better that than a fresh debacle.

So, crisis averted with only a little bit of crying instead of the entire mall being alerted to James' hatred for outerwear, we made our purchase and left the store with, if not ALL our dignity intact, at least some of it. (Chris, of course, was traumatized by the shopping trip and thinks I'm crazy for pronouncing it a success. Shopping with kids for Chris is like a winter coat is for James.)

Coming soon(?): James wearing his winter coat. (Please, please let him wear it without covering the western half of Canada in snot.)

Saturday, July 31, 2010

A Tale of Two Beds

It was the best of times, it was the worst of times; it was the age of wisdom, it was the age of foolishness; we were on the path to big-boyhood, we were all on the fast track to crazy.

As my children one day look back on a childhood that will -- regardless of how they are raised -- likely be regarded as Dickensian (although in fairness, they are always welcome to as much gruel as they like), one of the great tragedies that stand out will be the tale of James' two beds.

Tragic for James simply because he was expected to move to a new bed. Tragic for Thomas because he had to wait more than a year to get his long-awaited toddler bed. And tragic for the rest of us because bedtime comes at the end of the day and we prefer sleep to prolonged, hysterical tantrums.

When we moved into this house at the beginning of last July, we placed the big-boy bed in James' room, right across from the toddler bed, hoping its presence would entice James to one day crawl into it. We decked it out in Diego sheets and made a big to-do about how cool it was. Months passed, and James was happy to play on the new bed, but still crawled into his toddler bed to sleep.

"James," I told him on several occasions, "Tonight you are going to start sleeping in the big-boy bed."

I placed all his special toys in the right parts of the bed, and covered him up with his special blanket.

"Good-night," I would say. It was then, as I tucked him in, that James invariably leapt from the bed, pulling all his toys with him.

"I sleep in my little bed!" he insisted. "I can't sleep in the Diego bed!"

One night, I removed the sheets from his toddler bed before this familiar routine. James was undeterred. He tackled the bare mattress, blanket in hand, crying, "I sleep in my Thomas Train bed!"

"Would you sleep in your big-boy bed if we put Thomas Train sheets on it?" I asked him.

"No, I sleep in my little bed," he wailed. "I not big, I just a little boy."

This was true. He was barely 3 at this point, and being screened for autism to boot. Since Thomas was (and is) perfectly happy to sleep in his crib, James remained in the little bed.

Weeks passed. Months passed. And this month, I realized we were halfway through summer vacation, and that my next chance to break him of his toddler bed without adding to his stress would be next summer -- when he's 4-and-a-half and Thomas himself is nearly too old for the toddler bed.

So I began telling James, "Very soon, you will start sleeping in your Diego bed. Thomas is a big boy now and needs the little bed."

James tried to reason with me.

"Thomas not a big boy," he'd say. "He a baby. Thomas sleep in the crib."

"Thomas can't sleep in the crib, James. He might climb out and break his head."

"Thomas can sleep in my little bed, and I sleep with him."

"Your bed is too little for two boys. You will sleep in your Diego bed."

"I can't sleep in the Diego bed! Thomas sleep in his crib!"

And so on.

But yesterday, when we had the conversation at naptime, James suddenly said, "I sleep in my Diego bed today."

He ended up sleeping in the toddler bed again, but tonight, Chris and I stripped his toddler bed and moved it into Thomas' room. Out of sight, out of mind.

James hopped calmly -- even happily -- into the big-boy bed, where all his special cars and stuffies were waiting for him. He insisted that I play cars with him for an inordinately long time, and requested not just his lullabye but three Christmas songs. But when I tucked him in, he stayed. And shouted "Sweet dreams, Mommy!" as I shut the door.

I have been known to cry at bedtime -- usually from sheer frustration. It's nice to shed a happy tear, for a change.

Not a single thump or shriek has been heard from James' room in the two hours since I tucked him in.

Tonight I rest. And tomorrow, Thomas gets the long-anticipated toddler bed. Unlike the yearlong saga of James' big-boy bed, however, we're pretty sure how that one will go over.

Wednesday, April 14, 2010

Big

Some babies really enjoy their babyhood. They refuse to drink from big-kid cups. They rebel against toilet training. They'll give up the pacifier -- when you pry it from their gritted teeth before sending them off to preschool.

But not Thomas. No. Because he is NOT a baby.

Well, sure, he's only 18 months old. He certainly looks like a baby. His dining chair sports a tray and he rides in a carseat. But rest assured that Thomas is -- in his own mind, at least -- a full-fledged Big Kid.

He's happy to slap high fives, blow kisses, speak words on command, and generally show off how big he is. If we're leaving someplace, Thomas insists on saying good-bye to everyone personally -- with a pageant wave, no less. If James is on the potty, Thomas wants to sit on the potty too. (Except, while James sits on the little potty chair, Thomas demands to be placed on the big potty. He's just THAT grown-up!)

For awhile, Thomas was happy to stay in my arms while I dropped Maddux off at preschool. But eventually, he realized that all the other children were taking learning toys off shelves and playing with them. So he had to, too.

Then, he noticed that the teacher greeted and dismissed all the preschoolers with a firm handshake. So, in January, Thomas began thrusting his hand at the teacher for a good shake.

Recently, he noticed that none of his siblings' classmates are carried around by their parents. So while we're in school, he insists on being let down to walk.

Last week, the first time I took the kids to school by myself on James' preschool day, Thomas seemed inordinately excited all morning. At the entrance to the building, he leapt from my arms and toddled at top speed toward the classroom.

After greeting the teacher with a cordial handshake, Thomas motored over to a nearby cubby and proceeded to remove his shoes and place them on the shelf.

Oh. No.

I suddenly realized why Thomas had been so unusually eager to drop his siblings off at school. In all the hubbub over James' going to preschool, it never occurred to me that Thomas might have assumed he'd be staying all day as well.

As I put his shoes back on to leave, Thomas realized he was not going to school with the big kids after all. And he began having a most un-big-kid-like tantrum. His eyes welled up with tears. His lower lip curled into a plaintive, quivery gasp. And the screaming commenced.

I thought about scolding Thomas for wailing loudly in school, something I often have to remind James that "we don't do." Then it occurred to me that although Thomas likes to think he's 3 or 4 years old, sometimes he is just a baby after all.

Nobody puts baby in a corner

Friday, April 2, 2010

Mom Goggles

When I was a kid, there was a girl named Kristina who lived down the street. She was a thug and a bully, and at the age of 9 she pronounced the word ambulance, "ambucklance." But her mom (a teacher) insisted to all and sundry that Kristina was a gifted and wonderful child who would never lie, brawl or harrass smaller children. Because, as parents, we are quick to see the best in our children and are often blind to potential problem areas.

As a kid, I thought Kristina's mom was either evil or a complete idiot -- or maybe both. But now, as a parent who tries to be realistic about my kids' strengths and weaknesses yet often finds her perceptions failing to jibe with reality, I can view that deluded neighborhood mom's situation with a little more empathy. She was just seeing her child through "mom goggles."

We've known for awhile that James is not like other 3-year-olds. We knew he wasn't like other 2-year-olds, and before that, other 18-month-0lds. He lost speech and lined up toys. He filled his excavator buckets with spit bubbles for what seemed like hours. He refused to wear a jacket even at -20 degrees. He was so late learning to walk that we nearly consulted a doctor about it, and when he did learn, he split his face open on a regular basis because he never put his hands out to catch himself. Yet he was always doing just enough to get a passing grade on the developmental checklists.

When he finally began speaking sentences regularly, around 2-and-a-half, his speech was repetitive, loud and monotonous. Often, when asked a question, he'd just state it back to us. There were meltdowns -- not just toddler tantrums, but panick-stricken, I'm-going-to-die-imminently meltdowns -- based around clothing, shoes, new situations, dirt, grass, you name it. I resolved that if our doctor did not agree to refer James for an autism assessment at his 3-year checkup, I would find a new doctor.

Of course, developmental delays and neurological differences are much easier to spot in a 3-year-old than in a prematurely born 18-month-old. James was immediately given a referral for an assessment. Unfortunately, the referral was to the most popular pediatrician in the area, who seems to be on vacation all the time. His office staff got back to my doctor's receptionist last month, a mere four-and-a-half months after the initial call, and told her there was a year's wait. And then, after the year's wait, he might be referred to yet another doctor. (Austism experts are in such high demand, both in Canada and the States, that this will be a familiar refrain for parents dealing with autistic spectrum disorders.)

So now we're going to a new, less-popular pediatrician, and have an appointment for later this month. My doctor's superstar receptionist has been calling everywhere on James' behalf, and discovered that the second doctor we'd eventually see would likely send James to a special network that refers kids to all kinds of early-intervention programs (after the two years of jumping through hoops, of course!). So she had our doctor refer James himself, saving us the two-year wait for a referral to the program.

Not one to sit on my hands and wait for my little boy to age out of the early-childhood programs, however, I had also contacted the Ministry of Children and Family Development, which provides assessments for kids who show signs of developmental and neurological disorders. And, pretty much the moment I hit "save" on James' online form, we got a call from the woman who screens children for autism, telling us that James sounded as if he needed early intervention and that since there was a wait for preschool-age children and he'd been premature, that he could get an open spot in their infant program (which goes to age 3). All we had to do was go in and let her meet with James.

Normally, when you introduce your kids to people, these are the thoughts that run through your head:
"I hope he doesn't have a tantrum."
"I hope she is polite."
"Please don't let him punch her in the throat when she tries to shake his hand."

But when you're taking a kid in for an autism assessment -- a kid whose preschool teacher has suggested applying for a classroom aide because his social skills and motor coordination aren't even close to that of your average preschooler -- you just hope she sees what you and those close to your child see. (Especially after a year and a half of being told "It's just too soon to tell whether this is autism or delays caused by being premature.")

And even as I brought him in, there was always the lurking suspicion that my little boy was so high on the spectrum that his autistic traits might be dismissed with a wave of the hand.

"Oh, your child is a little odd," I imagined the evaluator saying, "But we don't really see anything alarming -- nothing that would prevent him from, say, graduating summa cum laude from Harvard and running a wildly successful business and marrying an astrophysicist supermodel."

Yesterday was our appointment. I canceled the gym and we headed out with the kids. Chris had volunteered to drop us off so I wouldn't get lost in the jumble of one-way streets downtown, and he took the other kids to pick up Timbits while James and I visited with the early-intervention clinician.

After a terrifying elevator ride (for which I forgot to prepare James), we entered the office and met with the assessor. I filled out questionnaire after questionnaire, while James found a basket of vehicles and immediately retrieved the sole digger.

In autism-speak, diggers and other heavy equipment are something on which he "perseverates," meaning that he is completely obsessed with them.

"Well, he doesn't have any problem with eye contact," the assessor noted cheerfully. My heart sank. James is always smiling and making eye contact, and despite having so many other traits that would almost certainly put him on the spectrum, he is not discernably different until you try to have a conversation with him.

James played with vehicles and helicopters the entire time. Except when he noticed dirt on the floor. Then he carefully scooped up every stray piece of sand from beneath the clinician's sand-play table and helpfully deposited it in her hands.

"Now THAT," she told me with a wry smile, "Is not developmentally appropriate. At 3, we expect children to be using a little broom or suggesting a vacuum."

And indeed, it occurred to me that, when she was 2, Maddux had begged for cleaning supplies for Christmas. And that she hadn't handed me dirt since she was about 14 months old. Even Thomas doesn't hand me dirt. I felt a little more validated in my concerns about James.

Then the screener took a quick look at one the forms I'd filled out.

"Well, James' lifetime Social Communication Questionnaire got a score of 25," she told me. "Anything above a 10, we recommend an evaluation -- and 15 is the cutoff for autism. This isn't a diagnosis, just a preliminary assessment, but James definitely meets the criteria."

Even though I had known he would easily meet the cutoff, my heart dropped into my stomach. In my motherly disconnect from reality, I had still grossly underestimated the amount by which he'd blow the cutoff out of the water. This wasn't an Asperger Syndrome score. This might be closer to an adult-daycare score. The rest of the meeting was a blur as I filled out yet more forms for seemingly every early-intervention program and tool in the province's arsenal.

All I could think as we finished the visit was, "How could I have ever doubted there might be something really amiss?"

The clinician must have noticed my numb expression, because she leaned over and said reassuringly, "Don't worry. This is his lifetime score, not his current score. He's obviously come a long way in the last little while, which is a really positive sign -- and the early intervention will help."

So, we still have no official diagnosis in hand, and won't for at least a month or so. But James is now in the queue for physical therapy, occupational therapy, speech therapy and a host of other services available for children with autistic spectrum disorders.

I feel relieved and validated on the one hand, because my instincts were not wrong -- James is a child who requires a little extra help in many areas, and now he will be able to get it. On the other hand, I feel foolish for thinking it was possible my son's case was so mild that he could fall through the diagnostic cracks.

OF COURSE a 3-year-old should not be screaming blue murder for a half-hour at the prospect of wearing school clothes. OF COURSE it's abnormal for a kid to spend an entire naptime creating an impressive tower of spit bubbles at the foot of his bed. OF COURSE it's not too much to expect to be able to have a real conversation with your average preschooler.

I'm so used to looking at James through "mom goggles" that it's difficult for me to accept how very unlike other children his age he actually is. While they are impressing the teacher with their phonics knowledge, James is running away from proffered handshakes (or worse yet, doing his signature throat-jab). He won't hold a pencil. He sits backward at rectangle time. And despite repeated admonitions, he doesn't see why oscillating his hips like a sprinkler while he pees is not as amusing to his parents and teachers as it is to him.

So now I've had to take the "mom goggles" off and gain some realistic perspective on James' development. Don't get me wrong. I'm not going to join the fund-raising pity party at Autism Speaks and tell everyone how my child makes me want to drive off a bridge and has Ruined My Life. No matter what his challenges may be, James is a treasure rather than a burden. He's the same sweet, sensitive, dry-humored, eager-to-please, dump-truck-loving boy he was two days ago. But in order to help him navigate school, and life in general, I need to acknowledge that he faces significant difficulties in certain situations, and that he will need at least a few accommodations and coping strategies in order to survive a world full of people who don't share his particular neurological structure.

However, I will point out that, unlike that bratty neighbor girl, James has not yet told a deliberate lie, and he can pronounce ambulance at least as well as Kristina could.

Did I mention he REALLY LIKES construction vehicles?

Sunday, March 28, 2010

Kiss and Tell

To some kids, being affectionate comes easily. Maddux, for instance, has been saying "I love you" since forever. And once Thomas mastered the high-five, he moved on to blowing kisses.

James, on the other hand, has been reluctant to come around. He was nearly 3 before he uttered the phrase "I love you" for the first time, and until last month, I was pretty sure he would never kiss anyone without a gun pressed to his temple.

But one night, as I was leaving his room after tucking him in, James proclaimed with a big smile, "Mommy, I give you kiss!"

Well, far be it from me to pass up this once-in-a-lifetime offer! I knelt down obligingly for a sloppy kiddo kiss.

Now, most kids will just pucker up and kiss their parents. But James is very meticulous about the whole thing. With his lips extended for maximum drooly contact, he roots around on my cheek for the perfect place to plant a wet one, breathing hotly in my ear all the while. Sometimes he unpuckers and re-puckers his lips just to make sure they're in firing position.

Finally, once he has found the exact center of my cheek, he opens his mouth, checks it with his tongue just to make sure he's right (this takes approximately 3 to 5 seconds, accompanied by yet more heavy breathing), and then, after all of this drooling and hot breath, he pulls his lips AWAY from the target cheek and makes a kissing noise in the air.

After this several-minute process, he is then ready to kiss the other cheek. (And heaven forbid that the kiss or his bedtime routine in general is interrupted -- that requires that the whole process begin afresh.)

A few days into my now-nightly kiss routine with James, I noticed that while he was searching my cheek for the perfect place to lay a smooch on it, he was whispering something very quietly under his breath. Not wanting to jinx my new sloppy-goodnight-kiss routine, I didn't ask my son what he was whispering.

Days turned into weeks. James was now asking for stories and new songs in addition to his insistence on covering my face in slobber and toothpaste-sweet baby breath. And still, I couldn't quite make out his whispers.

Finally, tonight, he leaned toward me with sparking eyes and grabbed either side of my face with a chubby little hand.

"Come here, Mommy," James smiled. "I kiss your little tongue."

"You're going to kiss my cheek?" (James is still a little confused about all the different parts of the face.)

"Yes," James corrected himself. "I kiss your little chin."

And then, as he leaned toward me, warm breath whispering those mysterious nothings once more as his drooly little mouth grazed my cheek, I just barely made out the words, "I don't bite Mommy's ears off."

So maybe I can't count on James to remind me constantly that he loves me, or to blow me kisses. But at least I can rest assured that he won't be gnawing off my face, either. And I can't say I've received that promise from the other two.