Friday, July 22, 2011

What would I tell parents that are facing a possible diagnosis

People ask me what they should say to their family members about a diagnosis. They ask me what to say to get them to get the children tested if the parents don't see any issues.

I don't know exactly what to say but I know what NOT to say.

DON'T Say:

*Something is wrong with the child.

*The child is delayed.

*The child will speak if they speak more to them.

*It's a cry for attention.

Instead say:

*The child is very quirky and then point out a hard marker like rocking.

*The alphabet seems to be a bit hard for the kid, maybe he/she needs to take it a little slower.

*The child is quiet.

*You're doing your best.

*Does the doctor have any strategies to deal with that behavior? They are professionals. They have experience with all types of personalities.

DON'T SAY AUTISM!

This is definitely a case of killing the messenger. The best thing to do is support the parent. Babysit. Don't criticize. Trust me, they are baffled as to why things seems so hard. Their child is perfect in their eyes. And ultimately, a parent needs to make peace with the fact that no matter how hard they try, no matter all the things they pay extra attention to to make sure that their child doesn't cause a disruption and be an active part of the family, they will need a professional to help them understand their child.

That's the hardest part. I remember listening to the first therapist telling me that Bugabuga was functioning at a 0-3 month level in speech and she was almost 14 months old. I couldn't understand her words.

I remember walking into the neurologist's office and hearing her say, "Yes, I agree. Hypotonia. Developmentally immature." I remember nodding and being too ashamed of my lack of knowledge of the terminology to ask questions. I remember the shock of being given a follow-up appointment. Why did she need to come back when she was fine?

"I guess that's a standard practice." Denial is beautiful in its intensity.

I remember coming back for a 4th visit and her mentioning the phrase spectrum disorder. She didn't say that she had it but she just mentioned that it may be a possibility.

I remember thinking that she was way too pretty to be on the ball. LOL. Anger is vicious, although she is pretty. LOL.

I remember the CEO waking up one morning silent after speaking simple sentences without a problem. I remember the paralyzing fear that she had a seizure.

I'll never forget the pediatrician's expression when I ran into his office without an appointment, crying that something was very wrong. I wasn't ushered back to the waiting room with the triple stroller. I was escorted into a room and the doctor followed right behind.

He checked her thoroughly and made the medical assistant get a neurological appointment for the same day.

I don't remember the hours between that meeting and walking out of the neurologist's office. I remember she was wearing a green shirt, black skirt and black boots. She ordered a battery of tests and referred me to a behavioral neurologist, or as I like to call her, a special specialist.

She called me Mrs. Moronta that day. All the other meetings, she was friendly and caring. On this day, I saw the doctor stone face that medical professionals get when they aren't ready to tell you something but they know or have an inkling of something.

She said AUTISM is a distinct possibility.

I remember nodding and holding a stack of referrals. I remember looking down at the CEO and watching her rock her little body back and forth so hard that the carriage was about to tip over.

I was in shock. She was perfect.

I remember 6 months later bringing Baby in to see the neurologist to show the therapists in the house that she was okay. I remember walking out with paperwork saying PDD-NOS.

I remember the doctor taking my hand and asking if I was okay. I remember looking at her and saying, "No, but I will be."

I remember coming to see her with my son. I saw him rocking and I was so frightened that I could barely breathe.

I remember playing it so cool but she knew. "I am so sorry. Let's discuss the types of therapy that will be the best for him at this time."

I remember my hands shaking when taking all the paperwork. There is so much paperwork. That was the only outward sign of my emotion. "What's another one, right?" I said to make a joke.

I remember her giving me a hug. "It'll be okay. You'll see with therapy, he'll do just as well as his sisters."

She was right.

There is nothing more scary than the idea of something you don't know or understand. The most important thing to realize is that a diagnosis is not a reflection of you, your spouse, your family or your child. It is not giving up the dreams for your child. It's learning how to make all your dreams come true in a way that is meaningful to your child.

I thought for a time that my dreams for my children were dead and broken but they are not. Many people describe autistics as living inside a box, everything needs to be orderly and symmetrical. When I felt that my dreams had been shattered, it was because I was afraid to think outside of the box myself. Once I was willing to think of ways to accomplish our goals, I realized that they are going to do everything they hope to do because my husband and I, along with their team of talented doctors were going to help us find a way to make them happen.

Their potential is limitless, just like always.

Monday, July 18, 2011

It's all about Communicating.

1986

"Why do you want to learn sign language?"

"Um, what if I meet someone who can't talk and hear me and they're lost? What if they need help? Everyone needs someone to help them. I can do it. I can help them." - The eight year old me.

1992

"Why do you want to work with Senior Citizens?"

"They are so interesting. I learn so much. Besides, they need friends. I can be their friends." -The 14 year old me.

1998

"I think you would be exceptional working with special children. Try it."

"I can't do it. I can't handle it. They need so much. What if I'm not as good as they deserve?"-The 20 year old me discussing student-teaching in an Autistic classroom.

2004

"Why do you work with the most difficult, untrained animals? What if you get injured?"

"Everyone deserves to be loved and feel kindness. Everyone, cats and dogs, can show love and kindness once you find the way to communicate on their level."

2008

"You need to start using Sign language to communicate with her. You have to use another means of communication if she doesn't develop the ability to speak."

"She WILL speak. I'll try sign but I know she will speak."

2009

"Mow. Mow." Accompanied by the sign for "More." Bugabuga's first sign! My baby was communicating with me! I smiled and cheered. I hugged her and danced around the room. She was so proud of herself. She signed over and over, faster and faster, "More." I cried and my smile was frozen on my face. "Great job, Bugabuga! Great job! I love you!"

She tottered over to her little pocketbook laying on the floor, focused on her favorite toy. Her focus, razor sharp on the latch, I am forgotten again.

We communicated. That's what matters. We communicated.

I wanted her to speak. I was so proud but I wanted her to speak.

2010

"Ma... Maaaa.... Ma!" "Mama!"

I started crying, so hard that my voice was broken. I signed, "More!"



Thursday, July 14, 2011

"Mommy, you short."

My husband is tall. My children are tall.

I'm short and I have a complex.

I organize my life around my height. Pots in the lower cabinets, spices on the counter. The cabinets on the walls are for storage because I have to pull out a step ladder to reach them. It's interesting seeing the world through a 5' 0" frame when the world is made for people a minimum of 5'4".

I always figured that my kids would outgrow me at some point, probably before they were teenagers but as the years started passing, I realized that they may be in 1st or 2nd grade!

And that, in case you don't realize it, is not cool.

Baby: "Mommy, you short."

"I know honey. I was born that way."

Bugabuga: "Don't be sad, Mom. You'll get big too."

"I'm not sad. I'm happy, but short."

CEO: "Awww. It's okay, do you need a hug?"

"Sure. Big hugs!"

Handsome: "Mommy, you short? Uh oh. Oh no!"

I actually always enjoyed being short. People are always nice when they reach for things for you. I can slip into the train quickly because most people are looking over my head. I have a huge personality, just packaged in a short frame.

Baby: "Don't worry mom, Daddy do it. He's tall, you're short."

Bugabuga: "Mom, why you short?

CEO: "Awww. Do you need a hug?"

Handsome: "Daddy, tall! I tall! Mommy short."

Every day, I hear how short I am. And as I look at the CEO, who is only 18" shorter than me, I think, I need to start wearing high heels!

The kids are so helpful, reaching for things that I can't reach. I hate to break it to them that they are still smaller than me. They are so considerate of my special needs that arise with being a short person. And then I say, like they say to me, when I get too helpful,

"I do it myself!"

Sunday, July 10, 2011

How did this happen?

"How did this happen?"

That question runs through my mind at least once a day. There are several schools of thought. The vaccine group is the loudest and most controversial. I don't believe it for a minute. I think the timing of symptoms and the shots are very close and everyone needs to blame something. Why not blame the shots?

I believe this happened because I used fertility drugs. I remember with frightening detail signing a waiver about autism. I remember questioning it and the doctor saying, "Is there anyone in your family with Autism?" I said no because no one shared that information with me. If I had known, I may not have taken that drug. I probably would have because I wanted a family so badly but I would have made a more educated decision. I can still feel the pen in my hand as I signed my name confidently. Autism will never happen to me.

I know many, many women that have used fertility to get their dream baby. I've read the studies that show that fertility babies are at higher risk for premature labor and developmental delays. I didn't care.

I wanted a baby. And with fertility, you can get a baby but not necessarily a healthy one. Too many parents are becoming versed in OT, PT and Speech Therapy jargon. I feel for the parents that are so excited to hold their little blessing and then find out that they may not have all working parts. It's not supposed to be this way.

I think that Autism is one of the best disabilities to get. Sure, my kids think differently but overall they are healthy as horses. But I see children with organs failing or not working correctly. Diseases that may shorten their little lives and I feel worry and anger toward the specialists that don't explain that the parent path may be rougher and shorter.

But in the quiet urgency of desperation to have a family, even being handed a crystal ball and seeing the potholes in the road, I would have still chosen my children, diagnosis and all. Because nothing in life beats waking up to a loving family, filled with hugs, smiles and laughter.

Saturday, July 9, 2011

Aunt Jane

I always wonder what my Aunt Jane would say about what I've become; how my life has turned out.

Growing up I thought Aunt Jane was every one's aunt, but in reality she was my grandmother's aunt. She never had children herself. She was married to a kind man named Uncle Pete. I grew up spending a lot of time them. We had a grand old time shopping. I remember being about 8 years old and Aunt Jane giving me a shirt that had "Silly" on the back. I was so concerned that the printer made a mistake! It should have said, Cilla. I remember asking her if we should go back to the store because I'm not silly. She looked like she was going to crack up. I was so confused. I think I even cried. Little did I know that she knew me better than I knew myself.

I am silly. I love being silly. I wish I still had that shirt. For that matter, I wish Aunt Jane was still here.

It's funny how you adopt the smallest things from people that you spend time with but you never realize that their mannerisms became yours until a sudden moment of clarity.

Tonight I was watching 101 Ways to Leave a Gameshow with the kids. I love the absurdity. It's silly, like me. The kids and I were sitting on the couch laughing and then the CEO, shifted to lay down.

"If you're laying down, you must be tired. Go to bed. A couch is not for laying on."

Where the hell did that come from? I have no problem with laying on the couch. Never did. In fact, when I was 11 and stayed at Aunt Jane's house for a few weeks, I did the same thing and she said,

"If you're laying down, you must be tired. Go to bed. A couch is not for laying on."

It was a sudden moment of deja vu.

I missed her so much. As I grew older, I would visit just to say hello. I loved sitting in her chair listening to the radio with Uncle Pete, while she made a huge meal for dinner. I loved the bologna sandwiches for lunch and the super fresh salads in the summer.

Aunt Jane was the first brave soul to get in a car with me when I got my license. I drove right to her house and picked her up so we could go shopping. Two blocks into it, I went down a street the wrong way. "We don't have to tell your mother that now, for sure." LOL.

She's been gone for quite a while and my kids missed out on knowing an exceptional woman but maybe they are getting a bit of her when I make bologna sandwiches and huge salads. And maybe they are getting more than that...

She lived a full life with Uncle Pete, despite his blindness, and we're living a full life despite Autism.


Sunday, July 3, 2011

CDC Statistics for Autism

CDC Statistics


Data & Statistics

Prevalence

  • It is estimated that between 1 in 80 and 1 in 240 with an average of 1 in 110 children in the United States have an ASD. [Read article]
  • ASDs are reported to occur in all racial, ethnic, and socioeconomic groups, yet are on average 4 to 5 times more likely to occur in boys than in girls. However, we need more information on some less studied populations and regions around the world. [Read article]
  • If 4 million children are born in the United States every year, approximately 36,500 children will eventually be diagnosed with an ASD. Assuming the prevalence rate has been constant over the past two decades, we can estimate that about 730,000 individuals between the ages of 0 to 21 have an ASD.
  • Studies in Asia, Europe, and North America have identified individuals with an ASD with an approximate prevalence of 0.6% to over 1%. A recent study in South Korea reported a prevalence of 2.6%. [Data table Adobe PDF file]
  • Photo: Prevalence of ASDs with 8 Year oldsApproximately 13% of children have a developmental disability, ranging from mild disabilities such as speech and language impairments to serious developmental disabilities, such as intellectual disabilities, cerebral palsy, and autism. [Read articleExternal Web Site Icon]

Learn more about prevalence of ASDs »

Learn more about the ADDM Project »

Learn more about the MADDSP Project »

Risk Factors and Characteristics

  • Studies have shown that among identical twins, if one child has an ASD, then the other will be affected about 60-96% of the time. In non-identical twins, if one child has an ASD, then the other is affected about 0-24% of the time. [1]
  • Parents who have a child with an ASD have a 2%–8% chance of having a second child who is also affected. [1]
  • It is estimated that about 10% of children with an ASD have an identifiable genetic, neurologic or metabolic disorder, such as fragile X or Down syndrome. As we learn more about genetics, the number of children with an ASD and an identifiable genetic condition will likely increase. [Read summaryExternal Web Site Icon] [Read summaryExternal Web Site Icon]
  • A report published by CDC in 2009, shows that 30-51% (41% on average) of the children who had an ASD also had an Intellectual Disability (intelligence quotient <=70). [Read article]

Intelligence quotient (IQ) of children aged 8 years with an autism spectrum disorder (ASD) for whom psychometric test data were available,* by site and sex (IQ) score-Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2006

Intelligence quotient (IQ) of children aged 8 years with an autism spectrum disorder (ASD) for whom psychometric test data were available, * by site and sex (IQ) score-Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2006[D]

  • Studies show that 5% of people with an ASD are affected by fragile X and 10% to 15% of those with fragile X show autistic traits. [Read summaryExternal Web Site Icon]
  • One to four percent of people with ASD also have tuberous sclerosis. [Read summaryExternal Web Site Icon]
  • About 40% of children with an ASD do not talk at all. Another 25%–30% of children with autism have some words at 12 to 18 months of age and then lose them. Others may speak, but not until later in childhood. [2]

Diagnosis

  • The median age of earliest ASD diagnosis is between 4.5 and 5.5 years, but for 51–91 percent of children with an ASD, developmental concerns had been recorded before three years of age. [Read article]

  • Studies have shown that about one third of parents of children with an ASD noticed a problem before their child’s first birthday, and 80% saw problems by 24 months. [Read summaryExternal Web Site Icon]
  • Research has shown that a diagnosis of autism at age 2 can be reliable, valid, and stable. [1] But despite evidence that ASDs can often be identified at around 18 months, many children do not receive final diagnoses until they are much older. [Read articleExternal Web Site Icon]

Economic Costs

  • Recent studies have estimated that the lifetime cost to care for an individual with an ASD is $3.2 million. [Read articleExternal Web Site Icon]
  • Individuals with an ASD had average medical expenditures that exceeded those without an ASD by $4,110–$6,200 per year. On average, medical expenditures for individuals with an ASD were 4.1–6.2 times greater than for those without an ASD. Differences in median expenditures ranged from $2,240 to $3,360 per year with median expenditures 8.4–9.5 times greater. [Read summaryExternal Web Site Icon]


References

  1. Boyle C, Van Naarden Braun K, Yeargin-Allsopp M. The Prevalence and the Genetic Epidemiology of Developmental Disabilities. In: Genetics of Developmental Disabilities. Merlin Butler and John Meany eds. 2005.
  2. Johnson, C.P. Early Clinical Characteristics of Children with Autism. In: Gupta, V.B. ed: Autistic Spectrum Disorders in Children. New York: Marcel Dekker, Inc., 2004:85-123.

Friday, July 1, 2011

Sometimes you just cry.

Most days I'm filled with optimism and hope. Most days I can power through any difficulty and it will roll off my back. Most days, I have words of wisdom on handling special needs and challenges. Most days I'm fine because I have everything I have ever wanted.

And some days, things get a little bit too hard. The tantrums and silence are too much. While I gently and firmly hold a flailing baby and she makes contact with my nose and I feel the instant pain as my skin tears open and my nose begins to bleed.

I've got nothing. There are no wise words. There is no comfort for me. I slip into my mommy survival zone, rocking and soothing, repeating over and over in my head,

"God grant my the strength. God grant me the strength. To accept, to accept. Please help me."

I feel so angry. I don't understand. So I pray and pray and I wait to feel the calm.

And once they are all in bed sleeping, I take a deep breathe and cry until I can't breathe. Sometimes, that's the only thing that makes sense.

Sometimes, I just cry.