On the spectrum

prism

Lifted here

That people with autism live on a spectrum was clear from recent conversations at our forums and book signings.

When Melissa and I ask  people there about their contact with autism, we hear a diversity of experiences:

  • My nephew with autism just finished college
  • Our friend’s daughter with autism just got married
  • Our grandson with autism wrote a book
  • He’s very high functioning but socially awkward 
  • Nobody invites us to anything because he gets violent

For caregivers, the spectrum creates obvious problems.  Therapies that were useful in one situation simply bounce off of another.  Support networks are hard to build – yes, misery loves company but finding a common set of experiences and resources is not easy.

In our family, we are blessed that Joey is emotionally connected and affectionate.  Many families of people with autism don’t have that and expend sacrificial love with little in return.  It is hard for us to imagine their challenge, even though we might have many other common experiences.

Steve Silberman makes some important points as we wind up (did you know it was April?) Autism Awareness Month.  So much science is about “root causes” when the daily struggle is about quality of life for people on the spectrum and their caregivers,

…the lion’s share of the money raised by star-studded “awareness” campaigns goes into researching potential genetic and environmental risk factors — not to improving the quality of life for the millions of autistic adults who are already here, struggling to get by. At the extreme end of the risks they face daily is bullying, abuse, and violence, even in their own homes…

Obviously, even a month of acceptance will not be enough to dramatically improve the lives of people on the spectrum. What could be done to make the world a more comfortable, respectful, and nurturing place for millions of autistic kids and adults  — now, starting today?

There’s no one answer.  But there are millions of potential answers in the hearts of many who care for people with autism and those who know and care about our families.  Caring people are on a spectrum, too, from kindly neighbors and friends to the folks who form public agencies and organizations to medical and therapeutic professionals…

…to patient strangers who take the time to be kind in the face of confusing and even ugly situations.

Wondering about the void

Lake Minnetonka

Looking out from the club’s dinning room onto Lake Minnetonka

While Joey spent the weekend in a respite apartment (that’s respite for his caregivers, mind you, he’d rather be home with his own stuff), Melissa and I traveled to a lovely spot in Minnesota  as guests of a church with a big heart for service to others.

We spoke as a couple at a forum for Autism Awareness Month.  It was well attended by folks caring for loved ones with autism and others who have friends or extended family members living with or caring for special needs.

A number of great questions and comments came up.  I want to return to some of those here on the blog.  They’ll be in no particular order except as to when they pop back into my head.

Melissa brought up what we call “the void.”  Taking care of our son Joey for the last 23 years has blessed, warped, changed or any-number-of-other-verbed every aspect of our family life, our marriage included.

I hear similar thoughts from caregivers in other situations, such as those caring for a disabled or chronically ill spouse, or grown kids caring for parents with dementia or Alzheimer’s.  Care giving takes over everything.  Some relational bonding is put on hold or evaporates, while the care giving routines become a kind of alternative glue holding people together.

Then the daily care giving goes away.  The person under care dies or is institutionalized.  In our case, Joey is on the waiting list for a group home opening.  Our dawn to dark (and sometimes in the dark) duties will move out with him.  Melissa and I will be staring at each other with a lot of “Now what?” space in between us.

Daves dad and joeAs important and immediately refreshing as we found our trip, we were urgent about getting things back to “normal” and we picked up Joey and whisked him to one of his favorite restaurants. Daves mom and joe The house might have been uncomfortably quiet as we unpacked a few bags and…

…and what?

This is ground we’ve not been over, but can see in the not-too-far distance.  We are trying to regenerate some of our couple time together, and keep up friendships, and envision things we want to do when we’re free to get on with them.

But we’re also interested in the experiences of those who’ve been over the territory, especially as couples.  Did you experience the void?  What did it do to your relationship?  How did you (plural you, y’all) come out on the other side?  Or did you?

Isolation

The first book signing for Raising a Child With Autism is history, but this isn’t about the book.  It is about the people who stopped to talk at the display table and others who’ve been in touch via the internet.  My prayer list keeps growing with their names and needs.

One man took a break from his job down the street from the bookstore to come in and describe his family’s unique challenges.  They care for a son with autism.

We noticed that people stopped inviting us to stuff.  I think they’re afraid of our kid.  My wife is at home alone with him more and more.  She’s really feeling isolated.

All kinds of care givers suffer in similar situations.  People don’t invite you out or you find it too much of a hassle to go.  Competent babysitters or respite providers are hard to find.  The person in your care is agitated if you go out on your own, but resists going along when invited.

Many Christians will hear a familiar Bible lesson on an upcoming Sunday in Easter season.  It begins with people in isolation,

2012-12-22_09-13-56_966When it was evening on that day, the first day of the week, and the doors of the house where the disciples had met were locked for fear…

But the locked door is as powerless against what happens next as, well, our bedroom door when our son Joseph wants to bust in about something.

Although the doors were shut, Jesus came and stood among them and said, “Peace be with you.”

We weren’t able to attend an Easter service.  I had to work and Melissa had to – did you guess? – be home with Joe.  Yet Easter isn’t less Easter to us, because of the one who burst the isolation of his tomb and, by his Spirit, reaches into the isolation that afflicts the human race.

There’s no easy set of “steps” to make this happen, much as I’d like to bottle and sell such a formula.  But I suppose it begins like most efforts to end isolation, with a conversation,

And I tell you, ask, and it will be given to you; seek, and you will find; knock, and it will be opened to you. For everyone who asks receives, and the one who seeks finds, and to the one who knocks it will be opened. What father among you, if his son asks for a fish, will instead of a fish give him a serpent; or if he asks for an egg, will give him a scorpion? If you then, who are evil, know how to give good gifts to your children, how much more will the heavenly Father give the Holy Spirit to those who ask him!”

We are blessed this Easter.  Although we couldn’t be in church, we will soon have dinner with friends who love Joey and welcome him into their home.

We are grateful to all who read what we share, who leave messages and otherwise communicate with us.  You have been part of God’s response when we’ve asked, sought and knocked – you help deliver us from isolation.

May God’s peace be always with you.

NO, IT’S NOT BAD PARENTING

Award winning author Norma Gail asked me some probing questions in an interview shared on her blog.

Here’s a bit of it, with some key quotes available for Tweets embedded by the host,

NORMA GAIL:  Autism affects 1-68 children in America. That’s more common than most people probably realize. What are the most basic things you wish people knew about Autism and the families it affects?

Leonidas

Lifted here.  You might find the article amusing, too.

SOMETIMES CARE GIVING STINKS: I think I speak for many families of children with autism who want to scream, “NO, IT’S NOT DUE TO BAD PARENTING.”  It’s a neurological disorder, most likely genetic rather than environmental in origin (although people debate that with some ferocity).  One of the hardest things is that kids with autism are impaired socially and so their parents can invest sacrificial work with little to no emotional connection in response.  We were spared that – Joey is very connected emotionally, albeit in some quirky ways.

There is no “cure” for autism or any one therapy that is useful in all cases.  Families hope for a “silver bullet” that will solve things, and this can leave us open to bad advice, blaming or other traps.

Parents deal with feelings similar to grieving a death.  Various hopes and dreams we hold out for a typical child often have to be given up for a child with autism.  Some kids on the autism spectrum grow up to play sports, perform in the arts, excel in academics or vocational skill, get married and all kinds of other things we think of as making for a “good life.”  But many will never experience some or all of those things.  They have other pleasures – parents have to learn to love those.

Siblings can feel ignored due to all the effort and attention put into caring for the child with autism.  The whole family is impacted.

Allies mean a great deal.  Educators, medical people, community programs, understanding churches (not always easy to find), and just plain caring folks make life better.  There’s a neighbor of ours who routinely keeps going down our sidewalk when clearing his of snow – the time and effort he saves us is a precious gift.

NG: What are some of the greatest challenges faced by parenting a child with a disability?

SCGS: As the book points out, family caregivers – and this applies in situations beyond Autism, such as Alzheimer’s, spousal disability and many other conditions – are trying to fulfill roles beyond the knowledge, skill, energy, patience and finances of a typical individual or family.  We get stretched beyond our limits and, really, beyond any realistic expectation of becoming “good at it.”

In our case, we had to deal with Joey’s “meltdowns.” Kids with autism become frustrated when they can’t understand or be understood by others, and this can lead to a violent outburst.  It’s not the same as a tantrum, in which a kid wants a toy.  It is an all consuming surge of energy in an effort to connect with a world that seems out of touch.  It is heartbreaking to try and contain a beloved child who is putting you in serious danger – Joey would punch, kick, bite and throw objects at us.

There were several years where we didn’t think that Joey or any of us would ever sleep.  The stuff that makes you laugh after the years of raising a baby keeps going when autism is in play.  I sometimes tell people, “Imagine having a combination of newborn and toddler for a couple of decades.”

Parents share war stories of dealing with “the system.”  Some school districts are downright hostile to special needs kids, considering them a financial drain on services for “normal” kids.  Then there are the insurance issues, efforts to see specialists, quests for specialized therapies – it is exhausting and sometimes fruitless.

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Check out the interview.  Leave a comment there on Norma Gail’s blog and you might win a signed copy of Raising a Child With Autism.

Because it stinks…

air freshener

Image found here.

…caregivers have some capacity to freshen the stinkiness in others’ lives (and thereby in our own).

I think that our experiences can give us compassion for others’ struggles, even those not tied to care giving.

Here’s a positive review of our book, which notes that it can reach into situations that are not just like ours:

This is a most amazing book. The writing is phenomenal. Each chapter is divided into three parts, and each connected to “gardening or growing something”. This book is like a meditation and it does not just relate to raising a child with autism, it can apply to any difficulty, one might be going through. It even relates to just life itself. I have given this book to many people and all have loved it. The depth of this small book will amaze you.

I think we can fight off pity parties (OK, sometimes) by getting out of ourselves and helping others with different challenges.

Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our affliction, so that we may be able to comfort those who are in any affliction, with the comfort with which we ourselves are comforted by God.  For as we share abundantly in Christ’s sufferings, so through Christ we share abundantly in comfort too.  (2 Corinthians 1:3-5)

 

MORE read, discuss and do?

We recently shared an article on practical preparations for being a caregiver to an aging loved one.

What if very early diagnosis says that your newborn is living with autism?

New research suggests that autism can be detected in the first year of life by brain scan, rather than waiting on traditional behavior observations in the second year.  (Here’s a news summary of the scientific article).(Here’s a news summary of the scientific article).

A suggestion: if this pans out, absorb the early shock and then start setting up your support systems.  It is an early and useful opportunity to get your care giving resources and your life in position before the major behavioral issues emerge – while your child is still dependent like a typical baby.

Worth reading, discussing and doing

Forbes Magazine has a #LifeHacks piece called 4 Critical Things To Do Before Becoming A Caregiver.  It is concise – almost a simple checklist of ways to prepare “General, Legal, Medical and Financial” documents and plans before becoming a care giver to a family member.

Ideally, discussion and preparation should go on while the family is in good health.  Spouses should talk about plans as they age; extended families should talk things out with parents, grandparents or other aging loved ones.  Families like ours, engaged in long term care of a special needs child, need to get ahead of these matters as well.

Unfortunately, care giving falls into many lives without time to prepare, as the result of a catastrophic illness or accident.  This article will still serve as a valuable resource, even under difficult “catch up” conditions.

While the article does mention getting “Names and phone numbers of religious organization and points of contact,” we would amplify this to include discussion and documentation of funeral/burial wishes, whether religious or not.  Don’t underestimate the wear and tear on care givers and other survivors;

  • the unexpected cost of a funeral, often setting up stress between unexpected price and available budget, leading to guilt and family squabbling;
  • the bombardment of questions – “What music at the service?  Burial or cremation? Who is going to speak?” – that comes in right when survivors just want to be still, remember and grieve;
  • the challenge of providing an event for a large number of people, many of them strangers to the survivors, on short notice;
  • oh, so much more.

It is a great gift to the family to have talked out and written down the loved one’s wishes in advance.  Most funeral homes and many churches have worksheets that ask all of the relevant questions, and having these available at the time of death takes a great deal of strain off of those dealing with loss.

Beer, bang, blood & BS

O, God, where to start retelling last night?

Got home from work in the late afternoon with two consecutive days off coming up. We had a fun Chinese pick up dinner; Joey downed his own weight in Lo Mein.

Melissa and I were settling in to binge watch something and I was so relaxed that I had a second beer.  Then a third.

Then, a floor shaking bang and noise  like the fusion of snoring, opera and a train going by.  Joey had a seizure.

It must have been abrupt because he usually senses them coming and gets to a couch.  This time he was down on the floor in his closet with his face shoved into the floor.  It was hard to get to him and we needed to make sure we could keep his airway open.

I’d just downed that third beer…

Melissa managed to wedge herself in with him, get a hand under his head and get his nose and mouth out of the carpet so he could breathe.

When she got her hand free, it was covered in blood.

As the seizure subsided, Joey began to rouse himself a bit and we were able to get him out of the closet and inspect his head.  There was running blood all over his left ear and we couldn’t tell if it was coming from an external cut or from inside of his head.

Melissa said, “We need to take him in,” meaning to the ER as it was evening, and she was right.  But I’d had three rapid beers and she was going to have to drive.

So we loaded up, her hair a mess and no makeup (that doesn’t bug me but she hates going out like that), Joey and I in shorts despite the winter temps.

I had the presence of mind to call the ER and let them know we were on the way and what had happened.

OK, OK, I need to back up just a bit so I can tell you about the BS.  As soon as we realized that we had to get to the hospital, Melissa had the insight that Joey gets combative after a seizure.  He just wants to sleep and doesn’t want to be poked, prodded, asked questions… it is like a man-cold on steroids.  He can get violent if pushed, no matter the pushers’ good intentions.

So she showed Joey her bloody hand and said, “Look, Joey, mommy has an owie.  I have to go to the doctor.  Will you help take mommy to the doctor?”

It worked.  She actually turned him into a caregiver, and, although we could see he’d rather do something else (hey, that’s a working definition of care giving, ain’t it?), he wanted to help mommy be OK.

This morning I realize that autism worked in our favor.  His older brother, the engineer, would have asked, “Hey, if mom’s injured, how come she has to drive?”  No such problem with Joey.

At the ER, Melissa quickly informed the staff of the BS story under which we were operating.  It was wonderful – all of them, from the receptionists, to the nurses, to the admitting clerk, to the doctor – adopted the line.  “So, what happened to you,” they asked Melissa, “and where are you hurt?”

Meanwhile, they convinced Joey that getting his blood pressure would be helpful to treating his Mom.

They very dramatically cleaned the blood off her hand so Joey could see mom getting fixed, then told him that some of the blood was on him and they needed to clean him up, too.

Thanks be to God, the bloody wound was an external abrasion.  No stitches, just some topical disinfectant and a day of rest (today) at home.

And, because of Melissa’s impromptu and epic BS, no combat.

No pics to share.  I wasn’t thinking of blog illustrations at the ER.

20170130_104531

So here’s one of last night’s empties and some morning coffee.  In a mug that Joey painted for me.

Trying to cancel a pity party

Care giving pushes a person toward their outer limits.  The repetition of unpleasant tasks and the human desire to receive as much or more than we give can make the caregiver sad, surly, stressed out or all of the above.

Throw in some of life’s normal irritations and it’s time for black confetti, diabolical tunes and spoiled snacks – a pity party.

A wise friend once advised me to get ahead of the onslaught by asking myself, “If I were the devil, what would I do to upset Tim?”  This week, it’s been an overload of all the life crud I’d rather not deal with;

  • Bureaucracy – got a call from the pharmacy that insurance was declining to refill our son’s array of medications, which include anti-seizure and anti-aggression chill pills.  So I had to dig through piles of forms that all look alike, call automated “customer service” numbers, hack my way to a live person who wouldn’t talk to me because of HIPPA (he, they’re my son’s meds, not mine), etc.  Hate doing this on my best day.  Got it fixed but it left me frazzled.
  • Money – I get to pay bills AND do taxes on my upcoming days off.  WooHOOO!  Yay, Me!!!!!
  • Conflict – part of my work has me representing my superiors to two dug in groups that refuse to resolve a conflict and keep trying to manipulate me to to choose between them.  My superiors simply want them to make up or get lost.  I don’t like delivering bad news; I’m a decent care giver because I’m flexible and it is not easy for me to be bossy; I like peace and hate being around people who’ve lost their rationality.  Today I get to call the two faction leaders and tell them, “You’ve exhausted the patience of my superiors.  You’re both gone.”  Even more delicious was the whole night anticipating these calls.

pathetic-7Pity parties make us passive and hapless.  The make us throw up our hands in woe and just let circumstances continue to crush us.  What to do?

  • Stop bundling the problems as one big mess.  Mentally separate them.  Take them one at a time.  They are not related.  They are not God’s wrath coming upon you.  And they will go away the sooner you stop pity partying and take them on one by one.  Don’t look at them all at once or the whole universe will look like your problem.  Give each one its time and place, curse it if you must, and then get down to dealing with it.
  • Delegate.  Can someone else help?  I just realized that someone else is going to see the feuding hard heads face to face before I do.  So, I will still make the bad news phone calls, but my colleague can deliver the formal letter from our superiors.  One less bit of stress and wasted time.  Don’t play the hero; accept offers of help or better yet, stop waiting for an offer and ask for it.
  • Practice spirituality.  Stuff that’s hard can be turned to your advantage.  As a follower of Jesus, I’m aware of the words  In all things I have shown you that by working hard in this way we must help the weak and remember the words of the Lord Jesus, how he himself said, ‘It is more blessed to give than to receive’  (Acts 20:35).  Yes, care giving is about giving more than you get back.  In our animal flesh, that’s a big negative, but in the mystery of the Spirit it’s a way to find blessing, that is, deep and abiding happiness.  So wrestle with the invisible possibilities instead of just slogging through the pathetic feelings.
  • Take your times of rest and recovery.  Sometimes this means just turning away from the problems when you’ve done what you can do.  Other times it means to celebrate because you’ve knocked something off the list.  Rewarding yourself for a victory will help you go out and win other battles.

I’m sure there’s more stuff to list but you know what?  I’m tired of thinking about it and I’m going to drink coffee and get those stupid phone calls out of the way.

Hope your weekend is good.  If you have a pity party planned, cancel it.

We’ll leave the light off for ya

People with autism connect with the world through repetitive behaviors.  I mean, we all do, right?  None of us want to live in a town where red light means stop on Tuesday and go on Wednesday.  I think.

But people with autism take repetition to the nth degree.  One of the the behaviors that led to our son Joey’s diagnosis was a daily pattern of running around the house, clockwise, pausing to touch certain objects in sequence along the way.  That’s a game a neurotypical kid might create, of course, but then a typical kid would lose interest and create a different game without having to be coaxed out of it by a therapeutic intervention.

20170121_085218One of Joey’s current repetitive behaviors is turning off our house’s outside lights.  It’s almost like he’s adopted a daily chore, which would be nice, except we can’t figure out the timing.  It’s irregular and sometimes inconvenient.  Why he’s even aware of those lights is a mystery, since they don’t glow into the window or anything.  But he’s taken to turning them off, sometimes while waiting for his morning bus, sometimes when he gets up to get a drink at night, sometimes in a cantankerous little gesture just after we’ve turned them on.

Joey’s repetitive behaviors create repetitive behaviors in his caregivers.  Now my wife and I have to check the light switch every time we go by at night.

Today is Saturday, and the whole family engages in a big repetitive behavior based on Joey’s imposed pattern of glazed doughnut with chocolate milk.  It means I have to get up earlier than I want, including on bitter winter days; the dog expects a car ride to the market; Melissa has to go on seizure watch while I’m out, during which the cat nags her for a brushing.  This pattern, almost down to a minute by minute precision, has been in place for years.  All because Joey is happy with his doughnut and “off” – possibly to the point of a seizure – for the rest of the day if it doesn’t show up.

When I got back from the market, I knew that Joey was awake.  How?  Not because there was a light on in his bedroom window, but because the lights in the driveway were off.

These repetitive behaviors can infest the care giving family in a couple of ways.  Obviously, they can become a grind.  Or, they can become cute and sentimental, preserving the feeling of caring for a child long past childhood.  This can create a void when the person with autism moves out, as Joey might at any time.

Then you have husband, wife, cat and dog all staring at one another wondering what to do.  Care giving can create some patterns of relationship, but it can also make those a facade ready to collapse when the person receiving care leaves the pattern.

Care giving is a consuming, sacrificial act of love.  But we have to be careful not to dramatize it or sentimentalize it, because it can take over too much of reality like some kind of idol.

One of the ways I resist that is to have my own @^%*#@$ repetitive patterns that aren’t tied to care giving.  I read during my lunch hour at work, for example.  This week, I got something worth sharing.  Hope it helps where you are:

We fill in the center with something or someone and ask it to be the fulfillment of all our desires.  We attempt to quench our thirst for the infinite with something finite.  When this happens, we terribly distort whatever it is we are asking to be our god.  No one, and nothing, can bear that responsibility and so we begin to squeeze the life out of our loves.  And we die, too, because we need the nourishment only God can give.  A lesser god means a lesser self.  (John Welch, O. Carm., The Carmelite Way)