Straddling the Autistic/parent divide

The division in the autism community between autistic adults and parents of autistic children is one that I find particularly frustrating, because I belong to both groups and feel allegiance to both.

On the internet, I have encountered some intense hostility from autistic advocates who know that I’m a mother, but don’t know that I’m autistic myself. This hostility was not provoked by anything other than me being an “autism mom”. I support and identify with the neurodiversity movement, I don’t want to eradicate my son’s autism, and I am not seeking accolades for being an “ally.” Incidentally, in these conversations, I do not feel the need to identify myself as autistic or mentally ill or otherwise neurodivergent. I shouldn’t have to disclose my neurology in order to defend myself as a mother.

I have also encountered hostility from other “autism moms” when I objected to attempts to make murders (and sometimes torture) of autistic children somehow about the child instead of about the parent. Fortunately, most of the moms I know both in person and online, are as horrified by these stories as I am; but there are certainly some out there who will try to make it about how hard parenting an autistic child is, instead of the parent being a sadistic person who preys on the vulnerable.

There are things that are worth being angry about – the example I just gave is one. But most of the arguments I see online between parents and adult autistics are not about things like this. I see people from both groups starting out from a place of defensiveness and/or hostility, resulting in conversations where they are talking past each other, with very little attempt to come to a mutual understanding. Example:

Parent: “My son wears a harness that I can grab onto when he bolts during a meltdown.”

Autistic: “That’s horrible and degrading. Your child is a PERSON, not a dog.”

Parent: “Not everyone is as high-functioning as you.”

Autistic: “Functioning labels are ableist!”

The parent comes away from this conversation thinking that adult autistic advocates completely don’t understand what it’s like to parent their child, and therefore their perspectives are not worth listening to. The autistic comes away from the conversation thinking that autism parents believe their children are essentially animals. But from the beginning, both are making assumptions about the other: the parent is assuming that the autistic person is mildly affected and cannot understand their situation, and the autistic person is assuming the worst about the parent’s motivations.

Here’s an alternative version of the same conversation:

Parent: “My son wears a harness that I can grab onto when he bolts during a meltdown.”

Autistic: “Is that really necessary? It seems degrading to me, like you are treating him like a dog.”

Parent: “Yes, unfortunately, it is necessary right now. He’s been almost hit by cars so many times, and I’m not willing to take that risk. Also, he tells me that he finds the harness comforting, like a hug.”

Autistic: “Huh. OK. I still don’t like the idea.”

Parent: “I’m not crazy about it either, but I like it better than the idea of my son being dead.”

Notice how, in the second conversation, the autistic person’s severity level and the issue of functioning labels didn’t come up – because they are, actually, not relevant to the issue being discussed. Shocking! At the end of the conversation, these two individuals may not be in complete agreement, but they each understand where the other is coming from. They don’t come away believing the worst about each other.

Can’t we have more conversations like that?

Advertisements

Supermom

I have an alter-ego. Her name is Supermom.

Supermom wears makeup, which she compulsively checks in the car mirror because any imperfections in her mask might let her real self show. She dresses nicely. Maybe a little bit too nicely for such mundane occasions as grocery shopping and driving her child to therapy. The clothes are from thrift stores and from relatives who didn’t want them anymore, but you’d have to look closely to see the holes.

Supermom might be tired from getting up at 2:30 AM, but she has her shit together. She keeps detailed medical records and educational records. She makes to-do lists. She’s on time to IEP meetings and parent conferences. Usually. She schedules appointments and keeps them.

Supermom is comfortable with social interaction. Mostly. If she’s not, it’s just because she got up at 2:30 AM and she’s really tired …. It’s definitely not because she’s autistic or struggling with paranoia.

Supermom is mentally stable and does not need medication in order to function in day-to-day life.

Supermom does not have any weird political opinions.

Supermom is an advocate. She argues with doctors. She fires therapists. She files formal complaints. She keeps records and paper trails.

Supermom is involved in all of her kid’s therapies. She also implements the therapies at home on a daily basis, due to her endless amounts of energy and patience and lack of personal needs. She makes visual supports and uses them consistently.

When Supermom comes home, she wipes off her war paint, and there’s just me.

I laugh, I cry, I make terrible jokes, I feel overwhelmed, I struggle to keep my eyes open, I get mad, I yell, I apologize, I hug my son, I make silly faces, I stomp like a dinosaur. I put on a TV show and let him eat 3 boxes of yogurt raisins so that I can sit on the couch playing word games online. I rock back and forth and flap my hands. I take my meds. I grapple with self-doubt. I get worked up about politics. I slack off on therapy strategies. And I really do get up at 2:30 AM to give breathing medications and comfort and love.

I’m not sure how many people my Supermom persona actually fools – maybe no one. But I’m aware that I’m expected to try. At least try to pretend to be superhuman. And how my son is treated, the services and supports and medical care he gets, depends on my trying.

So I do. You’re welcome.

Visibility, accessibility, and judgy people

First of all, let’s get something straight: “invisible” and “physical” are NOT opposites.

A mental or psychiatric disability can be visible. For instance, when you see someone totally disheveled, walking down the street muttering to herself, you probably figure she’s got something going on mentally, like schizophrenia or a really, really, really bad day. A psychiatric disability can also have physical effects, like when you are so depressed you physically cannot get up to go to the bathroom, and brushing half of your hair feels like running a marathon; or the more extreme instance of catatonic depression.

Even more common is for a physical disability to be invisible. Examples: lupus, fibromyalgia, having a feeding tube and/or ostomy bag unless you are wearing a bikini, multiple sclerosis, cystic fibrosis, and many others. Some, though not all, of these impair mobility.

Often, the line between “physical” and “mental/developmental” disability is not at all clear (probably because our brains are part of our bodies? just a wild guess there). How would you categorize a traumatic brain injury? What about Tourette’s, which is neurological but causes physical movements? What about Down Syndrome, which is developmental but often accompanied by problems like heart defects and metabolic problems, and has distinctive (visible) physical features?

The line between “visible” and “invisible” is not clear either. The same disability may be visible at some times, invisible at others. And whether or not it is visible may depend on other people’s knowledge and perceptiveness. Does “visible” mean it must be automatically visible to every sighted person? Does “invisible” mean nobody can tell, even someone very familiar with disabilities?

My son Monkey has a disability, but most people don’t see that when they look at him. There are actually some visible signs: he wears SMOs, for instance, and you can see them over the tops of his shoes, but most people don’t notice or know that they are a form of brace. (Even higher braces – AFOs – are often covered by pants.) He wears an Alert Me band on his wrist with emergency information, but most people don’t register what it is; I’ve had another mom ask me if it was a watch. For that matter, when he wore oxygen full-time, somebody once asked me whether it was because he had allergies. (Yes, because that is a totally normal reason for a young child to be on oxygen ….???)

Basically, to many people, the only “visible” disability is when both your legs have been amputated and you’re being carried on a stretcher while not wearing prosthetics. Using a wheelchair is not enough, because if the person using it stands up a little bit to reach for something on a shelf, these folks will assume that the individual is just using the wheelchair out of laziness, or for attention, rather than because they need it.

Anyway, back to Monkey. He receives physical therapy at school. He has low muscle tone throughout his body, which means that he fatigues more easily than most kids. It also makes it much harder to lift and carry him; imagine trying to hoist a 43 lb bag of flour into a shopping cart. Now imagine that the 43 lb bag of flour has legs and you are trying to stuff those legs into the leg holes of the cart, and the bag of flour is not cooperating … a couple months ago I launched into some rather loud cursing in the checkout line at Target for this reason.

But why was I trying to put Monkey in the shopping cart in the checkout line? Because he was repeatedly attempting to elope. This whole shopping expedition, mind you, had not gone well; he was already dysregulated before we went; but there were some things I had to get. I usually tag-team with my husband, or we all go together on the weekend and I shop while he manages Monkey, but sometimes he works late or goes on business trips and I have to go to the store. This was one of those times.

Now, Monkey is a runner, which means he will suddenly break away from his adult and bolt – out of a building, into traffic. This is especially dangerous in parking lots. He was already attempting to run, so I knew that the only way I could get him through the parking lot along with the groceries without him bolting in front of a car was to have him seated in the cart. Which he is just about too big for, but technically he fits. It has never been easy to put him in these carts, but this particular day I just could. not. do. it. Physically couldn’t manage it. And I started cussing. I lost it. People were staring at me, probably thinking I was an abusive mother, and I don’t blame them.

I thought about this incident last week, when I learned about Caroline Carts. I thought about it again when I saw that our Target actually has one. If you don’t know what a Caroline Cart is, here you go.

The likelihood is pretty high that one of these days, I will end up using one of these carts for Monkey – not on a regular basis, but on expeditions like the one just described. But when I do, I can only hope that the nasty looks and comments are kept to a minimum. Because yes, my son can walk (and run). And no, he is not “visibly” disabled – unless you know what to look for. I dread a store employee or a vigilante coming up to me and telling me what a horrible person I am – the sort of thing that happens to people who don’t “look” disabled who park their cars (legally) in disabled spaces. Even more than that, I dread some mother of a child who is visibly disabled, challenging me. Because while I would be happy to turn over the cart to somebody who needed it more, I’m afraid she might think that I didn’t need it at all, that I was being callous, that I was utterly different from her. And I’m not.

We still use a Britax stroller (again, due to elopement and low muscle tone) even though Monkey is at the upper limit for height and weight. He gets tired and wants to be carried, and we simply can’t carry him any real distance; the stroller keeps him comfortable and safe.

Last Saturday, the three of us enjoyed a stroll around the mall, visited some shops, grabbed snacks and coffee. We got some looks and even a glare as Monkey climbed in and out of his stroller, as we pushed him around. I’m glad that “Too Big for a Stroller” tumblr thing isn’t still going, because someone probably would have snapped a picture of us. Dear people at the mall, my child is not lazy. He’s not spoiled. He is big for his age and has disabilities.

I’ve been unable to get into a building because Monkey was in his stroller and I couldn’t find a wheelchair ramp. I put him in the adaptive swings at the park; they are the only way he is able to swing. If no family bathroom is available, I change him in the accessible stall in a public bathroom, because I need the space. At home, he has adaptive equipment to help him use the toilet.

Physical accessibility matters for us. It affects our daily lives.

But you probably can’t see that.

Please don’t judge.

Signs that you might be parenting a medically complex child

You accidentally put Miralax in your coffee this morning.

Or, you accidentally put Thick-It in your coffee this morning.

You proceeded to drink the Miralax/Thick-It infused coffee because you were either too sleep-deprived to realize what you’d done, or too sleep-deprived to care.

Your energy level ranges from “tired” to “so tired I can’t remember my zip code.”

You send your significant other to pick up your child’s latest prescription, because you are avoiding the pharmacy tech that you caused to cry last week.

You’re on a first-name basis with the person in charge of “incontinence products resupply.”

You make To-Do lists on the discarded backs of Tegaderm bandages.

You are weirdly excited by velcro.

You own a laminator.

Alternatively, you continue to do all your laminating at Office Depot, even though you know it’s more expensive in the long run, because having other people print your stuff is one of your only opportunities for face-to-face human interaction.

All of your mom friends are online.

Your everyday conversation is peppered with acronyms that literally no one understands except therapists, nurses, and your internet mom friends. Like, not even your partner. Some therapists aren’t sure what you’re talking about either.

You spend your less-than-ample spare time educating your elected representatives about how health care actually works.

People get confused when they walk into your home for the first time, because your living room looks so much like an OT gym.

Your child’s OT asks if she can see clients in your living room while her building is being renovated.

Your child’s “pretend doctor” kit is composed of real medical supplies collected from the hospital. (“Hey, wanna put the anesthesia mask on Daniel Tiger? I sure hope he hasn’t eaten in the last 12 hours!”)

All of the ads in your Facebook sidebar are for adaptive strollers and catheters.

You cope with the oddities of your life by making darkly humorous lists about it, and instead of ending with something trite about how precious your child is (which should be everyone’s fundamental underlying assumption because DUH they are your child), you end the list with a little meta commentary on the fact that you made a list about these things. Then you laugh hysterically and take an Ativan.

 

My autism is not my son’s autism. Or is it?

When I was in college, I became friends with a fellow student who was diagnosed with Asperger’s Syndrome. I started reading about Asperger’s and was struck by how much it sounded like …. me. I’d been searching for years, my whole life really, for some kind of explanation as to why I felt so different from everyone around me, had so much trouble making friends, and was always offending people without understanding what I’d done wrong – and here was the first explanation that really seemed to fit. It also fit with the sensory challenges I’d had all my life, with my intense obsessions, my physical awkwardness and clumsiness, my need for routine, and the various self-soothing behaviors that I now know are forms of “stimming.”

I told my parents and they said “No way.” Then they read some books about Asperger’s, called me back and said, “Never mind, you definitely have it.” They consulted my old psychiatrist, who said something along the lines of “Oh, that explains a lot!” And so I embraced the notion that I was indeed on the spectrum.

Until I got a job working with autistic adults.

These adults were at the other end of the spectrum from me, to the extent that the spectrum has “ends.” (I think of it more as a scatter plot.) All the scariest-sounding behaviors people think of when they think autism, these folks displayed. They needed 24/7 supervision and maximum support. I liked them; I liked working with them. But it put my own challenges in perspective.

And then the DSM V came along and Asperger’s was no more. I continued to think of myself as having some autistic traits, but not really actual autism. I didn’t dare lay claim to the same label that, for my clients, was so encompassing, so disabling. In some ways, I related to them and felt that I understood them. At the same time, there was plenty that I didn’t understand; and my own great privilege in having a husband, a job, and the ability to more or less communicate my thoughts, was very very evident to me.

Then I had a baby. And that baby had all sorts of medical problems and delays. And then my baby grew into a little boy and was diagnosed with autism.

Around that same time, my therapist suggested that I’m also on the spectrum, and I had to confront, again, from a new perspective, just what exactly that means.

Only time will tell the level of support that my son needs long-term, but I know this much: he has challenges that I never had as a child. I was not delayed in speech or self-help skills. I didn’t leave buildings by myself, bolt in front of cars or wander into bodies of water. I was sufficiently aware of my body’s boundaries not to injure myself and others on a regular basis. I didn’t lose skills, become so anxious I’d stop eating or drinking for days, or have insomnia and GI problems that required medical management. On the other hand, my son already at the age of 3 has more language than my adult clients had, and many other skills are incipient or emerging.

Some people, often parents of individuals with severe autism (i.e. those that need maximum support), feel that we need different names for the mild and severe ends of the spectrum. I completely understand where they’re coming from; I feel the same way at times. The problem is all the people, like my son, who are somewhere in between those ends. Not only are they in between the extremes, but they are all over the map in that in-between area. That’s why I think of it more as a scatter plot than a spectrum. And if that’s the case, if there are points all over the map, then where do you draw the dividing line?

I do believe that autism is an umbrella term. There are autisms. Similar behavioral profiles with various etiologies and various degrees of disability. Genetic causes (including some known chromosomal anomalies), environmental causes, combinations of the two. Comorbidity is characteristic of autism, which adds further variation.

Rett Syndrome used to be grouped together with autism spectrum disorders; now it’s understood to be a distinct disorder. That may very well happen with other developmental disabilities that are now grouped under “autism.” But until it does, until we can scientifically sort this stuff out, it seems better that instead of fighting with each other, we use our commonalities as a starting point and try to learn from the huge variety of experiences on what is currently the spectrum.

That goes for both parents and autistic individuals. Autistic adults who need only some minor accommodations to live independently, and who want to dispute that autism is a disability in any but a socially constructed sense, need to pay attention to those who are undeniably disabled by their autism. (None of that “It’s not the autism that’s disabling, it’s the comorbidities.” That’s a cop-out.) And parents of nonverbal autistics need to listen to those at various points on the scatter plot who are able to communicate verbally (not necessarily vocally!), and have their assumptions about their child’s inner life continually challenged. (No, I’m not saying that inside every autistic person is a hidden genius. But there are parts of every person that are unknown to their parents and caregivers. Profoundly disabled people are no exception to that.) Most of us, whether we’re autistic or parents of autistics, are hurting, which makes it hard to be open to others. Even so, let’s try to listen to one another’s experience without discounting it.

It’s OK to make distinctions between severity of symptoms and levels of support needed, as long as we don’t use those distinctions to set up opposing camps. Lines can divide, but they can also connect and become beautifully complex shapes.

Dear medical staff: can we have the stickers without the gendered assumptions, please?

Monkey’s favorite show right now is “Sofia the First.” He loves the flying horses and the woolly wombeast. He particularly loves Cedric the evil sorcerer, and the dude with the magic show who kidnaps Clover and renames him Mr. Cuddles. (Monkey’s stuffed bunny is now named “Mr Cuddles” and is forced into servitude multiple times a day.) He got really excited a few days ago when he saw Sofia in her purple dress on a puzzle at the library. He also loves to watch the songs from the movie “Moana” (he has a name for each song: “How Far I’ll Go” is “the pig”; “You’re Welcome” is “the big rock”).

So it bugs me when, as this morning, we are at a doctor’s appointment and the doctor or nurse, who is kindly fanning out a handful of stickers for Monkey to choose from, shuffles rapidly past the Sofia and Moana stickers and go straight to Ninja Turtles and Spiderman.

OK, maybe it’s not a big deal. They’re just stickers, right? But you know what, screw that, it IS a big deal. My 3 year old just went through an uncomfortable and scary procedure (which happens to him A LOT) and he should get to pick a sticker that he really wants, not what YOU (well meaning adult) think he should want. I mean, at least let him LOOK at the stickers you would show if he were a girl. Just show all the kids the same stickers! I’m sure there’s a little girl out there somewhere who loves Ninja Turtles and would be thrilled to have the sticker Monkey somewhat reluctantly took for lack of options.

I’m trying to come up with a quick, polite way of letting these medical professionals know that they need to show him the “girl” stickers too. I’m just not sure how to phrase it. I did speak up once, and Monkey delightedly chose, from a full drawer of stickers, one with Dora on it, which was his favorite show at the time.

This is 2017, folks. It’s not even about gender identity or sexuality at this point, it’s about acknowledging that human taste doesn’t fall into neat stereotypical boxes along arbitrary gender lines.

When I was little, I loved dinosaurs (still do). I put bows on my dinosaurs and made them marry each other. I played with a “boy” thing (dinosaurs) in a “girl” kind of way (weddings), just like Monkey enjoys a “girl” thing (Sofia) in a “boy” kind of way (evil magician). (Even these designations are arbitrary; I love a good evil magician as much as the next person.) But it doesn’t occur to companies to sell shirts with dinosaurs wearing bows in the girls’ section of the store, or with Cedric and his evil crow in the boys’. I can’t decide if this is prejudice, or capitalism, or a lack of imagination. Maybe all of the above.

Circles

Parents of children with disabilities/special needs/whatever will often relate their experience to the well-known five stages of grief. Personally, I don’t find that these stages express my own experience well. I’ve never gone through denial or bargaining with regard to Monkey’s challenges. As for the other three – anger, depression, and acceptance – I go through all of those, but not in any kind of orderly sequence. They are all sort of jumbled up together. One will predominate for a while, then another for a while, and they move in circles, overlapping, mingling.

I don’t grieve for “the child I expected to have” or “the parent I thought I would be” or any of those things that people often mention. I’m not neurotypical, I never expected to have a neurotypical child, and if anything I’m probably a better parent than I thought I would be (I had low expectations). Monkey is so much awesomer than any child I could possibly have conjured up in my imagination. In my darkest moments I don’t wish for a different child.

No, what I wish for is a different world.

It’s the world that I grieve over. Sometimes – often – Monkey is the catalyst for that grief.

For instance, while we were on vacation, we took Monkey to the park. There was a little boy there who was the same age as him – their birthdays were a week apart. The boy was zipping around on a little scooter thing; he offered Monkey a turn. Monkey tried, but couldn’t figure it out. The boy kept talking, and Monkey couldn’t keep up with him verbally. Then the boy started literally riding in circles around Monkey, who stood in the middle, bewildered, still, uncertain.

I grieved over this incident for the rest of the day. It was just too perfectly symbolic of what I see so often, and what I know will often happen in Monkey’s life – that others will run circles around him.

I had a two hour meeting with therapists and school officials earlier this week in which we all talked about all the things he isn’t doing, all the things he struggles with and needs. He will be in a special needs preschool classroom. He will get physical therapy, occupational therapy, speech therapy. He is behind his peers. He is developmentally delayed.

But that’s not how I see it. That is, I see the difference from his peers, and I see his struggles, but I don’t see those things in light of the value judgments that the world makes. I grieve because the world values people who are FAST, and people who are STRONG. People who are loud and flashy and attractive, who know how to lie and manipulate others. Those who can run circles. Meanwhile, the world overlooks, or disdains, those who are standing in the middle of the circle – quiet, thoughtful, slow, observant – the center, the gravity that makes the orbit.