Sunday, October 25, 2009

The decision to look for something more

Before I begin talking about my decision to look for something more, I should talk about David's state of being when he started fourth grade.  There were a number of different aspects to this and they can only be enumerated:

1.  David still could not do math.  He could not add past 5 consistently without counting on his fingers.
2.  David had lost his prodigious spelling ability.  Being able to look at a word and remember how to spell it was gone.  His spelling, while one of the high points in the Individualized Education Program (IEP), was only mediocre.  It was a struggle for him to learn new words.
3.  David required ritalin to attend in class.  Without it, David would be disruptive.  David did not like ritalin.  I didn't either.  When he got home, we did not give any further doses.  He would start to crash at about 5 o'clock which was when I got home from work.  From 5 to 7 o'clock was kept free of anything except for dinner.  Homework began at seven when the ritalin crash was over.
4.  David perseverated when he got upset.  He became the "W'appen" boy.  Each time he got upset, and homework upset him a lot, there would be a long string of "What happens if" questions.  Once that started, it was difficult to steer him away from them and get him back on task. 

     What happens if I don't do it?
     You don't get that choice.
     What happens if I get that choice and I don't do it?
     You have to do it anyway.
     What happens if I can't?
     I will teach you so you can.

I am not sure just how long David could have kept this up.  I only know that it was longer than I could.  It was a daily struggle to keep him away from perseveration and on task when he was doing his homework. 
5.  It was every bit as painful for David to maintain eye contact with his homework as it was to give eye contact with me.  I often had to cradle him in my arms and hold his finger in place to point at the homework.  Still, he would drift off task and I would have to bring him back on.  His homework typically took 2 to 3 hours each night to get through. 
6.  David's reading and writing were dismal.  He could not maintain any coherence to his thoughts.  He could not stay on task long enough to allow him to read more than a paragraph at a time.  He could not stay on task long enough to write more than 3 sentences at a time even with me there to help him through.  Each year when the other children were progressing David remained back at first grade abilities. 
7.  After two years of trying, I could not say that David made any significant progress in his math abilities since he suffered his skill losses at the beginning of second grade. 

I would be lying if I said that there was never any time when I was ready to give up.  All of this repetitive work, all of the disruptions David would create, the time away from the rest of my family were hard.  In that time I came to a few conclusions.

1.  ABA and other behavior methods were extremely time consuming.  They required more time than I or the school could rightly devote. 
2.  The efficacy of ABA and other behavior methods depends on the receptiveness of the child's brain.
3.  That receptiveness is a medical issue. 
4.  While ABA and other behavior methods have given us a tool these methods are not the final answer.
5.  The next breakthrough in autism has to be medical.
6.  The medical community only has their psychiatric drugs to manage the behavior of autistic children and adults.  Each of these drugs has a long list of side effects.  These side effects can be serious including suicide, addiction and seizures.

I could see the day when David would no longer be manageable at home, when my wife and I would be too old to care for him, when he would be too disruptive for his brother or sister to take him in, when he still could not handle life well enough to care for himself.  I wanted more for him.  The place to look could only be in medicine. 

The medical community research has been dismal, with the largest block of research time dedicated to proving that autism and vaccines are not related.  I realize that this is almost slanderous since starting with the conclusion and working backward is not how research should ever be done.  If you start with the conclusion that 1=2 then you can find proof of it.   The most damning thing about modern medicine's autism research is that in the 20 years since my son's diagnosis there has been no medical progress.  I have done enough medical research to know that there are medical differences between autistics and the rest of the population.  With medical differences there should be medical tests that can be run to diagnose autism.  I know of no such test.

There it was.  If I wanted to see a breakthrough with David it had to be medical.  Back then, I concluded that I would not get any such breakthrough out of the medical community.  To date, the medical community has done nothing to prove that conclusion wrong.  If David was to have any medical change it would have to be through my own effort.  I reluctantly decided to start looking.  It was an insane decision.  I knew less about medicine than I knew about Arabic script.  I felt like I was looking for gold in the Himilayas without knowing what color it was.  Still, I ran across other clueless prospectors searching for something more.  I also ran across medicine men who felt like, while they had no more than their psychiatric drugs to offer, I had no business trying anything that was not approved by the medical community.  Medicine men may sound derogatory, but that was and still is the level of medicine for autistic issues. 

If you are a doctor or a medical researcher and you sneer at this decision, know this:  You have nothing to offer besides your psychiatric drugs and I am not looking for a management tool.  You deride anyone who says that there could be a link between autism and vaccines, yet you can offer no other explanation for autism.  You can't even come up with a diagnostic test for autism.  Explicitly or implicitly stated, your answer is for us to live with it.  I chose to reject that answer and even if David had made no progress I would have no regrets for that decision.

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