Moving Moment in the car…

Me: I’m so lucky to have you. Thank you for being you.

Frances: Who else would I be, Johnny Depp?

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Milestones: the infancy through toddler years

So, we reached a milestone yesterday, but I really think that I should put it in some perspective, give it some context.

Frances has had many milestones to reach over the years. You wouldn’t know it unless you had been around us at the time, but there was a point at which we didn’t know if Frances would walk.

She was the “floppy baby” that parenting books sometimes describe; some of her reflexes that she should have outgrown by seven months remained while other reflexes were absent.

She was delayed in sitting, rolling over, standing, and crawling. Plus, she had pronated feet (which later required orthotic inserts).

Weekly visits with occupational and physical therapists improved her gross motor skills and her coordination, and she was diagnosed with hypotonia (low muscle tone). She did, of course, walk steadily by 16 months, and she ran with breath-taking confidence by the age of two.

Also, from the age of four months, it had been clear that she needed to have her eyes evaluated. At five months, she was diagnosed with severe bilateral strabismus (both eyes crossed) and, though she was seeing out of both eyes in alternation, there was the very real risk that she could lose her vision. It was the worst case her paediatrician had ever seen.

She also got her first pair of glasses upon her first visit with the paediatric ophthalmologist at five months.

Finally, once she was walking and had had eye surgery at 18 months to correct the alignment of her eyes, the rehabilitation centre asked me if there might be any more concerns of mine to address.

I didn’t realize that I was being gently nudged, but, besides her eyes, walking, and those other infant milestones, I really couldn’t think of anything.

It was true that Frances would require the daily use of eye patches for several years due to an “over correction” during the surgery (which meant that one eye turned outwards), but that was being addressed and it wasn’t their area of concern anyway. So, I was bewildered.

Then, a clinician asked if language was a difficulty. By this time, I hadn’t noticed until that very moment that, in fact, Frances was not developing new words or even really using the words that she had acquired so early.

So, if you’re still following…In summary, at first we didn’t know if she would sit, crawl, rollover, or walk. Then, we didn’t know if she would lose her vision or be able to see well enough to not be legally blind.

Now, at 18 months, we didn’t know if Frances was going to be able to speak. A speech-language pathologist evaluated her: she scored very high with receptive language and lower than average with expressive language.

From that point on, Frances and I attended early-communication groups on a weekly basis for about a year which, for a while, were concurrent with the gross motor groups that had got her walking.

She didn’t speak in these groups, and it made me nervous. But, one day, about seven months into the groups, during the “pick a song and sing together” portion of the session, I realized that I could hear the faintest little voice singing “Old Macdonald Had A Farm” for the first time! So, we knew that she would be able to speak which was an incredibly emotional moment. (I can see that moment so clearly: she was sitting on my lap while I sat cross-legged on the carpet.)

Did I mention in all of this that nobody suspected autism? If anyone did, nobody mentioned it even once?

But that’s another story for another time. I will say that Pink Cup Sister noticed, and would continue to notice, at this time that Frances wasn’t “emotional” and didn’t “play right”.

At any rate, Frances remains very myopic but, with glasses, her vision is now corrected to 20/20 and 20/30 which is pretty damn good.

Over the years, she has been seeing the orthoptist and the ophthalmologist every two months or every six months. We have virtually been fixtures at the children’s hospitals.

Yesterday, after more than eleven years, we were told that Frances no longer needs to be followed by the specialist for her vision and that she can see an optometrist like the rest of the Pink Cup Family!

This is an exciting milestone and, while trying to describe its significance, I have skipped over the parts where my doubts tugged at me throughout her toddlerhood and preschool years: Was there something not typical in her development? Like, for instance, she didn’t respond at all when put in a swing at the park; she never spoke a word at preschool to anyone at the facility; she didn’t like to be spoken to or to be asked questions; she didn’t like to be touched; she wouldn’t look at anybody…I really could just go on and on.

I should note that, before Frances was even three years old, I would ask several doctors and other professionals if we should be concerned about these things. Nobody was concerned, but my suspicions lingered.

Sigh… Deep down, I had always had suspicions that my daughter’s development wasn’t typical; but, if everyone who is supposed to help tells you that everything is fine…Well, then, what do you do?

I ended up doing A GREAT DEAL about it: there was a huge struggle to climb, by hook or by crook, through the different tiers of healthcare in order to have Frances examined by the right professional (a developmental paediatrician).

I promise — I will come back to that struggle and to those very important years spanning the ages of three to six-and-a-half. I know that I can think about it and write about it, but it’s so difficult for me that it has be at a slow pace.

Suffice it to say for now that the eventual diagnosis of high functioning autism spectrum disorder was very much anticipated and welcomed. We actually celebrated, but I’ll leave off here.

If you read through this very lengthy post, thank you.

🙂

In other words…

Frances’s use of language often impresses me.

Her teacher recently told me that she believes Frances is quite a few years older than 11 (which we’ve actually been told is the case) and that she is impressed by Frances’s very dry sense of humour.

I love her sense of humour, too.

Last night, at the dinner table, the following exchange:

Pink Cup Sister: What are you talking about? You’re short!

Frances: Let’s say I’m ‘below my growth curve’…

😂

Um, no…But yes, absolutely

Frances: Sarcasm — isn’t that just lying? (Nov. 17/17)

People with ASD can experience difficulty with figurative language. What I have discovered is that “not understanding” can, in a sense, mean “just getting to the bottom line” of the matter with Frances.

Ordinarily, she has difficulty interpreting euphemisms, idioms, gestures, etc. Here, her struggle appears to concern purpose or utility: Why would one use sarcasm? Why does one, oftentimes, use sarcasm as humour? In other words, why is it considered to be funny?

It’s really amazing that, even though she struggles with non-literal language, she is very witty and understands figurative language when it is her own, when she, herself, produces it.

For example, when she was newly six years old and was feeling unwell, she once said:

I’m feeling as sick as a tornado can be loud…Is that a lot? (May 28, 2013)

Frances has always kept me on my feet — in more ways than one — and always at least one step away from knowing everything about her.

She’s absolutely fascinating — I am her mother, after all — and her ability to get straight to the heart of any matter is just one more thing that impresses me.

Over the edge

Frances has a very dry sense of humour that appears at really funny times.

For example, every weekend, she and I have a sleepover: we usually camp out in a fort in the living room, watch a movie and eat popcorn.

Recently, my bed was the site of the sleepover, and I found myself often teetering on the edge about to fall off because she kept moving closer and pushing me. I even fell over once.

When I mentioned this to Frances, she simply said, “Well, they say if you love something, you should let it go.”

So, she was letting me go over the edge?

😂 

Decoding gestures

For anyone who struggles with the meaning of gestures (such as pointing, request for handshake, etc.) the world must be difficult to decode. For one thing, their meaning varies from culture to culture; for another thing, the different contexts in which a gesture appears at different times, or should not appear, within the same culture can be very subtle.

The okay symbol that we know in Canada and the U.S. — thumb and forefinger touching while three fingers are raised (👌) — came up in conversation after Pink Cup Sister sneezed rather forcefully in the car one day.

Frances: Are you okay?

Pink Cup Sister: (uses👌 symbol)

Frances: I don’t know what that means.

Pink Cup Sister: It means I’m okay.

(Frances struggles to imitate her sister using her middle finger instead of her index finger.)

I think this is where ageing can make features of HF ASD more distinct. Most children without ASD will probably know this particular symbol (👌) by ten-and-a-half years of age.

But I can remember when Frances was five years old: she looked puzzled as one of Pink Cup Sister’s friends held a hand up to signify a high-five was being requested of her. At that point, Pink Cup Sister took Frances’s hand and high-fived the friend. Before any diagnosis was sought, I remember wondering if perhaps a five-year-old would be expected to know the symbol for a high-five. I wasn’t sure, but I suspected so.

When she was six, and visiting with her developmental paediatrician, I remember the doctor telling her that he needed to put batteries in the train that she was holding. He held out his hand, and Frances just looked at it and then continued to be interested in the train. He repeated that he needed to put batteries in the train and kept his hand extended toward her and the toy. She didn’t pick up that cue, and I realized that she didn’t know the gesture and wondered, then, too, if she would typically know it at her age. (I silently suspected that a child of six would usually respond by handing over the train.)

Not long after, Frances was diagnosed with HF ASD based on psychometric testing and lengthy physician-observed appointments. The diagnosis wasn’t a surprise to us, but certain features of ASD were only just becoming apparent or hadn’t even yet been revealed. 

It was becoming clearer to me that social difficulties could be quite profound and that they involved more than the verbal interaction with which she was (and is) struggling.

But now, as I listen to her play a passage of the Moonlight Sonata perfectly and with great sensitivity, I can hear her communicating using her fingers in a way that many her age could not yet manage.

Certainly, gestural and body language challenge her— such as when people point to instruct or inform Frances — but she thrives on decoding the language of music (whether by ear or by reading notation). 

And when she plays the piano, it seems as if she is encountering something mysterious and interpreting it for us using a beautiful and clear form of communication that she intuitively understands.

Dinosaurs, literally

One aspect of autism spectrum disorder that affects Frances is difficulty with figurative language or words that are not intended to be interpreted literally. As she ages, the difficulty becomes more pronounced but it doesn’t always involve idioms or euphemisms.

We were recently at an event for children with autism, and Frances was describing her proposed birthday theme of dinosaurs. It seemed like a good time for me to join in the conversation.

Me: We can have lots of dinosaurs at your party…

Frances: What?!?

Me: Sorry, images of dinosaurs.

Even though Frances would know intellectually that I did not intend to have dinosaurs at her party, the fact that I omitted “images of” in that sentence immediately left her thinking that I had said something nonsensical to her.

At any rate, in order to help her, I frequently use idioms, euphemisms, similes and metaphors intentionally in order to build her repertoire of non-literal language. Fortunately, there are also social dictionaries that include figurative language entries which may be of use to her as time goes on.

Heh heh…

Me: (on phone) I’m so sorry! I slept in. I never sleep in!

Frances: (shouting in the background) Yes, you do. You sleep in ALL THE TIME!

All the while, she is jumping up and down trying to get my attention so that I can realize my mistake…