Saturday, February 7, 2009

Amy's back-story

Right from the start Amy has needed a lot of skin contact from me. She was breast-fed til she was three years old and I knew it was more for comfort than food for probably the last couple of years. As a newborn she slept very well then around the age of four months she stopped sucking her thumb and she lost her ability to self-sooth. Things were never the same again in the sleep department.

For many tiresome months I attempted putting her back in the cot after coaxing her to a settled state on the couch that was in her bedroom. But she would often wake just two hours later, seeking more comfort. I researched and got lots of advice around sleep issues then finally decided to give her what she was asking for - the warm of her Mum's body at night.

I have believed all the way through that Amy has needed me close to reassure her that all is okay. It is now, six months after Amy's diagnosis of ASD (autism spectrum disorder), that her strong needs for comfort and support from baby to preschooler make sense. Autistic children have trouble regulating their emotions and battle with high anxiety. I always thought as a baby Amy was struggling with some kind of anxiety and was afraid of being left alone. Crying it out to force her to come to grips with it all and face her fears felt so, so wrong, But I did try it only to have Amy get herself so worked up that it took hours to settle her down again. So I did the opposite of what is recommended by many, and allowed her to have as much support as she needed from me as her Mum - day and night. I'm glad as I did as now at almost four years of age she is sleeping through the night a few times a week. It hasn't been an easy road; but it has been the right one for Amy.

Amy was a baby who wouldn't go to just anyone. She clung to her Mum from a very early age. However as soon as she started walking (at the age of twelve months) it was clear she was quite the adventurer. Over time it was also apparent that she more interested in her surrounds than people. None of her toys have ever been a waste of money!

When our antenatal class met for coffee dates Amy The Toddler would be off exploring while the other children pottered around, not interacting, but looking at each other with interest. She was always on a quest and happy doing her own thing. When her peers were starting to stay "hi" and wave bye-bye, Amy seemed oblivious that both children and adults around her were attempting to make a connection with her.

Visiting the supermarket with Amy The Toddler often resulted in no response from her when the check-out lady asked her a question. As was typical of Amy at that age, she would look into the distance as if she hadn't heard anything. Often it was remarked that she was "shy." But I knew she wasn't. With the confidence she had exploring I knew that it was more disinterest than shyness. She just didn't seem to want to connect with those around her.

I started two regular playdates for Amy around the age of eighteen months. I thought perhaps the one-on-one playdates might encourage her to connect socially with some same-aged peers. I also thought we needed to build up some support systems around us should Amy need to be left with someone else. For quite some time I did child swaps with the other two Mums. I think it did Amy a world of good to get to know two other little people at quite a young age. She now at almost four years of age has two good friends as well as a handful of other same-aged peers she sees frequently.

Around six months of age Amy started going to Music classes and to Playgroup. As soon as she could crawl she was off exploring. Once again she was more interested in her surrounds than the other children. After months of chasing her back into the circle at Music group she started to grasp the concept and join in circle time. She came to love the songs, the dancing and the musical instruments. However half an hour was often a stretch for her and she made it clear when she'd had enough - it wasn't hard to read when she was overstimulated.

We enroled Amy at the local Kindy at two years of age, expecting her to get in at three. However there was quite a long waiting list at the time and she didn't get in til she was three and a half. It was obvious that she had out-grown Playgroup at three years and this was illustrated by her behaviour. It seemed whenever a child entered her space (which is an air-bubble of forever varying size!), she would push, hit or kick that child. Eventually this became a habit and whenever Amy saw a child, smaller than herself, she would automatically lash out. The only thing I could do to monitor her behaviour was to "shadow" her around Playgroup. We tried sticker charts to reinforce good behaviour ie: no pushing/hitting/kicking at the end of a session. Telling her not to push/hit/kick resulted in a blank look. We'd say "Be nice to people and animals" and she'd repeat the words yet didn't seem to understand that she was actually hurting other children. Explaining children felt sad when she hurt them didn't register for a while though thanks to a great book I found in the library When I Feel Sad, Amy does have some comprehension of why she and also others might feel sad.

Our attempts at controlling her behaviour at Playgroup didn't transfer to other environments so it seemed the message got lost. eg: she would still strike out at a random child in the playground and lashed out at one of her friends younger siblings for many, many months.

The family cat also went through his own share of torment. "Nice pats" and "gentle" seemed like wasted words for a very long time. Hurting others almost seemed to be something she found funny at times; it was sometimes more than a form of self-defense. She lashed out at us, her parents, as often she was angry and unable to express that. We've been encouraging her to "use her words" for a very long time, and now she is starting to say "I am cross" and express herself more. To deal with the hostile behaviour we tried time-outs which often resulted in Amy purposefully peeing herself in her time-out spot. If we put her in the hall she would scream until she got herself really worked up and at the same time wasn't able to comprehend why she'd gone out into the hall. Quiet time in her room was and still is the only form of discipline that seems to work - apart from distraction which I would say would be the parent of an autistic childs key weapon!

Since starting Kindy at the age of three and a half, Amy has made some huge improvements in her behaviour. A change was very good for her as were consistent rules and children older than herself that were able to role-model appropriate social behaviours. She stopped consistently teasing the cat, and laid off her friend's younger sibling and stopped targeting toddlers out there.

However six months down the track at Kindy, Amy's peers have changed so that she is now one of the eldest children in the afternoon sessions. She is clearly bored and a bit lost without the social guidance she needs from children a bit older than herself. She will be moving into morning Kindy in May which I think will be very good for her. At the moment she is acting out at Kindy because the three year olds there are just as socially inept as she is! There are not many children there who are able to initate play. This has brought out some of her extreme behaviour that we haven't seen for around six months. But luckily one of her old friends goes to Kindy and the girls tend to hang together a lot.

Right from the start I have followed Amy's lead. I knew she was perhaps wired differently to other kids. But I did what felt right for her/us - and didn't follow any traditional, Western parenting guidelines. A lot of it felt wrong with Amy and I didn't agree with it. I didn't enjoy the age comparisons that came with antenatal class catch-ups and eventually the group fizzled out anyway - though we still catch up every now and then. It seemed if your child didn't sleep through the night at six weeks, wasn't toilet-trained by two, or in a big bed, sleeping on her own as early as possible - things weren't faring too well. I never felt comfortable with the one-size fits all kind of parenting and Amy's needs certainly reinforced this for me.

I had worked as a nanny with a boy with Aspergers for two years in Canada many years ago. The older Amy got, the more I thought how alike this boy she was. At eighteen months her social disinterest was highly evident. Her regular playdates with the two girls changed this and eventually she became more interested in interacting with other children. But there were issues. Not just with the social stuff; it was also the way she was at home. She resisted toileting training for a long time. We often went two steps forward and one back. There was no picking the right time because she was "ready." There was a lot of coaxing and pursuading involved. Lollies didn't work nor did stickers. She just wasn't making the connection. Although we finally got her on the potty to do wees, it wasn't until we used a social story that she graduated to the toilet.

Amy was a late-talker. She moaned and groaned to us even as a toddler and often would drag us around by the hand if she wanted something. It seemed to frustrate both her and us that she wasn't able to verbalise her needs. This didn't help on the kicking/hitting and pushing front. One time when visiting some friends of ours who had three boys at the time (they now have four); the youngest came out of the room bawling with a very clear bite-mark on his arm. Amy was pre-verbal at the time, around two years of age and in tears herself. No adult was in the room with her yet it was obvious to us that one of the boys had tried to take her toy dog off her. She didn't know how to say no, felt overwhelmed and bit the boy. Not acceptable behaviour of course - but understandable.

Instructions had to and still have to be broken down to Amy's level. I cannot say when I thought there was something wrong. If anything it just became more and more evident that she was wired a particular way and I knew not many people understood that - and that I wasn't been a paranoid first-time Mum! I understood my daughter's needs that were very intense. One time I succumbed to peer Mum pressure to put Amy in a creche while I went for a swim. It is my only regret thus far in parenthood that I did that because I knew, just knew it wasn't the place for Amy. I have known for a long time that she needs the one-on-one connection with an adult where-ever she is. As an under-two, it simply traumatised her to be left alone with a whole bunch of kids and babies and if you ask me, two very inexperienced first-time Mums who were running the creche. When they returned her to me in the changing rooms I could hear her screaming "Mummy!" long before they entered the rooms. Her trousers were off, her face was covered in her morning tea and she was hot, bothered and shaking. For six months prior we had been able to leave her quite happily with another family in town. However we couldn't leave her with anyone for a good four months after that incident. It look a while to rebuild the trust.

Another friend had her same-aged child in the creche too and her child was fine. She's the kind of child you can put in a room and she will entertain herself and graviate to others. No wonder Amy freaked. All the things that aggravate her autistic traits were in full swing in that creche - chaos, no one-on-one attention, and her needs clearly weren't met. Apparently she started crying long before they brought her to me and they only brought her out because she was disturbing the babies (of the two first-time Mums running the creche). Grrrr! It makes me very angry to recall all this from almost two years ago. A bad experience for myself and Amy but I learnt from that. I have always trusted my maternal instincts since then - no matter how contrary they are to common advice out there.

As a baby while breast-feeding Amy used to wrap her fingers around my then long-hair. This continued all the way through the breast-feeding days. She now still holds tightly on my hair when she is overwhelmed or is seeking extra-comfort. This is one of several cues I have that she either wants to get out of a situation or needs some quiet time with her Mum.

It was the Head Teacher at Playgroup who said she'd seen a lot of children in her time and that every now and then once stood out. Amy was one of those children. She agreed one hundred percent with me that I ought to get her "checked out." Even though my gut was telling me I was right, it was her support that gave me the courage to start the ball rolling.

I have worked with many special needs children over the years and have a BA (Psych) in Education and Psychology. I have always treated children as individuals first, disorders second. Although getting my own daughter diagnosed wasn't easy, it was a relief as it has given us something to work with. I have always accepted Amy for where she's been at. Yet a diagnosis has helped categorise a lot of her behaviours which means we have a team on board to help us.

For me I am so pleased that we have raised Amy as Amy this far - and not tried to force her to be something she isn't. Her needs have always been met; even if they have been quite intense for us as parents.

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