Pointing the Way

I sat on the floor with my little boy, him ensconced in the safe area between my legs, feeling my apprehension rise.

We were in the middle of an evaluation at Cincinnati Children’s Hospital, a screening for possible developmental delays.  We’d already paid $200 for a similar battery of mind numbing hoops for Michael to jump through at a local therapy provider, but the results seemed more attuned to them selling us expensive therapy sessions than any real diagnosis of what might be wrong with our son.

“I’m sorry, ma’am, but you can’t help him with the answers,” scolded the psychologist as I reminded Michael what a ball does when you throw it.  “He has to answer the questions exactly as we ask them, no variations.”

I looked at her, puzzled.  “But isn’t the objective to learn what he knows?  If you vary the question into a phrase that he is familiar with, he’ll be able to give you the answer you want.”

She looked at me sympathetically.  ‘I know this is hard.  But the whole point is for him to be able to do the tasks exactly in the way they are prescribed.  This gives a consistency amongst all children who are tested, and allows for an honest comparison of him against his peers.”

I nodded, cheeks flushed red.  Michael squirmed on the floor and a reassuringly rubbed his arm trying to subtly hold him in place.  I could see his attention waning; soon he would grow frustrated and start crying or worse, screaming, until I let him free from the pseudo cage I’d set up with my legs on either side of him.  “Michael,” the therapist encouraged, “What does the ball do?  Point to the picture.”  Michael blankly stared at the book of photos in front of him until he reached forward and tried to turn the page, desperately trying to find an activity that he would find interesting.

“Alrighty then,” the therapist said, writing down on her pad of paper as she closed the book.  “Let’s’ just let him play now and get to the parent part of the interview, shall we?”  She assembled some of her toys in front of Michael and watched as he took the shape sorter, a toy meant for children half his age.  He dutifully emptied it and lined up each shape, just touching edges, and then carefully placed them all in their exact right holes.

“Uh,” he grunted, holding out the full sorter to me.  I emptied it and he began the ritual again.

“Did Michael hit his milestones on time, like walking, crawling, pulling up?”

“Yes,” I answered confidently.  He had indeed.  Zachary had walked later than any of the younger two, and he was a straight A student.  What of it, I thought.

“When was Michael’s first word?”

“Um…he really doesn’t have any still.  Sometimes he’ll say something one day, but he doesn’t say it consistently.  I’ve heard him say a few words, but honestly, I think they are accidents.”

More words written down on the pad.  “And what happens if you break with his routine?  Say, you always drive a certain route home, but one day you drive a different way?  Or if you try to put on his socks first when you always do that after you dress him?”

My mind filled.  Just the other day we’d been driving home and Zachary informed me at the last minute of something he’d needed to drop off at a friend’s house.  So instead of taking the final turn home, we’d kept going straight and onto his friend’s subdivision across the way.  Michael’s screams were loud and immediate, and lasted nearly the whole ride until we came back to the place where we’d made the wrong turn.  “He definitely doesn’t like a change in routine,” I answered slowly.

“What about toilet training?  Is he showing signs of readiness?”

No, I thought.  Not even close, even though he was nearly three.  Melinda had been trained by this time.  So had Zachary.  “No,” I answered quietly.

“Does he ever ask ‘what’s that’?  Or point?”  I remembered that both of those were a constant litany during Melinda’s toddlerdom, just two short years ago.  I used to get frustrated with her constant “Wassat?” while I was sitting at my computer, or while I was driving, or during a grocery run.  I opened my mouth to answer when I suddenly shut it again.  I had to think, hard.  Could I remember Michael ever doing either of them?  Pointing?  I closed my eyes and shook my head slowly.

“No,” I whispered.  “He never has done either of those things.  I didn’t even realize that until just now, you asking me that question.  What does that mean, that he’s never done that?  Never pointed?  All kids point.  But Michael hasn’t, not ever, not once.”  I looked at her, fearful for the first time instead of just insecure.  “What does that mean?” I repeated.

“I will have to tally everything up,” she answered with the tone of a woman who has given the same test a thousand times, with the same, sad result more times than she’d like to remember.  “But I will tell you that not pointing, not asking what’s that is a classic, classic sign of autism.”

There it was again.  The A word.

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