What a day!

Today saw the last of the formal tests that have been administered to Andrew as we attempt to find out if he falls somewhere on the autism spectrum. Today's test was an MRI as requested by his doctor. She wanted to eliminated any possible medical reasons for Andrew's behavior, so besides a gazillion blood tests, she also ordered up an MRI.

To prepare for the MRI, Andrew could eat nothing after 8 this morning. Before that time, all he could consume was Jell-o, broth, and clear juice (like apple). When I told him last night that he was going to eat Jell-o for breakfast, he just giggled. In solidarity with my son (and so he wouldn't ask me why I was eating), I had a bowl of cereal and nothing else all day.

The appointment was for 12:15. I wanted him to take it easy and yet I needed to get a couple of jobs done. He helped me water the newly planted hostas and we ran three short errands. As we returned to the car after the third and final stop, the car would not start. It did not click. The only noise it made was a soft whimper, much like the one coming from Andrew in the back seat. A quick glance at the clock showed 10:45. Okay Andrew, we're going to walk. No hat or sunblock. But the route back to our house has full of trucks. I would have taken a bus, but the routes are weird and I would have had to wait for who knows how long. With a boy like Andrew, movement is the best choice. The walk took about 45 minutes (probably less than a journey on the bus). The sun was bright and we encountered very little shade. I was worried about Andrew becoming dehydrated, because he could have nothing to drink before the test. He turned out just fine and I called my husband and left him in charge of handling the car.


I had been preparing Andrew for the test by telling him that he was going to lay on a conveyor belt (like the ones at the grocery store), go into a tunnel where a big camera was going to take a picture of his brain. His reaction? "This is going to be pretty cool." We walked to the hospital (only three blocks) Of course when we got to the clinic, they had been set back in their schedule by an emergency MRI. We went in about an hour after our scheduled appointment. The technician gave Andrew the sedative and about 40 minutes later he was completely zonked out. They wheeled him into the MRI and I returned to the waiting room. A half-hour later, I went and and waited for him to wake up. He slept for another hour and would have slept for more if the technician and I hadn't woken him up. He was extremely groggy and couldn't walk. We were wheeled out to our ride at the front of the hospital.

I had no energy to cook, so pizza and ice cream were on the menu. On Thursday, the psychologist will give us her report. This one will determine if we will be eligible for special services or not. So, until Thursday, I hold my breathe.

Blocks, questions, pictures, and even more questions

Today was the first day of the formal Andrew assessment. We had a 9:30 appointment to meet with the psychology student who came to our house last week. We had dutifully completed both of the questionnaires she had given us. We have shared about a million stories. Now, it was Andrew's turn to show what he could do.

Unfortunately, he woke up crabby. His body still needs to nap 3-4 times a week, but he simply refuses. He hadn't napped all week, so his body was feeling the cumulative effect of not enough sleep. Therefore, we had a number of mini meltdowns long before we left the house. Needless to say, I was a little concerned with how he would react to a formal testing situation. He kept asking me what would happen if he wanted to see me while he was with the psychologist. I didn't know how to respond, so I kind of left it unanswered. I packed a small snack and off we went.

When we got to the center, we were taken to a sparse room with a kid-sized table, a few kid-sized chairs and a mirror. No bright pictures on the wall. No windows. I suppose that the spartan like conditions reduce distractions. Andrew stayed in the room while I went into an adjoining room with our social worker. We listened on an intercom and watched through a two-way mirror. I felt a like I was on a police drama behind that mirror.

What I witnessed was an eye-opener in so many ways. I discovered that my son is very capable of repeating simple patterns using small blocks. I discovered that, if necessary, he can sit for long periods of time, attempting boring tasks (maybe he will work in a cubicle one day). I discovered that when bored, Andrew will begin to phone in his answers and roll his eyes.

Overall, he seemed to do okay on the cognitive tasks he was asked to complete. The tester asked me if there were items that I knew he could do, but blew off. I pointed out several instance where just put no effort into his answer. She told me that she would try those specific ones again on Monday.

On Monday, I was told that the testing would be more play based, more fun. I will actually be in the room, though off to the side. I will be interested to see how that goes. If I remember correctly, this testing will more directly address Andrew's social skills.

That was relatively painless

For two hours this morning, my husband and I answered questions about Andrew's various quirks, his behavior, and his growth over the last four years. This was the next step in the assessment merry-go-round. A psychology student completing her practicum came out to our house to observe Andrew in his natural habitat and to talk to us.

I have to admit that I was slightly dreading this step. I couldn't help but feel that our parenting skills were going on trial. Heck, I thought that even our marriage might work it's way into Andrew's overall evaluation. From what I can tell, my concerns were baseless.

The interview started off with allowing us to freestyle tell her our concerns about Andrew's behavior, along with anecdotal evidence to support our concerns. I started with my concerns about Andrew's social (or lack there of) skills with peers. At some point, my husband sucked some of the air out the room with a long series of anecdotes. I did a fair amount of head knodding and agreeing. Our narrative seemed to take about an hour.

The second hour was centered around a long list of questions that she asked us, which again we supported with yet more anecdotes. This poor woman now knows every detail of Andrew's short life, as I think she heard every story possible about the little guy. Of course, Andrew put on quite a show for her, from the very second she walked in the house. He immediately asked her what her favorite animal and color were - as these have been the latest in a series of obsessive questions that Andrew asks and asks and asks and asks...

Next week, Andrew and I will go into the Children First office. She explained that he will go through a series of cognitive tests, while sitting at a table. Very formal. This is to get some sort of baseline on his intellectual ability. I don't worry so much about his intellect. I'm not one of those mom's to brag that my kid was reading at 20 months, but he certainly is a bright cookie in several areas. He's great with numbers and easily counts to 100 and he seems to be trying to figure out the pattern for everything that come after 100. Based on letter sounds, he can pick out words from short texts. So, those are really positive things.

On to round two.

27 tests

No, that's not how many tests I'm giving my students between now and the end of the school year. I'm on leave - remember? That number represents the number of medical tests Andrew will undergo while we begin the assessment process.

The first thing our social worker wanted us to do was to take Andrew to the pediatrician to see if she wanted to test Andrew for any possible medical conditions that could explain his behavior. So, I took Andrew yesterday. The pediatrician is thoroughly competent, if somewhat distant. She took copious notes about his language and asked me dozens of questions about his appetite and his interactions with peers. Yesterday was even the first day she had ever joked with me, laughing after he stepped off the scale. He currently weighs 37 pounds. Three more pounds and he can switch to a booster seat in the car. I joked that it was time to fill him up on cake and ice cream and she chimed in with "Ah, the summer diet."

As we walked out the door, she handed me three sheets of papers with tests that she wants to run on Andrew. He has to have 24 different blood tests, two urine tests, and one MRI. She wants to check his chromosomes, his metabolic something-or other, and his brain. Our social worker told us that the psychiatrist was glad to hear the name of our pediatrician because she is so thorough.

I went this morning to a small lab near my gym. It isn't as busy as many of the other labs in town and it's walking distance to a bakery. I wanted to know how many vials of blood would be taken and how long all of these tests would take. I wanted to have a strategy going into this; I don't want to overwhelm Andrew with too much on one day. Unfortunately, the technician told me that there would several tests she couldn't run and that the only place to do them was the hospital. Also, it appears that Andrew will have to fast for eight hours before one of the tests.

The hospital is only 3 blocks from our house - so that's a plus. A serious negative is that I'm sure it will be packed, unlike the little lab I visited today. I think I'll find the lab tomorrow and the just pick a day next week to go. I suspect I might make cookies before we go to the lab. I don't know who'll need them more, Andrew or me.

The Assessment Merry-Go-Round

When we decided to seek assessment for Andrew, we were told that we were on a waiting list and that the assessment would start some time in the fall. Well, it turns out that Children First hired a few more psychiatrists in order to clear up the backlog. We will now know by the end of May if Andrew does indeed fall in the autism spectrum.

The start of the assessment program means that we will have a plethora of activities to complete. The first was to compile a list of red-flag behaviors that we have observed over the three and a half years Andrew has been home with us. We were given this task on Thursday afternoon and it's due late Monday afternoon. We chose to break the list into language concerns and social concerns and as I have mentioned before, these concerns are pretty extensive. The biggest lately is the repetitive nature of his language. Everyday he asks the same questions, dozens of times, even though he knows the answers. I have spent the year listening to his classmates and they simply have more varied speech than he does.

The second task was to make an appointment with the doctor to determine if there are any medical (i.e hearing) issues that could be the cause for the red flag behaviors. We'll go to the doctor on Wednesday morning to determine all of that.

We meet with the social worker on his case later this afternoon. I know that she observed him in his class today, so we'll get some feedback about that. I'll keep everyone up to date as we move through this process.

The 'A' word

There has been a small portion of my brain and heart that has dreaded this moment for a long time. As I picked Andrew up from school, the para-professional who has been working with him mentioned that she attended a workshop yesterday. That workshop was about Asperger's Syndrome. She said, "You know Miss, he fits many of the symptoms." I abruptly nodded my head and said, "I know." I didn't mean to be so rude to her. She has been wonderful with Andrew. Patient and loving, she has worked hard to help Andrew integrate with his class mates.

As the Mayo Clinic site states, all kids have quirks. It evens reassures parents that just because your child displays a couple a symptoms, it doesn't means that your child has Aperger's.

Andrew displays five symptoms in a fairly over-the-top manner.

1. One-sided conversations: This accounts for about 80% of my day. Andrew will get lost in his own obsessive train of thought (i.e. How many years until I am 20? What will my voice sound like when I'm 20?) to the point that he doesn't even hear me asking him to put his boots on. Either I end up raising my voices (which causes an Andrew meltdown) or I have to physically drag him to the boots and force them into his hands. Every fucking morning - this is our routine.

2.Lack of eye contact: Since day one, we have worked on eye contact, as a means of attachment. Adopted children have a tendency to avoid eye contact, so this has been a huge issue in our house. Still, if we ask Andrew to look at us, he'll look at the top of our head, over the shoulder - any place but our eyes.

3. Intense obsession over one or two objects: I would cry almost everyday in the fall because Andrew felt compelled to pick up every leaf, acorn, or pine cone we would see on the sidewalk while walking to school. His constant yanking on my arms gave me a mild case of carpel tunnel. It also took us forever to get to school and garnered him the nickname - Nature Boy.

4.Lack of empathy: He has been getting better here. Just yesterday, he asked me how my back was feeling. There are many times where he doesn't pick up social cues from his classmates. Today, as we were leaving, a little girl gave him a hug and he just stood there until I encouraged him to hug her back.

5. Poor coordination: This has been another major area of concern since day one. For the first two weeks, Andrew's 14 month-old back muscles were so weak he would randomly flop over knock his little head on the ground. He's better now, but his core muscles still show signs of weakness.

Mother's intuition has told me that somewhere along the line, a teacher would express these concerns about Andrew. My husband has tried to allay those concerns by telling me that Andrew is a "young" four. I don't know. I sense that we will enter the testing before the end of the year.