The evidence of history (successful ttc mentioned)

It is IEP time, Individualized Education Plan time for Scott. Monday we met with his adviser (that's what they call teachers at the charter school) and with his special education teacher.

This is dovetailing nicely with my exploration of a new practitioner to follow Scott's adhd and his medication. Gary and I met with her, just the two of us, 10 or 12 days ago. Friday we took both Scott and Connor so she could observe their interactions (and they obliged by deteriorating in front of her at the end of our hour long session). Last night was a session with just Gary and me.

One of the questions on the blue form--I forget its name, but it's a standard behavioral assessment form which gives indicators of what kinds of behaviors we're dealing with...inattentive, hyperactive, oppositional, defiant, compulsive, anxious--one of the questions was if he was having trouble academically at school. And when did it start?

I realized we're talking about two schools. He started kindergarten in our neighborhood school, and I transferred him to the charter school in January of first grade. I realized I wasn't sure how to answer the questionnaire, because at the neighborhood school his academic problems began in kindergarten...yet, his issues at Trillium were not being described in terms of 'academics'. No one's saying he's 'not at grade level' in reading, math, as if it's a "problem".

The occasion of a new school year, new special ed practitioners, a new teacher and a new classroom (he's 'graduated' from a Kindergarten-through-2nd-grade classroom to a 3,4,5 room) has challenged the part of my brain that wants to describe my intuitions about Scott. This classroom is conducted at a more mature level--it assumes a certain independence and capability of a student. Is this a place where Scott will be able to orient himself and get with the swim, or will he flounder and drown? In three years will he come out hopelessly behind? In other words, should it be a 'problem' that he's not at grade level? Am I being negligent if I'm not worried?

One of the ways I described Scott is that he is someone who is so captivated with the details of the first step, that a 5 mile hike is completely beyond him. This puts him in a totally different context than his peers who may be a mile, or two, into the hike. They may be oriented to a 5 mile hike. Scott is not. His adviser nodded when I made this analogy.

I'm remembering the children's book I used to read to the boys, "Leo the Late Bloomer". Leo's progress was only a problem for people who were waiting for him.

This kid has always kept me waiting. The mornings are an ordeal of our mis-matched paces. I stand, tapping my foot, as he oh-so-slowly puts on his sock. Then---the---other.

I used to joke that going somewhere was nearly impossible because Scott had managed to break getting into the van into a 50-step process that he lingered over --each and every one of those 50 steps. (First he opens the door. Then he gazes into the open door, slowly reaching for and scratching a spot on his leg. Finishes scratching. Oh, wait; it itches again. Scratches some more. Now the knee is lifting, lifting, the foot gliding forward. Wait. There's something on his shoe. He has to bend to examine it. Closely. Touch it. Now that he's down there there's something on the floor of the car he hasn't seen before. He needs to look at that, pick it up, there in the posture of one foot inside the van, the rest of him still planted outside.)

For a long time he was on a car model jag. We couldn't walk through a parking lot or down a street with parked cars without having to stop at each one so I could tell him what kind it was. It got worse when he added to the obsession the question of how much they cost. His preschool teachers described walking a group of twenty of them across a crosswalk on a busy street, cars waiting, and he and two other 3 year olds having to stop in the middle to settle a furious dispute of which of them was going to get to hold the little girl's hand. This is urgent, people.

It occurred to me in a flash yesterday that this kid has kept me waiting for signs of progress since birth. Oh, HELL no, he kept me waiting--for his very conCEPTion.

Connor was conceived on our first try after an early miscarriage (which was conceived on our second cycle of trying) when I was nearly 40. It never occurred to me that when we were ready to try for a second it might not happen so easily. I'd heard a three year spread was ideal and so
didn't even consider the wisdom of waiting. Connor turned two. We moved to St. Louis. We got settled in and started to try.

And nothing happened.

I went to a regular OB with an 'interest' in infertility. Tried two rounds of clomid. Moved on to an RE. Went through the diagnostics, which our insurance would cover; treatment it would not. Went another round of clomid with an IUI. We were living on one income and decided to gamble on one super-cycle--injectable fertility drugs with monitoring, trigger shot, and another IUI. This was one year after we moved to St. Louis. We put the meds and ultra-sounds on a credit card and rolled the dice.

So for a year we lived in limbo: would we be a one-child family, or would we realize our dream for another? I had a resource I hadn't had in 1996 when ttc Connor--the Internet--and it was a 2-edged sword: I'd been blissfully unaware of what an anomaly it was to conceive Connor so easily at 40. Now I realized what I'd been flirting with, and that there was no reason I'd be able to realize my dream when there were so many couples whose dreams were denied. With Scott I was totally in the dark until he was conceived after our one-shot IUI.

He kept me waiting for his birth. His due date coincided with the last of an unseasonably cool early summer in St. Louis, after which it got hellishly hot and humid. It also coincided with the visit of my parents and niece, so crowding a small house (single bathroom) with people waiting, waiting, and watching. At nearly 45 a passed due date was a worry for the OB, and probably for my parents as well. Who knows if all the expectant anxiety around the delay didn't lengthen it? A week passed, and we scheduled the c-section. The OB said, "The signs aren't favorable" (for a vaginal birth after caesarian). Without telling her I slipped in an Evening Primrose suppository and whispered, "Scott, if you want to come in the normal way, you've got to give us a sign."

The thing is, the signs WERE there, they were just too subtle for everyone around him. Part of what had resulted in Connor's c-section was that he was facing ventrally in utero. Scott was positioned just fine, but that fact got lost in the other facts--no progress in dilation, no rupture of amniotic fluid, a week overdue. The fact that I was having miserable diarrhea all day was lost on everyone. The story ended with his vaginal birth that very night, after a two-hour and ten minute labor.

Scott makes his connections in secret, far below the radar of the people who watch, and wait. This is his pattern. One year I worried because he did not seem to be 'getting' the notion of a calendar measuring time passing. It seemed to mean nothing to him. If I had 'tested' him I would have only been more anxious. Then, suddenly, he was meaningfully referencing times of year, and months. I'd had no indication he was putting it together, until I noticed him talking about it. He talked about it so naturally, and so matter-of-factly, that it was as if he'd always known it.

So in talking with his teacher and special ed teacher what was coming through was my anxiety that the classroom might be over his head and he might be drowning. Rob said, "This year I have a lot of third graders, and he's not the only one who is spacey. This is where we can appreciate the luxury of time. I have him for three years. With three years I can say to a child, 'Let's... hang... out. Let me get to know you, and you to know me. You'll figure it out, and take as much time as you need figuring it out.' Some kids spend all of third grade figuring it out. He won't be lost, because there is a certain funneling. Whether he can go somewhere independently or not right now, the current of the class takes him there regardless."

Holy shit, can I really just relax? Perhaps the heavy lifting of my job was to find him a place where he does have the luxury of the time to figure out things on his own, and make his connections in his private, inaccessible places. At the neighborhood school his skills, particularly his math, would be an academic problem, because the window with which he is supposed to demonstrate progress is so short.

And, I see that I have the weight of his history as evidence--he is going to develop in his own time, in his own way, independently of the priorities of others. He's in the right place.

Blah-blog

I have a jig-saw puzzle in the middle of the living room floor. Every time I look at it I feel drawn to fill in more pieces, but I'm resisting that siren song right now. I know that if I start easily an hour or two will go by and I risk feeling I haven't accomplished much.

Haven't I though? There is the practical experience of persisting and finding order in chaos. There is the experience of looking for little distinguishing nuances within blandly similar regions, and finding that each gradation has an important contribution to the whole. There's the lesson of feeling overwhelmed, but noticing that little efforts over time reduce the mystery.

Is it worth a few hours with only a few pieces successfully placed? (For someone like me, who does tend to get overwhelmed quickly by details, this puzzle is really hard. Thank goodness it's only 500 pieces.)

It is one of four that I snagged from my neighbor's "Free Or Best Offer" pile out front of their place. Since Scott's learning and understanding remind me of a puzzle--more forest-y than trees--I thought it might be beneficial to him. Beneficial to him, beneficial to Us, since he's the kind of child where meaningful conversation usually slips out in tangent to some other activity. It wasn't long before I realized this puzzle was way beyond him, and by then I had enough investment in it that some stubborn pride has kept me going.

I'll be very cautious before opening any of the others.

I have a veritable box of puzzle pieces spilled around me, and I'm wondering if I'll be able to piece them together.

One of them is Scott. A few days ago I got a phone call from a mother whose child used to be in Scott's classroom at the first elementary school, before I pulled Scott out and took him to Trillium. This is another very active boy. His mother said that Skyline is not working for her child and she's exploring alternatives and so thought of me. Her son's teacher had raised the "M" word, medication, and she firmly said, "I am NOT putting my little boy on Ritalin."

This reminds me of how heated the debate can be over the use of medication to treat attention deficit and hyperactivity in children.

Still, the whole issue reminds me of a puzzle, and I feel overwhelmed. It makes sense to me that if our consciousness is mediated by biochemical processes in our bodies, that the deficiency of a certain molecule may create a gap in a crucial function, such as memory, or the ability to persist in attending over time. I'm not at all ideologically opposed to the use of medication in children, though I sure wish we were further along in refining our understanding so it's not such a blunt instrument. I took Scott's pediatrician's word for it, that ritalin has been subject to years of long-term studies, and that it's safe and effective. I started him on it just about a year ago when it was clear that he wasn't functioning well in the alternative school setting either.

Still, I feel nagged at having 'read the cliff notes' about the medication issue, and not piecing together my own puzzle from the ground up as to its risks and benefits. I'm overwhelmed at the prospects--just now I googled "ritalin use children" and found 1.3 million hits (and top of the list are "ritalin death" results).

I did see an improvement in his ability to attend. He seemed to have more of a solid core, a centralized Presence. He is definitely not a zombie, but he can tolerate periods of stillness longer. His reading has improved.

But with the beginning of school, I'm uncertain. I feel like I need to find another parameter to explore adhd and formulate effective responsiveness to it. I really liked Gabor Mate's book Scattered (Scattered Minds, in Canada), and need some kind of follow-up. I'm at the beginning of seeking another pediatrician, since I've felt this one is not responsive in a timely enough manner to my questions, and does not provide an atmosphere that invites the development of questions and discussion.

I just realize I'm temperamentally unsuited to raising a child with adhd. I tend to be agenda-driven, and have an expectation that when I apply pressure a child moves in that direction. Connor responds fairly compliantly to this--Scott just seems to spread out. If the boys are toothpaste, Connor oozes right out of the tube opening; Scott merely expands in all directions. This impacts everything from getting out of bed in the morning to getting to school to doing homework in the evening. I begin to feel like a drill sergeant, because I need to remind him at every step what the next one is. It's hard to not feel irritated, and outright angry with him. Last night it took a half an hour to read 5 pages from a book, because every word, every picture, reminded him of something else he wanted to talk about. But he was reading beautifully, and far more fluently than he would have a year ago.

It makes me wonder what factors there are to consider in adhd, in the ability to attend. Is there a kind of learning style that is linear, where one idea is foundation for the next, and so on, so that attention is the string of the chain that links the ideas together into learning. This certainly seems to be the style that most schools teach to, and the tests measure--what is going in...what comes out. The picture in the puzzle emerges because the pieces are given in a certain sequence and are adjacent to one another. Perhaps this is where medication has it's most value--to hold one's attention long enough to see the continuity between the pieces. Scott seems to take in and assemble understanding differently. He seems to link a couple of connections at random in one part of the puzzle, then another few in another part, and over time I see that something, some kind of pattern, is emerging. But in the day-to-day, it looks like he's not 'getting it'. Maybe this speaks to a whole different kind of learning style, and medication has much less return for this style. It holds his agitation level down some, and helps him be patience with stillness, but is it really giving bang for its buck in terms of helping him make connections?

I realize I feel really alone in my struggle to comprehend him and find ways to be more effective with him. I need more support, but I'm not sure what kind of support I'm looking for--so that complicates my efforts to find it.

I sympathize with his attention issues. I wonder if making sense of the world is like a big unwieldy puzzle for him too.

There are a lot of tricky issues that have taken a back seat, but they nag at me, and I feel paralyzed. Instead of one big puzzle box spilled all over my floor, there are four or five. The effort to inform myself seems so much. I'm troubled by the tea parties, and their message that Obama is taking our country in a totalitarian direction. My father sent an article from the Investor's Business Daily publication that he gets. Its basic premise is that Obama wants to set up a 'Democratic Dictatorship' (now how's that for an oxy-moron?). Death-panels, Smeath-panels--the Democrats want to hold power to make life-or-death decisions over all of us!

It's peculiar when the right wing wears the cloak of liberty, because it seems at heart they are loyal to a kind of authoritarian mindset. It seems this group was silent in the face of surveillance over Americans, mining our data, authorizing torture, using the material witness act in unprecedented ways to lock people up without recourse, sometimes for years. The only outcry this group gave was against those who revealed and questioned these practices.

Their assertions have a peculiar internal logic that I feel I can't quite just turn my back on. I'd like to follow them up, and see how much is based on fact, how much on distortion of fact. But I just don't have time.

A couple other issues I yearn to make sense of are: Iran's nuclear program: in just the past year I've learned that Iran had a weapons program, but suspended it years ago...Iran is years away from having a bomb; Iran could have a bomb within a year. Iran has a facility that was undeclared until last Monday. Proof of further deceptiveness, or well within the rules? Has Obama painted himself into a corner in his efforts to engage Iran? How about Afghanistan? Has he painted himself into a corner there? Which really does make sense--get serious about protecting the population from the insurgency--or give it back to the Taliban? Isn't that what got us into trouble years ago and culminated in 9/11?

The part of me that loves order wants to put the puzzles together. But I'm daunted by the prospect of where to start, what sources to use, and the spectre of hours going by while trying to find the pieces that match.

Update

Shortly after publishing I was waiting for another program in my laptop to open and was staring at the photo of the puzzle on my blog page. I noticed a gap that had been bothering me, and I also noticed a piece lying right next to it that looked like it was a match. I'd stared at them for a long time yesterday. I got up, and sure enough, Bingo. That piece happened to be a watershed; at least 10 others easily found their homes. Of course, this was in the course of a half hour. I guess the lesson is I need to take a picture of a problem and post a blog about it, and it will "all fall into place".

language

I'm six, and we just moved to Tempe, Arizona. It's June, with a few weeks left in the school year, so my parents enrolled me in Mrs. Miller's first grade class at Rural School.

I'm coloring at my desk, and a child has been called on. The teacher told me to stop coloring, saying, "We need to listen to x speak, not to your coloring." I thought she meant that I was coloring too loudly, and that I should be quieter. So I tried coloring more softly. A few minutes later the teacher swooped down and took my crayons away, and I was left humiliated and publicly disciplined.

If she's still alive and still remembers the incident she probably sees my behavior as an act of defiance and insubordination. I realized that then too, that she saw me as disobedient. I also knew then that she had misunderstood me, just as I had misunderstood her. But I had to wear the crown of shame: there wasn't an avenue for me to explain to her that she had made a mistake, just as I had.

Language is the medium through which humans interact and participate with one another. It is the means through which we take in what the Other has to offer. It's our means of expression, and our means of receiving.

When I was a child I believed I was stupid. I remember gazing in a mirror at age seven and singing my own version of "If I Only Had a Brain" from "The Wizard of Oz" (my favorite movie): "I already have a brain, I already have a heart...if I only was smart."

I couldn't understand math, and I often had misunderstandings with people like the story above.

I've noticed with Scott that he seems to not understand what is expected from him in school...not just from the teacher, but from his peers. He's been receiving speech and language services since before he turned 3. Speech delay and articulation were the identified issues. At his IEP meeting in April the speech therapist said that goals for intelligibility had largely been met, but there was an area he wanted to investigate further, his language skills, the ability to receive and communicate meaning.

I think elsewhere in this blog I've mentioned that Scott's classroom behavior has been problematic. It was what I'd hoped would be resolved by moving him to a school and classroom that was more flexible and age-appropriate in its expectations of 5 and 6 year old behavior. I was dismayed to realize that this was not something that a friendlier venue would resolve and his behavior continued to be a problem. I was glad to see that the adults around him didn't dismiss his behavior as a moral-character/defiance issue but looked deeper and understood its roots seemed to be in his not engaging with either the culture of classroom or the material. Hence the language evaluation by the speech therapist. I got the results Tuesday.

And I'm stunned.

First, there's an irony in that his classroom demeanor has improved a great deal over the past month. Disruption is occurring in isolated incidents now rather than defining his days. I suppose that's largely a function of settling into this new and different setting and finding a comfort level with the teacher.

The irony is that from the results of the testing, it looks like his skills at language are so low that he must be taking in very little to engage him within this format. He's like a member of a litter who is feeding beside his littermates, but he lacks an enzyme that allows him to digest, or to absorb what he has digested. So while the other children gain 'weight', a large amount of knowledge is passing through and out of him without being usable--he's just not assimilating it.
He scored in the 2nd percentile for overall language skills for his age group.

I feel...so sad for him. How he is able to spend 6 hours a day in a setting that is providing him with so little to meaningfully engage him without totally acting out and misbehaving is beyond me. I suppose it's a measure of how nurturing this environment really is and how accepting it is of diverse learning styles...but it's also a measure of his own ability to adapt himself and sustain himself even when there's not a lot to interest him that's interesting the majority of children around him. He's finding something to keep himself calm and largely centered, but he's not getting the really nutrient-rich content. It's right there, but there's something wrong in his 'up-take mechanism' and that's keeping him from accessing the rich stuff.

So now I have all of these questions to consider.

Is the AD/HD that Scott has been diagnosed with a symptom of his language issues, or is it a cause? If it's a cause, it makes a case for using medication; if it's a symptom it's less clear whether medication is indicated. But that depends on whether the language problem is a disability/impairment, or if it's an issue of maturation of the areas of the brain where language develops. If it's an issue of maturation, would medicating be akin to trying to hurry the final maturation of a butterfly's wings by blowing on them?

I'm keeping Scott at this school for at least another year because he will continue to be in Billy's classroom through 2nd grade. If he needs medication he shall have it, and to determine if he needs it I will use the following benchmarks: his learning, and his self esteem. If he is making gains in his learning at an appropriate pace and his self-regard remains high I think we'll hold off on medication. I think his teacher will be a good partner for me in assessing this.

To reference my own story again, I thought I was stupid when I was a kid. I managed to bump along as a fairly average student, and then one day I started to understand things. It was nearly that dramatic. All at once complex concepts were in my grasp. It happened in 7th grade, around the time I turned 12. It was noticeable enough that I was moved to an accelerated classroom.