Susan's Blog

Friday, April 12, 2013

If you are a Massachusetts resident…

This is your chance to effect services for people with developmental disabilities!!  Go to the capwiz application here and contact your state rep about supporting and cosponsoring the DDS bills in the works! These bills would improve DDS funding for programs like Turning 22 and Salaries for Caregivers!  Here is my sample letter. Cut and paste it and put in the name of your disabled loved one!

April 12, 2013

[recipient address was inserted here]

Dear [recipient name was inserted here],

As the mother of a 23 year old with fairly severe autism, I am concerned
about adequate community-based services and supports for people with
developmental disabilities served through the Department of Developmental
Services (DDS).  There are many people waiting for services and we also
are concerned about potential cutbacks for staff working in the field who
are among the lowest paid in our Massachusetts workforce!

Please co-sponsor the following amendments by contacting the amendment
sponsor.  Thank you in advance for your consideration.

DDS, 5920-5000, Turning 22 Programs and Services:  lead sponsor Rep. Sean
Garballey. The proposed amendment of $2 million to help all of the
graduating High School Services who will need services upon graduation.
Total would then be $8 Million.

The Turning 22 program provides first year funding to special education
graduates for adult services. If funding is not available students go from
receiving special education to having no supports as adults. Some lose
jobs while others require residential services. Family members may have to
leave their jobs to address the lack of adult services for a family member
which may result in severe consequences for the family.

DDS, 5920-3000, Family Support/Respite Program, Sponsor Paul Brodeur.  The
Arc/ADDP/MFOFC are asking for $3 million more to serve another 2500 people
needing family support & respite. (House Ways and Means provided $2
million additional. More families seek family support and respite each
year, with increasing wave of people with autism and other developmental
disabilities, family in home support and therapies are most cost
effective. The supports assist families to maintain a balance. These
services also delay or avoid costly residential and emergency services.

DESE (DEPT. OF ELEMENTARY & SECONDARY EDUCATION)-DDS alternative education
program, 5948-0012 and 7061-0012, sponsor-Rep. Jen Benson. This is a
FAMILY PRESERVATION program which transfers money from DESE to DDS to
prevent residential school placement on a voluntary basis for families.
The Arc/ADDP/MFOFC request $1 Million more to address the need for and
additional 75 families in need of  services. In 2009 the account was at $8
Million and this increase brings it to $7.5 Million.

DDS Residential Account, 5920-2000, sponsor-Rep. Denise Garlick. This
Community Residential Services (5920-2000) is $14 Million below the
Governor’s (Gov) budget request. That request funded 50% of chapter 257
increased rates for this line item over three quarters. This amendment
will require the administration to provide a plan to the legislature in
September 2013 that outlines how it will meet 100% of funding of chapter
257 for all EOHHS programs covered by the law, including but not limited
to DDS, Early Intervention, MRC, Brain Injury, DPH and others.

Thank you again in advance- please co-sponsor these amendments.

Thank you,

Susan Senator

Wednesday, April 10, 2013

Not Your Average MIL

Here is a piece I wrote for WBUR/NPR’s Cognoscenti column, about my mother-in-law Eleanor — whom I now cherish.

Sunday, April 7, 2013

A Boston-Area Event About Work & Disability

Michael Weiner is a friend and mentor of mine. He is a special needs financial planner who knows pretty much everything families in transition and beyond 22 need to know about housing and work — particularly for people on the Spectrum. Here, with his permission, is a notice about his next monthly meeting for parents, held at the Newton, MA Jewish Community Center:

Our next meeting is scheduled for April 17 (Wed) at the JCC, 333 Nahanton St (Room 508), Newton, from 7:00 – 9:00 PM.

The topic of the meeting will be “WORK”.

For those of us who have children who are capable to work, with the appropriate support, we all realize how important this opportunity is.  As our children leave their academic programs, the activity of working can provide the foundation on which to build a fulfilling life.  To rob a phrase from Jim Cassetta (executive director of Work, Inc.), “work is the hub of the wheel”.  A simple statement with enormous benefits, but often elusive and can be challenging to provide these work opportunities for our children.

This meeting will be devoted to discussing how best to prepare our children, and ourselves, as it relates to these work opportunities.

We are fortunate to have two representatives from organizations who put an emphasis on work, and are both on the fore front of provider agencies who can work with us to try to create these vocational opportunities.  We all know there are more of our children who are seeking employment, than there is employment available.  However, with the support of DDS (and their “Work First” initiative), and combined with a joint effort of parents and support organizations, these opportunities are possible.

Our speakers will be:

Ms. Sharon Smith.  Sharon is the Senior VP and COO of Work, Inc., Dorchester.  This organization has been in existence for more than 40 yrs serving individuals, with all types of disabilities.  Today, they serve over 800 individuals, and provide vocational training and placement services.  They are New England’s leader in the Federal Ability One program.

Ms. Mary Ellen Cameron.  Mary Ellen is the Program Director of the Lifeworks, Inc. Supported Employment Center in Norwood. The foundation of this organization has been in existence for more than 50 yrs.  They offer a wide array of employment services, including competitive employment, group employment, and job training centers amongst their supports.  They have successfully placed hundreds of our children in community based employment.

Both Sharon and Mary Ellen are intimately familiar with today’s landscape, and how the agencies (primarily DDS and MassRehab) are approaching the immediate future as it relates to employment.

So, whether you have a child in the transitional age (less than 22), or who is post 22, you will benefit from participating in this discussion.

Please send me an e mail if you plan to attend so I can be sure there are adequate arrangements.  Thank you.

Lastly, on a personal note.  I serve on the board of the Federation for Children with Special Needs, and am the current Treasurer.  Our annual Gala is scheduled for May 3, 2013 at the Seaport Hotel, Boston, MA.  The Federation has supported, and continues to support, all our children.  Any support for this wonderful organization would be greatly appreciated.  Please consider attending the Gala, and if you are not able, a donation, in any amount, is appreciated.  Here is the link to the Gala event:  http://fcsn.org/gala/2013/index.php

Michael W. Weiner
Financial Advisor
Special Needs

Commonwealth Financial Group
101 Federal St. (Suite# 800)
Boston, MA 02110

617-312-5115 (Cell)
E Mail:   MichaelWWeiner@financialguide.com
www.commonwealthfinancialgroup.com

Sunday, March 31, 2013

Red Tape Rant

Nat had a strange rash today. I got the call from his caregiver, who also sent me photos of the rash via text. I immediately remembered the shingles Nat had a few years back. Shingles is an awful disease that is related to chicken pox. It hurts and hurts and it takes a while for it to clear up. I called my sister who is a pediatrician and sent her the photos. It was just a rash, she concluded. Thank God. Give Nat Benadryl, she told me.

The thing that bothers me is that when I called the house manager I was told that legally, the caregivers are not allowed to give Nat Benadryl without a doctor calling the pharmacy and signing off on it. What? I said, “Well, can I give it to him? I’m his legal guardian.” And his mother. So, of course I could do that, and even though Nat had just gone back to his home after spending the night here, they had to bring him back so that I could give him an antihistamine.

Makes sense, right? So riddle me this. What if Nat had — God forbid — been anaphylacting over something, and needed Benadryl? Would the staff have had to wait for all that red tape before helping him??  If so, then this is insane. The state purports to care about these guys like Nat, with this kind of overprotective shit, while still denying person after person funding and housing because the resources are too tight. The caregivers watch over Nat at night, give him meals, drive him around. We trust him in their cars, we trust him to their care. But there not allowed to administer Benadryl, for God’s sake?

Spare me this sanctimonious safeguarding, State of Massachusetts. Until you show me that you can take care of every vulnerable person — homeless children, impoverished elderly, destitute veterans, the disabled — then keep your sticky red tape off my kid.

Saturday, March 30, 2013

The Dreaded Cycles

Nat’s anxiety has returned. Or should I say, Nat is anxious these days? With someone who doesn’t have autism, I would say the latter. With Nat I say that his anxiety has returned, which gives away my own anxiety about what I used to call Nat’s “cycles.” I used to think of Nat’s psychological statein terms of the famous seven years of feast, seven years of famine. We would have periods — of 3-6 months usually — where Nat would try new things, answer questions, keep calm (not in the cliched British sense) and go with the flow of our whitewater family. Then, inexplicably, there would be another phase. Nat would stare out the windows at the streetlights and ask repeatedly for them to go off if they were on too late into the morning. Or he would watch Ned’s feet to make sure his shoelaces were tied. Or he would walk quickly about the dining room until Ben finally came in to have his breakfast.  Screaming, repeating questions ad infinitum, trying to get something out of us that probably did not exist. We did not know what caused it and we would try all those things that people tell you to try when your life goes out of control: (supplements, diets, regimens, etc.). I would get articles from well-meaning relatives that would be about scientists’ new optimism about mitigating the symptoms of autism. It would always annoy me. There’s really nothing new under the sun that I’m going to try for Nat. I’m sorry. I tried so much when he was younger. Looking for — what? a cure? a change? How do you measure progress if you don’t have a baseline?

Well, for the first time in years, as I said, Nat’s anxiety is back. Unlike those other years, I know why. Maybe I even knew why then but it was all so scary to me — having a kid who simply could not communicate pain, discomfort, anger, desire. He would jump up and down, screaming, biting his arm, hitting us, clawing us. There was no place to be that felt safe. Put him in his room and pull the door shut and hold fast to the doorknob for — a minute? How long was this supposed to last? How do you gain control. It was so fucking scary. You just watch, cry, or duck.

Nat is anxious because they have not yet moved into their group home — the new house, that is. Yet they had been told months ago that it would be “soon.” But unfortunate event after unfortunate event has prevented this from occurring. Now there has been a problem with the plot plan, the permits not being pulled, and various other P-based pain.  There have been no tantrums, no arm-biting, no screaming. But he is clearly anxious. Wide-eyed, hand wringing nervous.

Poor Nat. Oh my God. I want to comfort him but he will take no comfort. If I look at him empathically he says, “Noooo.”  What he needs is predictability, Goddammit, haven’t we covered this already? How can it be that his service provider has messed this up this badly? Of course, now that the parents have yelled and screamed a lot, there has been progress. They will be moving “soon!” Yay, soon.

Meanwhile Nat is running around like a squirrel asking with his eyes when his nervous living situation is going to smooth out again. And of course he looks at me the most. I am still Mommy The Great and Powerful. That melts my heart and scares the shit out of me. I am still the main one in his universe who really truly has got to keep it together. And we all know how stable I am.

Plus, even if I knew what to say to him, he’d probably still say, “noooo.” So I guess we are going to have to wait until the cycle changes back.

Friday, March 22, 2013

Autism Mommy Swami: Braces

Dear Swami,

What advice do you have regarding getting braces put on?  

My son is almost 13, has minimal language and will not understand why his teeth will have these “things” on them. He doesn’t have sufficient receptive language for him to understand. In addition, how can we teach him to keep his mouth open long enough for braces to be applied to his teeth?  And finally, the braces will
hurt when first put in. We won’t know where exactly it hurts in order to put on the wax the orthodontists give the children to coat their mouth when there is a problem. My son will not be able to exactly pinpoint where he has discomfort.

The only positive aspect of this process is that my son has a twin (typical)  sister who just had her braces put on.

We are very worried about how upset he will be by this whole thing. But getting the braces put on seems line an undaunting process.

Can you give us any advice?

Thank you so much.

–Braced for Trouble

 

Dear Braced,

Thank you for bringing up such an important question. As you know, The Swami’s own darling son Nat got braces put on when he was about 12 or 13. We were able to bring this about because Nat happens to be very relaxed at the dentist to begin with. I don’t know how or why we did this, but we started him going before we knew about his autism definitively. So the whole experience for Nat was very “normative,” as our psychiatrist likes to say. I think he means “normal.” I guess it is like introducing less tasty, adult foods to babies while they’ll still try anything. That’s the theory, anyway. We did that for Ben. We put all of our dinner foods into a Mueli grinder and fed it to him mashed up. Oh, he ate anything we gave him alright.

And then suddenly, he did not. And he is still my PICKIEST EATER YET. So, there you have it. Nothing.

You already know that what works for one family may not work for another. You feel that your son will not sit through getting these things on his teeth, let alone keeping his mouth open for so long.

So, I think you have to dig down into your instinctual knowledge and grab onto clues for yourself. Here is the biggest clue you have offered: his twin sister just had them put on. Is your guy visual? The first thing I would try is writing your son a Crisis Story. Known these days as Social Stories, (but I created my own version when Nat was 3, before I knew about Carol Gray and her copyright), these are simple stories that explain, step-by-step with photos, exactly what your child should expect from this upcoming “crisis.” Unlike Social Stories, however, Crisis Stories contain real photos from the child’s life to accompany the text. While the Swami is aware that symbolic or iconic representative drawings do work for children on the Spectrum as a quick shorthand for grasping basic meanings, they do have their limits. For someone who is literal and has difficulty generalizing — like Nat — you need actual photos from the child’s immediate life. Then he sees it and connects it without a huge leap.

So what do you do first?  Determine just how important the braces are. You clearly want to do something for your son’s teeth, and the Swami understands. We parents want our children to have every advantage they can and straight teeth are important socially as well as in terms of health. But, temper this desire with compromise. Maybe you only have to do a little bit to correct the worst of the problem. Maybe you don’t have to get his teeth perfect. That’s what we went for with Nat: presentable, not perfect. You just can’t have everything, my dear Braced. So in this life, you make choices.

Next. Make sure that your practitioner is with it. Go to the dentist, sit down with the staff who will be working on your son and tell them his issues. Give them suggestions for how to deal with him. Be very clear that if they are not with the program you will take your business elsewhere. We did that. We made absolutely sure that our orthodontist knew what she was getting into and what we would and would not tolerate from her (the orthodontist). Yes, you are the client, so you set the tone of this relationship. This goes for any professional you work with. If they don’t get it, move the F on. Life is too short to waste on stupid insensitive “professionals,” and our children are too precious for that kind of nonsense.

In fact, let me step outside of this particular narrative for one moment and say: NEVER LET ANY PROFESSIONAL — ANYONE — MAKE YOU FEEL BAD ABOUT YOUR KID.

 Third, create the Crisis Story.

  • 1) You take pictures of your daughter’s braces — within her face, to keep braces connected to familiarity.
  • 2) You take pictures at the dentist’s office, of the person who will be working on your son and all the equipment.
  • 3) You take pictures of your son’s face, teeth, mouth.
  • 4) Try to get a fake picture, of your son already in the dentist’s chair! Stage it beforehand!!
  • 5) Write up your story with simple text that keeps the info clear and brief:
  • -Tell Johnny what is going to happen to him. (picture)
  • -Tell him that this already happened to his sister (picture). Show him his familiar dentist’s office (pictures of chair, tools, dentist).
  • -Then include the picture of him in the chair, showing him that this is what will be happening to him.
  • -Show him the inside of his sister’s mouth. Talk about keeping the mouth open (picture) for a LONG time.
  • -Talk about how he can have breaks, and treats (pictures) AFTER he does what is necessary.
  • -Talk about how it will end, and how proud he will be.

As for the wax, you might be able to ask his sister the most likely pain points. You might even be able to run your own finger inside his mouth and feel for sharp points to cover. Also give him pain reliever as long as the dentist allows it. But also know that one of the worst things about being a parent is that you cannot always take away your child’s pain.  You can prepare him in every way possible, though, and that is a great gift to him.  Good luck!

Love,

Swami

DSCF0023

 

 

Saturday, March 16, 2013

Dealing with what comes up on a walk with Nat

I got the the following article from Sunday Stilwell at Extreme Parenthood, and it really stirred up some stuff for me. We really have so many of these “odd souls” flying around these days. So many Nat-like guys in our stores, restaurants, streets, schools. We all know this, we encounter these people every day. We become friends with people solely because we share this experience, of taking care of someone who is Not Like Everyone Else. Not “normal.”

But with so many “not normal,” doesn’t that change what normal means? I guess that technically neurotypical, Developmentally On Time people are still in the majority. But the DD guys are so very visible, God bless them. Nat is so gloriously autistic, even when he is not flapping, not talking to himself, not walking fast. There is just something in his overly-alert, anxious-to-comprehend stare. His stance is uncertain and yet starkly evident against the blur of strangers.

Maybe that’s just my perception. But I have to look at it. And so I did. There he was trudging up High Street, his jeans a little too short to be stylish, no matter what I do to fight against his dressing disabled… please forgive me, but I know many of you know what I mean… with the huge CVS bag filled with 12 rolls of toilet paper. Like an old person, somehow. Two young woman walked purposefully downhill towards him, stepping adroitly out of his way. I heard snippets of their busy lives’ conversation, their competent, to-the-point words. They were roughly Nat’s age.

But today, before the sadness of missed potential descended fully, my own wider, open self kicked it out of my head.  You, Ms. Senator, are judging him. You are seeing him as inferior to them when you talk about missed potential. You are automatically assuming that normal is superior. That he is missing something, when truly he is existing on the same plane as them. Humans, humans, everywhere, each with a different set of neurons and experiences and synapses linked or not. One mind does not exist more fully, does it? We are all breathing the same air with our animal lungs, we are all evolved from apes and alive.

Yet my eyes can’t lie. There is sadness behind them anyway, and I suppose my words will not pat them away. The answer, then, is simply to go find Nat and give him a kiss.

Wednesday, March 13, 2013

Old Deval Had to Fund…E-O-H-H-S

Here’s a parody I came up with while riding my bike today. Inspired by budget difficulties for our state agencies under EOHHS (Executive Office of Health and Human Services), it’s called “Old Deval,” (our governor) and it is sung to the tune of “Old MacDonald had a farm.”

But first, here’s a glossary:

1) DDS = Department of Developmental Services  (under the aegis of EOHHS, along with Mass Rehabilitation and Mass Department of Mental Health)

2) ID = Intellectual Disability

3) Aspie = Person with Asperger’s

4) ASD = Autism Spectrum Disorder

 

And now, on with the song!

Old Deval had to fund E-O-H-H-S:

He had to fund the DDS …

E-O-H-H-S

With some ID her and some Aspies there

Here ASD, there ASD, everywhere ASD

Old Deval had to fund E-O-H-H-S

 

He had to fund Mass Rehab…

E-O-H-H-S

With no job coach here and no support staff there

Here a cut, there a cut

Everywhere the budget’s cut

Old Deval had to fund E-O-H-H-S

 

He had to fund Mental Health…

E-O-H-H-S

With some stigma here, and no nurse care

Where’s the home, nowhere’s the home

So that is why the street’s their home,

no job coach here, no support staff there

Here a cut, there a cut, everywhere the budget’s cut

ID here and Aspies there

Here ASD, there ASD there, Everyone’s got ASD

Old Deval had to fund… E-O-H-H-S!

 

 

Friday, March 1, 2013

Tim Shriver: Next Pope Should Be a Mystic

Once again, my friend and mentor Tim Shriver (Chair of Special Olympics) hits one out of the park, with this brilliant Washington Post oped!

Wednesday, February 20, 2013

Why Job Training Matters for Students w Autism

You can read my latest piece on autism and job training in Education Week, right here.

Thursday, February 14, 2013

A Mother’s Dream

A few days ago, I dreamed Nat could speak– I mean, really talk, not just the hesitant monosyllabic speech he uses. In the dream, I was riding in an elevator with Nat and a pretty blonde woman, in her early forties. She sees him, 23 years old and sucking his thumb, but doesn’t realize he is intellectually disabled. She says flirtatiously, “You must be a movie star to be doing that in public like that.”

I answer for him, as I always do, brusquely defensive and self-righteous: “Actually, he is autistic.” But then – Nat takes out his thumb and says, nonchalantly, as if he could talk all along: “Actually I do come from a long line of theater people.”

I awoke gradually, uncertain that this was a dream, but each moment of dawning clarity brought more pain. It wasn’t just Nat’s talking that blew me away, it was the level of self-awareness and subtlety. I hadn’t realized, after all these years, that I still wanted that so desperately. I think this flicker of desire must have come from a recent decision his doctor had made, to reduce Nat’s medication. I had agreed that we should try this, because Nat has been doing so well for so long. We reduced his meds around a year ago and found that even though he seemed more on edge, he also seemed to be able to answer us more often. And anyway, the goal had never been to have him medicated forever; it was just supposed to have been a “buffer” against aggression that started 13 years ago. I can never forget that horrible afternoon when he was 10 and he attacked me in the subway station, simply because we were going a different way home. I struggled to fend off his clawing hands while keeping hold of his baby brother and the stroller at the same time. I was desperate to calm him, to soothe him. Events like that became common, so we turned to serious neuroleptic medication to help him.

While the decision to medicate made sense back then, I have learned over time that so much of parenting Nat has been about a kind of letting go, of hanging back to see what could happen. After all, we learned how well he could ride a bike because we (accidentally) let him ride off around the block, out of our view. In a mixture of choking fear for what might happen, and a small soft certainty that he’d be okay, we ran after him, knowing we could not overtake him. We had to wait, hearts in our mouths, for his safe return around the corner. We didn’t really know for certain he could do it safely – and yet, didn’t we? Somehow, it was okay. He came barreling down the hill towards us with a devious smile that seemed to say, “I told you so.”

Taking Nat off his meds is a slower danger than a bike accident, but almost as much is at stake. Nat is living away from us, in a house with roommates and staff, taking care of himself in so many ways. He routinely makes meals, cleans, and decides how to spend his leisure time. He plays on a basketball team, and he works three days a week at a supermarket. I do not want to see this jeopardized by a return to outbursts and aggressive behavior. He could stand to lose so much. I dread the phone call from his day program or from the house staff, like what I used to get during his middle school days: “There’s been an incident…” It’s been peaceful for so long.

The fact is, though, that a less sedate Nat could mean a more alive Nat — alive in every sense of the word. He will likely feel more anxious simply because he will be more aware. He will experience noise and sensation more acutely. And yet, with some of that comforting haze lifted, he may see things more clearly. He might understand more. Isn’t it his right, as a human being, to take this chance?

I guess, in this season of audacious hope, I feel my own sort of optimism: that maybe Nat at 23 can indeed handle a new, raw but heightened perception. Maybe with greater perception will come better communication, a stronger connection to the world, and all that it brings – delightful or frightening. Because parents will do anything to help their children grow. Mine is a mother’s dearest hope; I have a mother’s dream.

Sunday, January 27, 2013

Tim Shriver: “We the People”

Chairman of Special Olympics Tim Shriver’s eloquent and forceful take on what “We the People” can mean for our country and perhaps the world. Read it here.

Sunday, January 20, 2013

Getting Balanced

Fast comfort.

The top of the roller coaster.

A little danger stops my breath. Lifts my blood. My head floats near my neck. Legs orbit endlessly around their pedal planets. Highest gear feels like lowest. The world turns upside down. The best of childhood, like jumping off a swing at the scary point.

The hill.

It varies me daily though always the same. Yesterday: burning lungs, smooth muscles.  Today: short gulps of breath, burning pull of thigh.

Why? Still, if I stare only at the ground, submitting to my tire’s steady insistent seduction, if I remain mesmerized by my struggle, I don’t see what’s left ahead.

The summit.

Now, I am there, searing pain that I have anticipated in almost sexual certainty; it explodes in my throat, a supernova of satisfying pain, glorious but now dying down so quickly. I listen for it to give way to vast open air. The harshness softens and I breathe.

Soon, soon, the heart wakes up after its brief post coital sleep and relinquishes my blood. The red blanket covers me, calms my lungs with a mother’s hands and I am warm.

At last, in balance.

Friday, January 18, 2013

The Barkers and The Colored Balloons

Today, while getting a root canal, I had a lot of time to think. A friend had told me to listen to music while it was going on, and so I brought my tunes along. I knew that would be risky because I am susceptible to music mush, where I hear a song and it takes me right back to a memory, kneading my heart like bread dough. But I have never been one to avoid certain emotional swamps, and so I went, because it would be better than watching bits of my tooth dust fly out of my mouth.

I say I am an emotion explorer, but that is actually not always true. Sometimes I avoid like crazy, so much so that I turn to stupid destructive behaviors and make them the problem, just so that I don’t have to sit with a bad feeling. An example we can all relate to: eating junk food. And that’s just the start of it, that’s the vice I can admit to. See, people think they know me because I write right from my gut but the fact is they don’t. There is so much inside me that I don’t even know because I can’t deal with it.

Lately I have not been able to write at all. One big expository kidney stone. So I decided now that the only way to relieve this is to just start typing. I have been having a very hard time since September. And while yes I do suffer from depression and also the opposite, I feel that this terrible sadness that has plagued me on and off, mostly on, since the fall is about change. Nat is in his house, Max is back at college,  and Ben is at the high school. The three of them are flying. They are launched. I am that familiar cliche: emptying nester. I’m a mother most of the time without children, children I’ve been plugged into, umbilically almost, for 23 years.

Roll that tape back a few sentences.  Let’s not skip over all three boys like some kind of long-memorized rosary prayer. Each of those beads is a world unto itself. I’ve shone so much light on that first bead, that gem, that diamond in the rough. My Nat. But this fall, it is the second bead that is sticking in my windpipe. Max is back at college. That is where my feelings alight, like scary bats at twilight who finally find some filthy hole to dive into. Max. I wasn’t sure until I was in that dentist chair today, and on came Sugar Mountain.  You know, you can’t be 20 on Sugar Mountain. And even though Max is 20 and no longer on Sugar Mountain, he’s in Greenwich Village in New York City studying film, and that’s pretty close to being in an amusement park.

I miss him so much I can barely even mouth it. But I can type it. I remember once when we watched a baby film of Ben, Max said to Ned, “I didn’t hug him enough.” That’s exactly the feeling I have now about Max. I didn’t everything enough. I still don’t. When he’s here, I want to do and say so much but I don’t know what. I want to hold him, but it’s not like holding that fat little baby, of course. It is a bony, muscular man who is a head taller than me, so it isn’t quite the same. He gives a quiet little chuckle whenever I lean in to kiss him. Why does he do that? Is he uncomfortable? I guess. It’s always been that I don’t want to overwhelm Max with all my emotion because — I don’t know why.

So I sit there looking at him and smiling because my mouth just does that when he’s around. He walks into the room, and there seems to be a big general exhale going on. Everyone is relieved. We all know we will feel good now. He brings with him his laptop, so we hear his music. Never obnoxious stuff that has to prove something. Sometimes whiny female stuff, sometimes ugly White Stripes cacophony. But mostly, feathery guitars and interesting lyrics. Light yellow stuff that makes you feel like everything is okay. That’s Max.

I know he wasn’t put here on this earth to make us all feel alright. It just happens. He’s not always happy, and when he’s not, he finds his way to me. He’ll surprise me, in the middle of a gulp of coffee, with some big raw cut in his young fleshy life, and I will drop everything, do anything to heal it. Out of nowhere, out of the deepest parts of myself, comes this clarity — for him. Things I just know. Ideas I have for him of how to look at it, what he might try. It’s alright. I make him feel alright. Every now and then, I can give him his own gift, and it lifts me like a balloon, softly into a light blue sky.

 

Sunday, January 13, 2013

A Ramp for Nat: Job Coaching for ASD & the Intellectually Disabled

I received this internship posting today, and I was reminded of what my grandma used to say about my brief visits to her down in Florida: “It’s only a crumb, but I’ll take it.”

First of all, let me say that the Lurie Center, who offers this posting, is an excellent, forward-thinking bastion of autism knowledge, compassion, support, training, and all the things we families with ASD look for. But the fact of this offering got me thinking about portions and crumbs, and having a seat at the table.   

JOB INTERNSHIP PROGRAM for young adults ages 18-30 on the AUTISM SPECTRUM offered at the Massachusetts General Hospital’s Aspire Program.

Internships are at established companies in the Boston area.*****9-week or 17-week placements with pre-internship preparation*****

This is an opportunity to refer students or graduates with Asperger’s syndrome and related challenges: The program’s goals are to:
* Offer interns work that is interesting and useful, where they apply job related skills that will help them to be prepared for future employment.
* Help participants learn the social aspects or “soft skills” needed to succeed in the workplace.
* Provide a Job Coach for on-site support and weekly off-site training and peer meetings to ensure interns have a successful experience.

First internships starting at the end of January. Sites are at established companies in the Boston area including three placements at Mass General Hospital’s finance and facilities management depts.
Internship Program
www2.massgeneral.org

So I deduced from the careful, thoughtful layout of the opportunity described that it is a rare enough kind of thing that an autism organization attached to a major research hospital has to offer it.  But opportunities like this one should be common, should be offered everywhere!  For example, isn’t every employer required to accommodate in the manner described above, if prospective employees need such training? If we have to build ramps, shouldn’t we also be building in Job Coaches and soft-skill training?

It reminds me of the finishing schools around here that some autism families have to send their graduated kids to (for big bucks) because the school system did not train them adequately, or simply ended too soon for them to acquire the skills they needed. Why do autism and ID families just accept this kind of educational approach? Shouldn’t the school system be required to job-train and independence-train (sorry about the syntax). Shouldn’t that family instead be allowed to take their IDEA funding elsewhere, say to a community college who offers the education they need?

My question is this: is it really so complicated to job train people with Intellectual Disabilities and ASD? Okay, maybe someone with a history of aggression; but ask Peter Gerhardt about how he has worked with many, many aggressive people on the Spectrum and guess what? They ended up learning how to work. For every person, there is likely a job out there that they can do. Every person. For a good analogy, look at Special Olympics. They take any guy with an Intellectual Disability and they get him/her a sport. In Nat’s case, they taught him three sports. They just do it, withNikes or whatever. Volunteer coaches, and rarely do they even have one-to-ones. It’s not rocket science, it is human relating.

Or ask the organization I work for, the Community College Consortium for Autism and Intellectual Disabilities, (CCCAID) about their community college programs that not only job-train, soft-skill train, but also independence-train, and the businesses themselves pay, and the students often end up working at these places after they graduate. At least, that is the plan. CCCAID has a partnership with Thompson Hospitality now which will provide a certification, a bona-fide working experience while its students with ASD and IDs are in their community college programs, and these students will have certificates that were vetted by the industry employers themselves. You’d come out of the program being able to do exactly what Thompson Hospitality Corporation wants its employees to do. Now that is what I call an opportunity. Especially because you are training people to do work that you need. It is not an act of charity. It is a business arrangement.

olivertwistWe shouldn’t be made to feel like Oliver when we ask for more. We are not biting the hand that feeds us. We — families of those with Intellectual Disabilities ASD and potential employees with Intellectual Disabilties and ASD — should be demanding accommodations in the workplace. A place at the table. And I don’t mean the kids’ table.

 

Tuesday, January 8, 2013

Check Out Jewish Family and Children Services of Combined Jewish Philanthropies

Here is a workshop up in Danvers, Massachusetts that would really benefit families with disabilities. Jewish Family and Children Services is a branch of Combined Jewish Philanthropies, and they do excellent presentations, very pragmatic and down-to-earth. They also have day programs and they create housing all over the state. Betsy Closs, who is leading the workshop, is a dynamo, who knows everything about housing for our guys. They are limiting the workshop to 12 so RSVP quickly.

Even if you don’t go to the workshop, you should consider contacting them to learn about their many helpful programs.
Understanding Housing and Support Options for Adults with Disabilities
On Monday, February 11, 2013, Betsy Closs, MSW, Director of Services for People with Disabilities at Jewish Family and Children’s Service, will provide an introductory workshop titled Understanding Housing and Support Options for Adults with Disabilities.

This workshop will provide a basic overview of housing and residential services for adults with disabilities. Special attention will be paid to supported housing options for those who will not receive DDS funded residential services.

Where: JF&CS North Shore Office
175 Andover Street, Suite 203, Danvers

When: Monday, February 11
6:00 – 8:00 p.m.

There is no fee for this workshop, but an RSVP is required. Please call 781-647-JFCS (5327) x3004 to register. Space is limited to 12 participants.

Monday, January 7, 2013

Approaching Autism Adulthood: What to do first

I was talking to an autism mom the other day while our sons practiced on their Special Olympics basketball team, when I realized I had three other parents waiting to talk to me. Suddenly I’m a wise woman simply because my autistic son is now an adult. We have passed through the Inferno gate of Adult Services but unlike Dante’s, we have not abandoned hope.

But hope was in short supply that Saturday morning. Hot anxiety rose from these parents like steam from a kettle. They rifled through their bags and pockets for something to write on, to take down what I was saying. Every few sentences, one of them would stop me and say, “Wait, what does that mean?’ And every so often, they would stop writing, stare out at the crowded gym and say, “Oh, god, this is so overwhelming. I don’t even know what to do next.”

I could tell her what to do next: everything. Even though her son is around eight, she needed to be planning for his future: job, housing, caregivers. I don’t just mean creating a Special Needs Trust; I mean learning about all the adult services and resources that are available and how to access them.

Just speaking those words makes me go bleary and looking for my bed. But as many autism parents learn early, sleep is something you learn to do without. From the typical sleepless nights of infancy, to the more autism-related sleep disorders that so often develop, to the worry, if you have a child with autism, you think of sleep as a precious gift, not an entitlement.

So I knew these friends of mine would understand it when I told them that in adulthood, there is only one entitlement for our guys: Day Habilitation, also known as DayHab or what it often is, Adult Daycare. The other thing they needed to know is that all roads pretty much lead to Medicaid.

This means you need to know about DayHabs and you need to know about Medicaid. The following is my understanding of Medicaid and how it is used in Massachusetts. Take it with a grain of salt, some of the details are probably incorrect. But if you understand the overall gestalt of what I’m saying, you have mastered the first lesson in Autism Adulthood 101. For the second lesson, you will have to ask specific questions about what you’ve just learned, to adjust my errors, my take on it. So leave that for the second lesson and just learn the first today:

Medicaid dollars are used differently state by state, but by and large they provide services either directly, as in the case of DayHabs which bill to Medicaid as therapeutic programs, or indirectly, as in the case of waivers channeled through the state agencies. In Massachusetts, the waiver money is harder to get, because the state agencies are all competing with one another for this pot of money that goes to the Executive Office of Health and Human Services. Whereas with the DayHabs themselves, the funding is more directly accessed, from program to money source. So families have to choose a DayHab, but they don’t get to choose which office of EOHHS they are assigned to. And they don’t get any say in how much funding their child receives — if any.

We have to assume that getting funding is going to be a battle. For one thing, there is the increase in numbers: while Nat’s peer group with autism numbered 2 in 10,000 just a decade before him, the two decades after him have seen the number increase to around 1 in 100. So, as hard as it was for Nat to get his funding, it is going to be exponentially harder for the up-and-coming families because there are so many more kids in need! For another thing, the budget is tighter. Some in the Federal Government want to cut or reduce the Medicaid program, strained as it already is. This is largely conservative Republicans, who believe that we autism families, veterans, elderly, homeless families, mental health patients — can all do without. I am so worried about that. I don’t see how this would work. I think it means mostly that families would care for their adult children until they died. Then if they have not been able to find or fund caregivers, the adult child is handled by the state — which means costly institutionalizing. Or worse — living on the streets. But some people have had one experience with someone living off the government who didn’t deserve it and that’s enough to sour them on these programs.

Others, largely Democrats, want to raise revenue to keep Medicaid going. I don’t know if taxpayers who don’t understand the plight of the Medicaid-dependent will feel about that. “Take care of your own,” some say. We do. We try. See above, sleepless nights. Broken families, traumatized siblings, depleted bank accounts. (And don’t you accuse me of bad-mouthing people with autism. I am bad-mouthing the difficulty of doing right by them with so little guidance.)

There will have to be compromises on both sides in order to come out with anything the two agree on. And this means there will likely be less for families with autism.

So parents of younger kids have to figure out now what they can do (and can’t do). They have to plan, like we did, for the worst-case scenario of no funding, and of only some funding. They have to understand that they must advocate with the state agencies while realizing that is the tightest place to go. So just like in an IEP, you go in knowing what are your non-negotiables and what you can live without. Nat needed good caregivers so that was our non-negotiable. Then I would take on the DayHab. I would do what I could to make his days worthwhile, but I was determined that he have his own place to live, with roommates and oversight. I had already seen how he fell apart living here, and the toll it took on my family, Ben especially. I knew that we would not live forever, and I wanted him to be with roommates, and we with other families, to have some kind of net underneath him.

What can parents of non-adults with autism do right now?

1) Find out who your Department of Developmental Services liaison is and make them know you and your kid. Google the number, find out, call.

2) Go to ADDP.org and find DayHabs you want to visit. Get aquainted with what they are like.

3) Learn about Medicaid-funded programs like Adult Family Care (AFC)

4) Get your kid on Section 8 (subsidized housing) waiting lists.

5) Do what those parents did with me: find each other and exchange knowledge. Parents are pretty much the only ones out there who will be glad to help you.

6) Acknowledge that you are going to feel overwhelmed by even just one of these items. Feel it, but then dive in a little bit again.

Rinse and Repeat.

 

 

Saturday, January 5, 2013

Family Feast

We all have to eat, so I figured I might as well make it fun. For Chanukah, Max had given me the Game of Thrones Cookbook: A Feast of Ice and Fire, and so far everything I’d made from it has been delicious. Our whole family loves the HBO series Game of Thrones, and Max and I have read all five of the George R.R. Martin books and loved them even more.  In case you have been living somewhere far away, like across the Narrow Sea, you must know about the phenomenon that is Game of Thrones. It is a fantasy version of the Yorks vs. the Lancasters, set in fictitious Westeros. The loyal and true Starks and the scheming and fascinating Lannisters are great houses, as are the beautiful, powerful, and oft-mad Targaryens and the, well, the Martells. (The Martells are the Hufflepuffs of Westeros). Each of these houses and lesser families also intertwine in a tale of passion, intrigue, journeys, treachery, and growth.

At first, however, I did not quite understand why I liked GOT. Max raved about it and finally got us to watch it with him, in — of all places — his dorm room at NYU. There I was, lying next to Ned on Maxie’s bed with friends of his on the opposite bed, feeling like we were back in college, but better. When Max loves something/someone, he does it with his heart and soul. His loyalty is Stark-like and everlasting. He still has his Blue Blankie from his Day One. He cried when Ben lost his (Ben’s) favorite Superman toy. He loves the people in his life and truly shows up for them.

I think my GOT obsession is wrapped around my love of Max. I saw the story through his eyes, almost literally that first night in his room. And when I read the books, he would Instant Message with me from college to find out where I was in them and what I thought of what was happening in the story. When I finished Book V, we talked and talked about what it all meant, what was to come (there are two books still to be written), how did this relate to that, and so on. I never felt quite finished with these conversations; I wanted to talk and talk to him but I could not articulate the longing I was feeling.

Tonight, I realized that this was likely the last dinner we would have in a while as the original five of us. Max was going off on his adventures and then back to school pretty soon; Nat had his various social outings. Ben is here but he does not enjoy eating dinner that much — except tonight was different. I made a beef and bacon pie; the top was a bacon lattice which Max lovingly made. I baked two round loves of oatbread, and finished up with corn fritters drizzled in honey. This is an authentic meal from Winterfell, the North, the land of the Starks.

Max was with me, sauteing while I chopped and stirred. The smells of cooking filled the downstairs: the bakey smell of bread, the hot buttery smell of bacon, the bubbly brown of stewing meat. Nat flitted back and forth, watching what we were doing. At one time he seemed alarmed by the unusual combinations of food (steak bits and bacon, pie dough filled with meat, not apples) and he put his hands to his head and said, “Spaghetti. Pot.” I reassured him that he would like this dinner.

When the food was ready, I ran upstairs and put on an old midnight blue velvet dress I’d bought 20 years ago from Laura Ashley. I pinned up my hair and when I came down, Ben complimented me by calling me a total dork. “Welcome to nerddom, Mom,” he said. My heart swelled with pride because I could tell he approved. I motioned us all over to the table, which I had set for a Medieval-style feast, in Stark colors of white and gray. Ben made the Stark sigil  of the wolf, and hung it in the window. We lit candles, and Nat said the Hebrew blessing for candles. Ned got out the music from Game of Thrones, which his brother CB had bought me for Christmas, and Ben pronounced it, “epic.”

We ate and ate. Everything went well together: the slightly sweet, oaty bread; the honey and corn fritters, the dense pie. Ned and I shared a goblet of wine (my sister Laura had bought the wonderful goblets for us years ago), and ate off of my grandmother’s china. I was swathed in velvet, surrounded by my  grown-up sons, my handsome husband, the shining silver, swelling music, and hot delicious food. I think we all felt it, this crystalline moment in time, suspended in a different world, and yet, grounded by love, the simplest and most splendid of emotions.

.2013-01-05 18.34.102013-01-05 18.35.50

Tuesday, January 1, 2013

What is Empathy?

From Dictionary.com:

Empathy: the intellectual identification with or vicarious experiencing of the feelings, thoughts, or attitudes of another.

The other day in my favorite bookstore, I came upon a paperback by Dr. Simon Baron-Cohen, The Science of Evil. I have not read the book, but in the New York Times Book Review in June of 2011, Katherine Bouton writes: “The Science of Evil, by Simon Baron-Cohen, seems likely to antagonize the victims of evil, the parents of children with autism spectrum disorder…” Baron-Cohen is in some ways the Bettelheim of the Modern Autism Era (1989-present) because he is the one who coined the term “MindBlindness” and developed the Theory of Mind. I believe that these concepts have likely done more harm than good, at least in the hearts of autism parents. I can’t speak for people on the Spectrum, but I assume that some of them don’t like it being said that autism = inablility to empathize. But this is essentially what Baron-Cohen believes and has researched. While I see how he came to those conclusions, I do not understand why he has not moved beyond them. His theory when applied to autism is flawed because he is attributing flat affect and perhaps communication errors and neurological mix-ups to an inner lack of empathy. In other words, just because someone with autism can appear not to care about or understand another person’s mind, doesn’t mean that is the truth.

I don’t believe that in autism, empathy itself is broken, as much as is the mechanism for interpreting social signals and cues. Nat, for example, may smile at a moment where smiling is basically wrong. That doesn’t mean he is sadistic. I believe it means that he doesn’t know not to smile. But he might be feeling the “correct” emotion. Smiling may mean something different to him than it does to me.  Baron-Cohen and those who use the term Mindblindness are reading the autistic’s signals wrong.

In the wake of the violence in our nation of the last few years — the killing rampages in Columbine, West Virginia Tech, and Newtown — and the speculation about the diagnoses of the murderers (the media asked questions like: Did they have Asperger’s? Did this have any relation to the deadly behavior?) it is absolutely necessary for us to unhook autism spectrum from explanations of evil. And if people continue to believe that autistics have no emotions or empathy, then autism is going to be blamed for crimes that actually have nothing to with it.

My experience with autism spectrum is very different from the misconceptions in the media. People will still ask me if Nat has special brain powers. My guess is no, but he is particularly gifted in charming people. Just today, I had wandered upstairs to my room, where I was suddenly experiencing an awareness of depression, dripping all over me like cold rain. Nat was in my room, on my bed. I knew he’d leave because I had come in. That’s what he does.  He doesn’t like to stay in a room with someone else, if he has previously been in there alone.

I was looking in the mirror, thinking, “why?” as I often do when I’m depressed, as if coming up with the reason will somehow make it go away. I heard Nat walking around near my room. He was near my door and I said, “Nat, I’m starting to feel really sad. I don’t know why.”

“Yes,” he said, and stopped his pacing. He paused a beat, and then he came quietly into my room, settling himself on the bed. He stayed a while, watching me in the mirror, looking intently at my expression, my tears, my eyes — with simple yet complete presence.  And after what seemed to be a decent amount of time, he left. But for the rest of the day, I could still feel him with me.

My Four New Year’s Resolutions

New Year’s Rezzies:
1) Stop doing that bad thing
2) Start that hard thing
3) Decide to become that other thing
4) Work on that dream thing

–Susan Senator 12/31/12

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