Wednesday, June 1, 2011

Flow Chart

One of Alex’s favorite books is the American Medical Association Family Medical Guide. With its colorful diagrams, clearly written explanations of a myriad of diseases, and graphic photographs depicting various conditions, the book can hold his attention for hours. Judging by the worn cover and pages, he has perused most of the book’s nearly 800 pages repeatedly. Perhaps the most interesting section of the book, the Self-Diagnosis Symptoms Charts, guides the reader through various symptoms on flow charts to possible diagnoses. To emphasize those symptoms which could mean potentially dire circumstances, the editors have used bold face type and capital letters to emphasize the urgency of the situation, letting the readers know that they need to call 9-1-1 or go to the nearest emergency room. Since children with autism often do not follow the typical patterns of development and behavior outlined in parenting guides, flow charts like those in the Family Medical Guide could be helpful to parents and caregivers of children on the spectrum. For example, a chart on muttering, which can be a precursor to the dreaded meltdowns, might appear as follows.

MUTTERING

Are you in a public place?
YES-Attempt to leave NOW!
NO-Good!

Are the cable and/or Internet working?
YES-Good!
NO-CALL SERVICE PROVIDER NOW!

Are there any objects within reach that could become projectiles?
YES-MOVE THEM NOW!
NO-Good!

Is the muttering child wearing shoes?
YES-REMOVE them quickly; being kicked by child with shoes hurts more!
NO-Good!

Has muttering escalated to yelling?
YES-WAIT until yelling stops before trying to reason. DO NOT YELL BACK!
NO-Good!

Are the muttering child’s hands shaking?
YES-Shaking indicates excess adrenaline.Have sedative ready for MELTDOWN.
NO-Good!

Of course, most parents who have children with autism already have typical symptoms committed to memory as well as how to deal with the behaviors and, therefore, would not actually need a step-by-step flow chart. For those who’ve never experienced an autism meltdown, whether they be parents of typical children or the general public inclined to look down upon parents dealing with these issues, charts like this might help them be more sympathetic and realize that the parents and their children with autism are doing the best they can under difficult circumstances. We can’t expect others to be understanding if they honestly don’t understand, so maybe we need to be more candid in our explanations. So now you know; when my kid is muttering, I remove his shoes and all objects that can be hurled, pray that the cable and internet are working, hope that we are home, fight any urges to yell back at him or attempt to reason with him, and always keep Ativan close at hand for the really bad times. Having read a lot of medical books for fun like Alex does, I never ran across any autism meltdown guidelines from Dr. Spock, Dr. Lendon Smith, or “Dr. Mom,” but “Dr. Pam” figured it out through experience and wants to share the wisdom gained over time. Of course, now that we have this down to a science, Alex will probably come up with a new behavior to control; I’ll anticipate that new challenge and hope we can make a plan for that, as well.

“We can make our plans, but the Lord determines our steps.” Proverbs 16:9

3 comments:

K. C. said...

You're a fantastic doctor, advocate, and anticipator for Alex!

lynnitis said...

Great article. It seems we are having crying meltdowns which sometimes the cause is known and real but sometimes it could be from something before or something he thinks is going to happen. I know as his gramma that I have received some calls during meltdowns about geamma dates, He believes I should know when he wants one and be on top of it.

Pam Byrne said...

Thanks for your nice comments, K.C. and Lynn! I wonder if these kids assume that everyone thinks like they do, so they get frustrated because we can't read their minds. I think that Alex loves calendars and clocks because they have predictable patterns, which he needs to make sense of the world.

Take care,
Pam