Pleasant Plateau

For the past few weeks, every evening after Alex goes to bed, Ed will remark in a questioning way, “He’s been good all day?” When I nod and answer in the affirmative, Ed will say, “Knock wood, he’s doing really well,” and we will both rap our knuckles on the nearest wooden table. Knowing that I really shouldn’t buy into this superstitious ritual and should give proper credit, I add, “Praise God!”

Because Alex’s progress has not been a linear path as we have seen setbacks along the way, we fear speaking about the good could somehow make him regress. When he is dealing with anxiety that causes his behavior to decline, we pray mightily for change. However, when Alex is sweet and calm, as he has been lately, we worry that doing anything differently might cause an unwanted change.

For years, we have prayed for God to heal Alex. At times, frustrated by regressions and waiting, I have been jealous of those who have experienced complete healing from autism. Researching diligently, I have thought if I kept reading and praying, I could find a cure for Alex. While some children with autism have been healed by chelation therapy to remove heavy metals, vitamin B12 shots, special diets and nutritional supplements, and other methods, none of these gave us the miracle I desperately sought. Nonetheless, the efforts have been worthwhile because these interventions did make him better.

In addition, I have been frustrated that acne has left mild scars on Alex’s face, even though he cooperated with methods to treat the inflammation and never picked at his face. He also has a small bald spot left behind by a minor scalp infection, folliculitis, that we treated immediately under medical supervision. Thinking that Alex has suffered enough from the obstacles autism has presented, I hate that he has small scars as reminders of previous infections.

However, perhaps these minor flaws are evidence of healing, reminders that sickness is not a permanent state. Over time, the acne scars have faded their angry redness, and the bald spot has shrunken from the size of a silver dollar to that of a penny. I cut and comb his hair to cover the small bald spot so that no one really sees it, and the acne scars along his hairline are fading with nightly applications of Mederma scar cream and time. Most importantly, these slight imperfections don’t bother Alex a bit. The only mirror he uses is a toy mirror that softens and slightly distorts in its reflection, much like that described in I Corinthians 13:12: “Now we see things imperfectly, like puzzling reflections in a mirror…”

Nonetheless, we still battle infection and its lasting effects. Two years ago, Alex had a bad case of yeast infection in his mouth and throat that ruined his healthy and hearty appetite. While we have been praying that he would regain his love of nearly all foods, he still chooses to eat a rather limited diet. Even after the yeast infection has been controlled by weekly doses of anti-fungal medication and after working with a fantastic speech therapist to overcome sensory issues related to eating, Alex is still a picky eater, which is not uncommon in autism. However, sometimes he will surprise us and ask for a food not usually part of his chosen menu and devour it happily.

Since we have seen him overcome other issues with time, we wait expectantly for the day when he returns to his varied appetite. Furthermore, we are thankful that he has regained the weight he lost from his self-selective diet because he has cooperated with drinking nutritional non-dairy protein smoothies I make for him every evening to increase his daily calorie intake. Every week as I weigh him on our old-fashioned doctor’s scale, I say a prayer that I can push the bar a little farther to the right, and God has been faithful, as Alex has continued gaining weight at a healthy pace.

Along with gaining weight, Alex has also shown reduced anxiety lately. He’s not just content but happy, skipping through the house and grinning from ear to ear. He has once again enjoyed going places, and he’s chatty and interactive, making appropriate comments that intrigue and amuse us. For example, he nicely asked me the other day to adjust his wristwatch because “It’s too close to the armpit.” Mind you, it was just a little above his wrist, but the exaggerated description made me laugh. The professionals who work with him have also noted how well Alex is doing and have commented on how pleasant and observant he is, asking good questions. Last week, his companion came to stay with him while Ed and I enjoyed lunch at a restaurant. When we returned, she told us that he had been “perfect.” She also shared that when she asked him who was winning the baseball game he was watching on television, he told her––knowing that she’s not a fan of the sport––“The team that has the most points is winning.” She found his literal explanation amusing; he was trying to explain something he thought she didn’t know.

When we reach these pleasant plateaus where things are going smoothly and every night and day I thank God that Alex is doing so well and Ed and I knock on wood in hopes of keeping the trend going, we closely analyze circumstances to make sure nothing happens to change the peaceful existence we gratefully savor. However, sometimes things occur that we cannot control. A few weeks ago, we learned that one of the medications that helps keep Alex calm is no longer available. Despite the best efforts of a dedicated pharmacist, we cannot get that medication, so the nurse practitioner who prescribes Alex’s medications has given us a plan to wean him off that drug.

While my first instinct was to panic that this change would upset Alex and cause a setback, I had to remind myself that God sometimes shoves me forward with both hands because He has plans to move Alex into something new and better. Although I would have preferred to enjoy the pleasant plateau a bit longer, not being able to get this medication means that we must make a change. Remembering that Alex has always responded to medication reductions favorably, I prayed that this change would be equally smooth for him. As we have decreased his doses over the past few weeks, he doesn’t show any negative side effects. If anything, he actually seems even better with this medication reduction, and we pray that once we take him off completely, he will continue to do well and perhaps even get better. I have to believe that God was showing us that Alex no longer needed this medication because the weaning process has gone so well, and Alex continues to be calm and good natured.

Perhaps healing looks different than I had imagined. Certainly God’s ways and plans are better than mine. Maybe God reminds me that all my searching for a cure is not nearly as important as trusting Him to make Alex better. Definitely, I have witnessed His hand in our lives, guiding us and healing Alex in unexpected ways that make us know He was responsible. For us, healing and progress have rarely been the sudden and dramatic changes I prayed for and expected, but instead the culmination of small signs that reveal God has been there all along. Knock wood and praise God!

“For I am about to do something new. See, I have already begun! Do you not see it? I will make a pathway through the wilderness. I will create rivers in the dry wasteland.” Isaiah 43:19

Individualized Support Plan

A week and a half ago, we met with Alex’s case manager and behavioral therapist for his regular quarterly meeting. As I have mentioned in previous blog entries, those who receive support services from the state meet every three months with their teams of professionals to go over progress and goals and to discuss any concerns. We have been blessed with outstanding people who work with Alex to develop his skills and who truly care about our family. The primary topic for this particular meeting was to go over Alex’s individualized support plan, which is similar to an individualized educational plan (IEP) developed by special educational personnel for special needs students.

Last year, Indiana’s Bureau of Developmental Disabilities Services implemented Person-Centered Planning that requires gathering a great deal of information in hopes of providing better services for individuals with developmental disabilities. [To read my April 22, 2018, blog entry, “Person-Centered Planning,” explaining this process, please click here.] Although Alex’s case manager has only been working with us for a little over a year, she has done an excellent job getting to know him and collecting the details needed to develop this comprehensive report. Currently, Alex’s person-centered individualized support plan is 32 pages long and will likely increase with the additions we made at our last quarterly meeting.

Prior to our meeting, his case manager sent me a draft copy of the plan, which I read and summarized for Ed, who trusts my judgment. Essentially, Alex’s goals are to continue progress in the following areas: improving his communication skills, engaging in community activities, developing coping skills to deal with anxiety, and achieving greater independence. Considering that autism impacts his language, social, and motor skills, as well as anxiety, these goals make complete sense and are worthwhile pursuits.

Reading the positive statements in the document noting Alex’s achievements and progress over the past few years was quite encouraging. However, his case manager wisely worded these comments, noting that continued success requires keeping vital supports in place, such as ongoing behavioral therapy and music therapy. Those of us who know Alex well recognize how valuable his therapists are to his continued progress toward these essential goals.

After going through the draft copy of the plan prior to the meeting, I made notes regarding changes or additions that might give more insights into Alex and his current interests and concerns. For example, the report noted that Alex’s hardest time of day was between 9:00-10:30 A.M. While this was true several years ago because his bedtime medications had worn off and the morning doses had not yet taken effect, this is thankfully no longer true. In fact, Alex has improved so much that he only takes two medications at bedtime and awakens pleasant natured. Fortunately, he doesn’t have any time of day that is difficult for him, and we are grateful for this significant progress.

However, he still struggles with sensory issues that can trigger anxiety. For example, because his hearing is quite acute, noises can startle him, and he can become overwhelmed by loud music or sounds. If we are out in public, and volume annoys him, we may have to leave. In addition, he has had difficulty recently with weather bothering him, especially rain. I have read that dogs don’t like to go out in the rain, not primarily because they don’t like getting wet, but because their ears are sensitive to the sounds of raindrops. Similarly, I suspect that Alex hears the sound of rain amplified to a level that makes him prefer to stay indoors. With this in mind, we asked his case manager to add the following to his report: “Inclement weather, such as rain, extreme cold, and wind, can bother Alex, due to sensory issues. He also has anxiety about thunderstorms and tornadoes.” Hopefully, these added details will enable others who work with Alex to understand his weather-related concerns.

Additionally, we requested that a few more details be added to the “About Me” introduction to the document under the subheading “What people like and admire about me.” While his case manager had done a good job of explaining tasks Alex does to help around the house, we wanted the report to describe Alex’s positive traits and personality a bit more. Trying to be objective, I considered what other people have said and noticed about Alex. With these observations in mind, we asked that Alex be described in the report as pleasant and amusing as well as noting that he likes to share interests with others and strives to do his best. His behavioral therapist agreed with these descriptors of Alex, and his case manager confirmed the value of including these details in the report.

Finally, in the “Social and Spirituality” section, we felt that addressing Alex’s faith in God was necessary to understanding him. Although church services can prove overwhelming to Alex with sensory issues, such as the vibration of the church organ and the echoing sounds of a sanctuary, he has developed a strong personal faith reinforced through our religious teaching at home. Every night, he asks God to bless a long list of people who are important to him––from family and friends to his support team to former Chicago Cubs baseball player Sammy Sosa. Consequently, we requested that his report include the following statement: “Faith is important to Alex, and he regularly says bedtime prayers.”

Even though Alex’s individualized support plan can be daunting to read, especially as it details the obstacles autism has imposed upon his life, the positive tone regarding the progress he has made with time and support offers encouragement for the future. As we keep working to develop his communication, social, and motor skills, as well as to develop his coping skills and work toward greater independence, we continue to pray for God’s healing. Furthermore, we hope that someday Alex will no longer need a support team or an individualized support plan, knowing that with God all things are possible.

“Jesus looked at them intently and said, ‘Humanly speaking, it is impossible. But with God everything is possible.’” Matthew 19:26

2018: Year in Review

“Five hundred twenty-five thousand six hundred minutes. How do you measure, measure a year?” from “Seasons of Love” by Jonathan Larson

Since this is the last blog entry of 2018, I thought a review of our highlights from this year would be appropriate as a good way to measure Alex’s progress. Tomorrow evening, he will eagerly await the ball drop in Times Square in New York City, and he will count down along with Ryan Seacrest as he watches the televised event. In that spirit, I will also count down from ten.

10. We began the new year with a new case manager to oversee Alex’s disability budget and coordinate his support services. Although we were sorry to see his former case manager go because she was sweet, energetic, and efficient, his new case manager is kind, conscientious, and experienced. One of her main tasks has been collecting information for the new person-centered individualized support plan required by the state of Indiana. By asking numerous questions, she was able to construct a comprehensive multi-page document that accurately reflects Alex’s strengths, interests, and needs. However, I’m betting that after all that work, the only people who will read that document are his case manager and me.

9. Because Alex has poor fine motor skills as well as impaired gross motor planning skills, he has a great deal of trouble putting on his shoes and cannot tie shoe laces. This year’s discovery of Skechers men’s shoes with elastic bungee laces, allowing Alex to simply slip on these comfortable shoes, has made my life easier. Thank you, Skechers!

8. Due to a change in company policy, Alex’s music therapist informed us recently that he would have to do music sessions in his office instead of in our home. While he had many concerns about making this change, I felt reasonably confident that Alex would adapt. Thankfully, Alex proved me right and has done quite well so far in making the transition to the new setting. Of course, the warm welcome the office staff provides Alex each week probably helps, too.

7. Last year, Alex’s behavioral therapist was promoted to supervisor, and her additional responsibilities meant cutting back from two sessions to one each week with her. The second weekly session focused on going out in the community and practicing social skills they had worked on earlier in the week. This year, she decided Alex has made such good progress that she could spend less time working on skills with him and add the community component back into his sessions. Consequently, she now spends half of the session working on skills, and for the other half, we take Alex out in the community again. Alex was pleased with this change, and the sweet ladies who work at Burger King and treat him like a king seemed delighted to see him again.

6. After reading research from Dr. Chris Exley regarding aluminum toxicity links to autism and Alzheimer’s disease, I decided to follow his suggestions about chelating aluminum. Every day, Alex now drinks bottled Fiji water, which contains the mineral silica that bonds with aluminum and removes it from the body. Hopefully, continuing to drink the Fiji water will lessen or even eliminate any aluminum lurking in Alex’s brain, where it can do damage.

5.  One of the most valuable lessons Alex’s behavioral therapist has taught him this year is being assertive but polite. Often, when posed with a choice, Alex seems indecisive and will ask, “What would be good?” She has helped him learn to weigh his options and tell what he wants or needs while using good manners. He has done much better about expressing himself, and sometimes to make sure he’s covered all of his bases, he’ll tell us what he wants immediately followed by all three of the polite indicators: “Please, thank you, and you’re welcome.”

4.  This year, we have been able to reduce more of the medications Alex takes to manage anxiety. Since he has learned ways to deal with anxiety cognitively through behavioral therapy, he relies less on medication. With the guidance of his psychiatric nurse practitioner, we have been able to reduce dosages of nearly all of the medications he takes and are hopeful we can eliminate some of them soon. His behavioral therapist has told us that medication reduction is rare in autism, so we are delighted that this is a sign he is doing remarkably well.

3.  After 2017 found us constantly battling with yeast overgrowth in Alex’s digestive system, his doctor wisely decided to continue weekly doses of the anti-fungal Diflucan for several months this year to wipe out the dreaded thrush. This aggressive treatment did the trick, as we thankfully saw no signs of thrush this year. In fact, this year, Alex has probably been the healthiest he has ever been, with no colds, infections, or any illness.

2.  While we started the year with Alex having some increased sensory issues and anxiety about going places, especially in cold weather or in noisy settings, he thankfully overcame these concerns. In fact, he enjoyed going to several concerts this summer and to many basketball games this fall with no signs of crowds or loud noises bothering him. In addition, he looks forward to going grocery shopping every week at the new local superstore that opened this summer, where he does a better job of pushing the cart and staying out of other people’s way than any other customers do.

1.  Although we have been dealing with Alex’s aversion to food for about a year and a half following an especially bad case of thrush, he seems to be on the right track to regaining his appetite. After a year of his self-limited diet, we took him to a terrific speech therapist who reassured us that nothing was physically wrong. She believed that thrush had made eating painful and food taste bad, so we had to work with Alex on overcoming those negative thoughts. Her warmth and kindness inspired him to try a variety of foods. Still, progress has been slow; however, the past week, we have seen a real breakthrough as Alex has shown signs of returning to his formerly varied and healthy appetite. As we begin a new year, we pray that he continues to make progress so that he can enjoy eating again.

Looking back over all the accomplishments Alex has made in 2018 makes us hopeful for the progress he will continue to make in 2019. Most of all, we are thankful for the blessings God has provided this year and will continue to provide so that Alex will, indeed, reach his full potential.

“For I am about to do something new. See, I have already begun! Do you not see it? I will make a pathway through the wilderness, I will create rivers in the dry wasteland.” Isaiah 43:19

New Speech Therapy Method Offers Hope for Autism

For many children with autism, speech therapy provides crucial training to help them develop language skills. A recently published research article describes a new form of speech therapy that offers promising results to children with autism whose speech skills are limited. The article, “Behavioral predictors of improved speech output in minimally verbal children with autism,” published in the October 2018 issue of Autism Research and available online through the Wiley Online Library, describes the AMMT method and suggests which children are most likely to benefit from this form of speech therapy. [To read this article, please click here.]

The researchers, affiliated with Boston University, Harvard Medical School, and Beth Israel Deaconess Medical Center, all located in Boston, Massachusetts, looked for factors that would predict improvement in spoken language for minimally verbal children with autism. Their study included 38 minimally verbal children with autism ranging from ages three years and five months to ten years and eight months.

The children received one of two forms of speech therapy and participated in a minimum of twenty-five sessions that met five days a week for forty-five minutes each time. Most of the children engaged in auditory-motor mapping training (AMMT), “a novel therapy that uses intonation (singing) and rhythmic hand tapping.” The researchers further describe AMMT as “one of a small number of music-based treatments that have recently begun to be used effectively for teaching language and social skills to children with ASD” [autism spectrum disorders]. The other children in the study—the control group— engaged in speech repetition therapy (SRT), which involves no singing or tapping, only saying words aloud.

During these sessions of speech therapy, the children were given thirty familiar two syllable words to say aloud, such as “mommy,” “cookie,” and “bye-bye.” The children in the SRT group simply repeated these words with the speech therapist. However, the children in the AMMT group would sing the words while using two hands to tap on drums at the same time. This method not only combines using auditory and motor skills but also holds the attention of the children during the therapy sessions. The researchers discovered that the children who participated in the AMMT therapy improved their speech production more than those who received SRT therapy.

In addition, the researchers studied which factors were most closely linked to speech improvement, such as age, gender, severity of autism, nonverbal IQ, expressive language skills, and phonetic inventory (the number of speech sounds children can repeat correctly). In some children, the severity of autism influenced the amount of progress made in therapy. However, phonetic inventory was the strongest predictor of how much the children would improve. Researchers were surprised to discover that nonverbal IQ, expressive language, and age did not predict the level of improvement.

In fact, they noted that the older children may have better attention spans during therapy sessions that enabled them to make progress. While the value of speech therapy for older minimally verbal children with autism is sometimes questioned, the researchers note that their observations suggest some older children with autism can benefit from speech therapy.

Although the researchers admit that working with minimally verbal children can be difficult, they also stress the value of effective treatment. Approximately 25% of children with autism are considered minimally verbal. Developing language skills tends to reduce behavioral issues and improve long-term outcomes for these children. As the researchers stress, there is a “great need for these children to acquire even a few words.”

While the researchers affirm the need for further study in the area of speech therapy for minimally verbal children with autism, their study offers hope. First, the AMMT method appears to develop speech skills successfully by combining speech with singing and tapping. Moreover, their results indicate that even older children can develop their speech skills through proper therapy. Certainly, helping children with autism learn to speak is a noble cause, allowing them to communicate their wants and needs, to express their thoughts and feelings, and to interact with others so that they can lead fulfilling lives.

“He has given me a new song to sing, a hymn of praise to our God. Many will see what He has done and be amazed. They will put their trust in the Lord.” Psalm 40:3

Peaceful Plateau

Lately, we’ve found ourselves in one of those phases for which we’ve prayed fervently: the peaceful plateau, where life is rolling along blissfully and smoothly. Times like this occasionally make me wonder whether we should try something new to push toward more progress. However, most of the time, we think of this phase of relative ease as a Jenga tower in which we don’t want to make any sudden moves that might topple a potentially precarious stack of blocks.

During these times when Alex is healthy and content, Ed and I compare notes in hushed tones, somehow fearful that saying aloud how well Alex is doing might disturb the delicate balance. We add to our superstition by adding the comment, “Knock on wood!” as we both seek a table or chair to rap our knuckles upon, hoping to ensure our good luck will continue.

Certainly, we have reason to be leery. For a year, Alex took antifungal medication to battle an unusually virulent case of thrush that invaded his mouth and throat and did not want to leave. When he finished taking Diflucan in June, we hoped and prayed that the thrush had been eradicated, but we continued to look for the symptoms: tiny blisters on the inside of his lower lip, a white coating on his tongue, and difficulty swallowing his morning pills. Thankfully, Alex has remained thrush-free for the past few months, and we have breathed a sigh of relief that he has been healthy. Knock on wood.

Although we have been working for over a year with Alex’s psychiatric nurse practitioner to reduce the medications he takes for anxiety, every time we reduce or remove a medication, we worry about how he will respond. Since August, two of his medication doses have been cut in half, and he has done remarkably well. Fortunately, with each medication reduction, we have seen Alex respond favorably, improving instead of regressing. Knock on wood.

After over a year of dealing with Alex’s food aversion that changed him from a hearty and healthy eater to a reluctant and picky eater, we enlisted the help of a speech therapist this summer. In just a few sessions, he made great gains and expanded his diet to include a wider variety, rediscovering the foods he formerly enjoyed. While we were delighted with his progress, we were a bit apprehensive when his speech therapist told us that Alex had made a breakthrough and no longer needed her help. However, he continues to look forward to mealtime and makes suggestions about what he’d like to eat. He’s even been able to eat at restaurants, despite all the sensory issues of sound, smell, and taste, while showing no anxiety about food. Knock on wood.

As part of behavioral therapy, his therapist has worked on Alex’s social and language skills by teaching him how to say hello and goodbye to people. One would think this would be a simple task, but autism makes this interaction difficult for him. To reinforce these skills, Ed and I often cue Alex to remind him to exchange these social niceties when he’s out in public. Sometimes, we directly tell him, “Say hello,” or we physically nudge him to speak to others because he doesn’t usually initiate greetings on his own. The other evening when we went grocery shopping, the gentleman who often greets us at the door was treated to an enthusiastic, “Hello!” from Alex. Ed and I exchanged surprised looks, wondering if the other had cued Alex, but he had done it on his own. To prove it wasn’t a fluke, he said, “Goodbye!” to the same gentleman as we were leaving. Maybe Alex is finally catching on to the social skills we’ve worked so hard to teach him. Knock on wood.

Since Alex’s quarterly meeting with his support team is coming up this week, I have been thinking about how to summarize the past three months, something we routinely do at every meeting. He’s healthy, sleeping and eating well, and willing to go places and interact with others. More importantly, he just seems content. We catch him skipping through the house, grinning in the back seat as he rides in the car, and generally amused as he observes life. In short, he’s happy and healthy. Knock on wood.

When we’re in the midst of difficulty, I find myself searching for God’s goodness and praying earnestly for progress. However, when things are going well, I vacillate between enjoying the comfort of ease and fretting when the next proverbial shoe might drop. However, we know that faith is greater than any silly superstition. Moreover, we know that God is in control, and we are truly thankful for His goodness in our lives. He has been with us every step of this journey and has plans for Alex’s life that are greater than we can imagine.

Alex is healthy. Praise God.

Alex is getting off medications. Praise God.

Alex is eating better. Praise God.

Alex is getting out and interacting with people. Praise God.

Alex is happy. Praise God.

Life is good. God is good. Praise God, indeed!

“Come let us tell of the Lord’s greatness; let us exalt His name together.” Psalm 34:3

"In Thy Light"

“Thy Word is a lamp unto my feet and a light unto my path.”~“Thy Word” by Amy Grant and Michael W. Smith

Last week, a sudden storm knocked out the electricity to our home briefly, sending the three of us into darkness. Although Alex tends to be unnerved by thunderstorms, he has learned over the years that we will quickly assemble flashlights and candles so that he can see. After a recent power outage that lasted hours, we bought him a pair of “Super Bright Switches”: battery-operated LED lights that look like light switches and give off bright light, as advertised and recommended by my mom. As soon as the power flickered, I took a flashlight and ran and got his Super Bright Switch so that he could carry around light easily and feel secure. Alex seemed content to have the ability to flip a switch to gain light quickly, and fortunately, the electricity came back on shortly afterward.

In dealing with autism, we often find ourselves stumbling in the darkness, searching for a light that can easily be turned on with the flick of a switch. After dealing with Alex’s sudden and uncharacteristic food aversion for over a year, we found the proverbial “light at the end of the tunnel” when we began working with a speech therapist last month. Although I thought helping him overcome his issues with the tastes, textures, and temperatures of food would take months, his speech therapist felt confident Alex could conquer his anxiety about eating more quickly. She was right.

In our session last week, she declared that Alex had graduated from therapy with her and would no longer need speech therapy for food aversion. After only five sessions in less than two months, she had taught Alex how to enjoy food again. In that last session, he was able to tell her that he had tried more than a dozen varied foods in the two weeks since he had last seen her, and he liked almost all of them. Suddenly, he was suggesting foods he’d like to eat, something that we had not seen in more than a year. Another sign of a breakthrough was his telling us that he was hungry––a sharp contrast to his more recent behavior of protesting that he didn’t want to eat because he was already full.

Although we were delighted that Alex made such rapid progress in overcoming a problem that had plagued him for several months, we were also a bit sad to say goodbye to his therapist. However, she assured us that if Alex ever needs her, she will always be happy to help. In the brief time we worked with her, she had endeared herself to us through her patience, kindness, and enthusiasm. Most of all, she genuinely cared about Alex and celebrated each step of progress with us. When we couldn’t find a way, she enlightened us.

On Friday evening, we took Alex to see a Homecoming celebration fireworks display at Valparaiso University, where Ed teaches and I received my college degrees. Even though fireworks should cause sensory overload for Alex with the loud noises and flashing lights, going to the Homecoming fireworks is an annual event he eagerly anticipates. This year was no exception. Moreover, these fireworks seemed to be an appropriate way to celebrate all the progress Alex has made recently.

As the three of us watched the exploding multicolored lights in the sky, I thought of the motto of my alma mater: “In Luce Tua Videmus Lucem/In Thy Light We See Light.” Despite all the times we have trouble seeing the path for Alex, God has illuminated His purpose and shown us the way. Not only has He helped us find strategies and methods to help Alex, but He has also led us to other people whose expertise and support we needed to make Alex better. When we were in the dark, God provided the light so that we could see and have hope for the future.

While I thanked God for the progress Alex has made in overcoming his fear of storms and regaining his appetite and being willing to go places so that he can enjoy life, Alex was just mesmerized by the fireworks. With a smile on his face, he counted the flashes in the sky and proclaimed that he liked the fireworks “one hundred percent.” While his faith may be less analytic than mine, Alex’s faith is purer than mine. He trusts God implicitly, knowing that just beyond the darkness, the light will always shine brightly.

“For God, who said, ‘Let light shine out of darkness’ made His light shine in our hearts to give us the light of the knowledge of God’s glory displayed in the face of Christ.” 2 Corinthians 4:6

Seeking Small Miracles

“Why, who makes much of a miracle? As to me I know of nothing else but miracles…”~ Walt Whitman

For over a year, we have been trying to help Alex regain his healthy and hearty appetite. Although many people with autism have issues with eating, we were blessed with a child who would happily devour nearly any food placed before him. After a nasty bout of thrush last summer made Alex’s mouth and throat sore and made food taste bad, he has had difficulty overcoming the loss of appetite, even months after medications eradicated the thrush.

For more than a year, his self-imposed diet consists almost exclusively of cool and smooth foods: applesauce, dairy-free yogurt, a few fruits, lemon pudding, Jello, and smoothies. We have tried various approaches to increase both the variety and volume of what Alex eats on a daily basis. However, we must always be careful that our encouragement to eat doesn’t become pressure to perform that may trigger anxiety.

After months of prayer and gently persuading Alex to try different foods, we decided to take him to a speech therapist his primary care doctor had recommended for food aversion. Immediately impressed by her understanding of why Alex’s appetite suddenly changed as well as by her warmth and kindness toward Alex and us, we felt hopeful that she could help him. Moreover, we were relieved to discover nothing was physically wrong with Alex’s ability to eat; he simply has sensory issues and anxiety about eating.

Last week, I found an excellent article on the Child Mind Institute website that explains food aversion clearly and offers helpful tips. [To read this article, please click here.] In “More Than Picky Eating,” Rachel Ehmke notes, “Kids with a serious aversion to many foods may need help with food habits and overcoming avoidance.” She goes on to say, “Their aversion goes beyond normal choosiness and into an area where parents find they need to call for backup.” Clearly, this reinforced our decision to seek the expertise of a speech therapist regarding Alex’s new aversion to food.

In the article, she explains potential reasons why children limit their diets, namely, anxiety issues and/or heightened senses of smell and taste. Specifically, she describes fears of trying new things, worries about choking, and issues with textures. With Alex, he seems to be more driven by sensory issues––taste, texture, and temperature. However, he also seems to have anxiety about the act of eating, and he is trying to deal with his fears by reading medical books. For him, knowledge is power. Of course, we have tried to reassure him, as well.

The article goes on to explain using exposure therapy, working with foods that have been avoided “in a carefully controlled, therapeutic way.” Children are encouraged to try new foods and rate them, eating foods that don’t make them gag, and allowing them time to get used to the taste of new foods through repeated exposure to them. The results of this approach, which usually takes 8-10 sessions, are encouraging: “…with treatment, picky eaters can make great strides.”

Although we have only met with Alex’s speech therapist three times, we have seen her use a similar approach with him. After noting the foods that he will eat, she has offered suggestions about foods he can try at home that are similar to the ones he is currently eating. For example, since he likes applesauce, she suggested that he try different flavors of applesauce, and he discovered that he also likes cinnamon-flavored and strawberry-flavored applesauce. This way, he is expanding his palate to accept new flavors with familiar textures and temperatures. In addition, since he likes orange juice, she recommended that he try Mandarin oranges, which have a similar flavor to his favorite beverage but a different texture. In his most recent session, she asked him to try warm apple pie filling, which is similar to applesauce in taste but offers a different texture and temperature.

Thankfully, Alex has been willing to follow her suggestions, and we have been able to expand his limited menu with some new fruits. However, he has definite ideas about things he refuses to eat, even angrily telling us in his last session that he didn’t want to eat the Honey Nut Cheerios we’d offered him. Despite Alex’s rare yelling outburst, his therapist assured us that she loves working with him and considers our family “a blessing” to her. Moreover, she reassured Alex by telling him most crunchy foods aren’t that nutritious anyway, so he doesn’t have to eat them. If we had any doubts, God was reminding us what a blessing he’d given us in Alex’s speech therapist.

In the month since beginning food aversion therapy, the progress has been slow, but we are grateful that Alex has been willing to try new foods. The other day, however, we were surprised when out of the blue, Alex requested chili dogs for dinner. Neither cold nor smooth, they didn’t fit his preferred diet, and the spiciness of the chili seemed out of the ordinary for him. Since Alex had not given me advance notice, I had to improvise and make him a hot dog with leftover taco meat. To my surprise he ate every bit and enjoyed it thoroughly.

Not wanting to get my hopes up, I dismissed this chili dog incident as a fluke. The next day, he again asked for chili dogs. Had my faith been stronger, I would have made chili in preparation for this new food request. Instead, I could only offer taco meat dogs on the spur of the moment. Again, Alex ate this second-rate chili dog happily. Still not quite believing this small miracle God had given, I was taken aback when Alex again asked for a chili dog the next day yet seemed satisfied with the substitute taco dog. Every day, I thanked God for this breakthrough and prayed that this was a sign we were making headway on Alex overcoming his food aversion.

Yesterday, I decided to test how strong Alex’s breakthrough was by suggesting that we take him to a hot dog stand and get him a real chili dog. Since we had not been to this restaurant in over a year, Alex was eager to go because it was “special.” After ordering his hot dog with no bun and chili on the side, I had doubts that he would eat the chili dog, especially away from home. However, God provided another small miracle as Alex devoured the chili dog and proclaimed he liked it “one hundred percent.” For most people, this simple act would be rather meaningless; for us, it was an answer to many daily prayers.

Even though we don’t know how long before or even if Alex will totally regain his varied appetite, we are encouraged by the amazing progress we have witnessed this week. God has provided us with a therapist who understands Alex’s needs and has offered us support and a good plan to help him overcome his food aversion. As we continue to seek daily blessings and pray for breakthroughs, we are grateful for all the progress Alex has made over the years. For today, Alex has requested chili and a baked potato from Wendy’s fast food restaurant for dinner. In the words of poet Walt Whitman, “What stranger miracles are there?”

“He does great things too marvelous to understand. He performs countless miracles.” Job 5:9

Blooming

“Little darling, it’s been a long cold lonely winter. Little darling, it feels like years since it’s been here. Here comes the sun. Here comes the sun, and I say it’s all right.”––“Here Comes the Sun” by George Harrison

After long cold winters in Northwest Indiana, I eagerly anticipate the arrival of spring. This year, winter seemed to last even longer than usual; with temperatures running about ten degrees below average, we had one of the coldest Aprils in history. (Thanks to my amateur meteorologist husband and son for sharing that statistic with me!) Because it was colder than usual, the trees remained bare, and flowers were slow to bloom, making the arrival of spring appear about a month late.

For me, the main sign of spring is the blooming of the magnolia tree in our back yard. Day after day, I looked out my back window to see if the tightly closed buds had opened, but the cold weather delayed the debut of the blossoms. Perhaps this year the tree would not flower, and I would miss my favorite sign of spring. Finally, about a month after the magnolia tree typically blooms, the beautiful magenta flowers all suddenly opened once the time was right, assuring me that sometimes we have to wait, but the positive outcome rewards the waiting.

Early into the long cold winter, Alex suddenly developed an aversion to going places, something he had thoroughly enjoyed. With any changes in his behavior, we analyze the potential causes, ask him for insights, and hope that he’ll soon get over whatever is bothering him. Because he had developed some increased sensory sensitivity, we assumed that he was bothered by the cold and wind, which seemed reasonable. However, becoming a hermit was not reasonable. Although we were able to convince him to go to regular medical appointments, he had so much anxiety about going outside that he had no interest in going anyplace until the weather improved. Despite our encouragement, he wanted to stay home where it was warm.

Like the magnolia tree, I kept looking for signs that Alex might be ready to change but knew that until the weather improved, change was not likely. In the meantime, I decided that this would be a good time for another medication reduction that his psychiatric nurse practitioner had suggested. Since nothing else was changing, including Alex’s aversion to going places, we might as well see how he reacted to decreasing a sedative. In the past year we have been able to reduce or eliminate five of the medications he takes for anxiety. With each medication change, we have gradually tapered the dosage, prayed for positive results with no setbacks, and, thankfully, he has responded quite well.

When the magnolia flowers blossomed, I knew the time was right to make the change with Alex’s medication. Watching him carefully, I saw no signs of regression, which is always encouraging. Reducing his nighttime dose neither impacted his sleep negatively nor made him awaken in a foul mood. Along with seeing a lack of negative behaviors, we were seeing positive changes. In the past month, Alex has become more alert and energetic, “happy hopping” skipping through the house, and he readily engages in conversation, asking appropriate questions. Moreover, he is speaking in longer, more complete, and grammatically correct sentences. Whether these changes are related to the medication reduction or simply signs of progress, we are delighted with the awakening in Alex.

After seeing the improvements in his speech and alertness, we decided that now was the time to overcome the winter hibernation Alex had imposed upon himself. We were determined to get him out of the house last week. Enticed by the opening of a new superstore in our town, Alex was eager to see just how big this new store is. With the bribe of new composition notebooks for his willingness to go shopping, he was on board for the trip. A perfect summer day––sunny, calm, and seventy-five degrees––meant that Alex had no excuses for not going outside. As Ed and I chatted to Alex about topics he likes, such as gas prices and the weather, we hoped to distract him from any fears about leaving the house. With all the stars aligned, Alex made it all the way to the store without telling us he needed to go home, shopped happily, and left with not only his beloved red notebooks but also a map of the store he could study. We knew the outing was successful when he told us that he’d like to go back and check out the grocery part of the store, and that he liked the store “one hundred percent,” the highest praise he offers.

The next day, he informed me that he wanted to go to Burger King with his behavioral therapist and me. As part of his therapy, she and I take him places in the community as recreational therapy to practice social skills she has taught him. However, her busy schedule and his reluctance to go places has prevented these outings. Like me, she was delighted that he wanted to go out, and we returned to one of his favorite places after months of not going there. When we arrived, two kind ladies who work there and take a special interest in him enthusiastically greeted Alex by name and told him how much they had missed seeing him. If he had any qualms about going there, their warmth made him feel welcome and reassured. After chatting happily with his therapist and me over an orange-vanilla ginger ale, Alex told us that he’d like to go back to Burger King again soon.

With two successful outings behind us, we hoped we were on a roll. Another evening, we took Alex to his dad’s office to check the mail and watched him walk confidently down the hallways, even though he hadn’t been there in months. Once again, he proclaimed that he liked going there “one hundred percent,” making us hopeful that his anxiety about going places may be gone. Yesterday, I asked Alex if he wanted to go to Culver’s, one of his favorite fast food restaurants, and he eagerly said that he did. He did have one stipulation, however. He wanted to go to the one in Chesterton because “it’s further away” than the one here in town. Clearly, he seems to be over his fear of being too far from home. Even though he had eaten an early dinner, he was willing to sit with Ed and me as we ate, contentedly sipping a root beer (that is “special because they make their own,” as he reminded us). Despite all the people and noise, Alex showed no signs of anxiety, concluding that he had enjoyed that trip “one hundred percent” also and wanted to come back again.

After a good week with Alex not only willing to go places after months of staying home but also with his showing signs of thoroughly enjoying himself during these outings, we are encouraged that he has gotten past his fears of leaving the house, which is an answer to prayers. Even though we had become tired of waiting for change, frustrated when we saw no signs of progress, and even concerned that what we first thought was temporary might be permanent, God caused Alex to bloom at the right time. Once again, we have been reminded that God is always faithful and will fulfill His plans in His good time. As we look forward with anticipation to a summer of family outings, we are thankful that God continues to heal Alex so that he can enjoy all the good things in life.

“The wilderness and the dry land shall be glad; the desert shall rejoice and blossom like the crocus; it shall blossom abundantly and rejoice with joy and singing.” Isaiah 35:1-2

Treating Autism

One of the greatest resources in dealing with autism is the ability to communicate with other parents through the Internet. When Alex was first diagnosed with autism, the presence of autism support groups was somewhat limited, but using my dial-up modem and belonging to a few Listserv groups allowed me to gain a wealth of knowledge from other parents who were in similar situations to ours. Thanks to Facebook, parents today have many autism groups from which to choose, giving us the opportunity to share ideas, empathize, and gain insight into ways to help our children.

Perhaps because we have been dealing with autism for more than twenty years, the attitudes of some parents on these online groups puzzles me. In fact, they remind me of some of my former middle school students. While many are earnestly and eagerly seeking information, others ask questions that have repeatedly been answered, and still others who don’t like the provided answers argue with those who have told them the truth. For some whose children have recently been diagnosed with autism, they want solutions that are inexpensive, easy, and quick. Of course, parents don’t want their children to suffer more than necessary, and we seek the best ways to help our children. However, autism treatment requires money, dedication, patience, and time.

Over the years, we have tried a variety of therapies and interventions to help Alex: speech, occupational, sensory integration, cranial, chelation, behavioral, music, and vision therapies, along with the gluten-free/casein-free diet, nutritional supplements, vitamin methyl B-12 injections, and medications. Some methods worked better than others, but all of them have contributed to helping Alex make progress. When Alex was younger, insurance typically did not cover expenses for autism therapies, and we paid for these therapies ourselves. We were blessed to be able to afford these expenses somehow, even on our teachers’ salaries. Thankfully, more therapies are covered for families by insurance and state funding, as Alex’s current therapies are, so that families don’t have as much financial burden as they did in the past. Nonetheless, I don’t regret a single penny that we spent on Alex’s treatments because I know they helped make him healthier and improved his skills.

Along with the expenditure of money, parents must also realize that helping a child with autism requires a great deal of effort. Certainly, putting a child on a restricted diet can seem overwhelming at first, but the benefits of improved behavior and healing digestive issues reward those efforts. However, parents need to be fully committed to making changes before attempting interventions. When we decided to put Alex on the diet free of glutens and milk products, we committed to removing these foods completely from his diet for at least three months. After seeing improvements during that trial period and grateful for Alex’s cooperation with the diet, we have kept him on this diet for nearly twenty years.

In addition, therapeutic interventions, such as speech and behavioral therapy, often require a great deal of practice and take months and even years before significant progress is made. Rarely do sudden changes occur in response to interventions. For us, the quickest changes we saw were in response to the supplement melatonin that immediately helped Alex sleep better instead of wandering around in the night and vision therapy that significantly improved Alex’s balance within a few weeks. Another intervention that had sudden impact was the introduction of vitamin methyl B-12 injections. Within a week of starting the B-12 shots, Alex was finally able to use the toilet independently after ten years of potty training. Apparently, the methyl B-12 injections caused nerve healing that allowed him to feel the urge to use the toilet. In this situation, a seemingly quick fix solved a problem we had been dealing with for many years. However, most of the improvements we have seen were more gradual, requiring dedication and patience, even when we could not see much progress being made.

For those of us whose children are now adults with autism, we have gained years of experience that we are happy to share with others. We have learned that treating autism is not a sprint race, but instead, a marathon where we must pace ourselves along the way. Perhaps one of the best pieces of advice I learned came from Alex’s childhood doctor, who always reminded me to begin only one new intervention at a time so that we could assess the response to therapy accurately. In addition, she advised us to give new things a fair trial because healing is not usually instantaneous; progress takes time.

Most of all, the lesson I have learned along the way is to trust God, especially in the difficult times and when progress seems slower than I’d like. Despite our fervent prayers for Alex, God has His own plans for healing. Through our experiences, we have developed our faith as we’ve waited and been encouraged by the progress we have witnessed. While Alex has not fully recovered from all of the issues autism has caused, his support team of therapists calls him “a success story,” and we realize that all the costs, efforts, and time have been worthwhile. Moreover, we are thankful that Alex is happier and healthier, and we continue to place our hope in God, knowing that He will always be faithful to us, just as He has always taken care of our needs in the past.

“…And let us run with endurance the race God has set before us. We do this by keeping our eyes on Jesus, the champion who initiates and perfects our faith…” Hebrews 12:1-2

Five Hundred

On June 13, 2010, I posted my first blog entry on One Autism Mom’s Notes. When I wrote that initial entry, Alex was eighteen years old and doing quite well after some trying teenage years. I thought we had come to a point in our lives where we could breathe easy and keep moving forward. With a little more free time on my hands, I decided to create a blog where I could write about Alex and how autism had impacted our family life. My hope was that by sharing our experiences and the things we had learned along the way, our stories might help other families dealing with autism. Moreover, I wanted to write a history for Alex so that he could see how far he has come in the years since his diagnosis with autism at age four.

Now nearly eight years later, this is the five hundredth blog post I’ve written. When I began writing about Alex, I had no idea that I would have enough to say for five hundred essays. Moreover, I had no idea that we still had struggles ahead of us, especially a terribly turbulent time in which anxiety overtook Alex and made him aggressive and wildly unpredictable. As parents we had to make our most difficult decision: to hospitalize him for several weeks in the behavioral medicine ward of a nearby hospital in the spring of 2012. However, this heart-wrenching time led us to professionals who could help Alex, and this was the beginning of new healing for him––truly a blessing in disguise.

Over the past 499 essays, I’ve shared the good, the bad, and the ugly as candidly as possible in hopes that other parents won’t feel alone in dealing with the obstacles their children face with autism. I’ve also passed along research and methods I’ve found interesting or helpful, just as I would pass along a great recipe for cookies. With each research study I read, in my optimistically Pollyanna way, I believe that I’m going to stumble onto something that will not only make Alex better, but also aid other children and adults dealing with autism. Consequently, I keep reading, researching, and writing about autism, waiting for a cure.

In thinking about this 500 milestone, I wanted to celebrate with five unexpected blessings that have occurred in writing this blog. First, I have been amazed to see my words go out into the world, where they––according to the Blogspot stats––have been read on six continents. (I’m guessing the folks in Antarctica have more important things to do, like keeping warm, instead of reading my blog, so I’m good with that.) When I was happily working at the “Be Creative” table as a third grader, wondering if anyone other than my teachers and my mom would ever read my writings, I never dreamed that people in countries I had to find on a map would read my work. I’m honored and awed by that.

Secondly, when I was a college student working on my undergraduate and graduate degrees in English, I had a keen interest in psychology and took as many elective psychology classes as I could fit in my schedule. I’m sure that was God’s plan because those courses have come in handy in dealing with and understanding a child whose brain works differently than most and whose development has followed a unique pattern. Moreover, the terminology I learned has proven useful in reading autism research. Imagine my surprise and delight in being contacted by a psychiatrist in Australia who wanted to use an excerpt from one of my blog entries as part of an online psychology textbook. Dr. Joseph Rey, the Head of Psychiatry at The University of Notre Dame School of Medicine in Sydney, requested my essay on Theory of Mind to be included in The IACAPAP Textbook of Child and Adolescent Mental Health published online in 2014. For this work, Dr. Rey received the 2014 International Association of Child and Adolescent Psychiatry and Allied Disciplines (IACAPAP) International Contribution Award. To have my writing published in such a distinguished textbook is an opportunity I never would have dreamed could happen.

Another awesome connection made because of the blog has been one with author Marjorie Ingall. In the summer of 2012, Marjorie contacted me after reading my blog and wanted to interview me for an article about autism she was writing for a magazine. Her warmth and humor made our phone conversations comfortable and pleasant, as though we were old friends. Those interviews became a feature article in the November 2012 issue of Woman’s Day magazine in which Marjorie told our family’s story skillfully and compassionately. In her own blog on October 19, 2012, Marjorie describes the connection we found as mothers during the interview process. Not only did I appreciate the kind words she offered about me, but her description of my blog also made me smile: “Her blog is full of evidence of her Christian faith––each post ends with a Biblical quote, and there’s a whole lotta Jesus going on...” Despite our differences in religious backgrounds––her Jewish faith and my Protestant faith––God knew we would appreciate each other and brought us together through the blog.

Besides getting to meet some very interesting and talented new people, including some wonderful autism parents, One Autism Mom’s Notes has helped me reconnect with old friends. My best friend from college with whom I’d lost touch over the years, emailed me after seeing an article about my blog in our college alumni magazine and introduced me to one of her closest friends, who is also an autism mom. Also, one of my good friends from junior high contacted me after reading the Woman’s Day article and the blog; she, too, is raising a child with autism. The demands of raising a child with autism makes maintaining friendships challenging; being able to get back in touch with old friends has truly been a blessing.

However, the greatest blessing of all has been seeing God’s promises fulfilled over the years as Alex has made progress. Through the challenges, trials, and uncertainties, God has been faithful to our family and brought us through it all. While our faith has been mightily tested at times, we always knew that God’s plans were better than our own, and we knew that He was looking out for Alex’s best interests. In those times that we wavered and wondered whether he heard our prayers, we only needed to listen to Alex’s earnest bedtime prayers, filled with childlike faith, to carry us through. As we celebrate Palm Sunday today and anticipate Easter, remembering the resurrection of Jesus Christ, we know that with God, nothing is impossible. Consequently, we continue to put our hope and trust in Him, knowing that He will always take care of us, just as He always has in the past. With that in mind, we know that Alex’s future will, indeed, be bright.

To those who have read my blog, written or said kind comments, and encouraged me, I truly appreciate your support. Special thanks go to my husband and my mom not only for reading every single one of the five hundred at least twice, proofreading carefully, but also for the constant source of unconditional love, strength, and faith you provide Alex and me. I thank God every day for the three of you and what blessings you are!

“So teach us to number our days, that we may gain a heart of wisdom.” Psalm 90:12

Dentist Appointment

 

Last week, we took Alex to the dentist for his regular six-month cleaning and check-up appointment. Although he usually likes going to the dentist, his recent anxiety about going places had us concerned how he might react this time. Unlike some people who fear going to the dentist, Alex has had good experiences through the years and actually looks forward to his dental visits. The dental hygienist who has cleaned his teeth the past few years is especially sweet and patient with him, and her encouragement and praise make him eager to cooperate with her.

As with all of his appointments, I am careful to schedule a time that works best for Alex. For some doctors, we schedule Alex’s appointments first thing in the morning to avoid having to wait, which is more common in the afternoon. We try to avoid times when he might miss his beloved game shows, The Price Is Right or Jeopardy, and we avoid appointments that might overlap meal times. We also need to schedule around his regular behavioral and music therapy sessions because he doesn’t want to miss them. Working around Alex’s sacred schedule allows small windows of times in the morning and afternoon, but we manage to keep him happy.

For his dentist appointment, he didn’t have to sit in the waiting room but a few minutes before his dental hygienist came to greet him. Immediately, he happily jumped up and followed her back to the room where his teeth would be cleaned and checked—so far, so good. (We were even thrilled that he got into and out of our car without being coaxed.) Once he was seated in the dentist’s chair, his hygienist began putting on the paper bib to protect his clothes as she cleaned his teeth. She warned him that the metal chain that holds the bib might be a little cold on the back of his neck. As soon as he felt the chain against his neck, he decided it was too cold and decided he wanted nothing to do with the bib, pulling it off the chain and handing it to me. I assured him that he didn’t have to wear the bib and assured her that his shirt could be washed if anything spilled on it.

While the hygienist was preparing to clean Alex’s teeth, she chatted with him and tried to make sure he was comfortable, even asking if the light bothered him (probably knowing that the bib did), but he told her the light was fine. However, he was a little shaky, and she gently patted him on the shoulder and asked him if he was okay. Calmly, he admitted he was a little nervous. While Alex used to utilize a series of calm down skills, he now prefers only two options when he’s anxious: sit quietly or talk about his concerns. Consequently, I asked him if he wanted to talk or be quiet. He said he wanted to sit quietly and needed two minutes to calm down. Despite his nerves, he seemed to be in good control of his emotions.

Knowing that Alex literally meant he needed exactly two minutes, I figured this would give his hygienist time to note his medication reductions on his chart, so I gave her a copy of his updated medication dosages. Also, I asked her if she could put on the country music cable channel on the television after asking Alex if he would like some music. Clearly, Alex was regaining his composure in that short amount of time, as he stopped shaking and he visibly relaxed, even starting to sing along softly to the music. At the end of the two minutes, he announced that he was ready to have his teeth cleaned. He knew.

During the cleaning, Alex was calm and cooperative, answering any questions she asked him. Concerned for his comfort and attentive to his needs, she told him each step of the process and gave him choices to make him feel in control of the situation. For example, she asked him if he wanted her to spray his teeth with water or to drink from a cup himself. Usually, he doesn’t mind the water hose and suction, but he asked for a cup of water to rinse instead. Because of his sensory defensiveness, we always have to coax him to open his mouth wider, but he was cooperative, and she was able to clean his teeth successfully. Fortunately, Alex’s good daily dental hygiene habit of faithfully brushing his teeth twice a day with a sonic electric toothbrush pays off in that he had very little plaque that needed to be removed. When she was done, she enthusiastically praised him for doing such a great job. I think she was especially impressed––as was I––that he pulled himself together so nicely even though he started the session with some trepidation.

As we waited for the dentist to come and check Alex’s teeth, his hygienist asked him if he had any questions for her. He immediately asked her if he had any cavities. She told him that she didn’t see any, but the dentist would check that for him. While the dentist checked Alex’s teeth, his hygienist sang Alex’s praises, telling what a good job he did cleaning his teeth daily and how well he had cooperated as she cleaned his teeth. This seemed to make Alex (and certainly his mother) proud. After the dentist examined Alex’s teeth, he stated that everything looked good, there were no cavities, and he would see Alex again in August for his next six-month check-up.

Despite any fears Alex had about going to the dentist, or for that matter, any fears we had about taking him to the dentist, everything went remarkably smoothly. Even though he was a bit anxious, we were proud of the way he handled himself, never getting upset, calmly admitting his nervousness, and quickly calming himself so that he could do what needed to be done. Needless to say, his behavioral therapist, who has taught him many ways to cope with anxiety, was delighted to hear how well he had dealt with his nerves at the dentist. Of course, we were not only pleased with how well Alex coped at the dentist, but also with getting a good report that his teeth are healthy. Once again, we find ourselves grateful to God for the progress Alex continues to make in dealing with anxiety and for the kindhearted people who work with Alex and bring out the best in him. Most of all, we are thankful for Alex’s faith in God that helps him fight his fears, knowing that God watches over him and brings him the calm he needs whenever life overwhelms him.

“For the Lord your God is living among you. He is a mighty savior. He will take delight in you with gladness. With His love, He will calm all your fears. He will rejoice over you with joyful songs.” Zephaniah 3:17