Saturday, January 10, 2009

Aspie Ups and Downs

Going "back to school" after the winter break is much more abrupt and complicated now that the Boychick is actually going to school. With Homeschooling, the transition was suble and gradual in feel, whereas the transition to the new EMHS semester was accompanied by a countdown to when we return to reality--on a certain day at a certain hour.

The entire end of last semester and the begining of this one was also affected by some academic and social concerns that have added to the stress for both of us. One change was made in November when, in consultation with the Boychick's doctor, we decided to withdraw one his medications. This medication, given at sub-clinical doses, has a subtle but powerful effect on the quality of social interactions and also tends to blunt the cognitive, social and emotional apraxia (that sense of getting stuck at a decision point) that is common to people with AS. The medication in question regulates the neurotrasmitter Dopamine, which in the frontal lobes controls the flow of information from other parts of the brain. Thus Dopamine dysregulation in the pre-frontal cortex causes problems with memory, attention, and problem solving.

What we had noticed starting a few weeks after the medication was completely withdrawn (there was a process of gradual withdrawal), was that the Boychick was beginning to withdraw from social interactions more often, experience more episodes in which he would get stuck at a decision point, and shut down. When these experiences occured, however, he would "throw attitude around" (as his special education coordinatory so tellingly put it), as a substitute for action. During his winter break, the social pressure of needing to perform for peers was reduced, but we still saw these things happening.

The first day back began on a positive note, as Boychick reported it. He was excited about his guitar class, and on the way to Taekowndo, we stopped to get strings and a pick, and again to get notebooks. But as the week progressed, the notebooks in their bag stayed in the car, and on our drives to and from school, Nate listened to music on his I-POD. On Wednesday, he said that he hated his special ed math class. I told him that he needed to continue working on math even though it is hard for him (due to short-term memory issues), but that by doing it with a tutor, there is the opportunity to take frequent breaks when he gets cognitively tired.

On Thursday when I picked the Boychick up to go to Taekwondo he was very quiet. He seemed to have a very good Taekwondo session, and we stopped at the store on the way home. But when we got home, he put his ear-foams in and didn't respond to us at all. It turns out he and the vivacious L., she of the Winter Ball date had an argument. So I commiserated about the ups and downs of a woman's mood, and thought he'd be better after a good night's sleep.

Friday morning began in a rush, and the Boychick was once again not talking to us. But the Engineering Geek and I were rushing to get us all out the door so that we could attend Coffee with the Principal while the Boychick attended his first hour class. We spent about an hour discussing the re-chartering process for the school, and how the charter would be handled. It was interesting and informative, and I then had plans for the rest of the morning at home.

We arrived home, and I had barely poured my cup of tea when the phone rang. It was the Boychick's special education coordinator. He was having a bad day, she told me. He was incommunicative and throwing attitude around when he and Mrs. H., the EA, were trying to help him. As we talked, I checked his meds box, and discovered that he had not taken them. I told her so. We went on to talk about the problems he had been having that week. It turns out that there were several:

  • He had not taken the notebooks we had purchased into school. They were trying to help him get organized and off the a good start for the new classes, but he had no notebooks.
  • He was using his ear-foams all of the time, and was missing important instructional information. Since it is hard enough for him to process auditory information, missing parts meant he had no comprehension of what was happening
  • He had a library fine for an overdue book from October. Since he had not paid it, his account (including his computer account) was suspended and he could not use school-net for his academics. The librarian had spoken to him numerous times, but he had not told me about it, nor had he asked his teachers for help dealing with it.
  • In the despised math class, he was refusing to try the work, and when the special education teacher or the EA tried to engage him, he would shut down or give a display of attitude. The other kids were getting tired of it and trying to let him know.

In short, he was using a new strategy to deal with his apraxia. When he could not solve a problem or make a decision, instead of asking for help or shutting down, he was covering by putting on either the devil-may-care or class clown attitude. We had seen some of this during the last few weeks of school in December, but now the behaviors were coming out in spades.

As we talked, I developed a few hypotheses about what was going on. First, freshman boys tend to come to their first semester of high school using a bit of the tough-guy act to cover for their sense of nerves and inexperience. But by the middle of the year, most of them have discarded that attitude and have gained an understanding about how useful adult help is. But the Boychick, as is often the case, was perseverating in the behavior long after the others had figured out that there were more useful ways to navigate the high school experience.

Secondly, for the Boychick, the glass is not only half-full (the Aspie tendency toward a negative world view) but cracked and dingy as well. Things clearly weren't working for him socially, so he decided that everybody thought he was uncool. So once again, instead of asking for help, he covered with the teen-angst attitude. This exacerbated the social problem, but since he does not read others very well, he was not aware of it.

Finally, by Friday, the Boychick was completely overwhelmed. He could not access the computer. He kept forgetting to take money to pay his fines. He had no notebooks to collect his papers in, and L. wasn't speaking to him. When his Humanities teacher asked him to take out his ear-foams, he did not respond at all. The teacher, thinking he was being oppositional, got angry with him. Thus the phone call.

In discussing the situation with his special education coordinator, I determined that this was a situation in which I needed to take some steps to take the pressure off. So I called the school librarian and determined how much money he owed. I gathered his meds box and the notebooks and drove over to the school, expecting to find a shut-down and very unhappy Boychick.

When the Boychick came from his class to the office, he came bouncing in. I asked him if he was having a bad day. No. He was great, he told me. I pointed out that he had not taken his meds that day and gave them to him. Good. Then I gave him the notebooks and the advance of a few hours on his allowance (he usually gets it on Friday after school). The Engineering Geek and I shrugged at each other and then went to post office. Great? Clearly the Boychick has no clue about how he affects others.

Sure enough, after completing our errands, I returned to the school to bring the Boychick home for Shabbat. The beginning of the conversation was interesting:

Boychick: "You know, Mom, I didn't have my meds and I was completely focused!"

Me: "That's not what your teachers and peers thought, Sweetie. Mrs. R. called me and told me that you were pretty unfocused and having a bad day."

Boychick: "Hmmm. Well maybe I was but then L. made up with me at lunch. So now I am awesome."

That's my Boychick. Everything is black and white. When it's good it's very, very good, and when it's bad, it's aweful. To make a long story short, on the ride home we talked about his apraxia, what it means, why it happens to him, and how it affected every one of the problems he had been having that week. We also talked a lot about the social-language problems that come with AS. We then began to consider how best to deal with these problems. We developed a picture about how to act in class and how to get the best out of the people that are there to help him learn. We talked about the struggle with math,and I explained that the Engineering Geek and I understand that the Boychick does indeed know how to do the operations, if he sees the problem rather than hearing it. We talked about a great many things.

When we were talking about the differences in how an Aspie brain works, and why the Boychick might need to resume taking the medication we had just discontinued, he turned to me and said: "You know, this is the digital age. I wish that instead of needing to tweak my meds, we could just have Intel make a tiny chip and put it in my brain so that it would work like everybody else's."

To myself, I said: That may be coming sooner than you think, kid. But to the Boychick I said:

"You know, those of us whose brains work differently will really have to think about whether that would be a good thing. Although our brain differences create many challenges, they also provide us with great gifts. People like Albert Einstein, the great pianist Glenn Gould, and the inventor Thomas Edison all had Aspie-like characteristics. Our unique ways of seeing the world make us capable of doing great things. Should we want to be just like everybody else.?"

Boychick: "I don't know for sure. But when I'm left alone, I do like the way I think, sometimes. And I think Bill Gates is an Aspie. I think about that when I'm using the computer. And he's a billionaire."

Bill Gates? I think the Boychick may be right. Maybe someday I will be another kind of MOB--Mother of the Billionaire. Sweet!

And if he's a bit like Einstein, that would be great. But I am every grateful that I have never been called to school because my kid threw a chair at his violin teacher. Like Albert did.

I am suddenly feeling sorry for poor Mama Einstein.


Anonymous said...

I find your account of BC's ups and downs fascinating and helpful. As you know, my 14-year-old, "Marie," has some of the same Aspergian issues. I think it's brilliant that you focus on the gifts as well as the challenges (even when you're being called into the school and it would be easy to see the glass as half empty :-))

Elisheva Hannah Levin said...

Hi, Mama Monkey,

I think it is particularly easy to get too focused on the challenges and problems, and I also think that as American society has narrowed their view of normal to the point where even normal people do not fit, it is very easy to lose sight of the quirky gifts of Aspergians. And there are indeed come major concerns with how our brains work that give us tendencies towards depression and negativity. This is why I work so hard to remind myself and the Boychick about the positive side of quirkiness. Especially when I am being called to the school!

christinemm said...

I really liked that you shared this story and wove in general information. This is the kind of honest mom blogging that I would like to see more of on the blogosphere. I ranted about that a month or so ago.

On a different topic, I wanted to ask you == totally not related to this post=== today while on book swapping site I stumbled upon a book I'd never heard of. It is The Bible Cure for ADD and Hyperactivity by Don Colbert. Ther are no customer reviews on Amazon so I have no idea what this book says. Do you know of this book and if so what do you think?

Do you think that in some cases kids who are deficient in certain nutrients or are having what some may call'food intolerances' or even 'food allergies" have a symptom that is like ADD or causes hyperactitivity and when the offending food is gone the behavior is gone and maybe they never really had ADD or ADHD but just some of the same symptoms?

I have an interest in nutrition as in the past my kids have had negative reactions to food that when eliminated turned their behavior around.

I value your opinion and so am curious what you think of food cure or even one that someone says is based on a supposedly Biblical diet.

Also in your learning about the brain and behavior do you happen to have some sources of information about clinical depression and nutrition issues? I recall seeing an ad in the newspaper last year that Yale University was looking for test subjects to do a study about food and depression, that depression is not just brain biology isolated that can be helped with meds, that food or bad nutrition can casue some depression and they wanted more proof of that link.


Anonymous said...

My eldest child left homeschooling for public school as a ninth grader, his choice, and one that I sometimes think was not the wisest course. My middle child is of ninth grade age this year and decided that she would prefer to continue unschooling. (This gives her some opportunities for travel and intensive study that are not compatible with a school schedule.) At the halfway point of your son's first year in high school, how do you compare his academic/social/etc. growth with what you would have expected (based on your experience) had he remained a home educated student? (Unfair question, I know.)


Elisheva Hannah Levin said...


I will find some papers for you about food and depression later this week. In general, environmental factors do influence depression. It is possible that factors and activities that alter neurotransmitter balances in the brain have an effect on neurogenesis (this happens throughout life in certain select brain regions) which in turn has an effect on traits like depression. Of course, depression itself leads to environmental changes that increase the propensity for depression, making a vicious cycle. This is why recovering addicts--who are prone to depression and often use their addiction as self-medication--are taught to pay attention to the environment e.g. HALT (don't get too hungry, angry, lonely, tired).

Sorry, but I don't know anything about the Bible Cure, and the only biblical "diet" I know about has to do with the Jewish laws of Kashrut! However, keeping kosher has evolved a great deal from the Levitical lists of clean and unclean food sources!

Elisheva Hannah Levin said...


A short answer to your question. I think that at the moment, my son's social development is progressing unevenly, as we teach him certain social conventions and skills. The teaching is not so pro-active at this point, as it is in response to specific problems that he must solve. Now that he has chosen school, these problems have become more numerous than they would have been if we had continued homeschooling, but because of the larger number of social interactions, they are also more chaotic!

His cognitive and academic development are continuing as they would have (most likely) even if we had homeschooled, but I think right now, the academics are going more smoothly. Testing helps us remain apprised of his relative cognitive strengths and weaknesses, and so we can predict and pro-actively teach to that pattern. However, problem solving and cognitive apraxia are definitely part of his social skills learning, as well, so this aspect has been accelerated by the social environment.

I hope this helps.

Amie said...

I'm not sure if I mentioned this before, but boychick reminds me so much of my older brother! My brother was never diagnosed or treated for anything though, and he was basically "done" with school by 3rd grade.