Autism

The Result of Years of Neglect

Published May 24, 2009 @ 12:33AM PT

Hospital room from http://www.martin3d.net/sitebuildercontent/sitebuilderpictures/hospital_room.jpg
Like most every family with an autistic child that we know, we've done a lot for Charlie since we knew he was autistic back in 1999, from educational therapies (ABA, speech, OT), to biomedical treatments when he was younger, to more "traditional" medical ones. We've moved several times to find the best educational placement for him; we've given up jobs (a tenured full professorship, in Jim's case), taken whatever jobs came our way, and spent (poured) a significant portion of our finances in to paying for Charlie's needs. Sometimes things haven't always worked out quite the way people told us they would (like a one-time visit to do cranio-sacral therapy on Staten Island, or various medications and supplements). Sometimes we've really had to say to ourselves, what were we thinking?

At which point, Jim and I have reminded each other of what is a sort of promise we've always made to Charlie, that we'd do everything we could to help him, support him, teach him, and that we'll always be with him, every step of the way.

But what if we had not done all this? If we'd just said, we'll just let Charlie be, that's the way things are? If we just......did nothing?

I'm guessing he wouldn't be with us anymore, for one thing. And that he couldn't say even the short phrases he does. He certainly wouldn't be riding bikes from town to town.

Seeing what's happened to my mother-in-law, who's had psychotic depression on and off for the past fifty years, has been making me think a lot about what would Charlie be like without all of our efforts, and his.

My mother-in-law's depression has not been properly treated for all these years. She'd been in and out of psychiatric hospitals while Jim and his sisters were growing up. She's been on various medications for many years (one reason why, though she's about my height---5 feet tall---she weighed at least twice as much as me when I first met her). But more than my mother-in-law's psychotic depression going untreated, what's harmed her immensely has been the denial of her condition: While it's acknowledged that she's had mental health issues, the extent of these has been unacknowledged by everyone except for Jim, who's very close to her---her biggest fan---and credits his interest in history and stories to her. Back in the 1950s, she had a job selling ads for WOR in New York and loved it. She married my father-in-law in 1953 and has never worked since.

I met my in-laws in 1994. They mostly stayed in their house. On a rare visit to see us in St. Louis (where Charlie was born in 1997), my mother-in-law was the first to suggest that something "wasn't right" about Charlie, sitting quietly on the hardwood floor, absorbed in a sunbeam). In 2006, both in-laws had to have knee replacement surgery. My father-in-law returned home in June, just around the time that we moved into their house, so that Charlie could start attending the town's public school autism program. My mother-in-law did not return for months. While in a physical rehabilitation facility with her husband to learn how to walk again, she became more and more depressed. She was in a catatonic state when Jim (no one else thought anything needed to be done) had her placed in a psychiatric facility. She got better there after a lot of therapy and was able to return to the physical rehabilitation facility where she learned to walk again (somewhat---she has a huge fear of falling) and enjoyed trivia nights and the company of her roommate.

Once home, things returned to the way they had been (except, of course, my in-laws' household now included Jim, Charlie, a live-in nurse from Ghana, and me). My mother-in-law once more rarely left the house. While some efforts were made to attend to her mental health---a psychiatrist (who turned out to be a child psychiatrist) was found---not much else was done. Jim spoke up constantly for her needs, both when we lived with my in-laws and after we moved into a condo of our own, but it was not felt that more needed to be done, according to the rest of Jim's family. Jim repeatedly brought up the matter of getting more psychiatric treatment to his father and sisters, but these appeals went nowhere.

My mother-in-law has been in the hospital since two Fridays ago. She was brought by ambulance with inflammation of the pancreas. Jim and I have been to see her a couple of times and it was quickly apparent that she was hallucinating: She thought her younger sister, who died last summer, had visited her. She thought her husband was in the room. She saw the edge of my scarf and asked me if it was soft-serve ice cream. She didn't know what month it is, and thought her husband was shopping in New York (he hasn't done that in I don't know how many years). We went to see her yesterday and she was rigid in the bed and asked us repeatedly for blankets. Jim's been talking to the nurses who told him, this is a hard case.

There's a lot more I could say; there's a lot that could have been done, had the extent of her depression over the years been acknowledged, and real, long-term treatment sought.

We've tried very hard to be honest about Charlie's needs and challenges, and the extent of the severity of these. It's not easy to do this and it's sometimes meant taking measures that I'd rather not have had to do, but that have helped Charlie. And if my mother-in-law could have had her needs fully addressed years and years ago-----I don't think we'd be standing at her bedside now hearing her talk about people who aren't there, scared to ask for another blanket.

Jim got her two more and I asked the nurse for another one, and I'm looking for a fleece blanket---the kind that Charlie asks for and loves and that we have many of, for calm and comfort---to give her, at our next visit.

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Comments (16)

  1. Hai Dang

    I am sorry to hear about the condition of your mother-in-laws.  I hope that she is getting better soon.  I agree with your statement about being "honest about Charlie's needs and challenges."  I was in denial when my oldest son diagnosed with autism at the age of five.  I knew something was wrong, but at the time my wife and I had our own careers and unrealistic dreams that our oldest son would eventually "growing out of it."  During the last nine years after accepting the new reality, we have worked hard to be honest about the needs and challenges of our three children to the point that some of our relatives think we are "overly worried" parents.  We also have given up our career choices in order to help our children.   Our dreams are to have our children to be able to speak up for themselves and to have a fighting chance to live independent as adults.  We [my wife, me and our kids] have fought hard every day to keep alive the dreams.  “We shall overcome.” 

    Posted by Hai Dang on 05/24/2009 @ 01:57AM PT

  2. Kristina Chew

    thanks so much and share your dreams for your chidlren---it's especially ironic to me that, while I was in denial about Charlie's diagnosis in 1998 (he was only about 17 months old), my mother-in-law was the first and only person who had concerns about his development. I've always been grateful to her for that.

    Posted by Kristina Chew on 05/24/2009 @ 07:46AM PT

  3. @Hai. Thanks for sharing your story. I really liked your story because you talk about struggling to be a good parent. And how you balance things out in your life doing the best you can to be honest and meet the needs of your autistic child.

    I don't think it is about treatments or cures. There are books like Patience mentioned, and things parents do on their own like music or art because parents  are nurturing their child's talents.

     It about being the kind of  parent you want to be for  your child or any other child in the family. Nurturing a loving relationship with your child and their siblings; positive attitudes as much as possible and meeting the best you can their challenging needs. It's about having a balanced life. Doing your best is not the same as striving for perfection. Being a human being is more important than anything else.


    But will society respect all human beings? I was so sad yesterday because families still get stigmatize for having an autistic son or mentally retarded brother. Even by people who volunteer to help autistic and mentally retarded.  I still have tears today! Even in the nicest cities, (our city is known around the country for the best place to live), people remember the past and don't want to hear about the good news. You are trap. If you answer their questions with happy news you get looks of shame and comments of disgust.They don't want your child to exist. There is no safe answer. It still hurts. But I guess I get to see the real people I meet. So I gain knowledge that others don't.

    I love my child more than ever. I am so thankful my son was able to get a new start in a new city. He looks, acts etc autistic. But he is accepted on his own terms. Society needs to let she/he and his family be who they are. What would the world be without our children?

    Posted by L I on 05/25/2009 @ 01:50PM PT

  4. Hai Dang

    I completely understand your sentence "Even by people who volunteer to help autistic and mentally retarded."  Even being a parent, I do have good and bad days.  I learn to reminded myself that some of the behaviors of my children were manifested by their disabilities.  Their lack of communications make a simple problem becoming worse one.  That is why my wife and I work hard to improve their learning and communication skills.  It is not only for our own children but also for our own sanity.

    Posted by Hai Dang on 05/27/2009 @ 01:09PM PT

  5. @Hau, "Their lack of communications make a simple problem becoming worse one.  That is why my wife and I work hard to improve their learning and communication skills.  It is not only for our own children but also for our own sanity".

    Good point, Hai.
    At times I can see it is necessary for autism parents to be motivated for the sake of their own sanity. We have to be there for our kids and yet the challenges can be too much. Trying to reach our child during meltdowns and shutdowns. Trying to communicate with a non-verbal, agitated child. Ordinary things in life become a crisis because the child understands things differently than us. That was the most frustrating part for me.

     Doing so much as parents with little outside support and little resources. It is amazing that our children and us survived at home and in society .

    Posted by L I on 05/27/2009 @ 07:33PM PT

  6. Reply to thread
  7. Katie miller

    I'm also sorry to hear about your mother-in-law. What you said about Charlie not being where he is today if you had just "done nothing" really struck me. It seems that some critics of the concept of neurodiversity think that  "doing nothing"  for Autistic people is somehow what we advocate for. Of course, nothing could be further from the truth! Of course Autistic people like Charlie need lots of support, care, and education! The right support can be the difference between a good and a poor quality of life! If only all Autistic people got the same care and support that you and Jim give Charlie.

    Posted by Katie miller on 05/24/2009 @ 07:38AM PT

  8. Kristina Chew

    I think I was channeling that notion of neurodiveristy and "doing nothing" when I wrote those words. I just hope we've done enough for Charlie.............. seeing what's happened to my MIL has Jim and me all the more aware of why we do what we do for Charlie; how doing this means that one has to go above and beyond.

    Posted by Kristina Chew on 05/24/2009 @ 06:57PM PT

  9. Shondolyn (Synesthesia) Gibson

    I was thinking that when I was reading all these posts from anti-neurodiversity people. What they say couldn't be further fromt he truth.

    Posted by Shondolyn (Synesthesia) Gibson on 05/24/2009 @ 11:00PM PT

  10. Phil Schwarz

    Indeed.

    The notion that pro-neurodiversity people -- autistic self-advocates and their allies -- advocate "doing nothing" for autistic children (or adults!) is rubbish.

    It's actually worse than that: it is a pernicious lie that is spread by those who fear encroachment upon their hegemony, whether that be funding and policymaking regarding autism, control of autism organizations, application of reasonable standards of science and ethics to questionable commercialized "treatments" and "cures", or even what they as individual family members (sadly and incorrectly) see as a zero-sum game, a finite pie of benefits that they and their loved ones will get less of if disturbed.

    When we question or criticize a particular intervention, treatment, or teaching model, we do so on the merits and demerits of the particular intervention, treatment, or teaching model -- not because we think nothing should be done.

    And all too often the things we think -- and *know*, many of us, from personal and family experience -- will be helpful or even critical to improved quality-of-life for autistic people, are ignored by the mainstream, and *particularly* by those who make false claims about us.

    Another false claim often repeated about pro-neurodiversity people is that we ignore the existence and needs of severely disabled autistic people.  Nothing could be further from the truth.  Many of those things we push for -- for example, AAC and its use to develop means of trusted, reliable, and respected expressive communication for autistic people who do not have expressive speech -- are more critical to improved quality-of-life for severely disabled autistic people than to many other sectors of the spectrum.

    And yet another false claim is that all pro-neurodiversity autistic people are so-called "high-functioning".  That is patently false.  The board of directors, membership, and broader community of just one organization, the Autism National Committee (http://www.autcom.org), have many so-called "low-functioning" members who share pro-neurodiversity perspectives and priorities.  And there are many other so-called "low-functioning" people not connected with AutCom who have spoken out similarly.

    And Kristina and Jim, for what it's worth, you have done a marvelous and thorough job providing Charlie with every opportunity that makes sense.  And I think, despite the ups and downs, that he has come a long way.

    And I am sorry to hear about Jim's mother's situation.  I hope she is able to heal, physically and mentally.

    Posted by Phil Schwarz on 05/25/2009 @ 08:07PM PT

  11. @Phil. "And all too often the things we think -- and *know*, many of us, from personal and family experience -- will be helpful or even critical to improved quality-of-life for autistic people, are ignored by the mainstream, and *particularly* by those who make false claims about us". 

    Powerful words IMO because it is all about quality-of-life. Exactly. We need to look at what families are doing for themselves from personal and family experience.

    (IMO) We have stressed Research too much. I think research is important but it is slow and the person doing the research picks the question and the sample group. The research might not even be based on our child's diagnosis. I have never really seen any research on Childhood Disintegration Disorder, my son's diagnosis.

    We need to use research to validate results. To know we are doing things right. Research will take forever to figure out all the things we need to know to help our kids. There isn't much research or books on teens and adults. There is still fear of the unknown in later years because there is no safety net and little published knowledge of what parents need to know.

    What are we suppose to do- wait for research, wait for books or what? I don't have a close relationship with another family with an autistic child. How can I learn from someone else? Most of us are raising an autistic child alone. Some have family that are supportive. This blog by Kristina and Dora is most helpful in talking to other parents and not feeling alone. It was exciting to talk to a sister with a brother (who is a musician). I felt someone understood the challenges of having an older age sibling.

    The only good knowledge I got about the later years was anecdotal stories from other parents who were put in a difficult position of having to make some immediate choices because of the situation they were in with their child without the benefit of published information. I also got great feedback from my brother/son. Great Teachers.

    We need the anecdotal information Phil is talking about- personal, child and family experiences. Sometimes it takes more than one approach to deal with meltdowns, agitation, communications, social skills etc.

    Some parents have figured out some positive ways to help their kids. I would rather not reinvent the wheel.

    How do we get quality life for our teen/adult children?

    Posted by L I on 05/25/2009 @ 09:48PM PT

  12. Reply to thread
  13. Karen D

    I'm so sorry to hear of your MIL's struggles.  I believe depression over the long haul, untreated, changes one's brain chemistry.  I sincerely hope that the right course of treatment is found for her and she can recover. xo

    Posted by Karen D on 05/24/2009 @ 08:59AM PT

  14. Twyla Ramos

    I wish there were some words I could say that would make things better – casting a spell that would change your mother-in-law’s life or at least ease the emotions that you and Jim are feeling – or forming a prayer (unfortunately agnostic) that would have more effect than all the prayers which have no doubt been said over the years.  I wish that platitudes such as, “Everything happens for a reason” would be comforting.  I wish that the causes of severe depression were better understood. 

    Sometimes the amount of distress that we feel is in proportion to the amount of love that we feel.  Someone once said that when we love, we allow our heart to leave our chest and walk out and about in the world.  We would be much less vulnerable if we kept our heart in our chest and did not love anyone, especially not with the huge love that we feel for our children and parents.  Someone else said that we feel distress in proportion to not having control – such as the power to implement the best treatments over the years, and the power to change the current situation. 

    I guess all I can do is express my sympathy and my hope that things will go as well as possible, and the hope that the many prayers and good wishes your post will inspire from around the world will help to buoy your and Jim’s spirits at this difficult time.

    Posted by Twyla Ramos on 05/24/2009 @ 12:47PM PT

  15. Kristina Chew

    Thanks to everyone for your kind wishes. My mother-in-law's health (esp. her mental health) has been a long-term issue, but I only started to grasp it, and the troubling family dynamic that denied the extent of her illness, when we were living with my in-laws (2006-7). Decisions about her care currently rest with her husband and Jim has tried repeatedly to convince his father that she needs _much_ more care than she has received over the years. Just hoping we can keep her comfortable and let her know that she is loved.

    Posted by Kristina Chew on 05/24/2009 @ 06:54PM PT

  16. Shondolyn (Synesthesia) Gibson

    I hope she gets better soon...

    Posted by Shondolyn (Synesthesia) Gibson on 05/24/2009 @ 10:59PM PT

  17. Niksmom .

    Kristina, I am so sorry to read what's been going on with your MIL.  It must be so difficult for Jim to not be able (legally) to do more to change the situation.

    You raise such an important question about the cost of not doing anything --whether for our autistic children, our aging parents, etc.  It's such a delicate balance in trying to do something, anything, and doing too much.  Food for thought, for sure.

    I will continue to keep you all in my prayers and thoughts.

    Posted by Niksmom . on 05/25/2009 @ 08:26AM PT

  18. "Judge not thy neighbor until thou art come into his place"
     Hebrew Proverb quotes

    @Kristina. "We've tried very hard to be honest about Charlie's needs and challenges, and the extent of the severity of these. It's not easy to do this and it's sometimes meant taking measures that I'd rather not have had to do, but that have helped Charlie. And if my mother-in-law could have had her needs fully addressed years and years ago---"

    I am sorry about your mother-in-law. "She was brought by ambulance with inflammation of the pancreas." That is a very difficult medical problem for everyone to deal with. (IMO) You have had to deal with two challenging situations at the same time. It stretches you and your family (including Charlie). But you are dealing with this some how. You are a very strong person and caring-trying to do whatever is possible for each person.

    I think that was wonderful that your mother-in-law was the first to notice Charlie's development. I don't know of many grandparents noticing that there might be a problem.

    It is your own yardstick not anyone else' yardstick that you use to measure success or failure. Afterall, the opinion of the  most important people in your life are what is important. Not someone saying something at this moment in time.

    It's about doing the best you can with the circumstances you were handed. None of my plans when I got married happened. Life is different than what we planned on. Obviously things suffered at times when situations were beyond my control; when things got complicated. And then there are the needs of the other people in your family.

    If you had to go back to the past I am sure (knowing what you knew about the past and not the present or future) you would have made most of those same decisions.

    We are not to strive for perfection because we are human with feelings and needs that coexist with what we have to deal with.

    @"Seeing what's happened to my mother-in-law, who's had psychotic depression on and off for the past fifty years, has been making me think a lot about what would Charlie be like without all of our efforts, and his."

    It's all about what did we have control over in these situations and what was not in our control. I don't have control over what other people say about my son and our family. No one should be judge because we all walk in different shoes. Our family situations and our children are unique. I think when you have an autistic child you are judge more than other parents and that creates doubt.

    If you have seen one autistic child, you have seen one autistic child. If you see one family, you have seen one family.

    Your blogs show that you and Jim care deeply about Charlies' welfare.




    Posted by L I on 05/25/2009 @ 04:59PM PT

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Kristina Chew

Kristina is a Classics professor in Jersey City, New Jersey, a blogger (formerly at AutismVox), a translator (of Virgil), and an advocate every day for her son, Charlie.

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