Martin’s Dejection

This post is titled “Martin’s Dejection.” It’s more about my elation.

Martin has been going through a biting phase. He has a mild oral fixation; he also grinds his teeth and thrusts his lower jaw forward. In the case of biting, if he finds himself with his mouth open and pressed against flesh, such as when I’ve picked him up and his head is on my shoulder, he exercises the oral fixation by tightening his jaws against what is conveniently before him—flesh. It’s more a crime of opportunity than malicious, or even particularly intentional, biting. Nevertheless, Adrian and I are keen to put a stop to the behavior, ASAP.

When he bites, typically I kneel, stand him before me, hold his face firmly, and say, “No biting. We never bite. Never.” Then I make him repeat, “No biting,” several times, apologize to me, and hug. This method has not been particularly effective, but I’ve been at a loss as to what else to do. The primary problem is that Martin is not yet good at reading faces, or judging the seriousness of a situation, so his reaction is to laugh, to cry from distress, or to look away and exit the situation by doing something cute. (Our RDI therapy is aimed, in part, at helping Martin read faces better.)

This evening I was getting Martin ready for his bath. As I completed one HANDLE exercise, Martin ended up with his face against my neck, and he bit. He was sitting on a changing table, at my eye level, so I left him there and started my usual admonition.

After a few seconds, Adrian emerged from the bathroom, where he’d been preparing the bathtub. He brushed me aside, seized both of Martin’s wrists, lowered his voice and spoke very slowly, enunciating in a manner I’d never heard before: “Martin, look at me. You cannot bite Mommy. You cannot bite anyone.” Martin tried to smile and wiggle away, but Adrian stood his ground, holding Martin’s wrists. I remained behind Adrian, looking over his shoulder, with my arms crossed and wearing the most serious expression I have.

Martin looked from Adrian to me and back again. After several seconds he lost his smile. He stopped trying to free his wrists from Adrian’s grasp. Finally, a pure, unaffected look of dejection crossed his face. He didn’t cry, as he does instinctually against being restrained.  Nor did he protest. It was a new look for Martin. In that moment, it appears, Martin understood that he’d done wrong, and he felt bad about it. He seems to have experienced an emotion something like guilt, or sadness.

The moment passed. Martin said quietly, “Sorry, Mommy,” and allowed Adrian to take him to the bath.

His dejection was my elation. We may have turned another corner.

Shortcomings

Shortcomings. I have them.

Martin and I are headed to Chicago on Sunday. We have a Monday morning appointment to see his excellent Track Two doctor. This afternoon the doctor’s nurse called and said that they are missing blood results, some testing we were supposed to have done. I remembered that I never had the testing done. The prescription form was attached to paperwork that I turned over to Adrian to seek insurance reimbursement. By the time I went looking for it, the prescription had disappeared. And then the whole thing slipped my mind. I suppose I thought maybe the doctor would … forget that she prescribed this blood work for Martin? Of course, she didn’t.

The Big Imposing Hospital sent me a notice recently, too, inquiring about the blood testing the geneticist wanted. I don’t feel so guilty about that one; the geneticist said there was little chance that we would learn anything from blood work. Still, I should have had it done. I could have had LabCorp draw the blood at the same time as the blood for the Track Two doctor. My bad.

And then there’s the lipase. It’s been in Martin’s supplementation/medication schedule since our last visit to his Track Two doctor ten weeks ago. I was supposed to start giving it to him two weeks after that visit. (We “ramp up” to new supplements.) I waited the entire two weeks before I went looking for a compounding pharmacy that could fill the prescription. I had no idea how to find a compounding pharmacy, and by the time I finally woke up and asked Kathleen Reily for the name of one, the lipase prescription too was gone. Poof! Someday perhaps I’ll find it behind a heat register or under a cabinet in my home office.

So much gets done. I’ve promised not to beat myself up for what doesn’t.

HANDLE this!

Martin has been a little off this week. Not in the same way as last week—his attention span is back up (thank goodness). Instead, he lacks coordination and balance, he’s restless at bedtime, and he’s had a couple difficult nights. (We used to have terrible troubles with Martin’s sleeping, which were misdiagnosed by the experts at the Big Imposing Hospital as Restless Leg Syndrome, or RLS; Martin’s sleeping was more or less the first thing that improved when we started treating his autism biomedically.) I attribute this week’s symptoms to the fact that, on Monday, we visited his HANDLE therapist, Katie Penque.

Of the various therapies in which Martin participates—RDI, PT, OT, speech therapy—HANDLE therapy has proved to be surprisingly powerful. Counter-intuitively so, even, as it relies on simple and gentle “organized movement activities,” like tilting Martin slowly backward and forward, or tapping my fingers across his skull in a particular pattern. The therapy is designed to help Martin gain better control over his physical self, his movements, his actions.

We noticed immediately after we began HANDLE therapy, three months ago, that Martin had a series of restless nights and seemed a little discombobulated during the day. Katie advised us to reduce the HANDLE exercises, then work back to full capacity. We did so. Even so, I sometimes have to skip a particular exercise because Martin seems to resist it. (In HANDLE language, this is called a “state change.”) But more or less, we got the hang of it and proceeded accordingly.

Now we see restless nights after a visit like Monday, when Katie evaluates his progress and recommends new, more advanced exercises. This week we added “hoop elevator,” in which Martin stands still whilst I slowly lower a hoop around him, from his head to the floor and back up again. We also added “joint tapping,” which is about what it sounds like, i.e., me tapping Martin in a bouncy motion at various joints. Doesn’t seem like much, right? But even Katie doing the exercises with him on Monday, to show me how, set Martin on a course of nighttime restlessness and diminished coordination. It was Thursday before I could complete any HANDLE exercises at home without him resisting.

As Adrian and I see it, the HANDLE therapy is as successful with Martin as it is occasionally overwhelming. Martin truly is more in control of himself. He remains still for longer, and many of his movements have lost the clumsy jerkiness sometimes associated with ASD. The improvements are evident even when he sleeps. Martin used to circulate the bed during the night. Head at the top of the bed. Head at the foot of the bed. Head hanging off the side of the bed. Feet up the wall. Blankets on the floor. He continues to toss and turn, like any toddler, but for the most part he has become able to keep his head on the pillow, and a light blanket approximately over his body, from sleepy-time till morning.

It’s Friday night, and he has evened out since Monday. This weekend I will introduce the more advanced HANDLE exercises and see where they take us. I enjoy that Martin no longer attracts curious glimpses from passers-by, who look as if they can’t put their finger on why he appears different from other kids. Day by day, he looks more and more like the others at the playground.

Recovery Recipe: Veggie Pancakes

This morning Martin had his favorite grain-free pancakes, made with duck eggs instead of chicken eggs. He did not seem to notice any difference. Samara tried the pancakes and said they were as tasty as always but that she was having trouble getting past the idea of eating duck eggs. Whatever eggs you use, these pancakes are protein-packed and deliver a hefty serving of vegetables, too. In terms of the vegetables, this morning I pureed a yellow summer squash. I have also made these pancakes with butternut squash, acorn squash, and cauliflower; I find that with those more wintery vegetables, it helps to dice and steam them before pureeing. No steaming is necessary with a tender vegetable like summer squash. This recipe is adapted from one I saw on Pecan Bread.

1 cup pureed vegetables
3 chicken eggs or 2 duck eggs
1 tsp cinnamon
1 tsp vanilla
coconut or macademia oil

Mix all ingredients other than the oil well. If you are using a food processor, put the eggs in last and don’t let them get too foamy. (Usually I puree the vegetables in the food processor but whisk the eggs by hand and then mix everything together by hand.) Heat the oil in a large skillet and pour in batter a few tablespoons at a time. Cook until the pancakes until they are firm on the bottom, then flip them and cook for another minute or two. They come up oily, so I usually drain them on a paper bag before serving. As a bonus, especially when cooked in coconut oil, these pancakes leave a delightful sweet smell lingering for hours in my kitchen.

Recovery Recipe: Sunflour Patties

I’m going out tonight, so I just threw this together and left it, unbaked, in the refrigerator. Samara, who is staying late, will just have to bake the dish for Martin to have a fresh dinner. This is adapted from a recipe I saw once on the Pecan Bread site. One nice facet of this recipe is that, whereas nothing is actually fried in oil, and the baking temperature is not too high, you can use a variety of unrefined oils. Today I used walnut oil.

1 cup sunflour
1/2 cup finely grated squash
1/2 cup finely diced celery
2 tbsps minced turnip (used to be onion, but we lost onions on Saturday)
1 tbsp minced celeriac (used to be bell pepper, but we lost peppers on Saturday)
1/4-1/2 cup minced fresh herbs
1/2 tsp dried basil
1/4 cup vegetable juice (I used squash juice, another creation of my nighttime activities)
1 egg, whisked (today, a duck egg, thanks to the detective work of Adrian)
1 tbsp oil
1/2 tsp kelp granules or triple-blend seaweed flakes (I often use in place of salt)

Mix all ingredients well and pat into a lightly oiled rectangular glass baking dish. Bake 25 minutes at 350º and cut into patties.

Duck Eggs

We’ve lost some more foods.

A couple months ago I took Martin to Connecticut see a naturopath-allergist, who used a metal rod and a fancy computer set-up to test Martin for sensitivities to different phenols. This testing was at the recommendation of Martin’s homotoxicologist, who also referred us to this naturopath. The panels came back and said Martin is sensitive to a lot of foods he currently doesn’t eat anyway (soy, corn, milk protein, potatoes, berries, etc.) and also some foods he does eat—a lot. Foods like garlic, onion, eggplant, peppers, and egg whites. That allergist said we must avoid all those foods. Then he gave me some drops that I was supposed to add twice daily to Martin’s routine, diluted forms of the phenols that would help Martin overcome his sensitivities.

After that appointment I made the mistake (or not?) of getting on the phone with my older brother Rudy, who suffers from numerous allergies. Rudy said he’d been to a naturopath who used a similar metal-rod testing method, then later found out that “the whole thing was bunk.” The drops he was prescribed were too diluted to have any effect. Moreover, he’d read that the tests themselves don’t work, that you can be tested on different days and get totally different results. A waste of money, Rudy said. He even backed up his opinion by sending me a handful of links to people making the same complaints about this testing method.

In truth, I had not liked the naturopath. He had said dismissive things about other facets of Martin’s treatment—“You can’t starve out yeast from the gut. That’s just ridiculous to try”—and blown off the questions I raised about food sensitivities. He had talked down to me, which is hard for me to countenance. This general distaste for the naturopath combined with Rudy’s warnings and left me with a negative impression about the whole experience. I kept garlic and onions and eggs in my cooking. I never did start the prescribed drops with Martin. I was supposed to pull out Martin’s lower lip and let each drop sit on the lip for three seconds. For crying out loud, what three-year-old would let a parent do that?

The next time we visited the homotoxicologist I voiced these concerns and told her I hadn’t liked the recommended naturopath one bit. She said, however, that she believes in the testing method, and that if the first naturopath wasn’t a good fit, she could recommend another, one better at taking the time to address my concerns. I pondered. I did some more research on-line—here’s a good time to point out the unreliability of on-line research—and found some additional testimonials about the allergy testing method (it’s called the Orion® system, and I did not have an easy time finding information about it). Finally I fell back on my mantra: If I can’t find any evidence that a treatment will hurt Martin, I’ll give it a try.

And so Martin and I spent Saturday morning in the office of a second naturopath-allergist, Darin Ingels, ND. Indeed, Dr. Ingels was a better fit for me than the first allergist. He listened patiently to my concerns and did a lot of explaining. We clashed over the issue of vegetarianism (a subject for another post), but he seemed to respect my opinions. He said nice things about Martin. Most importantly, he also used the Orion® system, and the results came back exactly the same as the first allergist’s. (I did not mention that I’d seen another allergist previously.) This put to rest a lot of my Rudy-generated fears about inaccurate testing or different results from day to day. Finally, this allergist allowed that I could put the prescribed drops onto Martin’s wrists and rub them in. I can live with that.

Based on this second set of tests, I am admitting that maybe we do need to lose garlic, onion, tomatoes (were limited anyway), peppers, eggplant, nightshades, and eggs from Martin’s diet for six months or so, further narrowing his universe of allowable foods. Garlic and onion will be tough; they are mainstays of my cooking. But eggs will be worse still. Since adding eggs to Martin’s diet several months ago, I’ve become quite dependent on them for breakfasts and baking, and my mother uses them in her baking for Martin, too.

No problem, the allergist said. Try duck eggs, or quail. You can bake just as well with those, and they are a totally different protein than what Martin is sensitive to.

That was Saturday. Today is Wednesday. In between I’ve visited two Whole Foods Markets and two natural-foods stores, to no avail. I may have found the one item in desperately short supply in New York City: duck eggs. Next up, the farmers market. If I don’t find duck eggs (or quail!) there, I guess it’s on to . . .  an actual farm?

The Marvelous and Amazing Napkin Hand-Off

Adrian is a fastidious man. Among his many missions in life is to teach Martin the proper use of a napkin. He insists that Martin not eat without a napkin within reach. In the event that Adrian sees a sleeve rub across a mouth, he springs into action, cleans the sleeve, and assists Martin to use his napkin instead. So he was tickled pink last week when Martin, supervised at breakfast by me (of course), realized he had no cloth handy, thrust his squash-fry-oiled little hands into the air, and demanded, “Napkin!”

I am not a fastidious person. The napkin demands echoing through our apartment tend to annoy me. Not this evening, though. This evening I witnessed a miracle:

It was dinner time. Martin and I were sitting on stools in the kitchen watching a Sesame Street DVD while he ate. Adrian, unusually, was at home, so I was doing my part to ensure that Martin had a napkin. At some point during the meal, Martin wiped his hands, then tossed the napkin to the floor. I picked it up and explained that we don’t toss napkins to the floor.

A few minutes later, Martin’s hands were messy again, and I handed him the napkin. He wiped his hands. Almost without thinking, I kept my hand resting in my lap but turned the palm upward, in a subtle, unspoken suggestion of, “All right. Give it back to me.” Just as casually, without taking his eyes from the television screen (he must have seen my gesture from the periphery of his vision), Martin reached over and dropped the napkin into my hand.

Without words, without requiring exaggerated motions or repeated promptings, Martin caught, understood, and obeyed a tiny gesture. Kids on the spectrum really don’t do that. They don’t read faces. They seldom respond to commonplace non-verbal communication.

It’s true that Martin’s action may have been accidental occurrence. But I hope instead it was the breakthrough we’ve been waiting for, after a long week of diminished attention.

When I’m asked how I know that Martin is getting better, I often resort to accurate but indefinite answers like, “He is aware of his surroundings,” or, “He’s just more . . . present.”

If anyone inquires in the near future, I will answer, “I know he’s getting better because he dropped a napkin into my hand.”

And I will leave it at that, because a miracle allows no explanation.

The Stars Aligned / I Salute You

Before I blog much more, I want to make this clear: I know that I am very lucky in the time and resources I am able to devote to Martin. The stars have aligned for Martin’s recovery. I work at home, with hours that are mostly flexible, earning wages enough to cover private therapies and nanny expenses. Adrian’s work gives us excellent insurance (though not excellent enough to cover most autism treatments) and disposable income. More importantly still, Adrian is 100% on board with Martin’s regimen, a true partner. Martin is our only child. We live in New York City, up to our elbows in Whole Foods Markets and with a local natural-foods store on every second corner. My regular grocery is Fairway, which has an organic produce section the size of Jupiter’s largest moon. My mother is retired and happy to devote her time to baking Martin’s specialized muffins and cookies. Martin’s nanny is an early-childhood-education student who has thrown herself wholeheartedly into assisting with his recovery. When it comes to the support needed to move a child toward neurotypicality, I can’t imagine that anyone has it better than I do.
 
I think it may seem overwhelming, reading this blog about all-organic and homemade restricted diets, 3x/day supplementation routines, building a toxin-free home and kitchen, flying halfway across the country for doctor visits, RDI therapy, HANDLE therapy, Track One specialists, and so forth. In truth, it’s overwhelming to me. Even as I sit here writing this—it’s 12:34 a.m. Monday, laundry is strewn about our apartment in various states of dryness, and 8.5 hours from now I need to be driving Martin to Westchester for an appointment—I feel a little like I’m drowning in what did not get done this weekend.
 
I am not going to pretend that autism recovery is an easy process. To the contrary, what I want to acknowledge is that most parents have it far more difficult than I do, and that I do not consider the extent of recovery activities described in this blog realistic for every family. To everyone out there who is taking any action toward helping a child recover, I salute you. A special shout-out to single parents, parents without supportive partners, families with limited resources or inadequate healthcare, those who lack easy access to natural-food stores and organic grocers, non-English-speaking populations having trouble finding information in their language, the sleepless, the overworked, the stressed. I don’t know how you do it.
 
Autism is an epidemic. We’re in this together. Whatever action you can take toward recovery, no matter how small, is one battle in the war against this condition. Thank you for all that you do.

Potty Humor Progress

Yesterday we visited a new allergist, an N.D. with offices in Manhattan and Connecticut. He ran a battery of phenol profiles on Martin. When those were concluded, Adrian took Martin for a walk so I could chat with the doctor. At some point in that discussion, the doctor said this of Martin: “He really doesn’t strike me as a kid with Asperger’s.”

My heart leapt. This was a statement from a man who works extensively with children on the spectrum.

The doctor continued by remarking on Martin’s sustained eye contact, and the way Martin had laughed when I made a joke to entertain him during the phenol tests. (A stinky-feet-related bit of potty humor, but a joke nevertheless.) Humor, the doctor said, is a nuanced cognitive function, scarce in Asperger’s children.

I responded, “Thank you. This isn’t the same kid we had when that diagnosis was made. We’ve come so far already.”

My mind flew back to the days when Martin made almost no eye contact, when he spent his time wandering the perimeter of the room, running his hand along the walls. And I thought, We really have. We’ve come so far already.

Recipe: Nut Burgers

I adapted this recipe from page 461 of Vegan Planet (the cookbook author also blogs), just substituting sunflour for bread crumbs and increasing the amount of fresh herbs. I love this recipe because (1) it has good protein from three different nuts, and the seeds in sunflour; (2) it pairs well with a veggie side dish; and (3) it’s just darn tasty, and I can use it for Adrian as well. This week Adrian’s brother is staying with us. I made this recipe for Martin. After Martin went to sleep I popped some commercial French fries into the oven, added salad and toasted buns to the nut burgers, and called it “diner dinner.” Adrian and his brother thought this ensemble made a great meal.

3 tbsps olive or other cooking oil
1/2 cup minced onion
1 cup cooked lentils
1 cup chopped raw walnuts, soaked and dehydrated
1/2 cup raw cashews, soaked and dehydrated
2 tbsps raw almond butter
2/3 cup sunflour
1/4 cup minced fresh herbs
1/2 tsp sea salt
1/8 tsp ground black pepper

Cook the onion in 1 tbsp oil until softened. Transfer to a food processor and add all ingredients except the remaining oil. Process until well blended, then form into six patties. Heat the remaining oil in a large skillet and brown the patties on both sides. Yummy.