The Never-Ending Story

Even now, even with all the progress we’ve made, even with Martin’s upcoming transfer to general education, even with me being able to work part-time outside the home, even when friends and family pin accolades on Martin and acclaim how far he’s come, even with the confidence that he will be able to love independently—

Even now, there are times when I fear my son’s illness still could get the better of me.

For more than a month, Martin has been sleeping poorly. Not as poorly as in the bad old days, when he needed physical restraint to fall asleep and rarely managed more than a few hours consecutively. But his silliness and hyperactivity (reactions to his Lyme protocol?) often steal two hours or more before he can settle, and his anxiety (protocol, combined with life changes like a new school?) disturbs his sleep. The day after such nights, he’s tired, which leads to more silliness and hyperactivity and anxiety, which lead to more sleepless bedtimes, and so goes the cycle.

It’s 5:04 a.m. I’ve been awake since 3:22 a.m., and so has Martin. Initially I hoped he would go to the bathroom and back to bed. Instead, he giggled and complained and snuck into my and Adrian’s room. At one point I found him curled up on the throw rug next to our bed; when confronted, he declared himself unable to rest anywhere else. Fifteen minutes ago, I gave him activated charcoal, to absorb whatever might be causing this vigil. Five minutes ago, I shut the master bedroom door (I’ve moved to the kitchen, to write) so that maybe Adrian can be the family member who gets to sleep till dawn.

Today, beginning in half an hour, I need to make breakfast and Martin’s lunch and handle morning supplements; drive Martin to a doctor appointment for his medical exemption for vaccines; drop him at school; edit a complaint and a legal memo; coordinate drafts of joint prosecution agreements; lead a call with several attorneys; schedule three separate home repairs; continue working through my checklist of activities to prepare Martin for his new school; repair Martin’s trombone before his music instructor arrives; conjure a grain-free organic dinner; help Martin with homework and exercises; repeat the increasingly futile bedtime routine; and use the after-bedtime slot to make Adrian’s lunch and Martin’s “goldfish” snacks.

Though I no longer handle sleeplessness well, I will do all this on less than five hours’ sleep, and then I will hope for a better night, because tomorrow I need to take Martin to Chicago for an optometrist appointment.

These are the times when I trip into a pile of doubt and fear, and when I wonder about just giving up. These are the times when I have to remind myself how much better I have life than other moms with ASD kids. These are the times when I dig deep for every morsel of scrappy resourcefulness I have.

It’s past dawn now, and Martin is in the family room, insisting that daylight means he can get up and watch television.

I’m going to go take care of the trombone. I’m from rural Upstate, so by my reckoning duct tape and ingenuity ought to do the trick.

Compromised

Sunday’s Weekend Edition had an interview with Arianna Huffington about her new book, The Sleep Revolution: Transforming Your Life, One Night at a Time, which reminded me of a post I’ve been meaning to write about sleep.

Or as it were, sleeplessness.

Martin’s early autism was marked by profound inability to sleep. He took an hour or more (sometimes up to three hours) to fall asleep and managed only a few hours before waking again for long stretches, like from 1:00-5:00 am, and then, maybe, sleeping another couple hours. When Martin was awake, I was awake: He yelled and cried, climbed out of crib or bed, and usually needed physical restraint to rest, or for any hope of returning to sleep. (A weighted blanket made no difference.) For more than a year, I survived on as little as two hours’ sleep per night, and considered six hours a luxury. When I did sleep, it was often on Martin’s bedroom floor, or contorted around his body in a single bed, or upright in the chair next to him. I drafted a celebratory post when I could finally lie in my bed even though he was awake, and again the night that I lay awake in bed because I finally wasn’t exhausted.

I’ve said this before, and I believe I will say it many times again: Sleeplessness makes autism so much the worse. Autism is emotional turmoil. Adrian and I have had to fight the system to seek recovery for Martin. I endure constant guilt about whether my own actions contributed to Martin’s condition. I’ve given up on having a second child, and at times I questioned whether my only child would ever live independently. All of that notwithstanding, the single greatest challenge of Martin’s autism, for me, has been sleeplessness. I understand why sleep deprivation is considered a form of torture. When you’ve had only 20 hours’ sleep over an entire week, nothing makes sense. During the most challenging, jittery months, I had to avoid sitting down during the day, because I might fall asleep, wherever I was.

Even when Martin became a better sleeper, I regret to report, I continued to squeak by with too little rest, juggling writing, autism recovery, the bad nights Martin still sometimes had, and as close to a healthy a marriage as I could muster.

Now, three or four years after the Great Sleeplessness, I make an effort to get at least seven hours’ sleep every night, and eight full hours as often as possible. I’m doing pretty well. But I know that my health still shows the effects of having gone so long without sufficient rest. Before Martin developed autism, I caught two colds a year, one in the winter and one in the summer, and other than that rarely was sick. Since the Great Sleeplessness, I’ve endured as many as four major illnesses per year, despite eating a cleaner diet than ever. Nowadays when I feel “something coming on,” I can’t assume that if I take it easy for a few days and lay off the gym, I’ll be fine. “Something coming on” now means that I’m going to be effectively non-functioning. That’s what happened a few months ago, in January: On a Saturday afternoon, I felt vaguely unwell. By midday Sunday, I was coughing uncontrollably. I had to cancel a Monday afternoon flight to California and ask my law partner to cover the mediation I had been scheduled to attend; from Monday afternoon, when Samara arrived (thank goodness, she had been scheduled to come and care for Martin while I was in California) until Thursday, when Samara went home, I stayed in bed. After that, I was able to rise and get through the day, but I remained out of sorts, with a persistent dry cough, more than a week later—at which time a chest x-ray showed I didn’t have pneumonia, and the doctor asked me to please, please consider antibiotics. I suppose I’ve become too reluctant to use pharmaceuticals.

When I was 21 and living in India, I caught dysentery and quickly dropped from 110 pounds (those were the days) to 95 pounds (bad idea!). I’m 5’6″, and it took months for my weight to cross back into triple digits. I also started feeling cold, almost all the time. I wore extra sweaters and slept under piles of quilts. As I recollect, the cold feeling, which was ignited by being underweight, stuck with me four or five years before fading. I’m hoping for something similar now. Constant exhaustion weakened my immune system. Four or five years of taking care of myself—fingers crossed!—should just about alleviate the issue. Check back with me in 2018.

For now, I am done with sleeplessness. I hate sleeplessness. I hate sleeplessness all the more for these points:

  1. Chronic fatigue has imposed a heavy burden on my well-being. If this is what happened to my body, what did sleeplessness do to Martin, who was a growing toddler? Moments like these, I am so very thankful to understand that autism is medical, and to have found biomed as a way to restore Martin’s health, and mine.
  1. For children and adults on the spectrum whose symptoms are more severe than Martin’s, or whose health doesn’t improve with interventions, this kind of sleeplessness may persist for years. Years. And the same can be said for their parents/care-givers. Years. Remember the study that found that mothers of children on the spectrum can suffer damage comparable to combat stress? I think I know a big reason why that happens.

Oh, dear. I feel something coming on again, and this time it’s snark:

Tell me again why “autism is an important part of neurodiversity” and we “shouldn’t be trying to cure autism”?

New Sleep, No Crutch

“You sure you don’t want to try melatonin again?” asked Martin’s doctor, the one supervising the medical side of his recovery.

“No!” I responded. “No, definitely no. That’s one thing we’ve achieved recently. I don’t want to go backwards.”

The days before Martin’s autism diagnosis were dark times: Martin’s neuro-challenges left him so restless, so lost in spatiality, that he could not fall asleep unless physically restrained. Some nights it sufficed to sit next to the bed and hold his ankles to the mattress, so he couldn’t kick. Some nights we had to kneel over him to straddle his body, too. The worst nights, we had to find a way to still his legs, his torso, and his arms—only to watch his head thrash from side to side. No matter what we did, he needed more than an hour to fall asleep. Sometimes two hours. Or three. Even then, we couldn’t let go, or he’d wake.

Martin’s pediatrician, at a loss as sleepless nights became sleepless months, referred us to the chairperson of the department of pediatric sleep disorders at a prestigious university hospital. That “expert” told us to make “picture charts” to help Martin understand what bedtime meant. She also diagnosed “restless leg syndrome” and told us to put Martin on iron supplements, which stained his teeth purple. It was a garish era for photographs of Martin.

Meanwhile, Adrian and I slept in three-hour shifts, one of us trying to rest while the other pinned Martin.

We received Martin’s autism diagnosis in autumn 2010. Once we learned what was really causing his inability to sleep, we purchased a weighted blanket. That did not help, and later was donated to a special-education preschool classmate. Martin’s sleep situation did not change until we started biomed in February 2011. The difference, as far as I can tell, came through (1) restricting Martin’s diet, and (2) melatonin. Melatonin is a hormone that the body produces naturally for sleep regulation, and it can also be made synthetically in a laboratory. The NIH  states, “Taking melatonin by mouth is helpful for disturbed sleep-wake cycles in children and adolescents with intellectual disabilities, autism, and other central nervous system disorders.

On 31 August 2011, six months into the biomed journey, I posted this:

Almost as soon as we eliminated carbs (and sugar, and starch, and most everything else delectable) from Martin’s diet and added supplements, he began to sleep. As of late March, just for or five weeks into his recovery, Martin was falling asleep in 45 minutes or less and sleeping eleven-to-twelve hours through the night, five or six days a week. We still dealt with night waking one or two days a week, but the compulsive pitching about the bed ceased. Instead, Martin either lay still and chatted to himself or else laughed and acted drunk from his body detoxing.

As of today we more or less count on Martin sleeping through the night. If you’ve been reading this blog regularly, you know that we still have bad nights, and that we sometimes have two or three bad nights in succession, almost always related to Martin lumbering through a detox phase. But by and large, he falls asleep, and he stays asleep.

Until this past October, the sleeping situation, with some variations, remained that way: Martin fell asleep easily, and could be expected to sleep through the night, and when he happened to wake up wouldn’t go down again for three-to-five hours.

Martin takes some prescriptions (among them right now are levocarnatine and compounded piracetem), along with a lot of homeopathic drops and OTC supplements. Whenever possible, I try to eliminate from his daily regimen. So a few months ago, when Martin was on an upswing, I decided to try phasing out melatonin. We’ve made so much progress, I reasoned. Why not investigate whether we’ve resolved some of the issues that made sleep so difficult?

At the time (October), Martin was taking seven drops melatonin before bed. I eliminated one drop every one-to-two weeks. I’d reduce the dose by one drop, endure a few days of Martin taking a hours to fall asleep, wait until he adjusted and fell asleep within 30 minutes, and then reduce by one more drop. By Christmas, I had Martin off melatonin.

Things weren’t perfect. He was taking longer to fall asleep than he had with the melatonin—45 or 60 minutes, instead of 30 or less. But I discovered an unexpected benefit: When Martin woke during the night, he did not stay awake. He fidgeted and called out for me and sought reassurance, and then promptly fell back to sleep. I realized that Martin had been dependent on melatonin to get to sleep. Its absence, at 2:00 or 3:00 am, had prevented him from returning to sleep.

With Martin off melatonin, and capable of getting back to sleep, I’ve been able to attempt something new: nighttime potty training. Until now Adrian and I always left nighttime potty training on a back burner, reasoning that getting up to use the toilet was not worth the hours of wakefulness that would ensue. With that threat gone, we’ve been potty training since the week after Christmas.

As my posts these past few weeks have described, Martin’s been having a tough time. Among other issues, he’s been experiencing evening hyperactivity, and therefore taking hours to fall asleep. That’s why his doctor asked if we’d like to add melatonin again.

The doctor seemed surprised when, in response, I nearly barked my “No!”

Here’s the thing: Melatonin is a crutch. It got us past the long nights while we worked on remedying the underlying causes of Martin’s sleeplessness. Martin no longer needs that crutch. I would rather find and eliminate the cause of the nighttime hyperactivity than use melatonin to mask the hyperactivity’s effects.

The current melatonin situation reflects my overall approach to Martin’s autism. Of course I’m familiar with methylphenidate, amphetamine salts, guanfacine, and so forth—drugs that might improve Martin’s still-abysmal attention span. Maybe one day we’ll turn to such resources (in the end, I remain a pragmatist). But for now, while we have the time and opportunity, I choose to work toward eliminating the cause of his short attention span, instead of using drugs to mask the symptoms.

The Bad Nights Aren’t So Bad

Martin’s had two nighttime disturbance in the past two weeks.

Last Tuesday I heard him crying at 10:40 p.m. Crying usually signals a nightmare or some other fright, and such was the case. He had fallen out of bed. He was plopped on the hardwood floor, clutching his stuffed elephant, confused. I lifted him back into bed, checked for damage, reassured him while rubbing his back, then returned to the kitchen as he dozed back off.

This Tuesday he woke me by calling “Mommy! Mommy!” at 1:10 a.m., from his bed. That’s a worse sign; calling for me indicates that Martin is fully awake, and going to be up for a while. I went to his room and said, “Martin! It’s still nighttime. Go back to sleep until morning.”

“I want you to get in my bed,” Martin replied.

“No. I’m going to sit outside your door. You go back to sleep.”

“I want you to sit in the rocking chair,” Martin said. The rocking chair is in his room.

“No. But I’ll be right out here,” I said and exited his room, leaving the door ajar. I stepped into my and Adrian’s room—our door is only four feet from Martin’s, across a small landing—to retrieve my iPad.

Martin started to cry. “Mommy! Mommy! I want you to come inside.”

“Martin!” I said from just outside his door as I powered up the iPad. “You’re fine. I’m right here. Go back to sleep.”

He cried a little more, called, “Mommy! Mommy!”, and fell silent.

I sat down and scrolled through my friends’ Facebook statuses. Since I’d also done that right before I fell asleep 90 minutes earlier, there wasn’t much to read.

Martin started up again. “Ah, Mommy! Ah, Mommy!”

“Martin! Don’t be silly. It’s sleepy-time. Sleep.” I closed Facebook and called up a Scrabble game I had in progress against “CPU.” CPU was beating me by 95 points.

Ten minutes passed. I shut off the iPad, to gauge whether Martin would react when the glow disappeared from outside his door. Nothing. I waited another couple minutes, then quietly rose and returned to bed. It was around 1:30 a.m. I fell asleep.

“Mommy! Mommy!”

2:02 a.m. He was at it again. I stayed in bed and called, “Martin, it’s sleepy-time. Sleepy-time!” Next to me Adrian groaned and flipped onto his stomach.

“Ah, Mommy!”

“Martin, stop it! Go to sleep.”

Silence, then sudden crying. Martin was going to push the point. I got back up, grabbed the iPad again, and returned to my perch outside Martin’s still-ajar door. “I’m sitting right here,” I said. “Sleepy-time.”

Martin stopped crying and started chatting to himself: “You’re right there. Mommy is sitting right there. Mommy is right there.”

No new Facebook status updates. More Scrabble for me. Big defeat to CPU. I’ve got to stop setting the Scrabble difficulty level to hard, at least when I’m playing half-asleep. I shut the iPad off and listened for a reaction from Martin. Nothing. I snuck back to bed and dozed off.

“Mommy! Ah, Mommy!”

2:54 a.m. Martin was still awake. I called to him from my bed, eliciting more rumblings from Adrian. This time Martin didn’t push the point. Without crying, he said, “You’re right there.”

“Yes. I’m right here.” I didn’t leave my bed. I fell back to sleep.

Martin woke me at least twice more; the last time I recall was around 3:40 a.m. Each time I was able to quiet him without getting up again. Finally I heard no more from Martin, and I slept until my 6:00 a.m. alarm.

I estimate that, in total, Martin was probably awake for three hours. I entered his room just once. About 40 minutes of the three hours I spent crouched outside his door with my iPad. The remainder of the period I slept, albeit with interruptions.

I would not describe this as a good night. Not by any means. But it is progress. We aren’t so far from the time when Martin routinely woke for three-, four-, and even five-hour stretches during the night, and either Adrian or I had to be in his room every minute until he returned to sleep. Sure, he was up this Tuesday night, but (1) it was an unusual occurrence, (2) for the most part he stayed alone, and (3) eventually he got himself back to sleep.

Sure, I had to be up, too, and my calling out from our bed bothered Adrian. But for the most part, I remained horizontal, in my own bed. Anyone who suffers chronic lack of sleep will tell you—horizontal rocks.

Go to sleep, little man. Seriously. Sleep. Please.

The Good Kind of Sleeplessness

I’m drafting only a short post this evening.

I’m tired, you see.

I’m tired because I didn’t sleep well last night. I lay in bed awake for several hours, until 2:00 a.m. I woke when Martin clambered into my and Adrian’s bed, around 8:00 a.m.

Here’s the thing: Martin didn’t keep me up until 2:00 a.m. He didn’t wake at midnight and rustle for hours while I hovered nearby, iPad in hand. Nor was I anxious, thinking that he’d be up as soon as I closed my eyes, or pondering his future.

Incredibly, I wasn’t able to doze off because I wasn’t tired. Each of the previous several nights, I enjoyed eight or more hours’ sleep. My body, apparently, felt sprightly enough to play a few additional games of on-line Scrabble and then gaze two hours at a near-full moon.

Since Martin’s ASD diagnosis almost two years ago, and even before that (from age 14 months on, he had sleep troubles), and even on vacation (I worry a lot), I cannot recall a single night when sleep eluded me because I wasn’t tired. Between 16-hour days managing Martin’s recovery process, and worrying about whether we’ll succeed, and sitting up with him, I function in a state of permanent exhaustion, punctuated only by degrees. Most nights, I lose consciousness before I finish a 30-second prayer. The remaining nights, anxiety so clogs my mind that I give up trying to sleep and wander the apartment “getting things done” throughout the night.

We’re on vacation this week, in a rented seaside house that compels relaxation. Martin has been sleeping well. My mother-in-law is traveling with us; she wakes with Martin each morning and washes and dresses him before releasing him to me and Adrian. Despite the crap summer we’ve been having, I am sleeping.

I’m off to sleep more now.

Bad Day. My Bad

Last Sunday—a week ago now; perhaps the trauma has kept me from posting this confession?—was a bad day for me and Martin. The fault was mine.

Looking back, I suppose the stage was set on Saturday.

No, wait. It was Friday. The bad day that was last Sunday actually began on Friday.

Samara put Martin to bed Friday evening, 7:00 pm, without incident. Adrian was traveling, and I was dining with friends who’ve recently relocated to New York. I’ll call them, à la Martin, “Uncle Donny” and “Uncle Brian.”

I arrived home around 11:00 pm Friday, hoping for a good night’s sleep. With Adrian out of town, I’d made plans for a day trip on Saturday; Uncle Donny and Uncle Brian were to accompany me and Martin to Stuart Family Farms and then to lunch in Connecticut. At midnight I snuck into Martin’s room for a detox therapy, managed it without waking him, and dozed off in my bed.

I slept a pleasant hour before the night tanked. Martin woke at 1:40 am and could not close his eyes again until 6:00 am. At 8:00 am I did detox therapy again, almost hoping to wake him. We had planned to leave at 9:00 am for Connecticut; that hour passed with only snores from Martin. I decided to pack a breakfast and most of Martin’s morning supplement routine in a to-go cooler, along with the lunch I’d assembled Friday. At 9:30 I called Uncle Brian and declared that, come hell or high water, Martin and I would be on the road in 20 minutes. Then I woke and dressed Martin, pushed the most crucial morning supplements into his mouth, and hustled him to the car.

Would that be the dawn of the worst day ever? Hardly. There’s a pattern I’ve noticed: When Martin has a bad night—and in all honesty, we’ve seen a lot of bad nights lately, more than we used to—the next day does not reflect his sleeplessness. He’ll be drowsy, maybe mellower than usual, but sharp and agreeable.

And so it was on Saturday. Uncle Donny sat next to Martin’s car seat and helped Martin devour the to-go breakfast and supplements, which Martin gamely accepted. En route to Bridgewater Martin chatted; at the farm he delighted in chickens and pretended to water some grass; at the lunchtime diner he played quietly in our booth, then accompanied Uncle Donny to check out the fish tank.

Predictably, though, on the way home he fell asleep for almost an hour. From clapping to singing to insisting we’d soon hit the RFK Bridge (his favorite), nothing would rouse him. And an hour’s nap in the car makes bedtime a nightmare, so that instead of sleeping at 7:00-ish, Martin needed until 9:30 pm to doze off. And a late bedtime invariably prompts an early wake-up, so that instead of achieving his preferred eleven-and-a-half-to-twelve hours, Martin sprang up at 6:30 am, after just nine hours.

And then there’s the fact that, no matter what, Martin’s second day after a sleepless night is worse than the first. Martin didn’t sleep Friday night. Sunday was bound to suck.

We were late for church. Despite being up since 6:30 am, somehow we couldn’t get out the door before 11:00 am. (“Somehow” in this context means, roughly, “Martin refused to eat breakfast, dawdled with his supplements, cried for half an hour, seized dirty silverware from the dishwasher, and complained when I tried to shower.”) Martin threw a minor after-service tantrum when it was time to quit fooling around with the piano, and again when I made him sit on the potty. I didn’t leave the church feeling spiritual. I left feeling exasperated. Possibly murderous.

When our afternoon plan, hanging at the playground with a friend, fell through, I decided to call it quits and head home. I figured Martin could enjoy quiet activities and I could get some housework done.

Therein lay my error. We were home by 1:30 pm. Between our arrival and Martin’s bedtime, 6:30 pm, spanned five hours. Five hours, I soon discovered, is more than adequate time for a three-year-old to suffer extreme cabin fever and then, compounded by his sleeplessness, to morph into a fiend. By evening Martin had dumped toys twelve feet from our second-floor loft space, emptied the cats’ water fountain onto the hardwood floor, opened the valve on our Berkey countertop purifier to flood the kitchen, unfurled half a roll of toilet paper into the toilet, climbed the cat tree, refused to complete even a single HANDLE or RDI exercise, and pitched multiple crying fits.

Amidst this naughtiness Martin was also attacked by autism symptoms, the kind we used to see constantly but that now strike only at tired, stressful moments. He ran back and forth. He lost coordination and eye contact. He repeated my words, if they provoked any response at all.

I found myself—and this is not easy to admit—in the most deplorable parental state I know: counting the minutes until Martin’s bedtime, and annoyed by behaviors I know he cannot control.

It was not a satisfying day for either of us. Martin was frustrated by boredom and fatigue, and I by my hapless responses to his conduct. I spent the afternoon saying no!, enforcing time-outs, and wanting to ostrich my head.

Martin slept well Sunday night. I planned an after-school activity for Monday, and by Tuesday we were back on track.

But the memory of Sunday haunted me, and so I assembled a list of lessons learned. I must prepare for days when I know sleeplessness will be a problem. Preparation means a plan, and a back-up plan, and a last-ditch plan. If I wouldn’t expect Martin to spend an afternoon doing nothing on a good day, I’m a fool to expect it on a bad day. When I saw his behavior hitting bottom, I should have cut my losses, taken him out of the house, and headed for the nearest playground. Or at least in his stroller for a walk. Maybe for a green juice at the organic restaurant, or any treat. I cannot let my own fatigue ruin a precious afternoon with my son.

The bad day was my bad. I own it. I’m grateful that there’s always tomorrow.

The Tap

I’m middle-of-the-night posting again, via iPad from a chair in Martin’s room. He’s been up for three hours, since 1:00 a.m. I just fed him hazelnut butter on three-seed crackers (my mother makes these with her sunflour blend), in case he’s hungry, and also had him swallow a charcoal tablet, because he’s goofy and demonstrating detox symptoms.

Past middle-of-the-night posting events have sometimes reeked of aggravation and exhaustion. Not so much tonight. Sure I’m unhappy that I accomplished only 90 minutes’ sleep before Martin busted into our bedroom. Nevertheless, this marks the first bad night we’ve experienced since January 15, and only the second bad night since before the holidays. Because I’m not working anymore, I can deliver Martin to school whenever he wakes and has breakfast, then nap until I need to pick him up.

And there are two more mitigating factors. First, I think I can point to a cause of Martin’s nocturnal festivities: We just finished week two of a six-week herbal protocol designed to drive pathogens from his body, and it’s clearly working. His legs have a rash from secreting what his body does not need, and he is making daily progress in overcoming his ASD symptoms. Second—did I just mention this? —he’s doing really well. He is socializing regularly with his classmates and with a neighborhood friend; almost daily we get a report from his teacher detailing some new achievement; and even language (one of two great weaknesses remaining for Martin, along with joint attention in group settings) shows tiny movements in the right direction.

So instead of describing my aggravation or exhaustion (fascinating topics), I will middle-of-the-the-night post about our latest miracle.

Two nights ago, while Martin was eating dinner, I snuck up behind him and tapped his right shoulder.

Martin, in response, turned to look at me.

Ten minutes later, I tried the same exercise again. And Martin turned to look at me again.

Doesn’t sound monumental? Well, he’s never done it before. I suppose he just didn’t have the body awareness, or the consciousness of others and his surroundings, to sense a shoulder tap and realize that it had meaning. Now, apparently, he does.

I tapped his shoulder again at breakfast yesterday morning. No response. But at dinner tonight, I shifted from right shoulder to left and back again, tap-tap-tapping, and each time Martin craned his little neck to investigate. Good enough for me. Right now I don’t require absolute consistency, just evidence that Martin does possess the ability to engage in these neurotypical behaviors.

At Yale University, I’ve heard, undergraduates are invited to join exclusive secret societies via a “tap.” The chosen few are “tapped.”

I’m uncertain whether that means a literal tap on the shoulder. In any case, the events of these past couple days have made me confident that—should Martin choose to attend Yale, and then be selected for secret-society membership—he’ll be ready to respond to that tap.