When Janey got studied and blew our minds

Janey is part of a study of autism at Boston University.  They are interested in kids who are low verbal---who talk but don't talk a lot, and she fits right into that category.  We first started with them just right before all hell started breaking loose, when Janey went to Bradley Hospital and then in fairly short order had her appendix burst, so quite a while went by without us going to the study.  I called them a few months ago and got us started again, and we've been twice since then.

Dedicated parking!

BU has a great setup for the study.  They have a dedicated area, which has been designed to be very autism-friendly.  It's calm feeling, there are toys and books in the waiting area Janey actually has an interest in, they have a dedicated parking space for participants (a BIG deal in the city!) and most of all, everyone we have met working on testing or on interviewing parents seems to be absolutely wonderful at what they do.

Janey seems to love going to the study.  She's never one to have much trouble separating from us, and she goes off happily with the tester while Tony and I get interviewed about her by the head of the study.  The few times we went a few years ago, and the first time we went this go-round, the interviewing lasted as long as Janey's testing, but this last time, we finished the interview and so got an offer to go watch Janey being tested, through a one way mirror.

Well---that is where we got our minds blown.  We saw a Janey we've never, ever seen.  She seemed totally at ease, and very, very on.  She's been in a great mood lately, so that was part of her, but a lot of the credit has to go to the tester, a young woman who had the perfect mix of calm voice, persistence, encouragement and firmness.  

The testing was a mix.  Part of it was identifying pictures, and Janey whizzed through that---words I knew she knew like "cow" and "apple", but lots of action verbs, which I had no idea she really knew.  For example, a picture of a boy swimming got the response "The boy is swimming"---perfect grammar and a full sentence.  With a picture of some birds, Janey first said "bird" and then when asked how many, she actually counted them and correctly answered "four".  We looked at each other in the darkened observation room in amazement.

Some of the tasks were non-verbal things, like sorting silverware or doing little block puzzles.  Janey had no trouble at all with most of them.  Sometimes, she had to be encouraged along a bit, but she didn't get upset, she kept working and she did them!

It was interesting to us that what she consistently got wrong was what I've never had any luck at all teaching her---colors.  She honestly seems to have no clue about colors, and sometimes I wonder if she might be colorblind.  I've been told, though, that many kids with autism have a hard time with colors.  She also gets a little confused on shapes.  She called a star a diamond---sort of like she knew it was one of the more exotic shapes but couldn't bring the name to mind.

Toward the end of the session, Janey was getting a little restless, and she started singing to herself.  It took me a while to recognize the song, but when I did, I was happy---it's a song I love that she's never shown much interest in---"I'd Really Love To See You Tonight".  An old 70's soft rock classic!  She just kept singing the first few lines---"Hello, yeah, it's been a while, not much, how 'bout you?"  She probably sang those 100 times over.  What struck me was how although it looked like she wasn't really paying any attention to the tasks at hand, she kept getting them right.

On the way home, as I processed the whole experience, a few thoughts kept popping up.  One is that Janey's mind truly is different than most.  Not less than most---different than most. It made me think how often I've assumed she was paying no attention, because in her situation I'd not be able to pay attention while screaming or singing or watching a show intently, but from seeing her at work, I realized her mind seems to work on more than one track at once.  

I also kept wondering how often Janey is bored out of her mind.  I've always suspected and in fact felt quite sure she knew more than she showed, but I don't think I realized how much more.  However, it's so hard to access that knowledge, and to know what she knows and how to teach her.  Tony put it well.  He said he always tries to not bring work home mentally, to leave work thoughts at work, and it's like Janey does that with school, and in fact with much she learns in any way.  If it's not something she needs to show in a particular situation, she doesn't show it.  I've asked her to count lots of times, and to use action verbs, and all that---but she seems to feel they aren't something she needs to show she knows, unless it's obviously a testing situation (and then of course only if she is in the mood)

I'm very glad we are part of the BU study. It's the kind of study I heartily support---not one that is aiming to figure out WHY she is autistic (and unspokenly, figuring out how to prevent future autism) but one that is trying to figure out the autistic mind---for that is indeed also my main task in life---figuring out Janey.  It's going to be a lifetime study on my part, and one worthy of the time spent.

Surprises during the storm

The last few weeks have been tough with Janey (why do I feel like that's a common opening line when writing this blog?)  She's doing a lot of crying, screaming, hitting and self-biting.  She just doesn't seem very happy, and reports from school say she's the same there.  She isn't sleeping well (she's up right now at 10:20 pm, but using her iPad for a minute or two) and we are pretty worn out and quite discouraged.

However, the last few days, Janey has surprised me quite a few times with things she's said or understood.  Sometimes, she seems to break down during a learning time, like the greater knowledge or realization leads to her being upset.  I wonder if that's the case now.

Yesterday, Janey came home from school in a state.  She was hitting me over and over.  An email from her teacher told me she'd hit some kids at school, too.  I was feeling near the end of my rope.  I decided to try talking to Janey seriously, assuming she understood me.  This is something I try to do more often lately, although it's often very unclear if Janey does understand me or not.  This time, I told her she really, really needed to try not to hit people or bite people.  I asked her if she remembered last fall when we went to the hospital and then the "hospital-house" (which is what we have called Bradley Hospital, the psychiatric hospital she was in for about three weeks)  She didn't answer.  I said "Do you know why we took you to the hospital?"  I didn't expect an answer, but Janey said "You were biting your arm" (reversing her pronouns) and demonstrated how she bites her arm.  I was very surprised.  That was one of the issues---her increasing self-injury.  I've never before been sure Janey even understood that self-biting was something that was a problem, and I gave her a big hug and told her I hoped she would not hurt herself in the future.

Today, I offered to take Janey and Freddy to Chipotle, as Tony was at his high school reunion.  Janey was excited to go, but had a few minutes before done her Lady Godiva routine.  She put on her Crocs and said "Go in the car?"  I said "Can you think what you need before we can go in the car?" and she answered right away "Clothes!"  I was so happy.  My wording of the question was not completely straightforward, but Janey understood both what I was saying and what the answer was.

Freddy went into the Chipotle to get our food, and there was quite a line, so I was left to entertain Janey in the car for about 20 minutes.  I started asking her questions, kind of to see if she was still on a roll.  She was amazing.  First, we did counting, alternating between us with the numbers, and she easily caught on.  Then, I said "A...B...C" and with just a few times jumping in with a letter, she recited the alphabet perfectly.  I then said "Some people are girls, and some people are boys.  Janey is a...." and she filled in eagerly "Girl!"  I said it again the same way replacing "Janey" with "Freddy", and she said "Boy!"  Then I got fancy.  I said "Our sun has lots of planets.  It has Mercury, Venus, Earth, Mars, Jupiter, Saturn, Uranus and...." and Janey, without missing a beat, said "Neptune!"  I was blown away---truly blown away.

I think Janey knows much more than she ever lets on.  Part of figuring out what she knows is asking in exactly the right away.  She does much better filling in blanks than just answering questions.   Her mood makes a huge difference, too.  She was calm and happy in the car.  However, she wasn't when she gave me the answer about the hospital.  I think in that case, talking to her at a level beyond what I usually do made her reflective.

Sometimes, seeing glimpses of what Janey can understand and what she knows almost makes it harder.  I feel heartbroken when I think of what is trapped in her while she screams and hits and yells and bites.  I wish so much I could help her be all she is capable of being in a way that works better than whatever I am doing right now.

Acceptance and the best use of Janey's time

The last week, I've been thinking a lot about autism acceptance and what it means to Janey and to our family.  I have done some reading about it, prompted in part by my friend's great blog, On the Train With Sophie.  There is so much about whole autism acceptance movement that fits with my own beliefs, although there are parts of the idea I struggle with.  I'm realizing that, like with any philosophy, I need to consider my own child and her own needs over what might be the "rules" of acceptance, and also realizing that what I perceive as the "rules" might be wrong.  All this is a long-winded way to lead up to my thoughts about how Janey learns and how best to respect her time.

We had a meeting at Janey's school yesterday, and as always, I was impressed with the level of caring and thoughtfulness of those working with Janey.  I brought up at the meeting something that has been on my mind a lot---Janey's relative lack of academic achievement.  Despite many years of schooling and many hours of direct ABA type instruction, Janey's learning as measured on concrete academic tests would be considered by most anyone to be extremely slow, if not static.  Janey doesn't consistently know her letters or numbers.  She can't really count objects.  She shows very little understanding of shapes or colors.  She can't read, at least that she shows us except for rare glimpses.  She can sometimes write her name, although she hasn't done that much lately.  She has never drawn anything recognizable.  Her speech, although unique and interesting, is rarely useful in conveying anything but basic wants.  I have to conclude that at least based on evidence we have right now, Janey is not progressing academically in much of any meaningful way.

However, Janey certainly can learn.  I can think of hundreds of ways she's learned over the years, in areas she is motivated to learn.  She can put the TV on the channel for videos, pick through all her videos to find exactly the one she wants, put it on, remember what is coming next, sing along with all the songs and recite all of the dialogue, all that with ease.  There's a lot of learning shown right there.  If she wants her father to cook a particular dish, she can gather all the ingredients needed and bring them to him, including spices and sauces.   She can use YouTube with ease.  She learns songs after hearing them once, and can sing them back in perfect tune with all the lyrics correct.  She has a very good sense of direction.  She can go into any store she's been in before, and if there's something she likes on the shelves, find it again---including big stores like the huge Whole Foods near us.  She can imitate dances she sees on TV, far far better than I would ever be able to do.  She knows hundreds of nursery rhymes.  She knows just what time Daddy is supposed to be home.  I could go on and on.  In many ways, Janey is a very smart girl.

So---is it the best use of her time to work on academics?  Or is having her continue to try to learn to do traditional academics a basic disrespect for who she is?  Is accepting her also accepting what and how she learns?

These are questions I honestly can't answer.  But even if I could, how would I go forward?  For the first time ever in Janey's life, I've had thoughts lately about homeschooling.  Maybe it's because overall, Janey's mood has been good for quite a long period.  But still---I truly don't think I have the energy to homeschool her.  My latest thyroid test showed that again, my thyroid is working very little if at all.  I've been extremely tired.  Some days, I can barely hang on for the 3 or so hours between when Janey gets home and Tony gets home.  And the truth is---I have very much liked Janey's schools and teachers over the years.  I know they care for her, love her and want the best for her.  But schools are set up to teach academics.  I wonder how it feels for Janey, always working on something that is so hard for her, or if not so hard, something she has no interest in.

I am nowhere near ready to make any real changes in Janey's life, not at least outward ones.  But I think I'm making an inward change.  For me anyway, autism acceptance means seeing what Janey is competent at, what she enjoys, what her passions are, and valuing those things, more than looking at what she doesn't excel at and trying to change her.  Janey may never read.  She may never carry on typical conversations.  She may never understand money.  But by golly, she can do some things better than almost anyone you'd ever meet.  I am currently more up to date on the latest music than I have been since the early eighties, just from looking up the songs Janey sings after hearing them (I think) on the radio on the bus.  I am expending my food horizons---if Janey can enjoy sauteed kale with Korean hot sauce, I should at least give it a try.  I'm collecting new nursery rhyme books to try to find a few she doesn't already know.  Janey is leading the way for me in a lot of ways.

I want a future for Janey that makes best use of her strengths and joys and passions, not her areas of weakness.  That, for me, is the meaning of autism acceptance.

Further thoughts on iPad apps and autism

Janey's had her iPad a while now. I would say it's a moderate success. She certainly enjoys playing with it, navigates it well and seems to be calmed by it. She is probably learning from it too, but it's not a huge, huge step forward, although I can see how it might be for some kids.

The big thing is finding the right apps. Janey likes some very specific things in an app. The big three words are PREDICTABLE, SIMPLE and REWARDING. The apps have to be without huge surprises. Janey likes to know pretty much what is coming next. They also have to be simple to use. They don't have to be one touch simple, but they can't have all kind of menus and choices, or she just gives up on them. They also have to be rewarding. This is the big problem with some of the autism-specific apps. They are SO simple and predictable that they are boring. Nothing happens that would make a kid keep playing. They seem like they might be good to use at school with someone human present to give rewards every now and then, but Janey just isn't motivated to keep going with them without something happening she likes.

Those things being said, I'm a little surprised at the type of apps Janey uses the most. They are far more educational than I would have guessed she'd pick. She likes ones that involve putting letters in place to make a word, or counting items. I thought she'd like music apps more, and she was very taken with a few Christmas ones, but in general, her taste in music is more sophisticated than the jingle-jangle tunes most kid apps seem to have.

Here's a list of five of her favorite apps!

Whizzit 123

This is a simple counting app. A number of the same item show up on the screen, and once each one is touched, the item changes somehow, such as a pinwheel starts to spin, and it's not able to be touched again, so you learn to count one thing at a time only once. Janey likes the smaller numbers of things on a screen. If a screen shows up with something like 15 flies, she knows how to go back to the start and get another screen! When she does successfully count everything, the game goes to the next screen. Janey loves the start screen for this app, too---it plays a song she likes!

FirstWords Christmas

There are a whole bunch of FirstWords apps, and Janey likes them all, but she likes this Christmas one best, even now that Christmas is over! A screen comes up with letters scattered about, like tiles, and you have to move the tiles into the right place to form a word. The word is already there, you just have to put the tiles over the letters. There is a picture on each sceen, and when you finish putting the letters in place, the picture spins around and makes a sound, and the next screen comes up (this is a crucial point, as if the next screen of something doesn't come up quickly, Janey loses interest). Janey loves doing this one for long, long periods, and has gotten noticably better at quickly moving the letters into place.

Find Me

This is the only specifically made for autistic kids app that Janey has gotten into, and it's a very good one! A boy shows up on the screen, and a voice asks you to find him. It starts very simply, with just the boy on the screen and nothing else, but very gradually, there's more in the background, like butterflies and trains and flowers, sometimes moving. Once you find the boy 5 times, a screen comes up with a music-box like song and shapes dancing around. This is the kind of reward Janey likes---it doesn't vary, and it's interesting enough to keep her playing, and she also seems to really like finding the boys, and how each time finding him is a little harder. Whoever wrote this app seems to really get kids with autism.

Zoo Train

This is a Busy Bee Preschool app. It has several parts, but Janey has completely no interest in anything but the word train part. In that, a train with a flatbed comes along with a word on it, and letters that need to be put in place, pretty much like the FirstWords app. Once you put them in place, the item shows up on the flatbed, and the train moves out of the station, saying the word as it goes. Janey likes trains fairly well, and I think she likes the movement. What she doesn't like in this one is that for every 5 words, you get a reward screen where you can pick a sticker. This disrupts her flow, and she has no interest in picking the stickers. She reacts as she often does to things like this---she goes back to the app selection screen and starts over, hoping to get past that part. It makes the app not that engaging, but she seems to like it enough to keep going back to it.

Peek-A-Zoo

This is one of my favorites, and Janey likes it moderately well. It shows a screen of 8 cartoon animals, and a question comes up, spoken and written, like "Who is Sleeping?" You have to pick the right animal, and then he comes up and makes his sound. This is very well done, and I think could be huge for autistic kids, but some of the questions are too abstract for Janey, like "Who is trying to hide?" where you have to find an animal that is fading in and out---she just doesn't seem to get that. But the music and the simplified pictures are enough so she plays this a fair amount.


I think there is still a HUGE world of apps to be written out there for autistic kids. I don't think anyone's written the "killer app" yet. I wish I knew how to write apps. I'd love one that could use your existing music collection as a reward. Janey would do a lot more to get to hear her favorite songs, like "Tie a Yellow Ribbon Round the Old Oak Tree", but kids apps just don't often contain songs about people getting out of prison. I'd also like a look-see reading app. I'm all for phonics, but for Janey, it's not how she's going to learn to read, if she does. I'd love an app with two words to choose from, and a reward if you pick the word that is spoken. I'd also like an app with two faces showing a feeling shown (photos) and you have to pick the correct emotion.

Overall, if you have an autistic child and can swing it at all, I think an iPad is worth it. Not a must-have, at this point, but worth it.