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Ten Little Teddy Bears And Other Echolalic Utterings

About six years ago, when my older son was almost 4, I got all excited when I heard him say the phrase, “Ten little teddy bears.” He had virtually no vocabulary in those days, and he almost never spoke. And here he was, uttering a four-word phrase. This was indeed a cause for celebration.

Of course, this happened in a simpler time, when everyone assumed that my son had nothing more than a speech delay. The word “autism” had only made it into my personal orbit as a possibility to be in complete denial about. What? Autism? No way! He just has a speech delay, he’ll catch up!

When we got the autism diagnosis, we found out about echolalia, defined by Wikipedia as “the automatic repetition of vocalizations made by another person.” All kids do it at some point, but most outgrow it. Kids with autism keep at it with admirable dedication, sometimes for years and years. The words being repeated may change, but the concept remains the same.

Ten little teddy bears stayed with us for some time, eventually giving way to phrases related to Bob the Builder and Mr. Potato Head.

I used to think that as the frequency of George’s contextually correct speech increased, it would edge out the echolalia, but that has not been the case. George definitely talks more. He has an extensive vocabulary, and although he hardly ever talks in a social context and still cannot participate in a conversation, he does make requests using full sentences. There is plenty of room for George’s contextual speech to coexist with echolalia.

Over the years, we have been treated to song lyrics, phrases from YouTube videos, sentences uttered by teachers and things that have been said at home.

“Bob dropped the eggs. What a mess.”

“I need Dizzy, Lofty and Muck.”

“No pushing, no kicking, no hitting.”

“Well it’s a sunny day. I feel brand new.”

Some of the echolalia is charming, and it’s thrilling to hear my child utter any words at all. But it is a little disheartening to know that a lot of what he says does not have any meaning or context behind it.

The latest echolalia is not charming. It takes the form of a single word – a word that I would not use on this blog if it weren’t a pivotal part of the story.

Fuck.

I freely admit that it is my fault. Although I try my best to be aware of my choice of words when the kids are around, from time to time I slip up with the F-bombs. It happens rarely, but the kid only has to hear a word once.

At first it was simple repetition, and we responded in the same way we’ve responded to all other echolalia: by ignoring it. Sure, it wasn’t fun to listen to this word being said over and over ad nauseum, but for a while, the best reaction was no reaction at all. Many autism experts agree that any response at all, even a negative reaction, can be perceived by the child as positive reinforcement.

This tactic lost its effectiveness when George got wind of the fact that fuck is that most tempting of things: a Bad Word.

We are now dealing with a child who gleefully yells, “Oh FUCK!” and then runs away in fits of giggles.

Ignoring it no longer works. You know that persistence and single-mindedness that many people with autism display?

Yeah. George’s ability to laughingly repeat the word is greater than my ability to ignore it.

Reprimands don’t work, and in fact, just aggravate the situation and make it funnier from George’s perspective.

The only thing left is the dreaded removal of privileges. I really don’t want to go this route because there will be a meltdown for sure, but I may not have a choice.

Unless, as someone on Facebook suggested, he actually uses the word in context. If that happens, I might just throw a party.

How do you handle inappropriate language in your typically or not-so-typically developing children?

(Photo credit: Vectorportal. This picture has a creative commons attribution license.)

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Why Autism?

“Why do you think he has autism?”

This question is posed to me quite a lot by friends and strangers alike, people who for the most part intend no malice, but are genuinely curious about the origins of George’s autism.

That they are asking the question at all is something that I see as a positive sign. It tells me that increasingly, people are wanting to be educated about autism instead of blindly believing every tidbit of information – right or wrong – that is thrown their way.

Over the years, I have done research on a variety of theories.

Was it vaccines? No, I don’t believe it was. Deep down, I knew from the time George was a tiny baby that he was not on the trajectory of “typical” development. I don’t buy into the dietary theory either, for the same reason. George was exclusively breast-fed for four months, and by then I was seeing some little signs that something was not quite right.

No, whatever happened within George’s brain to result in his autism, it was a done deal by the time he came out of the womb.

Even with that knowledge, the title of Primary Cause is wide open. I have read a couple of recent studies suggesting that environmental factors in utero could have more of an effect than previously believed. As if moms of children with autism didn’t have enough guilt on their shoulders already. But that is neither here nor there.

When I was expecting George, I did everything that was considered by pregnancy gurus to be “right”. I ate lots of leafy greens and took my prenatal vitamins every day. I ate lean protein and avoided foods with a high fat content. Accustomed to eggs “over easy”, I ensured that my eggs were fully cooked, and I did not touch deli meat or anything else that could be a potential listeria risk. I did not touch a drop of alcohol, I stayed away from places where I might be exposed to second-hand smoke, and my body pretty much bullied me (through the magic of the laughably known “morning sickness”) into kicking caffeine to the kerb. I went to all of my OB/GYN appointments and followed the advice of my doctor. I did not take so much as a headache pill through my entire pregnancy. The only tablets going into my mouth were vitamins and Tums.

I don’t think I could have created a better environment for my baby if you had paid me a million bucks. Of course, there is the possibility that fifty years from now, someone will prove that some obscure enzyme in, say, oranges, has been linked to autism. But I think it is safe to say that the prenatal environment is an unlikely candidate for the cause of George’s autism.

Leaving aside other environmental factors like air pollution, there are two other possibilities: genetics, or the circumstances surrounding the birth itself. Or maybe a combination of the two.

When I was a child, I was developmentally delayed. I didn’t talk until I was five, and I had some motor skill delays. My body was physically capable of doing anything my peers could do, but the communication between my brain and my muscles was out of synch. It was clear – especially in the early years – that I had some kind of learning disability, although I was never formally diagnosed with anything. As I navigated my way through childhood and adolescence, I was able to compensate for my learning difficulties by simply thinking in a different way and leveraging areas that I was strong in. But as my academic performance got better and better, my social awkwardness and anxiety among people became more and more apparent.

To this day, I suffer from social anxiety, although in general, I have found ways to adapt and mask it so that people don’t really notice. I’m not so much a stickler for routine, but once plans are made I get very uncomfortable – almost panicky and kind of, well, spectrummy – if they are changed. Although I am now fully verbal – sometimes, downright talkative – there are times, usually when I’m stressed – when I lose the ability to communicate through speech. It’s as if the words get lost somewhere between my brain and my mouth.

Am I on the autism spectrum? I don’t know. I have never been for screening, and frankly, I don’t really see the point. But if I were to learn that I have Aspergers, I would not a bit surprised. When I look at the way George has evolved through his early childhood, and the way he is at this point in his life, I do see a lot of parallels with my own early years. So, genetics? It’s a strong possibility.

The other possibility is that something happened to George’s brain while he was being born. For the most part, my labour was pretty standard. Everything happened more or less when the Medicals said it would. When I was in the thick of contractions, I heard someone use the word “textbook”. When the time came to push, though, the going suddenly got a lot tougher. Even though the baby was perfectly positioned for birth, no matter how hard I pushed, nothing budged. The Medicals kept telling me to push harder, push harder, but I just couldn’t do it. After what felt like an eternity but was probably only a couple of minutes, the Medicals gave me an episiotomy (if you don’t know what that is, look it up, because I ain’t describing it here). Once that was done, I gave one more almighty push, and an eternal second later, I was rewarded by the sound of a baby crying.

Here’s the thing, though. While I was pushing to no avail, the baby’s heartbeat – usually in a range of 130-150 beats per minute – dipped to below 40 beats per minute. Only for a couple of seconds, mind. Like a momentary blip in the radar. But could those couple of seconds have been enough to alter the wiring in my baby’s brain?

In the end, I suppose it doesn’t really matter. George has autism, and knowing the cause with crystal clarity would not change that.

No matter what the cause, George has autism, and I love every inch of him for who he is.

(Photo credit: http://www.flickr.com/photos/macbeck/4146730230/)