“Watch me! Look what I can do!” How many times have you heard it from a preschooler as they build a block tower or crash their cars together? It is something I had heard a thousand times from my other children but never from Tate. Why?
As soon as I got the tentative diagnosis of autism from Tate’s pediatrician I was reading books that told me “early intervention is the key.” I jumped on the phone trying to find help for Tate. It seemed the developmental pediatricians, all qualified to give the final and necessary diagnosis and recommended treatments, had waiting lists of six months or more. How can a parent wait six months when all the books say “move quickly” and I knew time was wasting? There was one developmental pediatrician in my area I found who had a waiting list of ONLY three months. I made an appointment but I also insisted I must talk to his nurse immediately. I would not take “no” for an answer from the receptionist. The nurse had mercy on me and called me back. I had lists of questions written down to ask, and as the nurse and I talked, I began to sob. The compassionate nurse told me she would have the busy doctor call me and I specifically remember her telling me not to waste my precious phone call with him crying. I would have a very few minutes of his time to ask for his advice and then I would have to wait three months for our appointment. He called me between his appointments that same day. He was in his car on his cell phone and he told me he was very pressed for time. I will never forget that call. He was kind but he did not candy-coat anything. He asked me some really hard questions. He asked me if Tate had ever pointed out an airplane in the sky to me. I had to think for a few seconds and answer “no” but was immediately horrified that I had never noticed this on my own. He asked if Tate had ever pretended to talk on a phone. He asked me if Tate had any relatives (especially older brothers or cousins) without empathy for others. He asked me if Tate’s siblings or cousins ever got caught up in repetitive behaviors or had poor social skills, anxieties or odd habits. He asked me if Tate could follow my point; meaning: could his eyes follow my finger to see what I was pointing at? I was not sure. I remember thinking: “How could I not know? What kind of mother was I?” He asked me if Tate had ever said “watch me” or “look what I can do” and I had to say that he had not. It was one of my first lessons in joint attention and what that means. Tate had no joint attention. Joint attention is “the shared focus of two or more individuals on an object.” People draw attention to things through eye gaze, pointing, or commenting. Joint attention is essential for the development of communication. Joint attention is one of the earliest noticeable differences in the typically developing child and the child with autism. If I had known these things, perhaps I could have helped Tate much sooner. Know an infant? Watch for the developing joint attention. Early intervention is the key.
That phone call from that doctor opened my eyes to so many things. He had asked me if Tate had relatives with characteristics similar to his. I had said that he did not but later that evening, when talking with my husband, I realized I had answered some questions incorrectly. After giving it all more thought I remembered a lot of things that had not occurred to me while visiting with that doctor. There was a little boy in my family who had entertained himself with repetitive behaviors for long periods of time, although he had outgrown it. Tate did and does have relatives who suffer from anxieties. There were little boys in my family who had not developed empathy skills appropriate for their age and there were little boys in my family who had very poor social skills. Many of those things have been overcome with age, teaching and maturity. I, myself, had been a very anxious child, shy to an extreme, with some of the characteristics of autism. The difference between Tate and those with a few quirks is joint attention. None of us could ever be diagnosed with autism. We had “enough” joint attention. We have “enough” theory of mind. Have an infant? Watch for the development of joint attention. Early intervention is the key. No one can say it often enough or loud enough. Early intervention is the key.