Executive Function and Al Capone

I’ve been thinking a lot about this thing called executive function lately and I have been watching Tate and Sydney try to problem solve. I have to jump in often to help them solve very simple problems they should be able to handle. By “should,” I mean they WOULD be able to handle these things if they did not have a disability. Executive functioning allows a person to sequence events, problem solve, multitask, get organized and make plans. One of my autism heroes, Temple Grandin, speaks about executive function on occasion. She has said, "I cannot hold one piece of information in my mind while I manipulate the next step in the sequence." Can you imagine? Can you imagine always being lost in the steps it takes to complete a project or deal with the unexpected things that come up in any given day? Not being able to organize your thoughts and make a plan, then follow through and execute the plan?

This afternoon I took Tate to get a haircut. Tate’s been going to the same barbershop for many years. If I can get a parking spot right in front of the door and if there is no wait for the barber chair then I just wave at the barber and Tate goes in alone lately. Today I had to park several parking slots away from the shop so I walked Tate in and sat down with him. Why? Because I couldn’t tell if there was a line from where I was parked. I knew if Tate went in and there was a line for the chair he would not have known what to do. He would not have been able to figure out when it was his turn because a line for the next chair in a barbershop is not really a line at all. Although our kind barber would have given Tate instructions, there would have been potential for Tate to misunderstand or become confused and he would have been nervous. Remember that tyrant we fight everyday called anxiety. He’s brutal. And so I walked Tate in mostly because he does not have the executive function it would take to figure out what to do in a crowded barbershop without help. But stay tuned for the rest of the story.

This morning, before we left for the barbershop, I decided to give the kids’ bathroom a make over. I took down the old, mildewed shower curtain and threw it out. Then before the haircut, Tate and I went into a department store and he helped me pick out a new shower curtain and rug for the bathroom. We went with a fish theme, by the way. When we got home from town, I got busy with some chores. And then I realized I could hear the shower running. Tate was taking a shower without the curtain up. He always goes right to the shower after a haircut but I had not thought about it. (Where were my executive functioning skills?) Of course, the bathroom floor was standing in water by this time. I do not often lose my patience with Tate but I scolded him in my frustration. I know better than to do this but I did it anyway. I talked to Tate about what a mess he’d made. I told him he could have used other options and discussed those with him. He could have taken a shower in a different bathroom or waited. He could have asked me to put up the shower curtain right away too. None of those things had occurred to him. There was no executive function. And then when he saw the mess himself, it never occurred to him to clean it up. It probably never occurred to him that anyone would need to clean it up. There was no executive function. And because of my lecture to Tate about the mess he had made, he is perseverating about it. Not so much because he made a mess but because I was aggravated he made a mess. I’ve assured him several times that all is well and the mess is cleaned up and the new shower curtain has been hung. All is right again. But, he cannot get past the fact that I was annoyed with him and told him about it. Texts have been flying as he needs to let his siblings know of the injustice he received. 

This evening we were sitting at his school in an assembly to kick off the beginning of the school year. Tate leaned over to tell me that sometimes teenagers make messes. I said, “Tate, can we drop it now? It’s ancient history.” He said, “Messes are not history. I know a lot about history. Al Capone robbed a lot of banks and then he died in jail. That is history.” And there we have it. Tate made a mess that was easily wiped up. It was only water. I made a mess that will take days to clean up because I used words. Tate is not the only one who sometimes lacks executive function. I could use a little more of that myself. I wonder if Al Capone lacked executive function? 

If you like this post you will probably also like: The Hardest Thing About Autism

Sydney's Apologies and Insecurities

Sydney was diagnosed years ago with an unnamed anxiety disorder. I see the signs daily, some days being worse than others. There are so many little things I notice about her insecurities. One of the things I wish I could help her with the most is her constant need for reassurance from everyone around her, mainly me. She has to double check and triple check every answered question. It goes something like this: “Can I have this last cookie?” An affirmative answer would mean she will ask again: “Are you sure it’s okay?” I will assure her it is fine. She’ll take the cookie and then comment, probably more than once, about how she hopes it was okay to eat that cookie. It is no fun for her or for me. It gets old.

Sydney and Riley

This morning Sydney asked if she could wear the same shirt she wore yesterday. I said she could as it had been washed the night before and was back in her drawer. It’s a new shirt with a cow on it. After I said she could wear it again she asked, “It’s really okay? I just wore it yesterday.” I said it was okay because it was clean. She said, “Okay, if you are sure.” A few minutes later she came out of her room in a different shirt, not the new one. What shirt she wore made no difference to me but I knew the anxiety of not being SURE it was okay with me is what kept her from wearing the shirt and that is the part I hate for her. So, I tried to talk to her about it, as I sometimes do, knowing it probably will not make a difference of any kind. But I have to try. One of these days something might click.

I grabbed a lotion bottle next to me and a small pill bottle next to it and told Sydney I wanted to put on a play for her. I said, “This lotion is a mom and this little bottle is her little girl.” Sydney giggled and got very interested. I had the small bottle scoot over to the lotion and ask, “Can I go outside and play?” The lotion said, “Yes.” And the little bottle ran “off to play.” Then I said I was going to show her another way it could be done that was not nearly as easy. This time I had the pill bottle ask “Are you sure it is okay?” a couple of different ways after the lotion-mother gave the bottle-child permission to go outside. Each time the mother answered it was okay to go outside. Finally the little bottle ran off to play. Sydney loved the little skit I put on and she loved the attention. I talked to Sydney about how much simpler her life would be if she would just take the answer I gave her the first time and did not ask the same question over and over. I told her the first little girl would get to go out to play sooner and asked if she would rather be the first little girl or the second little girl. I thought maybe I was getting through. Maybe. I asked her, “Do you get it?” She said, “So you want me to ask if I can go outside and play?”  Insert heavy sigh. This is my life. Sydney just cannot connect the dots much of the time.

Sydney, June, 2015

Sydney’s anxiety and insecurity manifests itself in other ways. One of the things I wish she could get past is a constant need to apologize. All day long she apologizes. She uses the word “sorry” more than anyone I know. If she does not hear me and I have to repeat myself she apologizes. If she sneezes and I glance her way she apologizes. If she asks me for a drink and I have to get up to get it she apologizes. If she doesn’t feel well and thinks it might inconvenience me she apologizes. I reassure her all day long. Sometimes I lose my patience from being so patient.

And of course, because Sydney knows that her asking the same question over and over for her own reassurance is something I’d like her to work on, she apologizes now after asking the multiple questions. So after she asks if she can go out to play or wear a certain shirt and gotten permission and reassurance, she’ll then apologize to me for asking so many times. Wow. That little fifty-pound girl walks around with a very heavy burden I’m thinking. I tell her so often there is no need for her to apologize. I tell her that “sorry” only needs to be used when she’s hurt someone or made a big mistake. And now I’ve even somehow got her saying “sorry” for saying “sorry” so much. Being Sydney’s mom is like walking a tightrope. But I’d walk it across the Grand Canyon if I had to because my little girl needs me and I can do this. I will have enough confidence for both of us.

For more about Sydney's diagnosis, see The F in FAS does not stand for Fun.

Glasses, Eye Drops, and Drama

The first time I ever took Tate to an eye doctor for an examination I believe he was still in preschool. It was something the early intervention team wanted us to do. I had no worries about his vision but I wanted him seen by a doctor experienced with kids having autism. Children’s Mercy Hospital assured me they were the one I was seeking and I was very impressed. The Ophthalmologist at Children’s Mercy Hospital agreed with me. Tate was seeing fine. The second time we took Tate, he was in elementary school and was probably in second or third grade. I took him because the school nurse insisted he was not seeing well. I knew (or thought I knew) it was just his inability to understand the test directions and communicate with the school nurse. So we trekked over to Children’s Mercy again to see the pediatric eye doctor. His eyes again tested fine. When Tate was in fifth grade the school nurse failed him on the eye exam again and wanted me to take him back tot he eye doctor. I ignored her. When Tate’s sixth grade teacher and Para both told me Tate was struggling to see I made another appointment, fully expecting to fine nothing wrong with Tate’s vision. As we sat in that exam room and Tate tried to read the letters on the wall across the room I was stunned. The eye doctor asked me if I was sure Tate knew the alphabet. He’s known upper and lower case letters since he was a toddler. I wanted to crawl under the chair while someone made me a sign to wear that said, “BAD PARENT” because I had not known Tate needed glasses to see. He was as blind as a bat. Apparently, if a kid’s eyes are going to “go bad,” they often do it about the fifth grade.

The day Tate got glasses was quite a memorable day for more than one reason. It was snowing so hard that school was cancelled that day and I was going to cancel the appointment. It was a long drive and I did not want to make it. But my husband Shawn insisted he would drive us so we went. Normally if my husband goes to appointments with us he sits in the waiting room and works from his phone. He is a HVAC contractor and does a whole lot of his work on the phone. I asked him to come back with us. I suspected Tate was going to be a little difficult if they tried to put drops in his eyes. Wow. Was I glad Shawn was with us! Tate put up a fight. He did not mean to. He tried so hard to sit still and allow those drops to fall into his eyes but he just could not keep his hands down and his head still or his eyes open and he was thrashing around like a wild man. Tate is strong. He does not have much coordination but he is strong. And he is big. At that time he was over six feet tall. It took a lot of work and a long time to get those drops in Tate’s eyes. Without those drops though, they could not have really prescribed him glasses. Because kids like Tate cannot really go through the lenses and tell an eye doctor if their vision is better or worse, the doctor has to dilate the pupils and then look into the back of the eye and “see” for the patient.

Tate hated those drops so much. I don’t know if it was the stinging eyes, the dilated pupils, the required sunglasses, having to hold his eyes open for the drops, the invasion of his space, or the way his eyes felt for the rest of the day he hated the most. But when I told him a few days ago it was time to see the eye doctor again, it was the drops that became his number one topic of conversation for the next few days. He came up with every excuse in the book, including, “We only go to the eye doctor when it is snowing.” I got texts and his siblings got texts about this injustice. (I've posted his texts below.) He was sure I had made a grave error in scheduling an appointment in July. I promised Tate I would ask the eye doctor if there was any way we could forgo the drops this time. And I did ask but her answer was, “No.” I will insert here that both the doctor and her assistant were so patient and kind. They listened to Tate’s concerns in all his broken language. They waited for him to finish. We received a lot more than our fair share of time. They gave him several options, one of them being he could lie on the floor if he liked when they put the drops in. They worked hard to accommodate him. He chose to sit in the chair and try to do it without anyone holding his hands or head. He also opted to have Sydney go first (Yes. She had not had her eyes checked for about three years there so I had scheduled her too. Of course she was EXCITED to be there!) Sydney did fine as expected. And he did a great job compared to our last visit. He couldn’t keep his eyes open and his eyelids are SRONG. He kept raising his hands to “defend” himself but he tried hard not to. I held his hands down in the end but we got it done without other adults coming in. There were two nurses actually standing in the hall, ready to assist if we needed. He was proud of himself and he has not complained once since it was done! He has thin plastic slip-in sunshades for his glasses from the appointment and he is wearing them like a hot new accessory.  

Tate’s prescription had barely changed. But I got another surprise. Sydney needs glasses. She has always had a problem with her left eye drifting a little when she is tired. I don’t even notice it anymore but Shawn and her siblings do sometimes and they mention it once in a while. That drifting was the main reason I had made the appointment. I wanted the doctor to look at that again. Each time in the past the doctor told me it was not significant enough to treat. She told me that again today. However, now Sydney’s left eye has developed the need for glasses, unrelated to the other problem. The doctor said Sydney is using her right eye, which has almost perfect vision and not using her left eye, which is near-sighted. I have the same thing going on with my eyes and have since I became an adult. I caught myself just as I was about to say, “She gets it from her mama.” Oh yeah…. Ummmm No.  I have no family history on her birth mom’s eyes. Sigh.

So, we left Children’s Mercy and headed to Wal-Mart where we got three pair of glasses, one for Tate and two for Sydney. The total bill for three pair? $150.00 The frames are guaranteed for one year too. No questions asked. For kids under 18 years old, Wal-Mart does this as a service. Like them or hate them for many reasons folks but I like being able to afford the kids’ glasses so easily. I’m so glad a friend told me about their program for kids when Tate needed to get glasses. And of course, Sydney is excited and that will probably last a week. I imagine I will wish I had bought six pair when she starts losing them. 

This was 24 hours before
the dreaded appointment.
For ears? Seriously?
They made a huge
mistake then!!

There's been a huge injustice!
And he's still holding a
grudge about the past
appointment and the snow
day as well. Note:
Tate is always ready to
throw Levi under the bus.
He often tries to shift the
focus. HA!

He's desperate now. This was minutes
before we walked out the door. 

If you happen to be following Tate's photo gallery, he added a few today. While Sydney and I were looking at frames, I caught him out of the corner of my eye taking photos of the rows and rows of glasses. As usual, it's all about uniformity and lines. I added them to the post of his photos when we got home. You can find that here: Tate's photo gallery

And if you are interested in our dental visits then this is the post for you: cleaning, filling, and straightening the teeth of autism