Michelle (msagara) wrote,

Early grade one and the Developmental Assessment

We did suggest that my son be let off of afternoons until December, to help ease him into the new school routine.

His teacher, however, declined (to my frustration); she felt that it was important to use the time we had to integrate him into the classroom, as much of his life from here on in would, in fact, be in a classroom. At this point, he was in no way integrated into the classroom, and he did not participate in many of the activities; he didn't volunteer to answer questions, he didn't speak up in the circle, I'm not sure he sat still for story time.

The teacher also said that my son would simply stare at his desk for long hours of classroom time and refuse to do any work unless someone was standing over his shoulder to constantly prompt him. I volunteered to come to the class to do that, but she declined, and she found a different volunteer (I think the woman was from her church, but I may be mistaken; I only knew her name) who would do this on a daily basis in the afternoons.

The volunteer, however, was exactly that: a volunteer. Educational aides are available in the school system, but they require funding, and the funding isn't given on the basis of the teacher or principal's recommendation; it comes through the auspices of Special Needs, and to access that money, your child has to be designated a Special Needs child. To be designated a special needs child, the parents have to go to an IEP committee and apply to receive the designation.

We had nothing to take to a committee, or rather, nothing that they would require in the way of paperwork.

But we had the teacher's suggestion. A developmental assessment might help the school, and it might help us. Honestly, at this point we knew our son could be two things: very, very difficult if you did not know him reasonably well, and very, very sweet if you did. We had pretty much juggled our way around the difficult parts, assuming these were personality quirks that time would eventually smooth out.

The grade one teacher had spent all of her teaching career as a special ed teacher, in classrooms of six (or fewer) children, and we'd no reason at all to doubt her observations, so we headed off to our son's paediatrician to ask her for her opinion and her advice. She pointed out that our son had never failed to make decent eye-contact -- which is true; he never did -- but agreed that it wouldn't hurt.

However, psychological assessments can take some time to book. We live in Toronto, where the Hospital for Sick Children resides, and it's a fabulous hospital for children. But it had a waiting list of eighteen months. Eighteen months didn't seem all that useful, and the doctor therefore suggested a different child psychologist (actually at this remove, I'm not sure whether or not she was a psychiatrist, because she could prescribe medication). She said "Some of the parents find her difficult, but she won't have trouble with the two of you" which seemed a bit cryptic at the time. That doctor could see us in only a few months, in comparison.

When we went to see her, she was an elderly, small woman. The only thing I clearly remember about our visits was that we were always the only people in the office at the time, and that my son had to do a number of tests. It was interesting because on the first day, she came out to get us. "He wouldn't finish the written part," she said, in her clear voice.

I thought I knew what the problem was, so I said, "Your pencils don't have any erasers on the end, do they?"

Which made her blink. "Why does that matter?"

"I'm guessing he made a mistake while writing. If he has no way of correcting a mistake, there's nothing you can do that will encourage him to continue."

We went back in and she handed us the partial form, and sure enough, that was what had happened, so she asked us to return the following week, when she would have an eraser for the test.

I actually mention this because it was one of the key aspects of my son's interaction with his school work and tests. He hated to make mistakes. He hated it. All of his tests would come home, and the answer portions would either be correct or…blank.

(I just asked my son about this reaction, and this is one of the things he remembered: he hated to guess. It felt as wrong to him as just writing a random, stray word would have felt. And, given the way he thought, it would have been exactly the same thing. There weren't degrees of possibly correct answers; there was the right answer and everything else was the wrong answer. Everything else. An educated guess and a random scrawl of letters were the same thing to him at the time.)

We assumed that his fear of being wrong was due to something we had inadvertently done as parents, at the time. That he had developed some sort of phobia about making a mistake. There was a lot of soul-searching on my part, because I had tried so damn hard not to be judgemental about mistakes. Mistakes are unavoidable in life, and given just how poorly ASD children initially respond to anything new, I did my absolute best to minimize the consequence of honest errors because I reasoned that if he were afraid of making a mistake, he'd never try anything different.

But it wasn't. He knew that for a test, he was to write down the correct answer. If he didn't have it or know it, a blank was the same as any other attempt.

By the end of the not entirely complete assessment several weeks later, the Dr. believed that we did have a strong understanding of our son. She was actually very, very kind to us and said two things:

1. I don't believe that you could do a better job with your son than you are doing.

2. I believe that he would benefit from Ritalin.

He was six years old.

She promised to write a report that could be used when dealing with a school board's IEP program (Individualized Eduation Program; it's something for Special Needs children), and gave him a general diagnosis of ADHD and Aspergers.

We went away and discussed Ritalin. My mother didn't like the idea at all. My husband's mother, who never, ever gave any advice unless it was asked for in a very direct way, was a pharmacist. The whole of her comment was to send my husband home with a stack of clinical papers on studies about Ritalin that were two inches high (I'm not making that up, either). My husband and I were ambivalent because by time we had started his assessment, and had gone through the many weeks of visits, it was late enough in the year that the trial period for the drug would end after the school year did.

Ritalin does have side effects, but those side effects are known to diminish with prolonged use in many cases, so the expected trial period is eight weeks; if it's still causing difficulties after eight weeks, it can be discontinued. It's taken only during the school week, and is frequently not recommended for very young children. If it had been a two week trial, I think I would have been willing to try.

Our paediatrician was actually moderately surprised at the Ritalin suggestion, but said, "You must understand one thing about this doctor. Parents go to her all the time. I refer hundreds of parents a year to her, and most of them go to her hoping that she'll prescribe something that will calm their children down. She doesn't. She suggests medication for maybe four children a year out of those hundreds. If she suggests medication for your son it's because she believes it is necessary and it will help him cope, not you. If she feels that this will help him, I think you should consider trying it."

She knew we were very conflicted. My son's godfather wasn't; he was adamantly against it, because one shouldn't have to drug a child just to send him to school. I have nothing against medicating a child, in theory, fwiw, if the drugs are helpful and necessary.

But -- and this is very much one of my personal ticks -- I was uncertain because I wanted my son to be able to make an informed decision of his own, and at six, that's not really possible. We decided against it, in the end, because although everyone was struggling, he was coping.

The Doctor was furious at us when we declined. Really, really angry. She likened it to refusing to get glasses for him if he had poor eyesight. She really didn't care about us or what would make our lives easier; she'd suggested it because she thought it would help my son. I didn't appreciate how true this was of this particular Doctor until I met some of her other patients and discovered what her most frequent recommendation actually was: Parent better, you irresponsible idiots.

She did, however, now unleash that on us. She was just…angry.

I do sometimes wonder, at this remove, if we made the wrong decision at the time. I do wonder if it would have made it easier for him to focus and cope in the classroom. I'm still not entirely certain.

In that classroom, during the months we waited for the appointment to begin his first psychological assessment, my son was only barely keeping his head above water, and was only managing that much because of his very fine teacher and his principal, Jane Fletcher. And because this has gone long again, I will talk about what his classroom was like tomorrow.
Tags: asperger child
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