Showing posts with label Book Excerpt. Show all posts
Showing posts with label Book Excerpt. Show all posts

An Anorexia Primer

Professionals evaluating an eating-disordered teen
may be "helping" in ways they never expected

by Laura Collins


[The following is from "Eating with Your Anorexic: How My Child Recovered Through Family-Based Treatment and Yours Can Too" by Laura Collins; foreword by James Lock, M.D., Associate Professor and Director of the Child and Adolescent Eating Disorder Program at Stanford (McGraw-Hill, February 2005). This excerpt is from Chapter 9, "Folks, Don't Try This at Home"]

Finding a professional was not working out like it was supposed to. The prescription often accepted as gospel in eating disorder literature is the "team approach." In the fantasy world of these manuals, the family doctor notices the problem during a routine checkup and sits the parent down for a difficult talk. The doctor then refers the grateful and contrite parent to a therapist nearby who has extensive experience with eating disorders. The therapist meets with the young person, then assembles a team that includes the physician, a dietician, a psychiatrist, and -- if cooperative -- the parents. In that Disneyland of Eating Disorders Treatment, the team meets regularly to discuss the patient and coordinate treatment. The team is very professional and well qualified to understand and guide the family and patient. Everyone agrees on the method and prognosis and treatment goals. Everyone looks forward to a full recovery and their invitations to be on educational panels entitled "Success Stories."

But I live in the real world. Here where I exist, the magic team approach happens in rare and blessed confluence, which was no place I could get to. In the real world, the doctor isn't comfortable with the topic and your anorexic does not want to be "treated" (perhaps it sounds too much like a dessert). In the real world, you have to choose a provider from your insurer's list, your child's coaches just want their star player to keep playing, your husband wants the kid to "snap out of it," your other kids are starting to act funny too, the therapists you consult don't tell you anything, and your anorexic is laughing at you.

Meanwhile, during diagnosis and assessment appointments, your anorexic -- who is listening, not just providing data -- is tutored in his or her craft:

"Do you purge?" they ask with both eyes on the questionnaire, pen poised.

"Do you stick your finger down your throat to make yourself vomit?"

"What is YOUR ideal weight?"

"Do you use over-the-counter diet pills or diuretics?"

"Did you drink a lot of water before your weigh-in?"

"How many meals did you skip today? Only two? Is that all?"

Why not offer a primer? An anorexic gets so many of these questions and fills out so many questionnaires, you might as well just make a credit course out of it.

Meanwhile, although your anorexic is clearly growing more bizarre, no one examines her medically. None of the psychologists, psychiatrists, physical therapists, knee surgeons, coaches, or even our pediatrician ordered more than a perfunctory physical exam. No blood test or CAT scan. No one ruled out intestinal parasites, thyroid disease, a brain tumor, PANDAS, gallstones, chronic adrenal insufficiency, celiac disease, Addison's disease, diabetic gastroparesis, or any other of the kinds of illnesses misdiagnosed as anorexia that would have horrified me before, but at different points along the line might have sounded like welcome diagnoses.

They just kept weighing her.


[Laura Collins is the mother of two, wife of one, and a freelance journalist. She can be reached at Laura@eatingwithyouranorexic or at www.eatingwithyouranorexic.com.]

Reprinted from "Eating with Your Anorexic: How My Child Recovered Through Family-Based Treatment and Yours Can Too" by Laura Collins; foreword by James Lock, M.D., Associate Professor and Director of the Child and Adolescent Eating Disorder Program at Stanford (McGraw-Hill, February 2005). © 2005 by Laura Collins.)

Cross-Cultural Adoption


The Do's and Don'ts for Grown-ups

by Amy Coughlin and Caryn Abramowitz


[Whether they're thoughtless or just clueless, friends and extended family members can often say or do exactly the wrong thing when it comes to adopted children and adoptive families. If you've already adopted or just want to prepare those closest to you for your impending family expansion, these Do's and Don'ts from the authors of Cross Cultural Adoption: How To Answer Questions from Family, Friends & Community are worth passing around to the potentially tactless. If nothing else, it's nicer and less bridge-burning than screaming "Shut up, you insensitive clod!"]

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DO's

DO treat her like any other kid. It may be difficult and take a while for adopted children to feel like they belong within their extended families. Treating these children like they're "nothing special" can go a long way toward making them feel at home and comfortable within the group.

Avoid the temptation to spoil her because she didn't have everything that the other kids had in the first few months or years of her life. The most valuable gifts you can offer these children are patience, routine, and consistency -- and most of all, unexaggerated expressions of love and devotion.

DO support her when curious strangers ask questions. When curious (and sometimes thoughtless) strangers ask questions or feel the need to comment on the circumstances of the adoption, do not let them lead you into uncomfortable territory. Instead, gently steer them back to more suitable small talk or respond in such a way that shifts the conversation to positive adoption language that in turn lets the child know that you are on her side.

DO respect her privacy. Adopted children have the same need for and the right to privacy as you do. They do not want their entire life story being told to strangers. If she hears you discussing the intimate details of her origins, she will likely feel embarrassed. Until the child is old enough to decide for herself how much information she would like to share regarding her background, please respect her privacy.

DO treat prospective adoptive parents the same as expectant parents. Adopting a child is just as exciting for soon-to-be parents as being pregnant. They feel the same way all expectant parents do -- overjoyed, overwhelmed, nervous, impatient, and most of all, excited. Don't be afraid to ask adopting parents about these feelings. After all, adoption is neither a secret nor a source of embarrassment or shame.

DO acknowledge and celebrate the differences. One of the best things you can do to show your support as well as your love for the adopted child in your life is to learn a bit about the culture and history of her birth country. Read a couple of books, especially travel books. Even if you have no plans to travel there, there is no better way to get the feeling of another country.

DON'Ts

DON'T introduce her as adopted. The pain this inflicts on the child is obvious. The child is made to feel inferior, like she will never be considered a real part of the family. The rule is simple: Don't ever, ever do this.

DON'T say how "lucky" she is. After hearing this enough times, the child can be made to feel like a lifelong charity case, rather than the cherished child she is. Yes, she is lucky, but so is any child who has a supportive, loving family. And we parents are lucky, too, to have been able to create this loving, supportive family.

DON'T assume adoption is a second choice. The reasons people choose to adopt are as varied and unique as the people themselves. While it is true that many choose adoption because of infertility, it is also true that many choose adoption for a myriad of other reasons as well. Many people choose to adopt not because they are out of other options, but rather because they believe that adoption is the best choice for them.

DON'T jump to conclusions about the birth mother. Often thought of as weak, irresponsible, cheap, and worthless, birth mothers often suffer a lifetime of pain far greater than that of childbirth. Please don't jump to the wrong conclusion that these women are any different than you and me or that they love their children any less.

Most cross-cultural adoptive families know little or nothing about the circumstances that led their child's birth mother to relinquish her child. What they do know is that they love their children's birth mothers because they are a part of their children and it is because of them that their beloved children are who they are.

DON'T tell us we're sure to have "our own" now. She is our own. Those parents who choose adoption because of infertility do not secretly harbor lifelong yearnings for a biological child. Having "our own" is now irrelevant; the child we have is the one we want and it is inconceivable that we could love or want any child more. Like all parents, we have the best.

Copyright © 2004 Amy Coughlin and Caryn Abramowitz


[Amy Coughlin is an adoptive mom, a lawyer, teacher, and writer. She lives in Center City, Philadelphia, with her husband, Rich, and their two daughters, Audrey and Natalie.


Caryn Abramowitz is a freelance writer and editor. She is a lawyer by trade and the author of many legal and other types of articles in a variety of publications. She lives in Philadelphia with her husband, Andy, and their daughter Chloe.


They are the authors of Cross Cultural Adoption: How To Answer Questions from Family, Friends & Community published by LifeLine Press; September 2004; $18.95US/$26.95CAN; 0-89526-092-1. For more information, please visit www.writtenvoices.com.]

Your Expectations About the Emotional Needs of Your Child

An excerpt from The Post-Adoption Blues:
Overcoming the Unforeseen Challenges of Adoption

by Karen J. Foli, Ph.D., and John R. Thompson, M.D.

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"My child will like me, attach to me, and learn to love me."

There are many books that address the dynamics of the child's attachment and bonding, but few have explored how the lack of a child's attachment and bonding create feelings in the parents. These feelings can manifest themselves as confusion, anger, rejection, and deep sadness. Many parents believe that if they love enough, their child will reciprocate that love. Many times the child learns to respond, but there are also times when intervention is necessary. Your child comes to you with months, perhaps years, of learning how not to trust in others. Logically, you understand this; but if attachment is delayed, it can be nearly impossible for you to depersonalize this lack of attachment.

Esther confided to her support group how it felt to feel rejected after years of living with her daughter, Linda. She and her husband had adopted the child 4 years before, when Linda was 3. Now Esther lives with her anger, which has created a power struggle between her and her daughter:

It hurts. She turned to me and said, "You're not my mother anymore. I don't like you." I had just had it with her. I told her, "Fine. You'll give us our name back. You will not be a part of the family. You reject me, you reject the family."

Then she tested that on my husband, whom I hadn't said a word to. She announced at the dinner table that she didn't want me as her mother anymore. He echoed everything I had said to her: she would give up the last name and not live here.

We never heard another word about it. But she constantly tells me, "I don't trust you." I answer her, "I don't trust you either. You haven't earned my trust."

At times, children will attach to one parent more than the other. This preference for your partner can be painful. You're torn between the relief that your child has been able to bond to another and feelings of being alone and confused because that person wasn't you.

"My child will be as happy as I am."

You've waited months, years for this child. The anticipation of finally welcoming your child home is filled with joy. Her room awaits her. You have painted, wallpapered, purchased furniture, and changed your life to make everything ready for this child. But wait. She looks so sad. She's crying. She's confused. This holiday was supposed to be so happy for the family. Why is your child sullen and unhappy at Halloween/Thanksgiving/Christmas/her birthday?

Perhaps you thought things were going well. Your child had adjusted and her behavior had improved dramatically. Now, suddenly, she is exploding again, acting inappropriately in public, and crying for no reason. You're lost and wondering what is going on.

Anniversary responses to placement or other traumas can trigger unexpressed sadness in your child. She probably doesn't understand it herself and acts out the way children do -- through behavior. In some cases, she may have been placed so many times that she has lost track of those specific events and focuses on birthdays and holidays, traditional family times, to express how she feels through her behavior.

Your child may also come into your home with some chronic levels of stress and depression, feelings that are rooted in years of struggle. Responding to her past environments, the child has coped by using skills that were appropriate to that setting; yet behavioral changes (responses to perceived threats) could not alter her stress, depression, and anxiety (generalized fear).

If your child is older, she comes with a past that is one of the most significant influences on her present ability to feel and enjoy happiness. The joy of childhood may have been, at best, interrupted; at worst, that joy never existed. All human beings have basic needs in order to sustain life: oxygen, water, and food top the list. But there is also the need to feel safe. A chronic lack of feeling safe may be at the root of your child's inability to live a happy life in her new family.

"My child's needs will be the same as those of other children."

There are a multitude of parenting books that teach us about development and the "normal" milestones of children. As we've discussed, with time you will understand what needs your child may have. Multiple placements and damaging caregivers can leave a child with multiple and complex behaviors -- behaviors that overwhelm you, frighten you, and fill you with a sense of hopelessness.

But what about the tea parties? What about throwing the ball in the backyard? As with any child, adoptees need to be kids. Their play is their work. That's what they need to do, despite other needs that may exist or develop.

The evaluations by experts, the hours of therapy and tutoring, on top of just keeping a household running, can make us forget that playing is important to the child and to you. When you play, the child begins to know you. You are reminded of why you wanted to parent and of the joy parenting can bring.

Yet there may have been so many disappointments, so many celebrations gone wrong. Perhaps your child has accused you of horrible acts. Your resentment builds upon your anger. The child takes on the persona of a saboteur. A cycle forms. You become defensive when planning special events, anticipating that your child may act out. All of your strategies have failed up to this point. And on top of the anger, you feel helpless to change your behavior or your child's.

At times, you don't think of your child as a child. You forget that underneath the hurt and detachment, there is a young soul. You can't get past your anger to try again. You feel a stalemate has been reached. Yet the status quo doesn't seem to make anyone very happy. You wonder where is the happy family you envisioned.

You know your child needs something, but you aren't sure anymore what those needs are, or where to find help to meet those needs. You know your needs as a parent aren't being met, either. Where has the laughter, the lightheartedness, and the solidarity of the family gone?

"My child's story is our family's story."

Photograph albums now include a new face ... a new child ... your child. She is part of you now and is making family history along with other family members. But her history is different. She will need to make sense of it. Her peers and the public she is exposed to will ask questions of her and she will need answers for them.


[Karen J. Foli, Ph.D., is a registered nurse, medical writer, and the author of Like Sound through Water: A Mother's Journey through Auditory Processing Disorder. John R. Thompson, M.D., is a board-certified psychiatrist specializing in child and adolescent issues. The married couple resides in Bloomington, Indiana. Drawing on their own experience as adoptive parents as well as interviews with dozens of adoptive families and experts in the field, Drs. Foli and Thompson offer parents the understanding, support, and concrete solutions they need to overcome the post-adoption blues -- and open their hearts to the joy that adoption can bring. For more information, please visit Karen Foli's Web site, www.KarenFoli.com or www.writtenvoices.com.]

Reprinted from "The Post-Adoption Blues: Overcoming the Unforeseen Challenges of Adoption" by Karen J. Foli, Ph.D., and John R. Thompson, M.D. (August 2004; $14.95US/$21.95CAN; 1-57954-866-0) © 2004 by Karen J. Foli, Ph.D., and John R. Thompson, M.D. Permission granted by Rodale, Inc., Emmaus, PA 18098. Available wherever books are sold or directly from the publisher by calling (800) 848-4735 or visit their website at www.rodalestore.com.

The Power of a Clumsy Hello

What I learned from being "Sister of Joe"

by Maura Conlon-McIvor

[The following is an excerpt from Conlon-McIvor's memoir, FBI Girl: How I Learned to Crack My Father's Code, available from Warner books at all major booksellers in August 2004. For more information, please visit www.fbigirl.com, or www.writtenvoices.com.]

A fertile revolution against the status quo carved the social landscape of the 1960s. The events that riveted us to the TV mirrored another experienced in our home, albeit one with a quieter face. Joe, my youngest brother, was born with Down's syndrome. In the '60s, mental retardation wasn't cause for flowers or marches on the street. It was hush-hush news.

The scientific explanation for Down's syndrome echoes as a fait accompli: A genetic abnormality occurs in mitosis with an additional 21st chromosome, accounting for an array of developmental and physical challenges. As a kid this meant little to me, beguiled as I was by the poem my mother had placed next to Joe's crib: A meeting was held far from the earth. It's time again for another birth, said the angels to God above. This child will need much love.

I was in the second grade when Joe was born. My parents didn't learn of Joe's diagnosis for months, but they weren't fools to the obvious. Joe's "difference" settled over the family like a dense fog. Dad, a special agent for the FBI, assumed a deeper gravitas. Silence burrowed into our already quiet household. My mother shed tears over dessert. We kids went underground. Finally, my teacher, a concerned nun, rang one night, asking my mother why I'd become so sad.

Her phone call instigated what would become the first of many Conlon Family Meetings, presided over by my mother. We had reached the official switchback going from Life Before Joe to Life After Joe. In the world of the 1960s, my brother's birth was a tragedy. Our mission, if we chose to accept it, was to discover what the tragedy masked. Instinct would be our guide, as would the radar bleeping from our hearts.

I don't want to romanticize the notion of mental retardation. Such oft-called "accidents of nature" can be cause of real heartbreak. The boy you envisioned as star quarterback learns to tie his shoelaces at age ten. The girl who might teach physics instead boards the bus for special school. Opportunities have widened in recent years for people like Joe. Still, these children are paradigm busters. You don't hear them mentioned in wedding vows. And mothers and fathers who devote their lives to raising these kids worry about their care when the parents are gone.

But I was Joe's sister. SOJ. Sister of Joe, the person who helped him brush his teeth and get into his pjs at night. I was the pathologically shy kid and he the severely retarded one. Together we made our way into the world.

Joe spoke with a quiet animation. I learned to understand him by peering into his eyes, deciphering his mono-syllabisms using a combination of intuition, pantomime and later sign language. I discovered he could learn words using lyrics so I'd play the piano and he'd sing along as best he could. Ours became a language similar to music, enveloping the heart's larger truths so often constrained by human words.

Soon enough, my shyness morphed into the palpable hope of learning to scatter joy the way Joe did. My brother was the king of collapsing space and time. After school he'd stand on our corner sidewalk, and wave to car after passing car. The drivers, coming home from work, would crack a smile, some rolling down their window and yelling hi back. Joe approached people in restaurants, markets, theaters, ball parks, surprising them with his eager handshake and clumsy hello. Nobody was a stranger to Joe.

My father, the special agent, was a gravely quiet and sometimes a cynical man. After biting into his sandwich one day, he quipped that normal people were really the retarded ones. His work in the shadowy underworld no doubt contributed to this sentiment. But I knew what my father was saying. Joe held the mystery of love that melts the walls we "normals" spend our lives constructing. Joe made sense of nonsense by teaching us how to live in the moment.

The human heart is wired with an innate intelligence. How easy to forget this when we are preoccupied with pursuing "intelligence" of another kind. These days when fear of the other so pervades our culture, I am grateful for the greatest lesson I learned from Joe: our world is made by our reaching out and saying a clumsy hello.

Copyright © 2004 by Maura Conlon-McIvor

The Wild Boy

How can it be that we left our house an hour ago
with a healthy toddler, and returned
with a disabled one?

by Paul Collins

[Editor's Note: In his book Not Even Wrong: Adventures in Autism, author Paul Collins captures that turning point in the lives of parents of children with special needs when they realize that the child they think of as brilliant and unique and different in a fascinating way is, to professionals with clipboards and developmental charts, different in a way that's not good at all. The story of Paul; his wife, Jennifer; and their son, Morgan, is interspersed with Paul's research on autism, including the story of an 18th-century "wild boy" believed to be an early case of autism. In the scene excerpted below, Paul and Jennifer endure their son's first early intervention evaluation. Sound familiar to anyone?]

The following is an excerpt from the book Not Even Wrong: Adventures in Autism by Paul Collins; published by Bloomsbury, 2004; $24.95US; 1-58234-367-5. Copyright © 2004 Paul Collins.

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"So," Autumn tells us, "we're going to do this evaluation by setting up some activities for him to do, and it's sort of timed."

Morgan is sitting on a carpet at the child development center, running a toy pickup truck back and forth in an arc across the floor. The room is full of grown-ups -- me, Jennifer, and a clutch of women bearing business cards that all read PORTLAND EARLY INTERVENTION PROGRAM -- and our son could not care less. He is holding up the pickup truck and spinning its wheels one by one, then in pairs, then all at once, carefully observing how they slow themselves to a halt by friction or by his slapping a hand against their treads.

Autumn, the newly minted college grad of the group, goes over to a video camera at the corner of the room, adjusts its tripod angle downward, and then slips a tape into a boom box. The specialists sit at a table in one corner, observing our son. Autumn turns on the tape and then drops down on her haunches to Morgan's height.

"Okay! Morgan, we're going to have fun."

He looks up momentarily from his truck and then goes back to spinning the wheels.

"Ready," the disembodied voice warbles from the boom box. Beep.

"Okay!" Autumn says. "Morgan, let's play with blocks."

She pulls out a set of wooden blocks and takes one out.

"Can you take out a wooden block?"

He looks at the bag in a desultory way.

"I take a block out," she says. "Can you take one out?"

Morgan turns around to look at the video camera and boom box instead.

"Ready," it says again. Beep.

Jennifer and I look at each other. What are they getting at here?

"Morgan ... Morgan," Autumn repeats. "Where is the red block? Where is the red -- "

He mashes his finger down on the red block.

"Good! Where is the yellow block?"

He gets that one, too. He keeps wanting to look back at the camera instead, but at least he's getting the questions right now. Jennifer reaches over and squeezes my hand, and I feel a burden lifting off me. We desperately want to intervene and cheer him on, but we both have to keep quiet.

"Where is the bl -- "

"Ready," it says.

Morgan spins around to face the boom box.

"Set!" he yells back delightedly. "Go!"

Laughter ripples through the room.

Beep.

"Morgan ... " Autum smiles. "Can you look at the doggie here? The doggie? ... Morgan?"

The "Ready" keeps coming, and each time, Morgan turns around to yell, "Set! Go!" back at the boom box. This, he has decided, is the point of the game. He is barely paying attention to Autumn and her bag of toys.

"Morgan, can you clap your hands? Like this? ... Morgan? ... Morgan, look at me. Clap. Clap your -- "

"Ready."

"Set!" he yells. "Go!"

Beep.

He turns to Autumn but notices her case file folder and reaches into it.

"No, Morgan," she says cheerily as he rearranges paperwork. "Over here ... Morgan?"

Autumn waits until he is looking back at her, and then she deliberately pulls her lips into a sad-face frown.

"Ohhh," she sobs woefully, waiting for his sympathy. "Ohhh! Boo-hoo!"

He watches her a moment but doesn't react. Then he gets up and walks away.

"Ready."

"Set! Go!"

He charges at the big expensive video camera and grabs the tripod, and all of us -- a roomful of half a dozen adults -- are frozen for a moment.

Beep.

"Whoa!" I swoop in. "Morgan, no no no. Leave the camera alone."

"Cam-wa."

"That's right, honey. Let's go back and see Autumn."

But he pulls against me. He doesn't want Autumn or her toys or her funny faces. He wants to inspect the tripod.

"Morgan -- "

"Ready."

"Set! Go!"

I keep waiting for them to end the test, because it's all falling apart now, but they don't. It just keeps going, and the timed beeps won't stop, and the camera doesn't stop rolling, and he misses out on more and more of the evaluation prompts. And the specialists take more and more notes.


[Paul Collins is the author of Sixpence House, which records earlier adventures of the Collins family, and Banvard's Folly: Thirteen Tales of People Who Didn't Change the World. He edits the Collins Library for McSweeney's Books, and his work has appeared in New Scientist, the Village Voice, and Business 2.0.]

Reprinted from Not Even Wrong: Adventures in Autism by Paul Collins © 2004 by Paul Collins. Permission granted by Bloomsbury USA., New York, NY 10010.

Sensory Integration Inspiration

The new book Love, Jean: Inspiration for Families Living With Dysfunction of Sensory Integration promises to be a treat for anyone interested in DSI. It features letters written by A. Jean Ayres, pioneer in the field of sensory integration, to her nephew, Philip Erwin; Erwin’s own stories about his struggle with sensory integration; and ideas for parents from therapist Zoe Mailloux. Below are samples from each of the book’s three voices.

[The following are excerpts from the book "Love, Jean: Inspiration for Families Living With Dysfunction of Sensory Integration” by A. Jean Ayres, Philip R. Erwin, Zoe Mailloux; published by Crestport Press; May 2004; $15.95US; 0-9725098-1-X. Copyright © 2004 Philip R. Erwin.]

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A. Jean Ayres Baker
Torrance, CA

October 22, 1975

Dear Phil:

I was delighted to get your letter of October 19 and I found its contents most encouraging.

The fact that you can notice improvement in coordination as a result of the activities indicates that your nervous system can change in a positive direction. If it has changed that much in a few months, it will probably change some more in the coming months. I am particularly pleased with your report of reduced nausea when swinging on the platform swing. That means your brain is modulating the vestibular input better. As it becomes better modulated, you will be able to tolerate more movement; more movement will, in turn, help your nervous system to work better. It is like breaking a vicious circle.

Glad to hear the football is working out well. I don't think I gave you very good directions for using it, but you seem to have done well with what I said. Here is a more explicit set of directions. The objective is to get your brain to send automatic messages to the muscles that make your trunk muscles contract just enough to keep your center of gravity on the ball. I suspect those automatic movements don't come through very automatically with you. You may have to help them by thinking about rotating your trunk a little and consciously doing it when you find yourself beginning to roll to one side, or bending your trunk if you start to go forward or backward. The best way to do that is to first position yourself on the ball so that you are close to being able to balance, then put one hand on the floor. Then try not to use your hand to help you balance, just to keep you from falling off, but try to balance by wiggling your trunk. If it doesn't come naturally, explore movements a little bit by deliberately moving your trunk one way or another to see the effect.

Another way of getting those reactions is by nailing a piece of wood about 2" x 2" on the bottom of a larger piece of wood. Then get on top of the wood on your hands and knees and rock the board back and forth in different directions.

Something else you might try sometime is a jumping board. I don't use one because it is difficult to get one light enough for me to carry around but sturdy enough to hold up. Put a piece of 2 x 4 crosswise at either end of a long, narrow board that has a spring to it, then jump on it. Maybe a 2 x 6 would be better for a 14 year old.

Incidentally, many parents have reported growth spurts as a result of sensory integrative therapy. You might be interested in keeping track of your growth rate.

Blowing on a tin whistle while on the platform swing (which is mostly for balancing rather than swinging) is a good idea. The automatic system often comes in better if the consciousness is directed elsewhere.

Love, Jean


Magical Footwear

By Philip R. Erwin

Change did not occur overnight. Instead I was transformed in several ways over several months. Previously I had viscerally disliked balancing and climbing on things. I spent most of my free time in non-physical, non-competitive activities and private games of imagination. Solitude was fine with me.

One day I got new sneakers. It had been a very snowy winter, meaning that I couldn't spend much time out of doors. One day it thawed and I went outside to play. I picked up my long-unused lacrosse stick and used it to toss a tennis ball against the garage door. To my utter amazement and elation I actually caught it!

I then felt an overwhelming urge to climb the big tree in the backyard. I clambered up it with ease. Great shoes, I thought. But then I felt an urgent need to climb every tree on the large property where I walked my dog. I needed to get on the roof of the garage. I felt compelled to swing and climb on the structures at the playground at the school in back of our house. I needed to ride my bike. For the first time in my life I felt as if I had a physical presence on the planet. For the first time in my life I didn't feel puny. We were well beyond good footwear. Something inside me was changing.

My final year at the prep school was dismal. At every turn I was presented evidence that I was a substandard misfit. But my skills at coping effectively with these assaults were bolstered, I believe, by two things. First, I had been reassured that my failure to thrive in the school was not entirely my fault and was not necessarily my only destiny: hope was evident. Second, I felt better about myself because the therapies I was receiving were enabling me to cope with all of the stimulation — good and bad — in a more organized fashion. The world had gradually become a less hostile place for me. And great changes were on the horizon.


Will My Child Be OK?

By Zoe Mailloux

Some of the common questions parents ask when they find out that their child has sensory integration dysfunction are, "Will it go away?", "Will he grow out of it?", "Will therapy cure the problem?", and similar questions that ultimately ask what the future holds. In reality, all parents worry about their children's future, knowing that accidents, drug abuse, or simply making poor choices can mean the difference between a bright and bleak existence. However, parents of children with dysfunction in sensory integration are right to be concerned about how this "invisible problem" might limit their children's potential.

When a parent seeks and finds help for their child's sensory integration problems, I always feel that half the battle has been won. Clearly one of the most debilitating aspects of these disorders is the fact that they are little known and largely misunderstood. Whenever possible, helping the child to understand what is going on in his nervous system seems to be a positive step. The most common emotion I encounter from both parents and children upon learning about sensory integration dysfunction is relief. A great burden is lifted and there is often a sense of validation when there is a name for a previously confusing and vague condition. In addition, feelings of guilt are commonly alleviated, since parents and children alike often feel at fault for the problem. Well-informed and astute parents help their children a great deal as they learn to recognize how problems in sensory integration function are affecting learning, behavior, skill development, and social interactions.

Dysfunction in sensory integration is often referred to as a type of "inefficiency" of processes that occur in the brain and nervous system. Sensory integration functions typically occur automatically, fluidly, and subconsciously for most people. Some parents become alarmed to think that there might be a problem in their child's brain. However, sensory integration difficulties are not like the problems usually associated with "brain damage" or trauma. In most cases, the structures of the brain and nervous system are probably intact. It is more likely that the "messages" sent from one part of the brain and nervous system to another are not as clear, fast, or complete as expected.

One thing that is well documented about the structures and functions of the brain and nervous system is that they are "changeable," especially in a young person. The word "plastic" or "plasticity" is used to describe this characteristic of the brain. The fact that the brain is plastic allows us to be affected by the experiences we have, especially in early development, in both potentially positive and negative ways. We talked earlier about children whose development was affected by conditions of deprivation (such as in crowded orphanages) and that these children can make great gains when given more optimal developmental opportunities. The same principle is at work for children with dysfunction in sensory integration. They will often need individualized opportunities for experiences that will help their brains and nervous systems send and interpret messages more efficiently.

As important as sensory integration function is, it is still only part of what determines our success or failure in life. Intelligence, personality, drive, temperament, and persistence are all characteristics that will play an important role in whether or not any individual leads a satisfying and productive life. The most important thing a parent can do for a child with a sensory integration disorder is to ensure that this problem does not interfere with that process. This is accomplished by a combination of integration and understanding.

— ZOE MAILLOUX, MA, OTR, FAOTA. Ms. Mailloux is nationally and internationally recognized within the profession of occupational therapy in the area of sensory integration theory and practice. She is currently the Director of Administration at Pediatric Therapy Network, a non-profit children's therapy center serving over 1000 children and their families. She was a research assistant to Dr. A. Jean Ayres from 1978 to 1984 and was involved in many clinical and research projects with Dr. Ayres. In addition, she has published numerous journal articles and textbook chapters on these topics. Ms. Mailloux was the chairperson of the Sensory Integration Special Interest Section of the American Occupational Therapy Association from 1993 to 1996 and was named a fellow of this organization in 1993.

Reprinted from Love, Jean: Inspiration for Families Living With Dysfunction of Sensory Integration by A. Jean Ayres, Philip R. Erwin, Zoe Mailloux; published by Crestport Press; May 2004; $15.95US; 0-9725098-1-X. Copyright © 2004 Philip R. Erwin.

An Unexpected Journey

A father's quest to find meaning in difference.

by Dan Kennedy

[The following is an excerpt from the book Little People: Learning to See the World Through My Daughter's Eyes by Dan Kennedy; published by Rodale; October 2003; $24.95US/$36.95CAN; 1-57954-668-4. Copyright © 2003 Dan Kennedy.]

From almost the moment we were told that our beautiful new daughter was a dwarf, I've been on something of a quest — a quest to find meaning and purpose in Becky's having a life-altering genetic difference. I don't want to suggest that I've been looking for meaning in her life. That's a given. I've always believed that she has the same potential, the same opportunities, the same chance to succeed or fail, to be happy or sad, as anyone else. But I wanted more. I wanted to know why she was different — or, to be more accurate, why her particular difference was so much more obvious than those that affect most of us. And I wanted the answer to that question to be positive, uplifting, life-affirming.

Maybe it's a function of fatherhood, of the ever-so-slight distancing from family life that is imposed on men by biology and social conditioning. For my wife, Barbara, who's more focused on Becky's immediate needs, such questions of meaning are a waste of time and energy. She is who she is. But for me, forever part participant, part observer, the search for meaning is central.

My compass is the idea of diversity, of the belief that human variation is in and of itself a positive good, and that, though dwarfism will surely cause Becky problems, there are beneficial aspects to it as well. Greater empathy. Strength of character. Even service to humanity: she could be carrying genes whose purpose is unclear at the moment but that someday might prove beneficial. But is that really an honest way of looking at Becky's dwarfism? Or am I just kidding myself, rationalizing, trying to create a comforting fantasy out of a complicated reality?

By now you'd think I would know better. After all, Becky is my only daughter, someone I've looked at, admired, and worried over every day of her life. You'd think it wouldn't require the puzzled reaction of strangers, of the outside world, of a culture that simultaneously celebrates and fears diversity, to pull me out of my reverie and force me to focus on the facts of the matter: That at the age of ten she is no taller than an average five-year-old. That her head is already much bigger than her older brother's, with a heavy, prominent forehead. That her arms and legs are impossibly short, that her butt sticks out, and that she sways back and forth, waddling, when she walks. That she is a dwarf, not a poster child for some abstract ideal of diversity.

Not that I ever lose sight of this, exactly. In some ways, the realities of Becky's dwarfism are always with me. Every day I think about the dwarfism-related breathing complications that nearly killed her when she was a baby and that held sway over her first three years. And I know that dwarfism continues to alter her life in ways both large and small — from the slight hearing loss that makes it difficult for her to learn, to the miniature clarinet that she plays because she can't reach the bottom keys on a standard-size instrument. But these are side effects, consequences of her dwarfism, not dwarfism itself. To strangers, she is — as a physician's article on dwarfism that I once read so charmingly put it — a funny-looking kid. To us, though, her dwarfism has little to do with how she looks and everything to do with the ways it has changed — not diminished — her life, and ours.

Her learning disability makes it hard for her to understand what she reads, but she is brimming with empathy for others. Her tastes in television shows, movies, and computer games lean toward those of a much younger child, yet she has such a sense of responsibility that she will do her chores and her homework without having to be told. Her size often relegates her to playing with kids half her age, yet she is so outgoing with adults that she thinks nothing of picking up the phone and pitching Girl Scout cookies to friends of ours whom she's only met a few times. These are tangible signs of who she is, of a personality and an identity shaped partly by her dwarfism, mostly because no two kids are alike. The labeling — the idea that she is a dwarf, and that's all she is; that her individuality is subservient to how differently she happens to be put together — well, that's what I often lose sight of. Except on those occasions when others remind me.

On Labor Day weekend in 2002, right after Becky's tenth birthday, I took her to her favorite amusement park, a place in New Hampshire called Story Land, near Mount Washington. It was a rare father-daughter day; my son, Tim, had gone camping with friends; Barbara stayed home. As with the TV shows and movies that Becky watches, Story Land is geared mainly for children several years younger than she. But the reason she likes Story Land more than, say, Six Flags is strictly practical: she is just tall enough to be allowed on every ride.

I resolved to pay attention on this cool, sunny Sunday — to stand aside as much as I could and take in the scene. What I saw was a revelation — not that I should have been surprised. People were staring. There was a little pointing — not much — and some long, incredulous looks. Shuffling through the slow-moving lines for the more popular rides, I noticed people looking at Becky, whispering, wondering. As I was waiting to order lunch, a woman came up to me and asked how old Becky was. Now, I've gotten those questions before, and normally I suggest that the person ask Becky herself. Many adult dwarfs say there's a common assumption that because they're short, they must be mentally disabled as well. To counter that, I like to nudge people into engaging with Becky, to experience her outgoing personality and her wit. This time, though, Becky had found a couple of kids to play with, and they were running in and out of a mock jail with rubber bars, shouting and laughing. So I told the woman that Becky was ten, and waited for the look of confusion, followed by enlightenment, that invariably follows. She then asked me the politically correct term for — well, you know. I should have replied "Becky", but my tongue ran ahead of my brain. "'Dwarf' is fine," I said. She seemed satisfied and walked away.

Later I thought, What an odd encounter. Not unpleasant, mind you. The woman had been friendly and inquisitive, and there was nothing about her demeanor to suggest that she thought Becky was to be pitied or looked down upon. Still, her boldness in coming up to a perfect stranger and asking why his daughter was — well, a funny-looking kid — communicated the unspoken message that Becky is public property, and that her parents are obliged to explain her to the world. And I realized that obligation would eventually have to be taken on by Becky herself.

I've heard dwarf adults say that, from childhood on, they've been treated as if they're always on display, never anonymous, never able to blend into the crowd. I once heard a woman — an attractive thirty-nine-old mother of four who happens to be four-foot-two — lament that she can't even get out of the mall without fielding questions about what it's like to be a dwarf.

Whenever Becky and I go about our business near our home in Danvers, a suburb on Boston's North Shore, people — kids and adults alike — are always stopping, rolling down their car windows, waving, and saying, "Hi, Becky!" Because of her hearing problems, compounded by a certain congenital obliviousness, I sometimes have to give her a nudge before she'll wave back. And at least half the time she can't tell me the names of the people who've just greeted her. They know her; she doesn't know them. They're anonymous; she's not. They can choose whether to wave or not, to say hello or not, to drive on by or not. But she's expected to be polite and friendly at all times, to acknowledge the presence of others because they have chosen to acknowledge hers.

I have come to understand that Becky must learn to be an ambassador's visiting dignitary from the Land of Dwarfism, always upbeat, always polite, always on. It may not be fair. It may not even be possible. But it's there, all the time, tied up in our cultural fascination with difference, with otherness. Dwarfism, in effect, functions as a metaphor for that fascination, inspiring laughter, fear, revulsion, condescension — but never the sort of half-conscious non-reaction we normally experience when encountering ordinary people going about their ordinary lives. Dwarfs, too, are ordinary people leading, for the most part, ordinary lives. Yet they invariably provoke an extraordinary reaction.

This book tells Becky's story. But it also tells my story, a father's story — and that of a people, a race even, whose members are no different from anyone else except for the way they look, and yet whose difference has cast them in the role of perpetual outsiders. Above all, it is the story of my quest to find meaning in that difference.

Reprinted from Little People: Learning to See the World Through My Daughter's Eyes by Dan Kennedy © 2003 by Dan Kennedy. Permission granted by Rodale, Inc., Emmaus, PA 18098. For more information, please visit the author's Web site at: www.dankennedy.net.