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Monday, July 25, 2011

Decoding emotions

"I sad," our older son said to me yesterday amidst his mournful sobs. It was the most complete and profound sentence he had ever said to me.

I was trying to find out the source of his tears. Did he ouch? Did he feel yucky? Was he sad? Was he lonely?

"I sad," is what he told me. And, well, at least I knew we could rule out pain. But then he held out his hands, and they were shaking uncontrollably. I don't think "sad" was exactly the word that fit how he felt.

Nine hours earlier, we had administered a new medication to him in an effort to calm his overwhelming obsessive compulsive behaviors. I quickly ran to the print out of drug information about that medication and learned that his tremors were an adverse reaction to the medication.

Even if we held his hand, his body still trembled. I'm sure he felt weird. Maybe he even felt scared. Emotions are a difficult thing to teach to some people with autism. Feelings are not tangible, and often a person with autism will avoid looking at another person's face; therefore, they miss out on learning about emotions by reading and interpreting facial expressions.

With our older son, we've had to work on teaching emotions through basic pictures of cartoon images to real-life images of people he knows to real life images of people he doesn't know. In each picture,the subjects are displaying an emotion through the expression on his/her face. And, then, we just chip away. Label. Repeat. Label. Repeat.

Learning what our son is feeling at any given moment is not an easy task. He usually can't tell me. I'll be honest, this is one of the most difficult part of being his mother. He doesn't just have autism. He has medical needs as well. These needs require medication. He also has other conditions--ADHD, OCD and emerging bi-polar disorder. All of these needs require medication.

Medication trials on a nonverbal child with autism, a child who has difficulty expressing how he is feeling, is quite a challenge. It used to be that my husband and I just went into panic mode every time our son cried. Surely if he were crying, he must be terribly ill, right?

Perhaps, but, well, perhaps not. Also coming into play is a sensory system that does not register pain properly. What to the rest of us might feel like an uncomfortable gas bubble could to him be incredibly painful. When he was young and SCREAMING endlessly over a gas bubble, we thought for sure he must have something serious going on. :) And, while he does have serious gastric issues, that just wasn't one of them.

When our son was just a young toddler of two, we swore that we were not going to go down the route of behavioral medication. We were very natural in our treatments for him. Yet, as time passed and we learned of the genuine medical issues he had going on, we opted to treat him more traditionally. And, at a certain age, we also realized that his life could be more comfortable if we could find medication to calm some of his behaviors. This is a personal decision every parent must reach on his/ her own. Not every parent agrees with behavioral medication.

To be sure, giving him medication is tricky. We are altering his internal state and trying to make a judgment on that with vague clues.

After speaking to a pharmacist and a doctor, I gave our son some benadryl yesterday. His tremors were gone shortly thereafter. Then I asked him, "Are you sad or are you okay?"

"Okay," he answered. And then he touched me as if he were initiating a game of tag and said with a giggle, "Tickle me!"

Ahhh, music to my ears. Crisis averted. Some days I get it right. And, to be honest, some days I don't. However, I'm sure I will have a lot more opportunities to practice before all is said and done.

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