Wednesday, May 03, 2006

Tics & OCD & the dentist...

Well, it's 10:00 pm & B still isn't asleep... It's been a very long time since he's had this sort of trouble. I tried reading to him as usual, but the OCD-driven tics were so loud & frequent that I couldn't hear myself read, let alone B hear me. I tried to problem-solve, to see if there was anything that I could change in his environment so he could relax. At first he said, no... so dad took over & tried just laying on the bed in the dark with him, to see if he'd drop off to sleep with just his company. But that didn't work, so I came back up & tried to read again. No luck. This time, when asking if there was anything we could do, he said he couldn't breathe in bed, because of a thought. I offered first to spray his bed with lemon-lavender spray (which used to work...) but he said it wouldn't help, so I suggested we change the sheets, since this has also helped in the past, & he agreed. He moved his stuffies & bionicles, & seemed in much better spirits as we replaced his sheets with clean ones. I asked him if he wanted me to stay & he said no (he actually apologised quite a few times- he's been compulsively apologising for the past few days & I've been trying not to get frustrated, but it is annoying...), so I turned out the light & left him. C stayed upstairs to monitor the situation... & soon we heard the tics (loud, exploding noises) start up again. C came downstairs & said he was going to try putting B in front of a video (it was now 9:45 pm) to see if he could get his mind off things. I wished him luck- B sometimes rejects this sort of intervention when he's really tired- but it seems to have worked. I have been reading Stephen Hawking's "A Brief History of Time" to B at bedtime these days, & tonight we got into the warped nature of space, as predicted by General Relativity, which had reminded us of some of the cool graphics in "The Elegant Universe" (which we taped from PBS at least 1 1/2 years ago, which started B on his string theory craze), so he requested to watch "Elegant Universe" for a bit...

Reading Zilari's "Partprocessing" & Kristina Chew's "Autismland" blogs has helped me to remember that there doesn't have to be a "logical" reason for every behaviour of B's, & that days are days- some start out rotten & then get progressively better, & some begin "good" & end very strangely... today seems to be one of the latter. Today started out with B's semi-annual dentist appointment. The first good thing (we were unanimous in this sentiment) was that we didn't have to leave the house until 8:30 (rather than the usual 8:00), to get to the dentist by 9:00. B happily chatted about Pokemon during the car trip. He was a bit anxious in the waiting room... there are a lot of little-kid-type toys in there & these usually start him ticcing. I encouraged him to watch the fish in the big tank by making various observations about the different kinds of fish & what they were doing, which worked pretty wel,l until we were able to go in for the appointment. From this point on B was completely self-possessed. B has absolutely no fear of dental appointments, thanks to our having gotten him started when he was 2 1/2 years old with a pediatric dentist I knew from my research days. As a former dental researcher & myself a dental-phobic, I was determined to get B so used to the dentist that he'd be comfortable going there no matter what. My dental-phobia stems from having inheirited deeply grooved molars that were impossible to keep clean. I had my first filling at the age of 6 & the misery only started there. The dentist I saw all too often when growing up didn't believe in novacaine (he'd probably be charged with child abuse these days), so my experiences with dentistry were extremely painful & scary. Lucky we decided to be pro-active about B & dentistry, because he got my tooth morphology & also had his first filling when he was 6... with nitrous oxide and novacaine (although he swears there was no needle involved...). He also had his molars sealed when the filling went in, to minimise the caries risk. To make sure that B would continue to have good experiences at the dentist, I made sure to inform the dentist of B's Aspergers diagnosis at his first appointment afterward. Dr. Dan was very grateful when I did- my impression was that this doesn't always happen, which can make things unnecessarily difficult for him when dealing with his patients. When we were referred to an orthodontist, I asked for someone who would understand B's oral-motor issues & the person Dr. Dan sent us to was great (& told us to come back next year, to boot, which was good news :).

While watching B get his teeth checked & cleaned, x-rays taken & fluoride applied, I reflected on how well he was coping. He knows the office & the routine very well, plus he knows the hygienist (& she knows him :) & Dr. Dan, of course. B happily chatted (when his mouth wasn't otherwise occupied), said "hi" to the doctor as he walked in without prompting, did everything he was told, endured the fluoride apparatus & sucking hose for a whole minute, went off for his x-rays without a glance back at me... no tics, no intrusive thoughts. What a blessing!

I got B to school in time for math, which was serendipitous because they were starting their new geometry unit, which B had been looking forward to. I left him happily anticipating the challenge... C also had a dentist appointment today, so I did not get my usual Wednesday off from picking B up. Wednesday afternoon is music lesson time for B's class, something he also usually looks forward to. Lately, though, he's been tic-ridden & unhappy when C's picked him up on Wednesdays- it seems that there are more & more OCD triggers during music class, making it almost impossible for B to participate :( On the way home I asked him about the triggers... he said that one trigger was "an adult in the room, but not Joe (the teacher)" & I guessed, correctly, that it was an aide in his class. I had been getting the feeling lately that she was triggering him & had wondered why. So, I asked... & discovered that perhaps B's OCD sensitivities aren't completely off-track or unhelpful. B said that this aide had been scaring him with some of her methods for trying to modify his & some of the other kids' behaviours. She wasn't being mean (he was clear about that) but she was counting, & doing other things that made him feel pressured, so that he "couldn't think what he was supposed to do". I explained to B that techniques that might work with NT kids don't always work with kids who have autism, & that this aide might not understand that. I also explained to B that I meant by "NT" what seems to be accepted by the grownups with autism as a better word than "normal" to describe those who are not on the spectrum or have other neurological differences. He liked this idea a lot :) I then asked B if I might mention this problem to Cherie, so that she might be able to help the aide learn better ways to deal with kids with neurological differences. He made it clear that he did not want to directly confront this person, which I will explain to Cherie, & so he said it was ok. I also mentioned to B that, as much as a pain in the butt OCD is, his sensitivity in this instance might just help someone learn to do a better job with the kids they are supposed to be helping. I was really glad to finally find a positive attribute for the OCD... !

B seemed very functional, if a bit ticcy, for the rest of the day. He had earned a new Pokemon dvd, plus a small bionicle (the stars were in the right places :) & got them after school, plus he & I helped dad measure his sailboat shrouds, went for a bike ride... did all sorts of diverting & even tiring things, but something was still on his mind at bedtime. I'm happy to say that, now that it's 11:00, all is quiet upstairs. I guess Brian Greene worked his magic :) (we call him Brian at home, not that we know him or anything, but we've watched "The Elegant Universe" so many times we feel as if we know him). I'm trying not to draw any conclusions from this evening's sleeplessness... in the past, bedtime issues have been a terrible problem for B & us, with many strategies tried & tossed out, until we're ready to tear our hair out. I'm already making a list of things to try tomorrow: longer bike ride, no dvds after dinner, try to get him in a warm bath... make sure & wash the sheets tomorrow in case we need another change!! Past experience can be a good & bad thing- by helping me be prepared or causing me to needlessly anticipate problems- but thanks to my online mentors, I will try not to borrow trouble & let tomorrow be tomorrow.


At 1:27 AM, Blogger Zilari said...

Wow, that is so great you're reading "A Brief History of Time" with B! That was one of my favorites as a kid too (my dad had a copy).

It definitely sounds like B is right about the aide -- it sounds VERY much like what she is doing is stress-inducing. If there is one thing that makes it horrendously difficult to work, it's having someone "looking over my shoulder". And I'd like to know what exactly she was counting! I remember having a teacher in college who did not understand me at all -- one day during a test (the final, actually) he came by and sat right next to me and STARED at my paper throughout the whole thing!

One thing I think is definitely a bad thing is for people to engage in "behavior modification" without telling the person who is being "modified" what is happening. I got really annoyed at a co-worker last year because at one point he told me that he'd been purposely talking to distract me while I was hooking up some wires because he'd decided that I "needed to learn to deal with distractions". I know he told me afterward, but it seemed really unfair to just decide that some aspect of me "needed changing" and he tried to do it without letting me know his intentions.

I definitely think you should talk to this aide, because if anyone was like that around me I'd probably be up all night making noises too!

At 9:29 PM, Blogger Lisa/Jedi said...

Thanks for the feedback Zilari :) I have related the results of my intervention in my most recent entry. I think it's interesting that B picked-up on the behaviour-mod stuff without being told that's what she was doing... As for your stories, I seriously can't understand why someone would be so obnoxious as to try to mess with your behaviour as an adult. What gives them the right?!? How awfully disrespectful. Another good reason to advocate & give feedback...

We seem to have hit a snag with "A Brief History of Time" though... B confessed to dad that he's finding it deadly boring (it's kind of hard to convey the excitement of the diagrammes when he's supposed to be going to sleep :) He has been watching "The Elegant Universe" before bed, though, the last couple of nights, which seems to be getting him to sleep as well as reading did. He's doing a research project on black holes these days, so it's cool to have him getting back to physics & string theory... we'll try Stephen Hawking again when he's a bit older :)


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