Monday, February 10, 2014

Corey



Most parents remember their Child’s first word. That memory is overshadowed by another that changed the course of my child’s life, as well as mine. Corey was two years and nine months old when he stopped talking and responding to commands. Prior to that, he was able to communicate using simple sentences and minimal hand gestures. For instance, if he was hungry, he would bring his hand to his mouth and say: “Corey is hungry.”
When my child started displaying this unfamiliar behavior, my immediate conclusion was that he had suffered hearing loss. Devastated by the thought of having to raise a deaf child, I scheduled an emergency appointment with his pediatrician for the following day.
The walls of the waiting room were lined with a mural of children playing on the beach; One was flying a kite, another building a sand castle, and several of them swimming happily. “Look Corey, the beach! Look at the sandcastle!” I said enthusiastically. Corey did not look at the painting; instead he seemed to be fixated on an abacus that was on the opposite side of the waiting area. He wiggled out of my hands, slid off of my lap and onto the floor. He waddled towards the desired toy, picked it up, and stared at it with such an intense focus, that his eyes began to cross. One by one, his tiny fingers moved each ball on each line to the right side. When all of the balls were on one side, he would pause, stare at it, and then repeat the process all over again. At the time I thought nothing of it, but little did I know that my child was displaying a behavior similar to Obsessive Compulsive Disorder.
A nurse popped her head into the waiting area and ushered us into a room. “I’m just going to check his vitals, and then the doctor will be in to see him.” After the nurse did her pre-assessment, she assured me that he was physically in good health. She checked his hearing using a tympanometry tool, which measures pressure in the middle ear, as well as the functioning of the eardrum. The results showed that Corey had perfect hearing. I was puzzled instead of feeling relieved. “But- I- How?” I stuttered. “He seems perfectly fine, Ms. Greene. Why is he here today?” The nurse asked. “He stopped talking,” I said. “Stopped talking! Awww, well I’m sorry to hear that, Ms. Greene,” she said, looking at Corey with concern. “The doctor will be right in.”
As we waited for the doctor, Corey lay across my lap, his face buried under my arm, and his knees pressed into my stomach. He used to lie on top of me this way, when he was an infant. I rocked him back and forth as the paper barrier between us and the stretcher crumpled, and tore.
Dr. Powers knocked on the door while opening it. “Hello Corey! How’s my little train conductor?” About eight months prior to that visit, Corey had an infatuation with Thomas the Train. Dr. Powers plucked Corey out of my arms, and swung him up in the air and then down to his eye level, all the while
making animated faces and sounds. Corey did not laugh, but for a second he stared at Dr. Powers, and quickly lost interest. The doctor sat Corey on the stretcher and flashed the light of the otoscope in his ears. “Uh oh! I see a choo- choo train in your ear tunnel!” He handed Corey the otoscope and asked him to check his ears for trains. Corey grabbed it, twisted the tip off of it using four fingers, and handed the otoscope back to Dr. Powers. “How long have you noticed this change in behaviour?” He asked.
“Recently. I brought him in because he stopped talking, and I thought he was deaf, but it turns out-”
“Have you noticed any repetitive movements? Tics? Or rituals?” He asked.
“He sometimes lines things up in a neat row, like pennies and his cars and I guess puts other things in order. I just figured that he was a neat kid,” I said.
Dr. powers was writing down everything I said. Every time I answered a question, his head would lean to the side and he would say ,”Ohhhh. Ok,” as if he already knew what my answer would be.
“You know what? He’s been walking kind of funny. Like, he used to walk better when he was younger. I don’t know, maybe I’m just telling you things that don’t matter. The main thing is, is that he isn’t communicating with me… Right?”
Dr. Powers rolled the cap of the pen across his lips while looking at Corey, who was still fiddling with the otoscope tip.
“Ms. Greene, nothing is irrelevant here. Tell me anything that comes to mind. I have an idea what may be going on here, but I need your cooperation, ok?”
“Okay, Well his eyes cross a lot, like when he stares at things too closely,” I said.
“Ok.” He said.
“And he smells everything, I mean everything… Like inanimate objects,” I said.
“Ok.”
“His tantrums can last for more than an hour… He gets upset if you move something that he put in a certain order…”
Dr. Powers flipped to a fresh page in his pad.
“Mmhhmm go on,” he said.
“He hates noise. He blocks his ears whenever he’s in a noisy environment… But it’s like, he freezes or something. I don’t know. That’s all that I can think of for now. It’s funny you know. I didn’t… I mean I never said these things out loud, you know? Like these aren’t bad, right? The weird stuff that he does? It’s just random stuff, right?”
Dr. Powers continued writing, pausing momentarily to give Corey a wink. Corey was rolling the otoscope tip between his hands, unaware that the conversation was about him.
“Any complications during birth?” He asked
I paused for several seconds. I had a foggy recollection about the night I gave birth. It was fourteen hours of painful labour that I had long since tried to forget, but there was one thing that stood out about that night.
“He stopped breathing for a bit!” I exclaimed.
“What do you mean by ‘he stopped breathing’?”
“Uh his heart rate went down after they gave me the epidural. I just remember everyone rushing in the room and an alarm going off. They attached a heart monitor to his scalp while he was still inside me and-”
“Is this information in his chart? How is it that I know nothing about this?”
Dr. Powers had a look of perplexity on his face.
“I’m sorry, I just- I guess I forgot.” I said shamefully.
“How do you forget about something as important as your child losing oxygen? These are important factors towards diagnosing him.”
Dr. Powers shook his head in disbelief. He brought the pad to his chest, and with a deep sigh he said:
“You might want to get him evaluated for autism. Symptoms of autism usually emerge between the ages of two and three years old. Corey is right in that range. From what you’ve told me, and what I’ve observed from the last time that I’ve seen him to now, I’d look into it. It’s important to catch it early. It’s a good thing you came in, because if…” Dr. Powers’ voice drifted away with all of the hope and promise that I’d had for my child. I blamed myself initially. I hadn’t found out that I was pregnant until I was almost in my second trimester. I wasn’t living a healthy lifestyle, and I only took folic acid because prenatal vitamins made me nauseas. I was selfish, and because of that, I was sure that I’d ruined his life.
“Oh my God. What’s wrong with him?.” I bit the inside of my cheek, and took a deep breath in through my nose to slow the impending tears.
Corey continued to play with the otoscope tip. I watched him place it on each finger as if it were a little hat. I racked my brain for any situation in which I could have caused him to end up with autism. Perhaps it was that time I had my head phones on and he was on my shoulders, and the ceiling fan hit him on his head… Or maybe that time he got into my purse and chewed that Midol… Or maybe his dad caused it. He had ADHD as a child.
“Ms. Greene?” Dr. Powers placed his hands on both of my shoulders.
“How is it caused? I mean, is it my fault?” I asked.
“Nobody knows, Ms. Greene. It could be environmental, genetic, or even caused by complications in utero or during birth. There is still a lot of research being done on Autism. The main thing you want to do is to remain positive. We aren’t 100% sure, but we need to rule it in or rule it out, for his sake.”
“Can this be fixed? Is he going to be in Special Ed? Is he able to lead a normal life? Does it get worse?” I had so many questions, but they were self-centered and guilt ridden.
“If he has autism, depending on where he places on the spectrum, with his therapeutic process and your cooperation, he can lead a normal life. You have to be proactive, Ms. Greene. I will refer you to a Child a Development Therapist that will be able to answer some of your questions, and also schedule an Autism evaluation test. It will determine whether your child is Autistic and approximately where he falls on the spectrum. This disorder is more common amongst boys than girls. 1 out of 54 boys is diagnosed with autism, but I advise you to do some research yourself. It might help you answer some of your many questions. I will leave the referral at the front desk. Good luck Ms. Greene,” he bent down and patted Corey’s head, “and good luck to you too, conductor.”
After Dr. Powers left the room, I covered my face and cried hysterically. Good luck. Not, “I hope everything works out well.” I wiped my face on my t-shirt, and watched as Corey sat entranced by the repetitive game he’d made up with the otoscope tip. Drool poured out of the corner of his mouth slowly, like honey. His eyes crossed and uncrossed as he focused on the only thing that mattered to him at that moment.

-Bex

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