Samantha, an 18-year-old junior, diagnosed with autism, attending a regular school, has really matured over the years. She used to need a shadow, a professional, to watch her at school to make sure that her behavior did not escalate out of control. With maturation, she now inhibits her impulses better, and for the most part, she gets angry, but not aggressive. Her family is unbelievably supportive. In ways that I admire deeply, both parents, married to each other, have devoted their lives to her. Samantha has an older sister, Stacy, a girl who every parent dreams of. Stacy attends a prestigious university, she has always done well in school, she has lots and lots of friends, and she is confident without being arrogant. The parents, Tom and Alex, treat both their daughters in ways which are fair, even-handed, and loving. I think about how hard this must be, to raise two totally different kids, but my practice has taught me that some parents do an admirable job. I see these parents as unsung heroes in the autism world. I see how hard they work to balance their autistic child’s needs with that of their other children. I see how much time, energy and patience it takes to help these autistic kids mature. I see that they must advocate for their children, while at the same time, they must be realistic about the limitations.
Samantha had a setback. She threw a book at her teacher. This was not good. The teacher was kind, but firm. Samantha had to write a note of apology. That’s fair. She did. I thought, naïvely, that this would all blow over. Unfortunately, the school administrators did not like her note. They interpreted her few words of apology to mean that she did not feel bad. In point of fact, she felt very bad, but she could not express herself. She froze. The parents understood this, but they could not advocate for her, because it would seem that they are not realistic about Samantha’s limitations. I suggested a school visit where I, with the parents, with his tutors, could talk about Samantha and what she struggles with. For an hour, we discussed how to help Sam. I felt this undulating course where the school administrators were understanding Sam’s autism, alternating with periods, where they could not get their heads around her difficulties.
Autism is really hard to grasp. Sam is a pretty girl. She has no physical malformations. She speaks clearly and when she wants to, she can be articulate. She is good at math, but she has trouble with reading comprehension. She has never had a friend, although she is friendly. When faced with frustration, Sam sometimes goes into a rage. In the past, she became physically aggressive, but in the last two years, she just looks angry, and walks away. When Sam gets angry, the look on her face is one of utter despair. She appears so frustrated that she seems scary and sympathetic at the same time. I do not know why this time she threw a book, because earlier moments of frustration, she could walk away. The teacher asked her to finish her math homework during lunch, a reasonable request, a request that previously caused no anger.
I think of Sam’s anger outburst like a seizure. Sam can explode, but when she is feeling good, she can contain herself, and when she is not feeling well, or she did not sleep well, or she is hungry, then she rages. Epilepsy is not that different. Those who are prone to seizures, usually have seizures when their system is out of balance, for one reason or another. So, if her rage is like a seizure, does this mean she is not responsible for her actions? No, it does not mean that, but then again, it does. By that I mean that she needs to learn responsibility and she needs to learn to control her temper. At the same time, the teachers need to understand that it is harder for her than for other children. Like a seizure, she needs to cool off, before consequences are discussed. An apology, even one that is not as thoughtful as one would hope, is better than no apology at all. She needs to be praised for attempting to write a note of remorse. It is a good first step.
Education is about setting the bar for each child. Every student needs to be challenged, so they can work hard, and achieve a sense of mastery and accomplishment. It is the job of educators to know how to set that bar. Mental health providers, such as myself, need to help students get rid of the psychological barriers to learning, so a child can get the most out of his educational environment. With that in mind, I suggested the school visit. I need to work with the school to help Sam get the most out of her last few years of high school.
After an hour and a half, the meeting was over, and we all returned to our usual day. Like so many things in my professional life, I do not know how to assess the experience. Was I helpful? Did I say important and thoughtful ideas? Did I give them good tools to work with Sam? Did I justify the effort at putting this meeting together, given everyone’s busy schedule? I do not know. I do know that, to me, the meeting was mandatory. We needed to discuss ways to interpret Sam’s behavior. We needed to sit together and remind ourselves of all the progress Sam has made over the years. We needed to support the parents, to let them know that we are all on the same team. In the short-term, it is fair to say, we achieved those goals. In the long-term, about how the meeting changed Sam’s school life, only time will tell.