Oh, s*#t

The speech therapist sent over some new communication cards a couple of weeks ago. They are laminated sheets that contain about a dozen icons that our family can use to have better, more focused conversations with my son. Without them, there’s often whining, interruptions and repetition. With these cards, we still do all those things, but we also do a little bit more chatting about the day and our plans for the weekend, specifically whether or not we will eat tacos on Friday night. (Spoiler alert: We will.)

fredagsmys
Communication card for the weekly Swedish phenomenon Cozy Fridays, aka Fredagsmys

This particular pack of cards is aimed at older kids, now that my son is well into his teen years.skit också You can probably imagine my surprise when I see that on the cards is a pictogram for a swear word. “Oh, shit” shows a generic-ish person with a palm to the forehead. Useful for many contexts, but not the kind of language I promote with my kids.

I easily forget that my son is getting older, mostly because he’s physically small but also because he needs help with things that kids his age have figured out how to do long ago. But that doesn’t mean he’s a child in every way. Because he needs my help, it’s also easy to believe that I should be allowed to make choices about things that parents normally wouldn’t–his clothes, his music, his activities, and even his language. People with disabilities have been pointing out how society infantalizes them for decades. I do not want to be that parent, so we laugh and practice saying it together.

There are so many areas where I’m going to be pushed out of my comfort zone. Swearing, friends, alcohol, sex. His body is changing, his needs are changing. He’s getting older, and so am I. Oh, shit.

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Wait for it

I was thrust out of sleep last night for a few brief seconds into total free fall, just barely this side of consciousness, unable to recall where I was, who I was, why I was. For a moment I struggled to orient myself in space and time, until I heard myself say in a calm, competent voice: “Wait for it.” hyperspaceA total sense of trust washed over me, a sense of excitement even (who might I be?) until finally I slammed back hard into the labels and perceptions of me—my name, my place on the globe and in my bed, a knowing that today was Tuesday and that I’d go be going to work in a few hours, coffee first. Then it all receded and I slipped back into sleep.

My son turned 13 this summer. As a parent, there is a sense of barreling through the unknown now. After so many years of trying to make a childhood, it’s already time to start building an adulthood. We leave the Beginning behind, and head into the Middle. I know it’s a complicated process for all parents, but this is different, or maybe just a heightened, hi-octane version of the same thing. More intentionality, more paperwork, more letting go whether or not if feels like it’s time. For a child who is so far behind his chronological peers in so many ways, he must begin to prepare for his adulthood long before most the others. And we are here to help him, making decisions about which skills to focus on, which goals to scratch off the list. Mostly, it’s about accepting, for better or worse, that adulthood is coming, and even though he may need help like a child in some ways forever, treating him like one isn’t what he wants. Even when it is, it may not be possible.

What I wouldn’t give to feel that sweet sense of safety I had this morning during this process. To trust that the answers will come and “embrace the questions” of this transition. To perceive the unknown as no problem, exciting even. But I’m not there yet. I guess I’ll have to wait for it.

Durga’s Tool #198: 12% of a plan

“What percentage of a plan do you have?”
“I don’t know, like 12%.”
–Guardians of the Galaxy

Last month as we were decorating for Christmas, my son told me, “When I grow up, I’m going to have a Christmas tree.” I was floored. It wasn’t that the sentence was grammatically far beyond his typical speech.  It was this: even though he’s 12, it was the first time I’d ever heard him talk his future.

My son has a developmental disability. He needs lots of help doing everyday things, like getting dressed, eating, and cleaning up. There are also lots of appointments with doctors, school and services to coordinate and attend, as I showed in my care map. So most of my focus as a parent is on the present—putting one foot in front of the other to get through the day.

I have a hunch that I don’t spend a lot of time in the past, confirmed mostly by the way my jaw drops when I look at baby pictures of my son and my daughter, who is 10. Were they really that small? Did that really all happen?

The future, too, has been neglected, more because it’s a scary place. Parenting without a diagnosis, then with a rare one that includes developmental disability and little in terms of evidence-based treatment, the future seemed as quiet, dark and void as outer space. Everything I take for granted parenting my typically developing daughter was a question mark when it came to my son. Would he survive into adulthood? If he did, would he be healthy? Would he be safe? Would he be happy? Would he be independent? Would he fall in love? Would there be someone to look out for him after I died? Exactly the kind of thing you feel like thinking about after the kids go to bed and the dishwasher has been loaded. Not.

The normal questions I pose to my daughter just don’t come up with my son. Ones like “What do you want to be when you grow up?” and “Where do you want to live?” or “Where do you want to go to college?” I didn’t mean to skirt them, but somehow, the busy-ness and the fear just got in the way. To be fair, we had gone through a vision-writing process with the help of some other parent advocates a few years ago, and the resulting insights played a role in little things going to a model train expo as well as big things like our decision to move half-way around the world. So I’m not a total deadbeat. But most of our planning has centered on the current school year or evaluation period, with some generic vision statement about my son feeling that he belongs and has a meaningful life that we cut and paste when needed.

Recently I’ve felt the need for a more specific vision around early adulthood. The countdown to adulthood begins early for kids who need lots of time to learn and prepare. It’s time to make tough choices about skills and goals. Where should he spend his time and effort? Is it important that he learns to read, or is it a better use of his time to go the store where he can practice social greetings, handling money, and navigating his neighborhood? This kind of parenting isn’t for the faint-hearted.

What will be most important for him in terms of the life that he wants to lead? At some point, this has to be less about me and my dreams and more about him and his. (Another wonderful gift that special needs parenting dishes up for the willing.) Creating a plan for the future means letting go of what matters only to me and embracing what matters to him.

Planning for the future can be a lot of things. It can simply be daydreaming about what lies ahead, or it can be a facilitated person-centered planning process that results in a document shared with others. I’m ready to do both.

So far I know my son will probably live together with a few other people who also need a lot of help and who want to play a lot more XBox than I do.  There will certainly be an iPad involved. And keys. Most likely a dog. And definitely a Christmas tree.

Stay tuned! And send your tips.

Spending some time at the Threshold

When my husband and I moved our family from Boston to Stockholm last week, we decided to kick the whole she-bang up a notch by getting ourselves to Europe by boat on the Queen Mary 2. A week-long break between the stress of saying good-bye and hello appealed to us both. As the granddaughter of immigrants who had made their way to Ellis Island decades ago by sea, there was the romantic symmetry of returning to Europe on a boat for me as well.

oceanMostly though, I looked forward to experiencing the passage of seven days of trans-Atlantic travel, allowing my body to really feel the geographic scope of the experience, allowing it to catch up to the emotional and spiritual journey that my heart and head already knew I was making.

During the decluttering and packing frenzy leading up to “Crossing 2013,” a friend and family member pointed out that the boat ride was the missing element to make our move a true rite of passage.

According to the Encyclopedia Brittanica in the ship’s library (satellite wi-fi being thankfully out of our budget here on the North Atlantic) rites of passage are “ceremonial events, existing in all historically known societies, that mark the passage from one social or religious status to another.”

Weddings, funerals, coming of age ceremonies, graduations – all are rites of passage designed to provide a productive outlet for the stress caused by major life changes. EB went on to say that folklorists and anthropologists break down rites of passage into three phases:

  1. the preliminal or separation phase,
  2. the liminal or transition phase, and
  3. the postliminal or reincorporation phase.

In other words, during this event one is before the threshold, at the threshold, and past the threshold. Anyone who has been on an odyssey knows how significant a threshold is, an invitation and a call to change.  Once crossed, there’s no turning back.

Apparently, all that decluttering I was doing back in Boston was the preliminal phase. In this stage, anthropologists note that we cut ties, we give things away, we fast, we mutilate our bodies with a good tattoo, piercing or even a good head shaving, as Britney Spears and the Army know full well. Getting rid of about 90% of my worldly possessions seemed to do the trick just fine, inducing a mental state probably  similar to an intense fast or mind-altering substance.

Then comes the limbo, the phase I have been in for the last 2000 or so nautical miles, literally and figuratively. This is the solitary walk in the woods, the 40 days in the desert, the vision quest. It’s the confinement before the birth, the hours during which the bride must remain hidden from her soon-to-be groom. It’s invisibility, it’s in between, it’s the period when the caterpillar becomes cellular goop  inside the chrysalis before reorganizing itself into a butterfly. In my case, that means being in between continents, in between jobs, in between communities, in between daily grinds and languages. There is no way to find solid footing here, no Facebook updates, texts or tweets in which to create a narrative to this truly plotless period of floating.

So here I am, in the doorway at the threshold. By the time you read this I’ll have taken the leap into the reincorporation stage, becoming reimbodied in my new role as just-off-the-boat immigrant, ignorant outsider, new hire, new neighbor, novice, beginner, a veritable tabula rasa.

But until then, there are waves to look at and miles to cross. Time to reflect and take in the physical and metaphysical significance of my adventure, to be freaked out by it and then to toast it with a glass of champagne. To all my fellow and future sojourners, seekers and pilgrims at the threshold, I raise my glass—cheers!

 “Come, come, whoever you are, wanderers, worshipers, lovers of leaving, ours is no caravan of despair, come, yet again, come!”

— Rumi

Transition baby steps that lead to major milestones: It starts with YOU!

Recently my colleagues at the Federation for Children with Special Needs have been talking about the importance of preparing kids for medical transition to adulthood—how parents and caregivers need to deliberately teach kids the skills and build the confidence they will need to be engaged in their own health care as adults.

When the topic came up at first, I was resistant. With so many other skills to teach and care elements to manage, the prospect of adding another task to my long to-do list was overwhelming.

Luckily, one colleague offered one simple suggestion that I felt willing to take on: at our next doctor’s appointment, I would give my kids their health insurance cards, let them walk up to the check-in counter and say that they were there for an appointment. I felt it was something that my nine-year-old son, who has complex medical and developmental needs, and my seven-year-old daughter could handle.

Since our doctor visits are fairly frequent, I was able to try it out soon. My son, who has been practicing social pragmatics like this at school, loved this real world experience. My daughter also easily did it. I was also surprised by an unintended consequence: not only did it teach my kids a new skill, it reminded the staff, my kids and me that my child is the patient.

OK, I thought. I get it. This doesn’t have to be a big deal. As with most things we want our kids to know, we need to give them lots and lots of tiny opportunities to practice, not one big lecture a couple of days before they reach adulthood. I realized I could do this.

A couple of weeks later, a patient satisfaction survey came addressed to my daughter. Rather than fill it out myself or toss it, I gave it to her. To my surprise she had a lot to say, both good and bad. “I love Lorraine*,” she wrote about the medical assistant. She wrote earnestly: “The waiting room is really boring.” I was taken aback by the strength of her experience and her ability to articulate it. I chuckled thinking about what the person opening the envelope would think when they read the results.

Last week, she had her eight-year well visit. With minimal effort, I handed her not only her insurance card but also the card I use to pay her co-pay. I told her that she’d be fine checking herself in. Rather than standing next to her, I sat down on a chair nearby.

She approached the desk with a little hesitation, but the receptionist took the cards and proceeded to get her set up. He started to direct his questions to confirm our address and phone number to me, but I looked to her and repeated them, showing them both that this was between the two of them. I took real effort on my part not to jump in and help, but I managed.

We all survived and even smiled. By the end of the check-in process, he handed her a clipboard with a behavioral health survey. She came to sit near me and announced that she was going to fill it out. Once again I was surprised and delighted about how much I learned from her answers—for the questions “My child seems more tired during the day,” and “S/he wants to be with me more than usual,” she circled the options for “often.” Interesting information and the beginnings of a couple of great conversations we had afterwards.

As we went through the process, a woman sitting nearby with four boys, all clearly older than my daughter, remarked at how independent she was. They had already checked in, but next time, she said, she’d get them to do it themselves.

Shortly afterward, a hurried mother and her teenage daughter arrived. The girl stood over to the side while the mother took charge checking her in, while I got to sit and luxuriously read a magazine. Knowing that this girl would be going into her doctor’s appointment without her mother, as is required by law, I wondered how comfortable she would be.

Unfortunately, there wasn’t any way to pass along the lesson I learned to her mom, but I can pay it forward to you. Preparing our kids to become adult patients doesn’t have to be complicated. Just start giving them lots of tiny chances to practice, and they’ll surprise you. Before you know it, adulthood will be here, and they’ll be ready. Even if we’re not!

*not her real name