You've GOT to read this! was the the subject line of the email that Dr. Rachelle Sheely circulated company-wide in our office. The email listed a link to the full article, Carrying the Hope: Parenting a Child with Asperger's in the Psychotherapy Networker by Alexandra Solomon, a parent using the RDI Program for ASD with her son.

I was impressed by her grasp of the RDI principles, the core deficits of autism and the clarity in which she explained both. I appreciated her sharp sense of humor and willingness to share an authentic look at her life as a mother, wife and professional instead of a sanitized and polished Hallmark version. But I was completely rocked by the concept of the 'A-Game' that she talked about in her story. The idea that for the most part parents can rely on the momentum or sheer force of neurotypical development as it powers their child through stages of development. In high-def contrast, parents of an ASD child must be meticulously deliberate, deconstructing that developmental process for their child. They must bring their 'A-Game' not just for the special occasion but for every moment, every day.

I heard Dr. Gutstein talk about the 'A-Game' idea before. I thought I understood it. But when I read it framed in the context of this story, the hurried thoughts and busy-ness of my world came to a screeching halt. I grew in my perspective of what it means, of what it's like, for her. I caught a glimpse of the high cost of the 'A-Game'. I'm hoping that by reading her story you'll gain a fresh perspective for families living with ASD or that you'll feel validated or encouraged by an experience that you may possibly be sharing with Alexandra.  

"Mom, you have to come and look at my poop!" Brian yells, running back into the office where Fran, his therapist, and I are patiently awaiting his return. His blue eyes are shining, he grins from ear to ear. He gestures to me ("Come here!") and then runs and grabs my hand. When I arrive at the potty, I glance at the specimen and then at Brian. His eyes are glued to me, anticipating my reaction. I smile, he laughs and spreads his arms wide, "It's the longest snake ever!"

Such a moment might not strike everyone as so wonderful, but to me it's utterly amazing—on so many levels. When he was 26 months old, Brian—now 6½—was diagnosed with PDD-NOS (pervasive developmental disorder, not otherwise specified), an autism spectrum disorder (ASD) falling somewhere between autism and Asperger's Syndrome. Although, even then, he was considered "high-functioning," he was dealing with some significant problems for such a little guy. He had painfully sensitive ears (auditory hypersensitivity), no interest in other kids, aggressive behavior toward himself and others, scripted language, limited play skills, chronic diaper rashes, and continual gastrointestinal problems, vacillating between constipation and diarrhea.

Now, at 6 ½, thanks to intensive early intervention that was truly biopsychosocial in nature, he's making great strides. Not only have his physical and medical problems improved dramatically, but he's competent enough at relationship skills to want to show me something he made, to figure out how to get me to come see it, to wait for my reaction, to celebrate with me, and summarize the whole event with a declarative statement.

When Brian asked me to come and look at his poop, he wasn't trying to get me to do something for him or to make something happen. He wanted me to share an experience with him purely to share it. He used gesture, engaging in nonverbal communication both receptively and expressively, which even six months earlier he simply couldn't do. This level of social referencing (defined as the ability to read, recognize, interpret, and respond to others' facial expressions and tones of voice), coordination, and experience-sharing is extraordinarily difficult for a child with an ASD. Odd as it may sound to those unfamiliar with this disorder in kids, what Brian did is a very, very big deal.

Continue reading the full article on the Pyschotherapy Networker website by following clicking here.

Alexandra Solomon, Ph.D., is a clinical psychologist at the Family Institute at Northwestern University and clinical lecturer in the Master of Science in Family Therapy Program at Northwestern.