There are so many things I’ve been wrestling with over the past couple months, but one of the big ones is money. Not in the way you would expect, however. Yes, I’m overwhelmed at the amount of money we’re considering spending in just one year for J’s therapy. Yes, it’s mind-boggling, and I have moments when I wonder how the heck we can possibly do it. But the issue I struggle with most goes deeper than just wondering where the money will come from. You see, over the past couple years, Chris and I have had many conversations about money. Maybe because we lived without it for so long during medical school and residency, and now suddenly we have a “real” income. Don’t get me wrong – academic physicians don’t make nearly as much as you’d expect. But for the first time in our adult lives, we have more than enough. That’s an interesting concept to ponder – more than enough. What exactly does it mean? How much is enough? When Chris was still in residency, another doctor once told us that you can never have enough money. The more you have, the more you spend, so you still end up not having enough. Chris and I both walked away from that conversation cringing inside. That’s not who we wanted to be. That’s not how we wanted our lives to be defined. So when we (finally) did end up finding ourselves with a “real” income, we thought long and hard, and talked often, about what we should do with it. Should we buy a bigger house, a nicer car, a bigger TV, a couple of iphones….just because we can? That just didn’t seem to sit well with us. It’s not that we thought it would be wrong to buy those things; it just didn’t seem like a huge priority to us at the time. Instead, we started saving, since we had zero savings after residency. And we started giving more. The more we gave, the more we wanted to give. In the past year we read the book Radical by David Platt, which was painful and beautiful at the same time. I also read Generous Justice by Tim Keller, and have read parts of Kisses from Katie by Katie Davis (a girl from Nashville who moved to Uganda and adopted like 15 kids and now runs an orphanage there, and she’s only about 22 years old!). After reading these books, we both felt pulled towards even more frugal living and generous giving. Our motto became “Save money. Live generously.” When we began to look at the world, including our family’s income and lifestyle, through the perspective of the Kingdom, it just didn’t seem important for us to have a full cable package, the newest ipad, and a pair of Uggs. There is absolutely nothing wrong with ipads and Uggs, but it just wasn't a priority to us.
Even more than that, we felt God calling us to give deeper, but not necessarily with money. We felt Him calling us to sacrifice more of ourselves, to follow His call to love others, even when it’s not convenient or easy. We had talked many times in the past about adoption, but it didn’t feel like the right time for us to approach that journey. However, we felt very drawn towards foster care. The need for loving, stable, Christian foster families is so overwhelming, and that need is not being met. We wrestled with it for a while, because truly, foster care is not an easy thing to undertake. We knew it would be hard, we knew it would be painful, we knew it would be emotionally draining. But we also knew there was a need, and we could fill that need. We could love those children, we could care for them, we could immerse them in grace. And they so desperately NEED that. So we held our breath and signed up for foster parent training. About halfway through the training, we found out we were pregnant. That was great news, but a bit unexpected. We decided to go ahead and finish the foster care training, then hold off temporarily on taking in any foster kids until the new baby was at least a few months old. It would be a delay, but we still felt called to providing a home for children who need one, and we were committed to making it happen. We were looking at bigger houses and considering moving within a year, mostly so we’d have room for more kids. Then suddenly…BAM. Our son is diagnosed with a possible Autism Spectrum Disorder. Now we’re looking at literally thousands of dollars per month in treatment and dozens of hours of therapy. Our little boy is going to need intentional attention from me every minute I can give it to him. There’s no way we can take in a foster child any time soon…to give that child the emotional attention, healing, and support that he/she will need…and still focus on aggressive intervention with J. And in order to make the payments for his therapy, we probably won’t be able to continue giving as much as we have been.
So I’ve been wrestling with this. On one hand, it’s reassuring to know that if we cut back on our giving, we would probably have enough to make the therapy payments without having to use up our savings. But on the other hand, should we cut back on our giving? Should we stop supporting missionaries who we love? Should we stop sponsoring a child? Should we stop giving so much to the church? Is that the right thing to do? It’s not that I feel guilt about this. We don’t give out of guilt. We give because we want to, because it’s important to us. That’s why it hurts so much to think about not being able to give.. I still WANT to give. I WANT to be generous. I WANT to love and welcome foster children in to our family. I’ve reconciled myself with the fact that this diagnosis probably means we won’t be moving to a bigger house any time soon. That’s okay. I want J to get better much more than I want a 4-bedroom house. But I can’t understand why God would spend so much time leading Chris and me towards a desire to live generously, then suddenly take away our ability to do so. Why give us the passion in the first place, then not allow us to do it? I just don’t understand.
I don’t have an easy answer to this, but I keep coming back to the idea that God is not nearly as concerned with the dollar amount we give as He is with the heart behind our giving. And my heart wants to give. Maybe I can’t take in a foster child any time soon, but I want to. Every time I hear a story about foster care or even hear the words foster care, I want to cry. I can’t pick up the book Kisses from Katie right now, because if I do, it breaks my heart. So many children who need to be loved, so many children who I WANT to love. And instead, we’ll be pouring all of our extra resources in to just one child. But he’s OUR child. HE is the child God chose to put in our family. HE is the child God entrusted to us. And he needs us to pour everything we have in to loving him. How could we not do that? I don’t understand why God would burden me with the desire to help so many, then tell me that my calling right now is to help the ones He has already given me, and that’s all. But it seems like that’s what He’s doing. So I guess I will continue to pray for God to raise up others to step in where we leave off. And I will continue to pray for those children to find loving homes, to find grace, to find healing, to find Jesus. And then I will love my own children with everything I’ve got, literally. That’s what God is asking us to do right now. And somehow, it’s enough.
Tuesday, February 28, 2012
Monday, February 27, 2012
Unethical Scientist in the Making
I'm taking a break for a minute from the J saga to focus on his big sister, CB, for a minute. She's quite a character. She's 5 1/2, and her little brain is just always going. At school last week she had done an experiment to determine whether an egg (both with and without a shell) will float or sink in fresh water and salt water. I guess the idea was to figure out which is denser - the egg or the salt water. Anyway, she was so intrigued that she wanted to reenact the experiment on Saturday morning. So this is how we spent our Saturday morning:

She was having lots of fun, especially since her hypothesis was right. I knew that boiled egg with no shell was supposed to float in salt water, but it kept sinking. So I added more salt, then more salt, then more salt. Eventually the egg floated, but by that time she had already written on her paper that her hypothesis was right. So then she got angry, and she kept saying I had cheated. I tried to explain to her how science works, and how unethical it is to falsify data, but I don't think she cared. So later that day I found a note that she had written on the back of her paper. This is what it said:
"My mom cheated. It really floated. I was mad at her. So I said I was right, Mom was bad."
Ha ha! Crazy girl. She keeps us entertained, that's for sure!

She was having lots of fun, especially since her hypothesis was right. I knew that boiled egg with no shell was supposed to float in salt water, but it kept sinking. So I added more salt, then more salt, then more salt. Eventually the egg floated, but by that time she had already written on her paper that her hypothesis was right. So then she got angry, and she kept saying I had cheated. I tried to explain to her how science works, and how unethical it is to falsify data, but I don't think she cared. So later that day I found a note that she had written on the back of her paper. This is what it said:
"My mom cheated. It really floated. I was mad at her. So I said I was right, Mom was bad."
Ha ha! Crazy girl. She keeps us entertained, that's for sure!
Friday, February 24, 2012
The Little Things
The brain is a fascinating thing. It’s funny how many little skills there are that kids learn instinctively that we take for granted. I had never even thought about many of these skills until the doctors started asking me questions. Does he use his index finger to point at things? Does he nod or shake his head with meaning? Does he look at your face to gauge your reaction when he’s in a new or unfamiliar situation? Does he play appropriately with toys, or does he fixate on one individual part of the toy? Does he try to get your attention when he’s playing with a new toy, just for the sake of showing you what he’s doing? Does he look you in the eye when he requests something? Does he ever bring you something, just to show you, or only when he needs help? Can he turn the individual pages of a board book by himself? Does he imitate sounds and gestures? On and on and on. J is my second child, and I thought that by this point I knew what to look for in terms of development. But for many of those questions, I realized that I had no idea what the answer was. I kept saying, “I THINK he tries to get my attention just to show me something he thinks is cool, but I can’t really visualize what that looks like. I THINK he nods his head yes sometimes, but I’m not really sure.” So I had to start paying closer attention. And I watched other kids his age to see what they did. When I saw other kids doing certain things, I thought “Oh, so that’s what they were talking about. No, J doesn’t do that.” That’s when J’s delays really started to sink in to my brain, especially delays in the area of nonverbal social cues and interaction. Most of these skills are things we never even think about – things that most kids pick up naturally. But for some reason, J isn’t picking them up naturally. That makes it really sad for me to be around other kids his age (or younger) who are behaving in perfectly natural ways that J doesn’t know how to do. It’s not that I resent other parents for having “normal” kids. It just makes me sad that I haven’t gotten to see my little boy pick up those skills and learn these new things. It makes me sad that his little brain isn’t learning what it’s supposed to be learning. It just makes me sad. I don’t think I’ve ever been so sad about anything in my entire life.
But the good news is that I’m realizing that J can be taught these skills. His brain is so easy to train right now. Even if he doesn’t pick it up instinctively, he can still learn these skills. I’m seeing it happen every day. Just last week he learned how to ask for more bubbles. He knew how to say more, but he only associated it with food. He didn’t realize that it would also work to get more bubbles. It only took a few tries with me blowing bubbles, then stopping to wait to allow him a chance to ask for more. He just stood there at first, not knowing how to communicate that he wanted me to blow more bubbles, but after only 3 or 4 repetitions of me showing him how to request more, he had it down like a pro. Now he asks for more bubbles every time I stop, without being prompted. He asks for more water in the bath tub, he asks for more rolling the ball….he totally gets it now. And it only took a few repetitions. AND I’m not a therapist – so really I have no idea what I’m doing. Just in the past week he’s also learned to shake his head no. He had never done that before. Now he walks around shaking his head and saying “No, no, no” to every question I ask him, just like a 2-year old is supposed to do. I know I should be frustrated that he says no to everything, but really I want to jump up and down and clap every time I see him shake that little head in the back and forth no motion. Who would have thought I could get so excited by such a tiny thing? And today he nodded his head yes for the first time. I’m sure I looked ridiculous the way I kept nodding my head in an over-exaggerated way every time I said yes, but he picked up on it. He started to laugh, then he slowly started nodding and saying “Yeah, yeah, yeah!” while laughing hysterically the whole time. Anyone else would have thought we were crazy, but I wanted to squeal and hug him. I don’t know why he doesn’t learn to do these things instinctively, but it’s so encouraging to see that he’s making such amazing progress already, and we haven’t even started therapy yet! I really do believe that with the therapists coming so often, since they actually know what they’re doing, he’s going to do amazingly well. I need the therapists to point out to me what skills J is missing, then show me how to train him in to those skills. If there is any way to train and parent this child out of a diagnosis, Chris and I are going to do everything in our power to make that happen.
But the good news is that I’m realizing that J can be taught these skills. His brain is so easy to train right now. Even if he doesn’t pick it up instinctively, he can still learn these skills. I’m seeing it happen every day. Just last week he learned how to ask for more bubbles. He knew how to say more, but he only associated it with food. He didn’t realize that it would also work to get more bubbles. It only took a few tries with me blowing bubbles, then stopping to wait to allow him a chance to ask for more. He just stood there at first, not knowing how to communicate that he wanted me to blow more bubbles, but after only 3 or 4 repetitions of me showing him how to request more, he had it down like a pro. Now he asks for more bubbles every time I stop, without being prompted. He asks for more water in the bath tub, he asks for more rolling the ball….he totally gets it now. And it only took a few repetitions. AND I’m not a therapist – so really I have no idea what I’m doing. Just in the past week he’s also learned to shake his head no. He had never done that before. Now he walks around shaking his head and saying “No, no, no” to every question I ask him, just like a 2-year old is supposed to do. I know I should be frustrated that he says no to everything, but really I want to jump up and down and clap every time I see him shake that little head in the back and forth no motion. Who would have thought I could get so excited by such a tiny thing? And today he nodded his head yes for the first time. I’m sure I looked ridiculous the way I kept nodding my head in an over-exaggerated way every time I said yes, but he picked up on it. He started to laugh, then he slowly started nodding and saying “Yeah, yeah, yeah!” while laughing hysterically the whole time. Anyone else would have thought we were crazy, but I wanted to squeal and hug him. I don’t know why he doesn’t learn to do these things instinctively, but it’s so encouraging to see that he’s making such amazing progress already, and we haven’t even started therapy yet! I really do believe that with the therapists coming so often, since they actually know what they’re doing, he’s going to do amazingly well. I need the therapists to point out to me what skills J is missing, then show me how to train him in to those skills. If there is any way to train and parent this child out of a diagnosis, Chris and I are going to do everything in our power to make that happen.
Thursday, February 23, 2012
Logistics
My focus lately has been on logistics. There are so many things to learn, so many decisions to make. If I look too long at the whole picture, I feel completely overwhelmed and hopeless. So we’ve tried to take things one step at a time, one decision at a time, one day at a time, sometimes one hour at a time. It’s been a roller coaster of ups and downs, back and forth decisions, and I feel like we’ve changed our minds at least a dozen times. I’m beginning to get whip lash.
One of the biggest decisions has been choosing a developmental preschool for J. The doctor wants him in a preschool where he will be around at least a few typically developing children who can model appropriate behavior, but also a school that focuses on children with delays and disabilities. Many of these facilities have therapists on site who provide speech or OT services during the school day. And supposedly TEIS is supposed to cover 10 hours of this “special instruction” per week (they told me they don’t…because they suck… but I know they will if you push hard enough). So I set up some appointments to visit and tour these programs. The first place I visited came highly recommended. We had taken CB to their therapy clinic a few years ago for feeding therapy, so I was already familiar with it. Once I saw the preschool, however, I just didn’t feel like it was the right place for J. It seemed like a perfectly fine place, but I didn’t see how it would really help to encourage and develop his social interaction skills. I felt like it would be a great place for kids with other disabilities, but I didn’t feel like they did autism well. It was the first time I had looked at a school like this, though, and really, what do I know? So I tried to keep an open mind, but when I left the preschool, I cried all the way home. It’s not where I wanted to send him, but I wasn’t completely sure why. The other 2 schools I talked with gave me the same impression – they do great with other disabilities, but they don’t do autism well. Then I went to look at another treatment center. I’ll call this center The Gold Bar Center – you’ll see why in a few minutes. Within 10 minutes of being in that center, I knew there was no comparison. This place knew how to deal with autism. It makes sense, because it’s a facility specifically for children with Autism Spectrum Disorders. Everything they do is with the intention of improving these children’s communication and social skills. Even the placement of their toys and the arrangement of the room is set up to facilitate communication development. All of the therapy disciplines are available on-site, including behavior therapy (which is a HUGE component of autism treatment, and none of the other facilities even employ a behavior therapist). They provide home visits as often as needed, parent training and support, even counseling services if I have a breakdown and need to talk to someone. When I talked with the director, I felt like it was the first time I was talking to someone who really understood what I was feeling. She just got it. She has 2 children of her own on the spectrum, and she told me many times, “I know what you’re going through. I’ve been in that exact position. Twice.” The staff at The Gold Bar Center understand autism, because it’s all they do. I felt very strongly that they would equip and empower Chris and me to help J. They would teach US how to help him, how to train him, and how to parent him. And that’s exactly what we need. It really is an amazing center, and after talking to many other people about it, we’ve realized that it probably is the best of the best that Nashville has to offer for autism treatment. The downside to The Gold Bar Center, however, is that these services come at a very high price. When I told one friend how much it cost, she said “Good grief! Do they hand out shiny bars of gold every time you walk in the door??” It’s not their fault…in order to provide that level of intervention and quality of care, they have to charge that much. This type of therapy is just very expensive. The problem is that TEIS does not contract with The Gold Bar Center, and The Gold Bar Center has good reason for not contracting with TEIS (mainly because TEIS sucks). So TEIS is currently telling us that they will not pay anything for us to send J there (although we’re not finished fighting them on this). Our insurance will help with some of it, but we’re still trying to figure out how much. But even with what we expect to get from insurance reimbursement, we would have to sink every penny we have in to sending J there for a year (you have to sign a year-long contract). We would do it without a moment’s hesitation if we knew that’s what he needed, but given the doctor’s uncertainty about his diagnosis, it’s very difficult to make that huge of a commitment. I mean, we want to do the very best we can for J. We want to give him every chance we can possibly give him to improve his skills and lead a healthy, functional, relationally-rich life, and acting quickly and aggressively right now is the very best chance we can give him. Wouldn’t you spend every last dollar that you have to give this chance to your child? I mean really, wouldn’t you?? But at the same time, what if we enroll him in this program, then 3 months from now the doctor says that he’s improving so much that he doesn’t feel like an autism diagnosis is warranted, and then he wouldn’t need that level of intervention? And we would have already committed to an entire year and every last penny of our savings. But what if we wait to see how he does, and he doesn’t improve as much as we hope he does, and we end up missing this window when his brain is at its most trainable state? We never, ever, ever want to look back 2 years from now and say “I wish we had done more for him. I wish we hadn’t cared about the money and we had done more.” I don’t think I could live with that regret, I really don’t.
So now we’re confused. We’re considering another option, which our doctor has talked to us about and fully supports. J is beginning speech therapy with a wonderful speech therapist who specializes in autism. She’s in private practice and she’s out of network, which means TEIS pays nothing, and our insurance covers 60%. This makes her much more expensive than going to a general speech therapist at Vanderbilt (which would be free, actually), but it’s worth the extra money. She will be coming to our house twice a week (maybe more, but we’re starting with twice a week). And I’m in the process of talking with a behavior therapy center about setting up a behavior therapy program for him. The world of behavior therapy is very new to me, and I have to say, it’s really confusing. I’ve asked a lot of questions – both of the therapists and of friends who have worked in this field - so I feel like I’ve got a pretty good understanding of it now. We would hire a therapist to come to our house for a minimum of 8 hours/week, and maybe go to his Mother’s Day Out program with him for a couple hours to help him with social interaction skills. Do you watch the show Parenthood? If so, you’ll understand what I mean when I say we’ll have our own personal Gabby (better not invite my single, younger brother over for a visit!). Including speech therapy, this would give him at least 10 hours of professional therapy each week, plus the time I will spend with him throughout the day. That’s still very aggressive intervention, so we definitely wouldn’t be sitting around, watching and waiting to see how he does over the next 2 months before his re-evaluation. That’s more intervention than most children with autism get at this age (because TEIS won’t pay for it, because they suck…). It’s not quite as intensive as The Gold Bar Center, but we don’t have to sign a contract, so we can change his therapy plans at any time. If he doesn’t improve as quickly as we hope, we can pull him out and enroll him at the Gold Bar Center right away. But our hope is that with this intervention, the doctor will tell us in April that he is significantly improving and heading away from a diagnosis. That’s our prayer every single day.
We haven’t decided for sure yet. We’re still investigating insurance coverage, TEIS benefits, and negotiating on a contract with The Gold Bar Center. It’s a lot to decide. We just want to make the best decision we can make for J, but it’s so hard to know what that is given the uncertainty of his diagnostic profile. Chris and I have decided to make this decision based on what we really feel is best for J, not on the cost. We have to just trust that God will open the door where He wants us to be, then somehow He’ll provide the money. I have no idea how, but I have to trust that He will. And in the meantime, we’re praying and asking other people to pray for clarity and wisdom. I want the doors to open where He wants us, and to close where He doesn’t want us. I want it to be clear. I want to know that we’re making the right decision. Unfortunately, it might not work that way. We might just have to make our best educated guess. But we’re going to keep praying for wisdom. And most of all, I have to keep reminding myself that no matter how much I love J, God loves him even more than I do. No matter how much I want the best for him, God wants it even more than I do. He is my son, but even more than that, he is God’s child – his beautiful and perfect creation. He does have a plan for J, and that plan is also beautiful and perfect. It might not be the plan I would choose for J, but even still, it is the perfect plan for J. Honestly, I have to remind myself of this over and over and over, and sometimes I need friends to remind me of it even more often than that. Because I keep forgetting. I want to have everything under my control, and I want to know that everything will work out the way I want it to. But I can’t know that. I just can’t. And somehow I have to make myself accept that. All I can do is keep trusting that God’s plan for J is perfect, that God loves J more than I do, and that He will take care of my baby in His perfect, sovereign way. I have to admit, my faith is not strong enough to believe that all the time. I wish that it was, and people try to make me feel better by telling me how strong my faith is. But it’s not. So for now, like the father of the dying child in Mark, I just keep praying “Lord, I believe. Help me overcome my unbelief!”
One of the biggest decisions has been choosing a developmental preschool for J. The doctor wants him in a preschool where he will be around at least a few typically developing children who can model appropriate behavior, but also a school that focuses on children with delays and disabilities. Many of these facilities have therapists on site who provide speech or OT services during the school day. And supposedly TEIS is supposed to cover 10 hours of this “special instruction” per week (they told me they don’t…because they suck… but I know they will if you push hard enough). So I set up some appointments to visit and tour these programs. The first place I visited came highly recommended. We had taken CB to their therapy clinic a few years ago for feeding therapy, so I was already familiar with it. Once I saw the preschool, however, I just didn’t feel like it was the right place for J. It seemed like a perfectly fine place, but I didn’t see how it would really help to encourage and develop his social interaction skills. I felt like it would be a great place for kids with other disabilities, but I didn’t feel like they did autism well. It was the first time I had looked at a school like this, though, and really, what do I know? So I tried to keep an open mind, but when I left the preschool, I cried all the way home. It’s not where I wanted to send him, but I wasn’t completely sure why. The other 2 schools I talked with gave me the same impression – they do great with other disabilities, but they don’t do autism well. Then I went to look at another treatment center. I’ll call this center The Gold Bar Center – you’ll see why in a few minutes. Within 10 minutes of being in that center, I knew there was no comparison. This place knew how to deal with autism. It makes sense, because it’s a facility specifically for children with Autism Spectrum Disorders. Everything they do is with the intention of improving these children’s communication and social skills. Even the placement of their toys and the arrangement of the room is set up to facilitate communication development. All of the therapy disciplines are available on-site, including behavior therapy (which is a HUGE component of autism treatment, and none of the other facilities even employ a behavior therapist). They provide home visits as often as needed, parent training and support, even counseling services if I have a breakdown and need to talk to someone. When I talked with the director, I felt like it was the first time I was talking to someone who really understood what I was feeling. She just got it. She has 2 children of her own on the spectrum, and she told me many times, “I know what you’re going through. I’ve been in that exact position. Twice.” The staff at The Gold Bar Center understand autism, because it’s all they do. I felt very strongly that they would equip and empower Chris and me to help J. They would teach US how to help him, how to train him, and how to parent him. And that’s exactly what we need. It really is an amazing center, and after talking to many other people about it, we’ve realized that it probably is the best of the best that Nashville has to offer for autism treatment. The downside to The Gold Bar Center, however, is that these services come at a very high price. When I told one friend how much it cost, she said “Good grief! Do they hand out shiny bars of gold every time you walk in the door??” It’s not their fault…in order to provide that level of intervention and quality of care, they have to charge that much. This type of therapy is just very expensive. The problem is that TEIS does not contract with The Gold Bar Center, and The Gold Bar Center has good reason for not contracting with TEIS (mainly because TEIS sucks). So TEIS is currently telling us that they will not pay anything for us to send J there (although we’re not finished fighting them on this). Our insurance will help with some of it, but we’re still trying to figure out how much. But even with what we expect to get from insurance reimbursement, we would have to sink every penny we have in to sending J there for a year (you have to sign a year-long contract). We would do it without a moment’s hesitation if we knew that’s what he needed, but given the doctor’s uncertainty about his diagnosis, it’s very difficult to make that huge of a commitment. I mean, we want to do the very best we can for J. We want to give him every chance we can possibly give him to improve his skills and lead a healthy, functional, relationally-rich life, and acting quickly and aggressively right now is the very best chance we can give him. Wouldn’t you spend every last dollar that you have to give this chance to your child? I mean really, wouldn’t you?? But at the same time, what if we enroll him in this program, then 3 months from now the doctor says that he’s improving so much that he doesn’t feel like an autism diagnosis is warranted, and then he wouldn’t need that level of intervention? And we would have already committed to an entire year and every last penny of our savings. But what if we wait to see how he does, and he doesn’t improve as much as we hope he does, and we end up missing this window when his brain is at its most trainable state? We never, ever, ever want to look back 2 years from now and say “I wish we had done more for him. I wish we hadn’t cared about the money and we had done more.” I don’t think I could live with that regret, I really don’t.
So now we’re confused. We’re considering another option, which our doctor has talked to us about and fully supports. J is beginning speech therapy with a wonderful speech therapist who specializes in autism. She’s in private practice and she’s out of network, which means TEIS pays nothing, and our insurance covers 60%. This makes her much more expensive than going to a general speech therapist at Vanderbilt (which would be free, actually), but it’s worth the extra money. She will be coming to our house twice a week (maybe more, but we’re starting with twice a week). And I’m in the process of talking with a behavior therapy center about setting up a behavior therapy program for him. The world of behavior therapy is very new to me, and I have to say, it’s really confusing. I’ve asked a lot of questions – both of the therapists and of friends who have worked in this field - so I feel like I’ve got a pretty good understanding of it now. We would hire a therapist to come to our house for a minimum of 8 hours/week, and maybe go to his Mother’s Day Out program with him for a couple hours to help him with social interaction skills. Do you watch the show Parenthood? If so, you’ll understand what I mean when I say we’ll have our own personal Gabby (better not invite my single, younger brother over for a visit!). Including speech therapy, this would give him at least 10 hours of professional therapy each week, plus the time I will spend with him throughout the day. That’s still very aggressive intervention, so we definitely wouldn’t be sitting around, watching and waiting to see how he does over the next 2 months before his re-evaluation. That’s more intervention than most children with autism get at this age (because TEIS won’t pay for it, because they suck…). It’s not quite as intensive as The Gold Bar Center, but we don’t have to sign a contract, so we can change his therapy plans at any time. If he doesn’t improve as quickly as we hope, we can pull him out and enroll him at the Gold Bar Center right away. But our hope is that with this intervention, the doctor will tell us in April that he is significantly improving and heading away from a diagnosis. That’s our prayer every single day.
We haven’t decided for sure yet. We’re still investigating insurance coverage, TEIS benefits, and negotiating on a contract with The Gold Bar Center. It’s a lot to decide. We just want to make the best decision we can make for J, but it’s so hard to know what that is given the uncertainty of his diagnostic profile. Chris and I have decided to make this decision based on what we really feel is best for J, not on the cost. We have to just trust that God will open the door where He wants us to be, then somehow He’ll provide the money. I have no idea how, but I have to trust that He will. And in the meantime, we’re praying and asking other people to pray for clarity and wisdom. I want the doors to open where He wants us, and to close where He doesn’t want us. I want it to be clear. I want to know that we’re making the right decision. Unfortunately, it might not work that way. We might just have to make our best educated guess. But we’re going to keep praying for wisdom. And most of all, I have to keep reminding myself that no matter how much I love J, God loves him even more than I do. No matter how much I want the best for him, God wants it even more than I do. He is my son, but even more than that, he is God’s child – his beautiful and perfect creation. He does have a plan for J, and that plan is also beautiful and perfect. It might not be the plan I would choose for J, but even still, it is the perfect plan for J. Honestly, I have to remind myself of this over and over and over, and sometimes I need friends to remind me of it even more often than that. Because I keep forgetting. I want to have everything under my control, and I want to know that everything will work out the way I want it to. But I can’t know that. I just can’t. And somehow I have to make myself accept that. All I can do is keep trusting that God’s plan for J is perfect, that God loves J more than I do, and that He will take care of my baby in His perfect, sovereign way. I have to admit, my faith is not strong enough to believe that all the time. I wish that it was, and people try to make me feel better by telling me how strong my faith is. But it’s not. So for now, like the father of the dying child in Mark, I just keep praying “Lord, I believe. Help me overcome my unbelief!”
J's Story

This is J. He turned 2 years old this month. A couple months ago we started to have some concerns about his development. Our biggest concern was his speech/language skills. At 18 months J was using about 60 words pretty regularly, and everything seemed fine. But over the next few months he began to drop language skills. He stopped gesturing, he stopped following commands, and he almost completely stopped talking. It happened gradually and during the time when I was very sick with pregnancy nausea and vomiting, so we didn’t notice at first. But one day we realized that he really didn’t talk much anymore, and then only if he needed something. He was down to using maybe 12-15 words, and on an average day he might only say about 4 words. He also wasn’t using much nonverbal communication, and he seemed almost entirely uninterested in any social interaction. It was like he had withdrawn in to his own little world, and we were watching little pieces of his personality disappear before our eyes. Once we realized this, we were of course very concerned. I took him to the pediatrician, hoping she would tell me that he just had a speech delay, but that otherwise he seemed just fine. I knew what Chris and I were both secretly thinking in the back of our minds, but still we were hoping that the pediatrician would dismiss our fears and reassure us that he was fine. Unfortunately, that’s not what she said. She agreed with our concerns, and she encouraged us to take him to a specialist at Vanderbilt to have him evaluated for the very thing we had been fearing: Autism.
Once she said the word aloud, that tiny fear in the back of my mind became an all-consuming, overpowering terror. How could my child have autism? Surely he doesn’t. I mean, he still smiles and gives me hugs. He’s probably just really smart, and that’s why he studies all of his toys so intensely. And a lot of boys this age are not very verbal. Plus maybe he’s just really introverted and doesn’t like to be around new people. Surely there’s another explanation. But I knew enough to know that something wasn’t right. A 22 month old child should not just lose verbal skills like that. He should not suddenly lose all interest in social interaction. And he definitely shouldn’t spend 20 minutes just staring at the speakers instead of dancing to the music. I knew deep down that we needed to be concerned. So we immediately called to get him set up for an evaluation, and we were told that there was a 6-12 month waiting list. There was no way we were going to wait 6 months, so we started calling everyone we knew, using any connections we had, praying for a miracle. Fortunately, God is still in the business of miracles. As it turns out, the director of the Center for Child Development (the clinic where he would be evaluated), is a colleague of Chris's. Chris knows him, he just didn’t know he was the director of the CCD. He called him up to tell him what was going on, and the clinic called me the next day to schedule J’s appointment – just 2 weeks away. So for those 2 weeks we waited and we prayed. And we prayed and we waited some more. We watched everything J did, I took pages and pages of notes every day, I made lists of what words he could say, what words he used to say, what new words he had learned. We turned off the TV completely, and I spent every minute I could sitting on the floor with him, trying to get him to interact with me. And he began to improve! It was amazing how quickly he began to respond. It’s not that I had been neglecting him before, but he responded so well to my intentional efforts to draw him out and encourage him to use more words. By the time his evaluation appointment rolled around, I had once again convinced myself that he was fine. He was making eye contact (sometimes), responding to his name being called (sometimes), playing appropriately with toys (sometimes), using more sign language, and even picking up a few more words. During the 4 hour evaluation J was happy and playful, very socially engaged. He even sat in the psychologist’s lap and kept playing peek-a-boo and laughing hysterically. Chris and I both thought that he had done great and that the doctor would dismiss our concerns and clearly say that our child does not have autism. Once again, that’s not what happened.

The doctor sat down with us to tell us his conclusions. He said that J’s profile is very complex. He has a lot of strengths – he can use eye contact, he is very socially engaged, he’s affectionate, and he plays well in reciprocal, back and forth games. But he also has many areas of vulnerability – he only occasionally responds to his name being called, his attention can only sometimes be captured and diverted, he struggles to communicate his wants and needs, both verbally and nonverbally. And he does show some repetitive behaviors, limited shared enjoyment of activities, lack of imaginative play, and impaired/inconsistent functional play with toys. Many of those are fancy words for the concerns we already had about him, but hearing the doctor say them aloud made it all seem so much more real and threatening. He said he did not feel confident making a diagnosis at this point, given J’s young age and inconsistent behavior patterns. But his final conclusion was “At the end of the day, I am very concerned about the possibility of an Autism Spectrum Disorder.” As soon as I heard those words, I was crushed. That was not what he was supposed to say. That was not what I had been praying for, and definitely not what I had been hoping for. This was not supposed to happen. Surely my sweet baby boy is just fine!
The doctor was considerate enough to give us a few minutes alone, and as soon as he walked out of the room, the tears started to flow. Chris sat beside me and held my hand while we both tried to let this realization sink in to our hearts and minds: Our child may have autism. This is real. Our entire lives are about to change. He may never live a “normal” life. He may never be able to develop meaningful, intimate relationships. His future opportunities may be severely limited and impeded. He’s going to be that kid sitting in the corner of the classroom, moaning and rocking (because we’ve all seen Rain Man, right?) Our sweet, sweet, beautiful baby boy. And the whole time we sat there crying and digesting this news, J sat in Chris’s lap, smiling and hugging him, pulling on his tie, completely oblivious to our fears. How could this be happening? It all seemed so surreal.
Once the doctor came back in, he was ready to discuss our plan of action. He believes strongly in early intervention, and he assured us that we were really fortunate to catch on to J’s symptoms so quickly. He told us that with J’s young age and uncertain diagnosis, it was entirely possible that with some intensive intervention, he could significantly improve in his vulnerable areas and end up being perfectly functional, or not even end up on the spectrum at all. My hopeful heart latched on to this information right away, and we were determined to do everything we could do to help J. The doctor recommended intensive speech therapy and behavior intervention, then told us that he wanted to re-evaluate J in 3 months to see how he was progressing, hoping that we would have a more clear picture of what was going on at that time. We knew this would be a little tricky, considering that we were having a baby in 3 ½ months, but we also knew we would do everything in our power to get J the help he needs. So I went home, put J down for a nap, laid on my bed and cried for about an hour, then immediately switched to action mode. I contacted every speech therapist on the doctor’s list, researched every developmental preschool in the city, and set up a referral with Tennessee Early Intervention Services (TEIS). By the time Chris was home from work. I had done everything I could possibly do for the day, and once again all I could do was wait.

These last few weeks have become a whirlwind of phone calls, emails, internet research, touring preschools and treatment centers, evaluations, and investigating insurance/TEIS coverage for autism services. Needless to say, I have been completely overwhelmed. And emotionally exhausted. I wasn’t sleeping well, I went days without eating, I cried almost constantly. When I went to my OB check-up and the doctor told me that I hadn’t gained any weight in the past 4 weeks, and that I had only gained about 7 pounds total (at 24 weeks pregnant), I knew I needed to do a better job of taking care of myself, for the sake of this new baby. Thankfully, we have wonderful friends who immediately pitched in to help. They started bringing me dinner so that I could focus on figuring out the logistics of J’s treatment plan and still remember to eat. They’ve been coming over to play, just to help get my mind off things for a while. They’ve called, texted, and emailed frequently to see if I need anything, or to allow me a chance to verbally process the decisions we’re making. Most of all, they’ve just loved and supported me through this very difficult time. And they’ve prayed. They’ve prayed hard. I know they’re really praying, not just saying it because that’s what you’re supposed to say to someone going through a hard time. They’ve told me what they are specifically praying for us, and asked often for more specific things they can pray for. I can’t begin to express how meaningful it is to know that my friends are praying for us, because honestly, I can’t pray for myself yet. Somehow the emotions are still too raw, too fresh. I’m not angry with God, I just can’t seem to bring my words and thoughts in to anything coherent before Him. So in the beginning I prayed constantly throughout the day “Jesus, help me.” That’s all I could do, all the words I could come up with. Within a few days my prayers evolved in to me saying “Just stay close, Jesus. Don’t let me get angry. Don’t let me pull away from you. Just stay close to me.” It wasn’t much, but it was enough. I know He heard me, and that was enough.
It’s a strange feeling, not being able to pray about something so huge. I know that I need to pray about these decisions. We need guidance, we need wisdom. But I can’t pray about it, except to briefly say “God, give us wisdom. Show us what to do.” That’s as far as I can get. My prayers are rarely more than 1 or 2 sentences long, but it’s okay. I just keep asking Him to stay close and help me, to show us what to do, to take care of our little boy. And that’s enough. Plus I know that our precious friends are praying for us when I can’t pray for myself. It’s the beauty of community. And I’m so thankful that God never asked me to be strong enough to carry this alone. Instead he surrounded us with people who love us and who are helping us through, so that we don’t have to do it alone. He may have given me more than I can handle on my own, but it’s not more than HE can handle. I know that as long as we allow Him to help us, He will equip us with everything we need to get through this. He’s not asking me to be strong, He’s not asking me to handle this, He’s not asking me to have perfect faith and keep it all together. He doesn’t expect me to have everything under control. He just wants me to keep praying “Help me, Jesus.” That’s enough. He’ll take care of the rest, somehow.
Tuesday, February 21, 2012
This is Us

(family photos by Anna Roberson)
This is our brand new family blog. We've had a family blog for about 6 years, but we had some security/privacy issues (creepy weird internet stalker), so last year I made that blog private. I didn't like the private blog set-up...too much hassle, too much confusion, it doesn't show up on Google Reader, etc. But there was so much already on that blog that it would have been difficult to go back and re-do everything well enough to make it internet-safe, so I'm starting over. And this time we'll be more careful not to give creepy internet stalker man anything too interesting.
So that's one reason for the new blog. The other reason is to give our friends and family updates on our current situation. In the past few months we've begun to walk down a road that we never wanted to travel, but it is our road nevertheless. There has been so much to process, so much to think about, so many emotions swirling around. Being the verbal processor that I am, I needed a way to process these thoughts and emotions, so I've started to keep a written account of what's happening, both for my benefit and for the benefit of friends and family who want to stay updated. This is easier than sending out dozens of individual emails each week, which is what I've been doing so far. Beware that these first few entries will be very long and full of gobs of information. Like I said, that's partly for my benefit as I process these events and emotions. Feel free to skim as quickly as you like. I promise I won't be offended. But most of all, please pray for us as we continue on this journey. As you'll see through the following entries, our hearts are breaking right now. We are sad, hopeful, confused, worried, anxious, optimistic, lost, overwhelmed, and very much in need of prayer and support. So with that glowing introduction, the story begins.
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