Monthly Archives: February 2008

First quarter

Katie is three months old today.  It hit me a few days back that this was actually a quarter of a year, which somehow sounds much older – the thought that my baby has lived through an entire quarter of a year of extrauterine life is mind-boggling.  Then again, it’s also mind-boggling to think that this time last year she was just a twinkle in our eye.  I know it’s a hopeless cliché to say that the time has flown past, but what can I say?  It’s flown past.

She will crane her head and shoulders forward when she’s in her bouncy chair, trying to sit up properly.  She will swipe at objects suspended in front of her with an adorable look of puzzled concentration on her face as she tries to figure out this new experience.  She coos and gurgles and squeals. 

I’ve spent the past few days sorting out the 3 – 6 month clothes, not before time – she has been bursting out of her current ones for days now.  I’ve hardly been able to do the poppers up.  Today, I finally stored them away.  Good god, was that ever a nostalgic moment – all those outfits that she looked so adorable in, most of them ones that Jamie previously looked so adorable in, and I’ll never put any of them on a baby again.  I put a couple of my favourites on her this morning to get some last photos – the personalised T-shirt Emms made for Jamie, the pink romper suit and stripy top that my mother-in-law gave me before she was born and that comprise the first girly outfit I put on her, among all those hand-me-downs of Jamie’s.  That one was far too big for her when I first dressed her in it – now she fills it.

I was pleasantly surprised to find just how much I enjoyed these months, this time around.  Having my first baby left me with the general impression that the first six months are the bit you endure in order to get on to the better bits.  Well, to a large extent I felt that way about the first two years, but the first six months left me struggling to remember that the appropriate response when someone has just become the parent of a newborn is in fact "Congratulations!" and not "Oh, well, never mind – you only have to hang in there for six months before it starts getting better."  I’d hoped that this time, what with having had some practice, I’d dislike it less; but I hadn’t expected to enjoy it as much as I have.  It’s amazing what a difference it makes to have acquired the ability to ignore any parenting books that tell me to do things an entirely different way from whatever way is currently working perfectly well for me.  And, of course, to have a baby who stops nursing at the end of a feed and who settles well to sleep when she’s tired.  And to live in a house I like in a town I like, with a few friends around.  Granted, the past few months have sometimes been exhausting and overwhelming, but then so were the few years before that.  All in all, it’s been a lovely time.

However, with the exception of the wrench of putting away the first lot of baby clothes, I haven’t felt any nostalgia at all for the newborn stage.  Which is quite something, considering my astonishing ability to get nostalgic over the ending of some the most hated stages in my life.  I suppose it’s because all the good things about the early months – the cuteness, the cuddliness, the gurgles – persist into the next period of babyhood, so I don’t feel I’m losing anything except the steep learning curve and frequent night wakings.  (It would be an exaggeration to say I’m losing those, unfortunately, but they’re definitely less pronounced as time goes by.)  Besides, the longer this parenthood thing goes on for, the more interesting it gets.  I’m passionately impatient to get on to the next stages – the stages of watching Katie learn how to do things and of seeing her own interests emerge.  Being a parent is more exciting than Christmas.

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Filed under Here Be Offspring, How quickly they grow up

A brief digression from my own tales of parenting

One of my current Sunday pastimes is visiting Jeff Vogel’s website to read another installment in The Story About The Baby.  This is the on-line archive of Vogel’s blackly humorous and cynical week-by-week account of the first year of his daughter’s life.  He continued it on a monthly basis until she was four, and has also published the diary of the first year in a book called The Poo Bomb, all of which I have previously read.  However, I didn’t discover it until Jamie was several months old and I had long since given up keeping track of what his age was in weeks, so I never really did much in the way of week-by-week comparisons of my parenting experience and his.  Since I like doing that sort of thing, I’ve been taking the chance to do it this time around.  Every Sunday, as Katie’s age ticks over to another full week older, I visit the site and read Vogel’s account of what happened in his parenting life in the week equivalent to both the one we’ve just finished and the one we’re just starting (yes, I know this means I read all the entries twice).  Then I sigh if my experience of that particular week seems to have been lacking something compared to his, and smile smugly if it was better.  (It’s usually the latter.  Vogel’s general view on parenting a baby is that it’s the part you have to go through to get to the point where you get to parent a child, but just because he accepts that fact doesn’t mean he has to like it.)

By the way, I do the same thing with Dr Sears’ Dad’s Diary (the Dr Sears in question being not the famous one but his second son, Bob).  However, I like the IronyCentral diary better, because it’s funnier and because Vogel does not subject me to repeated offers to subscribe to some newsletter.  No, Bill and Martha Sears, I do not want to subscribe to your free newsletter, I do not intend to be worn down into capitulating and signing up after all, and would you please get over your own egos, accept that possibly some of the visitors to your site just aren’t that interested in your precious newsletter, and install a "Do Not Show This Offer Again" option already??

Anyway, the installment I’ve just read from The Story About The Baby contained the following anecdote, which I felt to be worth at least a passing comment:

"I have been getting our daughter to sleep for the last few months like this: First, I cram her full of food. Once she makes a sloshy noise when I shake her, I swaddle her really tightly. Once she looks like a sad little mummy, I put the pacifier in her mouth. Once she is being made artificially happy by a chunk of rubber, I set her down and turn off the lights. Badda bing. Sleeping baby.      

But I started to think that this series of peculiar steps might not be necessary. I thought, since she can suck on her hands now, she might not need the pacifier, and since she’s three months old, she might not need the swaddling. Tried putting her to bed without either.      

Inside of five minutes, she was crying. I found her trying to suck on her fingers. However, she was trying strenuously to jam her hand into her upper cheek, which was not leading in any way to her fingers being in her mouth. OK, that’s not working. So I put the pacifier in her mouth. Then she decided that she also wanted to be sucking on her hand. So she swung it up and punched herself in the eye. This is not conducive to getting to sleep….

So we’re back to the mummy-plugged-with-rubber sleep technique. I bring all this up because I want people to know one thing. When I call Cordelia "dopey", it is not entirely an arbitrary judgment, free from all evaluation of actual evidence."

OK, Mr Vogel, let me see if I’ve got this straight here.  You were able to get your baby to sleep at night with practically 100% effectiveness and with no crying on her part, purely by the use of a technique requiring only a couple of minutes of minimum effort on your part (I’m not counting the time spent feeding in that time, since feeding your baby when it’s feeding time is something you’re generally expected to do regardless of whether it’s part of a successful sleep promotion strategy or not).  To put it another way, you had a stroke of luck which thousands of parents would willingly have sold their souls to have.  Instead of falling on your knees and passionately thanking whatever gods might be in charge of parenting, possibly sacrificing the odd goat to them just to be on the safe side, you decide to abandon this technique.  For, so far as I can tell, no better reason than an arbitrary whim. 

And you think she’s the dopey one?

As for me, I am in no doubt as to how lucky I am that swaddling and settling my daughter at night will buy me a few hours of good sleep, and I have no intention of changing that until I have to.  In fact, I’ve been trying to figure out whether I can get away with swaddling her at night until she’s at least five.

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Filed under I think this line's mostly filler

Naturally, I dissent

I had both my babies by what you might call natural childbirth.  I don’t in fact call it that, partly because the term makes it sound as though the naturalness was somehow the goal in and of itself in some sort of Luddite repudiation of technology, and partly because it’s yet another example of how overused and meaningless the word ‘natural’ is.  After all, porcelain tubs filled with hot water are no more likely to grow in the natural setting than epidurals are, but I certainly found a soak in the bath of vital importance to handling the pain in my first labour.  However, I had unassisted low-tech vaginal deliveries for both, pretty much unmedicated (I had two Paracetamol when in labour with Jamie, and a very brief go on the gas and air with Katie, but no Pethidine or epidurals).

This is, apparently, highly objectionable to Dr Crippen.  Part of this, it appears, is because he has much the same semantic objections as I do to the term itself.  Much of it, however, seems to be because he thinks, incorrectly, that natural birth is another term for homebirth.  Dr Crippen is against homebirth, which he believes to be unacceptably dangerous.  The only evidence I’ve seen him offer to back up this viewpoint is of the Scary Isolated Anecdote variety so beloved by, say, anti-vaccine scaremongerers, but I only read a relatively small proportion of his posts and for all I know I may at some point have missed a more rational discussion of the relative risks of homebirth and hospital birth involving the citing of some actual evidence.  However, it’s a moot point, since he’s wrong in thinking that natural childbirth automatically means homebirth.  It’s a term generally used to refer to birth without intervention or medication, which (theoretically at least) is perfectly possible to do even in the most high-tech of hospitals.

Would Dr Crippen object to a woman having natural childbirth in a hospital?  I doubt it, but it’s hard to be sure – some of his criticisms don’t seem to have anything to do with the place of birth:

"Right on, trendy “natural” child birth is about jumping into the
birthing pool with husb… sorry, “life partner”
[Goodness.  And here was me thinking that the days when doctors could make snide comments about pregnant women not being married went out circa 1960], the vicar and the
independent madwife, singing ten green bottles whilst the baby
struggles to get out and then eating the placenta with a rocket salad."

All of which, of course, a woman could do perfectly well in hospital.  So what’s the problem?  Well, his objection to those various potential methods by which a woman might make herself feel comfortable during labour or circumvent the lack of decent hospital food after it’s over (placenta-eating isn’t an idea I fancy in the slightest, but, thinking back to the quality of the only available meal on the ward the evening I’d given birth to Katie and was starving for some protein after a day of eating nothing but easily-digestible carbohydrates, I can see how it might have its attractions) is apparently that the perinatal and maternal mortality rates are unacceptable.  He does not provide any statistics or details on the impact that any of the things he listed have on intrapartum mortality, but I await with interest his presentation of the randomised controlled trials studying the mortality rates of "Ten Green Bottles" renditions.

I did not, as it happens, have any of the above in either of my births, although the lack of the birthing pool in the second certainly wasn’t by my choice.  (In my first labour I used the bath instead, which worked perfectly well; whether or not that would call forth similar levels of derision from Dr Crippen, I don’t know.)  For me, natural childbirth – or whatever term you can come up with that describes the choices I made concerning my children’s births – wasn’t about what I wanted to do during the birth, but what I wanted to avoid. 

I did not want, for example, to have major abdominal surgery on the day when a new helpless person requiring a lot of care and a lot of heavy lifting joined my family.  I did not want cuts made in my genitals.  I did not want my children’s first experience of life to be the application to their heads of a suction machine vigorous enough to cause major bruising. If, of course, I found myself in a situation where the consequences of not having one of those interventions were likely to be worse than the consequences of having them, then so be it.  However, I wanted to reduce the chances as much as I could.  From my reading, there seemed to be good reason to think that the stronger forms of analgesia might increase my risk of getting one or other of those interventions, as well as having various other potential and unpleasant side effects.  So I found out as much as I could about alternative ways of dealing with labour pains, and decided to see whether I could get by on those ways if possible.  Which, as it turned out, I could.

You can’t get side-effects from a drug you haven’t taken or complications from an operation you haven’t had.  That’s why I wanted to keep intervention to a minimum.  I’d have had any intervention for which there was a genuinely good
reason; but I was also aware of how often "This is just the way we do
things" is considered a good enough reason on hospital wards, and I
didn’t consider it a good reason.  So, call it natural childbirth if you like – it’s what the term means, after all – or call it by a better name if you have one.  But those were the choices I made about my labours; and those are the reasons why I made them.

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Filed under Grr, argh, Sacred hamburger

Random acts of updating

I spoke to the nursery supervisor last Thursday to update her on the upcoming paediatric referral and the health visitor’s recommendation that we arrange more nursery time for Jamie.  As I’d thought, there are no sessions currently available apart from the one that happens to clash with his Tumbletots session, but she will have a word with the registration secretary and find out whether any places are coming up next term.  If not, I will try to get him some sessions somewhere else local, and she says that if that happens they will be happy to liaise with the other nursery. 

She mentioned something to the effect that there would most likely at some point be some kind of official meeting with all concerned in order to discuss how best to proceed with intervention, which surprised me a little as I was still thinking in terms of all this being a potential problem which might need something doing at some point in the future rather than an actual problem that required meetings to be taking place at this stage.  Still, I suppose that the different setting at nursery means that things that aren’t a problem in the home setting may become problems, and then of course it would be nice to pre-empt any potential problems at school.  I asked her how she thought he was doing generally, and she said that he clearly had a lot of strengths but he did have problems focusing on what people were saying and thus, if one of the nursery staff was telling the group to do something, it was often necessary for someone to come over to Jamie to make sure that he’d taken it in – he does seem to need more one-on-one help with that sort of thing. 

She also said that the other week, when the children were asked to get their coats on and Jamie didn’t seem to be taking it in, she’d tried him with a picture communication card that they used with one of the other children and that seemed to flick the lightswitch in his mind – aha, coat!  This makes her think that he takes things in visually better than he does auditorily (I’ve also noticed that he seems to have a strong visual memory.)  They’re going to be trying some Makaton sign language with the children and think that might be really helpful for getting instructions through to him.  That would be excellent, as I’ve been planning on trying signing with Katie – I was going to try BSL, but if Jamie’s going to learn some Makaton then I could teach Katie the same signs and maybe they can use them to each other once Katie’s a bit older.  She said she’ll see whether she can arrange a parent class for signing.  If not, then I remember Fiona saying she’s used it in teaching – I’ll have to get her to show me some signs.

Jamie had his latest orthoptist appointment on Tuesday.  His vision in the squinting eye is apparently still not quite optimal.  This came as no great surprise – having a new baby around does tend to distract one somewhat from details such as remembering the older child’s eyepatch.  There is also the practical problem that having a new baby divides life abruptly into things that can be done one-handed and things that can’t, and, although replacing glasses on a reluctant child who has just removed them is a wee bit borderline, it does on the whole tend towards the second category (depending heavily on the reluctance of said child).  Then, on top of all that, the left lens of his glasses somehow got scratched a few weeks back and this bothered him a lot when he had the patch on the other eye, thus meaning that he became more and more reluctant to wear it until he reached the point where he completely refused.  At this point I finally did what I should have done before and took the glasses to the opticians to order a new lens, but that all took a few days longer and meant yet more time without the patch.  So, all in all, I’m just pleased his eye wasn’t any worse than it is.  Anyway, same old same old – we continue with the two-hours-a-day patching regime (or as close an approximation as we feel we can get) and see Pat again in three months.

I have been similarly remiss in remembering to do the things I was supposed to be doing to encourage Katie’s foot to turn, but fortunately this does not seem to be a problem – as the final after-effects of being squished against my inner uterine wall wear off, her foot is returning quite nicely to the appropriate position.  I still sometimes notice it turning inwards, but not nearly as often.

Yesterday, we made the trip to Mothercare and bought Katie a bouncy chair so that she can watch the world go by from more optimum positions than formerly.  Bouncy chair technology seems to have moved on somewhat since I spent my geeky childhood perusing Mothercare catalogues – they used to be simple bits of canvas on wire frames, and now most of them seem to be all-singing all-dancing productions with bells and whistles on, probably literally.  We eschewed all the complicated ones that do things like vibrate the baby into submission or dazzle them with multicoloured whatsits and went, instead, for a simple and attractive design in pale green with a few soft objects dangling from the detachable bar over the top.  Katie seems to love it.  Now she can actually watch us while we’re having dinner, instead of being relegated to a cushion on the floor.

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Filed under Adventures in Squint Correction, Here Be Offspring

No-D-day

Shortly after 2 a.m. on Saturday, 9th February, I crept into my sleeping son’s room, pulled his final dummy from between barely resisting lips, slipped my hand under his pillow to retrieve the spare, took a minute to admire his sheer cuteness and adorableness, and left.  The Dummy Era had ended.  Not with a bang, and, as it turned out, not even with a whimper.  When I predicted that his protests would be brief and short-lived, I was wrong; they were non-existent.

He did inquire after the dummy a couple of times.  "Where’s the yion dummy?" he asked me at naptime the next day.  (He has some trouble pronouncing L’s.)

"The dummies have gone away," I told him.

"Where did they go?"

"Away.  They’ve all gone now.  You’re a big boy now, and…" I shut my mouth on that particular parental cliché before it could drivel on into the line about not needing them any more – after all, I realised, he might have a different opinion on that, and uttering mine was unlikely to be helpful here.  Instead, I realised, I could simply go ahead and tell him the truth.  "And it’s bad for your teeth to have dummies for too long."

He wailed.  I empathised aloud about how it must be difficult to give up dummies, only to discover that what he was actually wailing about was that he wanted all the Night Garden books before his nap and I’d told him I was only going to read him two.  That may of course have been displacement emotion, but he showed no sign, then or later, of being concerned about the dummies. He did ask Barry about them on one subsequent occasion, but apparently accepted their absence easily. 

Getting him to settle to sleep has been a bit more difficult, mainly, I think, because the dummy had become a signal that it was sleeptime – without that, it’s that bit more difficult to transition him from pre-naptime bouncing around to settling down.  He’s taking longer to fall asleep at his naps (he already took ages at bedtime) and on one occasion a couple of days after the dummy removal he didn’t get to sleep at all.  But, overall, he appears to have accepted the absence of the dummies just fine.  And that particular source of nagging guilt is lifted from my life.  I can face the next dental appointment with a clear conscience.

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What Katie Kaffrin did

My sister, championing the cause of little sisters in general, has asked why Katie doesn’t yet have her photo on my About page.  The reason is that this would mean sacrificing the photo of someone else in the family, as I don’t, as yet, have a photo of the four of us together.  I keep meaning to get one when relatives visit, and somehow we’ve never yet managed to get round to it.  I swore I’d get it done on Wednesday when Barry’s parents were here, but I went to the breastfeeding group in the morning and then when I got back they’d gone into town and then when they got back it was time for his mother to open her birthday presents and then Katie started one of her spit-up marathons and by the time I managed to get her to stay in one outfit for long enough to get downstairs it was time for Jamie’s lunch and then Barry was doing something else… you get the picture.  (Or, rather, you don’t.)  Anyway, I’m holding out for a photo of the four of us together before I change the one that’s there now.  If it’s any consolation, I have at least now updated the bio to mention my second child’s existence, although it may or may not say something that the comments policy got considerably more writing space than she did.

Anyway, in hopes that it will provide at least a partial substitute, here’s a post about her.

Katie is now eleven weeks old.  Well, actually nearer to twelve weeks for now, but for some reason I felt kind of a pang over never having put it in writing that my daughter was eleven weeks old and wanted to grab that particular moment while I still could.  She hasn’t been weighed for almost a fortnight (I’m going to get her weighed again this coming Monday when I take her in for her second lot of jabs), but she was 11 lb 11 oz then, so extrapolation from the rate at which she’s been gaining so far means that she is almost certainly over twelve pounds now.  This, according to parenting folklore, is apparently some kind of magic age at which babies start sleeping for longer periods of time.  I haven’t seen any particular signs of that over the last few days (particularly not last night.  Sheesh) but I am awaiting further developments with interest.

She’s longer, too.  Length is no longer routinely measured at the check-ups, due to the general inaccuracy of trying to measure a baby, but I measured her last night out of curiosity and it seems she’s 23 inches.  That’s a gain of four inches since her birth, if I’m correctly remembering what the midwife said her birth length was (annoyingly, I didn’t realise they hadn’t written length in the red book until I’d already handed back my maternity notes and could no longer check).  I can tell she’s longer – nursing her in my accustomed position in the living-room armchair with the laptop balanced on the arm for easy reading is becoming increasingly hazardous, as I have to be careful she doesn’t kick the thing off.  When I carry her cupped in my arm, the way I used to carry Jamie – my hand cupped under her bottom, her body lying along my forearm – her head no longer nestles comfortably into the crook of my elbow but spills over to partway up my upper arm.  I don’t carry her that way very often anyway, as she gets heavier – more often I have her propped up on my shoulder, balanced there with one arm, where she can peer over, bright-eyed, or curl her head trustingly into the curve of my neck when she falls asleep.

Jeff Vogel, author of The Poo Bomb, wrote when his daughter was this age that he didn’t agree with the term ‘quiet alertness’ and thought ‘lucid dopeyness’ would be a better description of his daughter’s waking non-feeding non-crying moments.  Well, in your face, Vogel – your daughter may have been lucidly dopey, but mine is alert.  She looks at the world with fascination, drinking it all in.  Interestingly, she appears to have a particular predilection for bookcases.  That’s my little girl, all right.

She waves her arms and legs in huge jerky swings that inspired Barry to speculate on whether they’re attached to a big wobbly spring in the middle of her.  She put concentrated time, in the past few days, into trying to grab the flowers on her grandmother’s jumper and the pictures of strawberries on our tablecloth (and took it in good part when, mysteriously, she couldn’t manage either of these endeavours).  When I pull her from lying to sitting by her hands, her head comes right along with her now, not lagging at all.  When I hold her in the air face down in the Superman flying position, she can hold her legs straight out behind her.

She loves it when somebody comes and talks to her, or echoes her gurgles back.  She rewards such attention with a massive smile that almost eliminates any need for other light sources in the room.

That, according to Open Office’s word count, is 617 words about her, which, according to traditional exchange rates, should account for marginally more than three-fifths of a picture.  I shall work on getting an appropriate picture up, but hopefully that’ll fill the gap for now.

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Filed under Here Be Offspring, How quickly they grow up

Assessment, abridged

I plan to write about the assessment in detail, as I did last time (not because anything particularly untoward or interesting happened, just because it interests me), but, of course, it’ll probably take weeks to get that finished.  So, in the meantime, here is the summary:

Jamie tested at the four-year-old level on visual and receptive language skills, two-year-old level on interactive social and self-care social, three-year-old level on locomotor and spoken language, and thirty-month level on manipulative and cognitive skills.  (As far as I can tell, the score on cognitive skills is due to the fact that this area on the test looks at some interactive-type skills as well as other things.)  The health visitor thinks he’s clearly a very bright little child (slight pause for parental smugness) but agrees that, in view of the things we’ve collectively noticed, paediatric referral is warranted at this stage, and she is arranging this.  Meanwhile, she thinks we should phone round the various playgroups in the region to see whether we can find any with some sessions free, as she thinks this would help him.  (We’re going to put him down for extra sessions at the one he’s at, but those won’t be available until September.)  She thinks that if he does have ASD then it’s extremely mild.  In other words, basically what we thought already on all counts, but it’s nice to have it confirmed by someone else and to feel that wheels are in motion.

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Ambling to conclusions

In response to my recent post about the discussion I had with Jamie’s nursery supervisor about his differences and the possibility of autistic spectrum disorder, Clare wrote:      

  Hello. I hope you are feeling OK about all this. I wonder if people
might be jumping to conclusions a little too much. I guess only the
assessment by the specialist will give you real useful information at
this point. But I just wanted to say, don’t you think that 20 years
ago, you might just have thought that you have a little boy who is a
little bit shy for his age?

Similar thoughts go through my mind whenever I consider the subject.  Even with the attendant disclaimers  about possible/suspected/might-be that I’m appending to each mention of ASD, I do feel rather silly typing the term at all at this stage.  The only reason I have got as far as introducing the term into type at all is the fact that both the health visitors and the nursery staff have independently raised concerns about Jamie’s differences – if I’m overreacting in even considering the possibility, then at least I’m not alone in doing so.

But I don’t think we’re overreacting to consider it.  I think that what we’re doing at this point is not jumping to conclusions, but raising the question.  It’ll be the job of someone else to draw any final conclusions about that question’s answer.  But, yes, I think it’s one that does need to be asked.

Jamie almost never indulges in what the books call ‘imaginative play’.  A couple of times, I’ve seen him pretend to talk into a toy phone; a while back, he went through a short phase of giving the toy ducks in his bath drinks of water out of a cup.  There was that time he pretended a plastic corn-on-the-cob was a drinking straw.  There may have been a couple of other times I’ve forgotten.  But it really does come down pretty much to that handful of isolated incidents, over a couple of years that would generally be expected to be a time fairly rich in imaginative play.  I’ve never seen any role-playing from him – no pretending to be a fireman or a driver or anything of the sort.  I commented a few posts back about his new interest in cars being normal to the point of cliché, but realised quickly that that wasn’t, strictly speaking, the case.  He doesn’t play games in which the cars make journeys or have races or get fixed at the garage.  Instead, he’ll push one car after another along the hall or through his room, then line them up carefully in a row.

He still has odd speech patterns.  He hasn’t worked out pronoun reversal – he still refers to himself as ‘you’ and me as ‘I’ – but a more noticeable feature of his speech is that so much of his speech to us consists of him making the statements he wants us to make or thinks we’re going to make.  So, for example, his way of asking to be picked up is to say "Do you want I to pick you up?"

He doesn’t ask us for food or drink even at times when he will eagerly accept offers of them and clearly was hungry or thirsty.  These sensations clearly affect him in some way – he’ll go into a meltdown if we forget to give him enough to drink – but he never translates that into a request, even though he certainly has the vocabulary to do so and has no problem asking for other things he wants.  It’s as though he can’t translate his body’s signals into a request.

He doesn’t seem to realise that signs of distress in others might indicate a problem to be concerned about.  This of course came in very handy when it came to his inadvertent presence during my labour, and I’m glad he wasn’t distressed by it, but I gather that one would actually expect a child of this age to show some kind of reaction beyond curiosity to the sound of another person screaming in pain.

He’s well above average with numbers – he can count to a hundred, count
backwards, and understands the concept of counting objects, not just
saying numbers in order – and he knows how to switch his computer on
and off, start programmes up and shut them down, and work the ones he
wants to work.  But he shows no interest in potty training or in
playing with other children.

Some of his interests – generally the ones connected with numbers – seem to border on the obsessive.  He used to know every Mr Men book by its number and recite the list to himself (he’s been less into that lately, but he still does know most of them).  If you mention a song he knows, he’ll tell you which number it is on the CD and then want to talk about which song is the next number after that and after that and after that.

He has a predilection for hard objects.  He’s never shown anything beyond fleeting interest in soft toys (believe me, we did try to persuade him when he was going through the separation anxiety phase babies go through in the latter months of the first year – when he wouldn’t let us out of his sight, it would have been very handy for him to view Teddy as an alternative source of comfort in extremis).  But he’ll fall asleep at night clutching his little hand-held light to his cheek.

From what I’ve been reading, some of those signs seem to be quite significant.  Others, of course, are trivial to the point where I feel ridiculous writing them down.  I’m well aware that a lot of this – and maybe all of it – can be explained just by normal variations in development or interests.  But the thing is that autistic spectrum disorder isn’t a diagnosis made on the presence or absence of one single feature.  It’s diagnosed on the basis of a pattern of behaviour.  I think that, when you put all of the above together, Jamie shows enough features of that pattern to make me (and others) suspect that that’s the diagnosis. 

This is not to say that any of it is currently a problem, as such – it isn’t (well, apart from the not asking for food and drink, which certainly can be in our disorganised household.  We’ve had to learn to be pretty on-the-ball about remembering to give him these things at appropriate intervals, since he rarely reminds us.)  Up until recently, we were both perfectly willing to adopt a wait-and-see attitude – after all, if any of this does cause problems in the future, we can do something then.  The reading and the thinking I’ve been doing as a result of Carol raising the issue has now made me think differently.  If Jamie does have ASD, the chances are that that (or, more accurately, society’s attitude to people who are different in some way) will cause him some problems at some point.  If and when that happens, it’s going to save a lot of time and trouble if we have a diagnosis already in place then rather than have to start from scratch and not get one until a few weeks or months later.  So, yes, I do now think that the follow-up to the basic assessment that the HV’s going to do should be to get a paediatric assessment, and then we can all find out whether our very tentative current conclusions are right.

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Foot and mouth

"I can’t even get a lateral curve," the specialist physiotherapist examining Katie’s foot announced solemnly to the one who saw her last Friday, who had come along to sit in on the consultation and get the verdict.  Or some similar phrase, anyway – it meant nothing to me, and her tone of voice left me with no clue as to whether this was good or terrible.  Fortunately, it appears it’s good.  The first physiotherapist and I were right in thinking that the way she’s currently holding it isn’t an indication of any underlying problem – most likely, it just got squashed persistently into that position as she lay inside me, and has tended to stay there as a result.

"Lots of this," the physiotherapist advised me, flicking her fingertips up the edge of Katie’s foot with a quick tickling motion that I could barely take in, let alone replicate.  I insisted on repeating it more slowly until I could do it to her satisfaction.  This will, apparently, stimulate her foot to turn into the correct position in response.  I am also meant to spend time holding her feet and legs in an outward-turned position reminiscent of a dancer’s plié, or just in a neutral position.  I should also avoid putting her to sleep on her front, but that, of course, is somewhat superfluous advice these days – while it’s nice to know that placing her on her back is improving the posture of her foot as well as fending off cot death, it doesn’t actually change what I was doing.  No further action beyond this is needed, and we do not need a follow-up appointment, which is good to know, given the hassle of making it to the hospital and near-impossibility of parking once there.  Indeed, Barry, having driven us there, had then been unable to come in for the appointment due to the utter lack of anywhere legal to leave the car, and was circling round and round outside even as we spoke.  I scooped Katie up, rapidly rearranging her clothing, and crammed her back into the carrier as I raced out to hop back into the car and put him out of his misery.

Since my workplace wasn’t too far off our route home, we took the chance to drop in on the way back and show off the children.  This was a success – the staff cooed over them both and Jamie impressed the receptionists by reading all the numbers on the wall calendar, with commentary ("And the 1 is white, but the 2 is black and the 3 is black as well…").

In other news, I have decided it’s time to call time on dummy usage.  (I was going to post about this after the dummies were already history so that I could give a full report on how their elimination had gone, but, of course, adding the story so far to this post gave me the chance to use a decent post title for a change, which was not an opportunity I could resist.)  More accurately, it was our dentist who decided this, telling me at our last appointment last autumn that it was time for me to get rid of them; this came as rather a nasty shock to me as I had read somewhere or other (on the Internet, so, gee, it must have been true) that this would not be an issue until he was closer to six, by which time he will hopefully have achieved some sort of wondrous Age Of Reason and will be amenable to the traditional routes of peer pressure, bribery ("The Dummy Fairy will bring you a present when you give them up"), or even just straightforward explanation of the necessity.  However, our dentist thinks otherwise, and some rather basic perusal of PubMed on the matter turned up abstracts that seemed to back up the dentist – dummy usage past age three has indeed been linked to an increased risk of open bite and posterior crossbite (whatever the hell that is).  I’m not sure whether there is any evidence for an effect on permanent teeth – the articles I read (I did not go into detail) only seemed to deal with children at an age where they probably had most milk teeth still in place – but then, that also means no evidence against an effect, so for all we know leaving him with the dummy at this stage may leave him with permanently deformed teeth and a grudge against the permissive parents who doomed him to this fate by their inability to say no to his whims.  Just in case, I reluctantly concluded the dummies had better go.

In all honesty, my gut feeling is that his protests are likely to be brief and short-lived before he moves on with life, but you never know for sure until you try and, if I’m wrong about that, we could be in for a miserable time.  However, since there seems no immediate prospect of that possibility changing, I’ve decided that if we’re going to be in for a miserable time it might as well be while I’m still off work and there are two of us around to deal with any fallout, so Saturday is going to be the day.  (I wanted it far enough ahead to give him a bit of warning, as I think that the affront to his sense of How Things Are Meant To Be will actually be rather more of a potential problem than his desire for something to suck on.)  I initially planned to go for an interim stage where the rule is that dummies only come out at night, on the basis that that way he (and therefore we) will at least get some sleep while he learns to fall asleep without it and putting him off until the evening is likely to be easier than expecting him to deal with the idea of never seeing the dummy again, but Barry thought this would be too much a case of cutting the tail off the dog by inches.  So cold turkey it will be.

I don’t think he quite has the level of abstract thought to grasp the concept of Dummy Fairies yet, so I have simply opted for the bald statement – "You’ve still got the dummy now, Jamie.  But soon [in three days time/in two days time…] it’ll be time for all the dummies to go away forever.  And then, instead, you can have your chewy beads and chewy keys!"  The latter are his old teething toys, which I dug out – I’ve noticed him chewing the dummy a lot, not to mention other things, so I think his desire for something to chew on is actually (hopefully) now stronger than his desire for something to suck on and if I can provide the former he may overlook the absence of the latter.  Anyway, he has had the three-day-warning and the two-day-warning and I have pulled the bed out from the wall to check for any lurking dummies under or beside it that he might discover at a later stage (none, but I did unearth quite a surprising variety of missing books and other objects), and tomorrow he will be warned again of the dummies’ imminent disappearance and then, at some point between him falling asleep that night and waking up the following morning, I shall sneak in and spirit the dummies away to their secret hidden location.  And hopefully they will then never be used again, because Katie has shown utter disdain for dummies when I tried them.  We shall see – if she shows any signs of developing a thumb-sucking habit in the future, she will be promptly steered towards the dummy instead, thumbs being somewhat harder to remove when the time comes – but it might just be that, however difficult or easy this particular battle proves to be when it comes to the crunch, this will at least be the only time I’ll ever have to fight it.

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Nursery conversation (or: Yes, I still can’t think of any interesting post titles, so sue me)

Some stuff that was initially on the end of the last post, but seemed to have turned into a post of its own:

In preparation for Jamie’s assessment, I was debating the pros and cons of telling the staff at his nursery
about it and asking for any
opinions they can add on the subject.  (Pros – when a child is being
assessed it’s useful to get opinions of people who see him in different
settings.  Cons – once labels enter the picture, that can affect the
way people see other people, and I was a little leery of opening up
that potential can of worms.)  I came down once again on the side of
not saying anything for now and waiting to see how it goes, but what I
hadn’t taken into account was that the staff at his nursery are quite
on the ball enough to notice things for themselves.  I guess I’ve read
too many of those true-stories-of-life-with… books in which the
parents always seem to have to battle for years to get anyone else to
notice that there’s a problem.  Anyway, the week before last Manda, one
of the nursery supervisors, called me aside to tell me that she and the
nursery staff had been noticing a couple of things about Jamie they
wanted to discuss, and what did I think?  What I thought was that there
wasn’t much point not discussing it if they were noticing for
themselves that there was something off-kilter, so, after listening to
what she had to say, I filled her in on our suspicions of ASD and the
upcoming planned assessment.

It was a very helpful conversation.  For starters, it was a good
example of how useful it can be to get opinions from different people
observing a child in different settings.  The two things they’d noticed
were that when Jamie concentrates on something, he’s off in his own
little world and it can be very difficult to get his attention, to the
point where they wondered about a hearing problem (which I know is not
the case, because his hearing was tested when we investigated his
former speech delay and it was found to be normal); and that he seems
to show no real interest in the other children, even though they would
be expecting him to do so by this stage.  The first was something I’d
also wondered about, but was one of those things that it’s hard for a
first-time parent with no reference points to gauge, and so that was
one issue where it was easier for the nursery staff to notice that he
does this to an extent which is out of the ordinary.  The second one
came as no surprise to me, but, again, was something that I just
wouldn’t have been in the same kind of position to notice.

Manda suggested that, since Carol was doing an assessment anyway, if
it was OK with me they could contact her to explain their concerns and
even invite her along to watch Jamie for a nursery session to see what
he was like in that setting.  She also said they’d had children with
similar types of problems before and mentioned some of the things the
nursery could do to help.  For example, there’s the visual timetable,
which I’d heard about before when I went to an open evening at the
nursery last term – a set of little pictograms representing the
different activities of the day that the staff attach to Velcro strips
on the wall each morning so that it’s easy for the children to see
exactly what’s going to happen that morning and in what order.  She
said they also put stuff on the walls about different emotions and what
they mean, and they have a picture-card system for helping children to
communicate when they want to be friends with other children.  The
really cool thing is that these are not interventions for a select
group of Children With Problems.  They’re available for all the children.  Anyone who would find them helpful can use them.

I signed the permission form for the nursery to contact the HV,
after first amending its worryingly vague wording (it gave blanket
permission for the nursery to pass on information about my child to
any, utterly unspecified, outside agency unless I had specifically
excluded that particular agency on the form.  I changed that carefully
to state that they had permission to contact our health visitor Carol
N___ and that I would like to be contacted regarding any desire the
nursery had to pass on information about my child to any other outside
agency.  Manda agreed with me that the wording of the form was a
concern, and she thinks she may contact the people in charge of such
things about this – apparently I am not the only parent who has queried
this.)  The nursery did speak to Carol and she has taken due note but
turned down the offer to observe Jamie at nursery – as she points out,
it wouldn’t really add anything.  Since the evidence already seems to
be adding up to him having some form of ASD, the decision now is
whether
we get him referred to someone officially qualified to make that
diagnosis or not, and, since Carol isn’t that person, getting her to
watch a session at his nursery wouldn’t move things any further
forward. Fair enough.

And one last thing: as we were saying our goodbyes and I was heading
out the door, Manda said to me "He’s a delightful little child, isn’t
he?"  It was what I needed to hear at that point.  Not because I needed
any affirmation of the fact, although it’s always nice to have it
confirmed by someone without a parental bias.  What I wanted
affirmation of was the knowledge that, even once A Label had entered
the picture of Jamie’s life, someone else was still capable of seeing
what was really important about him.

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