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Why is it so hard?
















By Louise Kinross

"Let me get this straight," my chiropractor said.

"You've had this pain in your neck and shoulders for 28 years, but you've only got $250 to fix it with?"

"Yes?" I said, with a plaintive expression on my face.

I sat on an examining table with my legs dangling in the air, like a child, and the doctor sat in front of me. I'd seen him for a series of sessions a year ago when my knees got really bad. Now my neck and shoulders, which I've had ongoing problems with, were burning. 

The night before I had to lay down on my back at 7 p.m. 

"It hurts too much to carry my head around," I explained to my husband, who was sitting in the other room. 

Shortly after that I called out: "I can't pick up my cell phone." 

"Why?" 

"It's too painful. I'm lying here with nothing to do. But it hurts too much to hold up the phone."

"Do you know how pathetic that sounds?" he said.

The chiropractor had taken a video of me to show that when I thought I was sitting with my shoulders down and even, they were completely wonky: one was way up and the other way down. When he felt my spine he said it wasn't "where it should be" and he wanted me to have an x-ray.

Why had I let things go so far? 

Just the week before when I saw my therapist I told her I was burnt out, even though I was taking a vacation day. "That's what you said the last time I saw you," she said. 

I was into the fifth week of a very exciting research project at work: nurses from across our three inpatient units were coming together for 90 minutes a week to write and draw about their emotional reactions to working in children's rehab. I was running the groups with two amazing researchers from the University of Toronto: one the illustrator in residence of the medical school, and the other heading up a new series of humanities courses at U of T, who was also  a Phd in English.

But it was something extra, on top of my regular work.

Sometimes I'd do a fantastic interview for BLOOM at work and I'd get so excited about it that I sat up late at night to finish it at home. I was also doing some personal writing at home, so after a long day of writing I'd come home with the intention of "writing" some more. 

"No wonder your shoulders are hurting, hunched over like that," my husband said as I sat at the dining room table tapping at a laptop in a distinctly unergonomic fashion.

In the morning there was the ritual of putting my son's brace on his leg and pulling him up to sit on the couch at a 90 degree angle. If I didn't take the time to lift properly, I wrenched my lower back. My husband had done this one too many times and refused to do it again, so we were no longer alternating.

"You can't keep adding more and more things to your plate," the therapist said. "You're already working full out at work and with the extra demands of your family. How about for the next three weeks you don't do any writing at night? Instead, you recover. You take a nap, or you read, or go out or do something that is completely relaxing. You take care of yourself and let yourself recover."

"Three weeks?" I said, already in a panic. "I don't think I can do it for three weeks. No, that won't happen. I'm 50 years old. Time is running out. Perhaps I can tell myself that I will pick certain days when I go home and I don't do anything at night. That sounds more realistic to me."

The therapist looked at me with a sad, knowing smile.

That night I got the stomach flu, and the next day I lay in bed, unable to go to work or do anything. It took me all weekend to recover.

A few days later I was sitting at the chiropractor's, telling him my sob story about my shoulders and neck. And it was sinking in that perhaps there wasn't a quick fix to running myself into the ground like this.

Two years ago I had a similar experience of being 'forced' into slowing down when I broke my arm badly

I know the research showing that parents of kids with disabilities have higher rates of physical and mental health problems. 

When my neck and shoulders seize up, I start to project pain into the future. If it hurts this much at 50, how much worse might it get? That freaks me out, because I have to be there to care for my son. I can't afford to be out of commission.

So here I am, 20 years after my son was born, recognizing that I still haven't learned this lesson properly. You know, the one where they say if you don't take care of yourself, you can't take care of anyone else?

And I need to.

Left out

I want to share a comment written last week on our most popular post.

The Invisible Mom, written by Sue Robins, has had almost 22,000 views and generated 80 comments.

It's about how mothers of kids with disabilities can face the same social exclusion their kids face: "In the foyer of every elementary school there's a gaggle of moms standing in a tight circle, waiting to pick up their kids," Sue writes. "In the 10 years I've parented my son Aaron, I’ve never cracked that circle. I've walked past that circle hundreds of times and nobody has ever shifted—ever so slightlyto give me room to join in."

And not only do these 'typical' parents ostracize parents like Sue, she writes, but they seem to sanction 'leaving the kid with disability out' when it comes to their child's birthdays and other get-togethers.

Sue wrote her piece over a year ago, yet listen to how it hit this parent.

Do parents of kids without disabilities have any inkling that this is reality for many of our kids? If they did, would they care? Louise 


Thanks for writing this. It has been in my heart for years. Yes, I know too well the gaggle of moms and dads. Like a gauntlet to run every day.

Every year I have hosted a birthday party for my child, every year something fantastic: a bouncy castle, paid entertainment, tons of loot. Every year the kids came, sometimes even ones not invited. But the reciprocal invitations never arrived. This year, he turned 12, and only one child showed up, despite the party being held somewhere all kids love. And this one kid probably came because I pay him to do yard work. I guess at 12 they are all too cool to go to the "retarded" kid's party. My sweet loving boy spent his birthday in tears. How do you explain it to a child? I don't know
.

Tell us your story

What do you want people to know about being a special-needs parent? 

What do you wish people understood about parenting a child with a disability or chronic health condition? 

Tell us in the comments! Louise

BLOOM media roundup

Happy Monday!

Looking for a read that will make you think? Check out the disability and parenting stories we've collected in the last week. Let us know if we missed a good one! Louise

When the diagnosis is rare, parents may know more than professionals
The New York Times
Great examples of why parents are essential partners with doctors in providing the best care for kids with rare conditions.

Discussing disabled sexuality is a radical act RH Reality Check
Why did the media largely ignore a section on sexuality and disabled youth in a critical update to guidelines on teen sexuality by the American Academy of Pediatrics?

Hidden population: Thousands of youths take on caregiver role at home  ScienceDaily
While most kids play sports or video games after school, more than 1.3 million American youth spent their free time caring for a family member with a disability or mental illness, according to this study. 


For people with disabilities, doctors are not always healers The Washington Post
'I saw blatant examples of unequal and insensitive care to patients with disabilities:' An emergency physician.

Toronto is a 'hostile' place for people with disabilities, academic says U of T News
A University of Toronto professor who studies accessibility says Toronto poses 'unfathomable barriers' to people with disabilities.


Wings for All offering special-needs families an airport dress rehearsal
The Washington Post
For three years the Palkodaty family avoided flying anywhere, convinced that it would be too much for their young son Tushar, who is autistic.

Woman with intellectual disability sexually assaulted on bus with worker nearby
CBC My Region
A 19-year-old Winnipeg woman who needs 24-hour care was sexually assaulted for 10 minutes before her support worker, a couple of rows away, noticed.


'I am different, that is good:' How an actor with Down syndrome is changing perceptions 
The Guardian
Sarah Gordy, who appears in Manchester play Crocodiles, breaks new ground by playing a character without a disability.


Mother wins right to end disabled daughter's life ITV News
A ruling allowing doctors to withdraw g-tube feeds from 12-year-old Nancy Fitzmaurice was the first time in Britain a child, breathing on her own and without terminal illness, was allowed to die.


Nancy Fitzmaurice, assisted suicide and assumptions
Girl With The Cane

Commentary on the Nancy Fitzmaurice ruling.

The work of outsider artist Judith Scott sheds light on living with disabilities
The Huffington Post

Institutionalized for more than 30 years and deaf and non-speaking, Judith Scott found her voice through art, forming intricate sculptures of yarn, fabric and other fibres tightly wrapped around an array of found objects.

'Butterfly child' dreams of the Northern Lights Ottawa Citizen video
Jonathan Pitre suffers from one of the most painful conditions known to medicine, a rare genetic disease that causes the skin to endlessly blister.


Kids with autism bullied three times more Disability Scoop
In the largest look ever at autism and bullying, American research shows that children on the spectrum are significantly more likely than others to be bullied.

Scientists implicate more than 100 genes in causing autism NPR Your Health
Researchers have identified more than 100 genes that are mutated in autism. These are spontaneous mutations, not ones passed down by parents. 

**Don't forget to sign up for a one-day workshop on bullying at Holland Bloorview on  Nov. 29, 10 a.m.-2 p.m. in the Conference Centre. Presenters are SickKids social worker Miriam Granger and lawyers from Stuart Law and Pro Bono Law Ontario. $10 registration fee. Register online.

Star-studded 'Serenade' benefits Beverley School families

By Julie M. Green

What does indie music have to do with children with special needs? 

Toronto singer/songwriter Hayden Desser and his wife Christie Greyerbiehl worked tirelessly to marry the two for one extraordinary night last Saturday. 

The result was Dream Serenadea concert at Massey Hall to benefit children with developmental and physical disabilities at Beverley School in Toronto. The evening was spectacular, with performances from Feist, The National, Sarah Harmer and Billy Talent, to name a few.

Like many of us, disability wasn't on Hayden's radar until someone he lovedhis daughterwas affected. And while much has been done to raise awareness of disorders like autism, there's a glaring lack of funding for therapies and family support.

Three years ago my son was diagnosed with autism at Holland Bloorview. Aside from a block of publicly-funded speech therapy, any support he's received has been paid for privately, by us. Friends and family are staggered when they learn that this is our reality. I know of too many couples forced to re-mortgage their homes or cash in life savings (assuming they're lucky enough to have savings) in order to afford programs for their children.

With my husband’s family overseas, and my own family living several hours' away, respite is virtually non-existent. And our son's needs are such that we can't get the neighbourhood babysitter to look after him while we take a much-needed break.

Demand for public services outstrips supply. Many children simply aren't getting the help they need, when they need it. Some are rejected for programs they should qualify for, while others sit on wait lists for years, missing out on early interventions so vital to their development.

When searching for childcare for his daughter, Hayden discovered firsthand how hard it was to find an appropriate program. Today, his daughter is a student at Beverley.

Hayden created the annual Dream Serenade to support this cause close to his family's heart.

Proceeds from the inaugural event will fund assistive technology and a custom green playground at Beverley School and also provide respite services to families.

When artists lend their voices to meaningful causes, the result is a thing of beauty. On Saturday night, the atmosphere at Massey Hall was electric. 

But oddly, the highlight of the evening wasn't the Barenaked Ladies goofing around on stage. It wasn't the haunting tones of Matt and Aaron from The National, or the audience singing along to Feist's hit "1, 2, 3, 4." It wasn't even Hayden's moving tribute to his daughter in a new song.

No, the highlight was video footage of the lit-up faces of the Beverley kids during an impromptu jamming session with the performers the day before. 

See you at next year’s Dream Serenade!

Julie M. Green runs a special-needs blog at Yummy Mummy Club. Check out the photo of her below with her son. Photo of the concert above by Farida Peters.



'No brother or sister should grow up thinking I'm the only one'

By Louise Kinross

Last year Dutch journalist Anjet van Dijken published the Brothers and Sisters Book, a first in Holland for siblings of children with disabilities, chronic health conditions and/or mental illness.

Anjet, 38 (above left), grew up with an older brother Jalbert (right), who was born with a visual disability and autism due to exposure to an infection during his mother’s pregnancy. In her book, Anjet interviews 36 siblings aged six to 69.

Her goal, she says, is to let all siblings know that they’re not alone, their thoughts and feelings matter, and that they must pursue their own dreams to be happy. Only then can their adult relationship with their brother or sister “come from the heart, rather than feel like a must-do obligation,” Anjet says.


Here she shares her own story growing up. Look to the September issue of BLOOM for Anjet’s tips to parents on siblings.

BLOOM: Tell us a bit about growing up with your brother.

Anjet van Dijken: When he was born he could only see a little bit and at age 11 he suddenly became blind. He had a mental disability that made him interested in just a few things: listening to marching band music and taking the train. He was perfect at knowing all of the bus and train timetables.

When I was three and Jalbert was six my parents decided to let him live in a home. My mother felt that he would get the best help there and that she had created a safe environment for him. She was worried about the future, about who would care for him when she wasn’t there. She didn't want to put the ‘burden’ on me.

To solve the problem that he lived 70 kms away, my parents purchased a summer vacation home near him. Every weekend we would drive from The Hague, where we lived, to our summer home in Utrecht. We’d pick him up, spend the weekend with him and then drop him off on Sunday afternoon.

I felt growing up that my brother was a lot in his own world and I tried to get him out of there. I felt his disability was too often used as a poor excuse for leaving him in his own world. For example, if people visited us, he could stay in his room and play his music for another three hours, while I was expected to come down, say hello, and sit for a while, even if I didn’t feel like it.

As a child I had all these thoughts about him and his development but I didn’t think my opinion mattered. The deepest reason for writing my book is to say to other siblings that their thoughts and opinions do matter and need to be expressed.

BLOOM: How did it feel when your brother moved away?

Anjet van Dijken: It felt normal. At age three I didn’t have any comparison. I didn’t feel a rupture because we went every weekend to my brother so I always felt I grew up with him, and that was a nice feeling. I loved his home. It was on a big terrain with lots of trees and until he was 11 he could see a little, so we could bicycle around that terrain together. He went to school but it wasn’t academic so I was jealous of him. He did fun and creative things like Snoezelen and colouring, while I had to learn things in my school.


BLOOM: Was it painful for Jalbert to go to the new home?

Anjet van Dijken: What has stayed in his mind is that he got to take a bus there and that the bus was great fun. It was exciting for him. He doesn’t complicate things. He doesn’t live in the ‘I wish I could’ world. He takes life as it is. I never felt that our weekends with him were not normal or that our goodbyes were painful for him.

BLOOM: What was it like for you to live in two places?

Anjet van Dijken: My life has been divided in a lot of respects. My upbringing in The Hague was like any other child’s. I had a mother waiting at home for me after school and activities like playing with friends, swimming and skating. Yet I felt like I was the only child, so I felt guilty about sort of ‘hiding’ my brother.

In Utrecht, life revolved a lot more around my brother. The plus side was that we were brother and sister. But Jalbert living away from us wasn’t ‘normal’ and I could never explain him to my friends: the fact that he lived in an ‘institution,’ as it was called then, always got in the way.

One thing that’s different for parents and siblings—especially for siblings who are younger than the child with disability—is that the disability and the brother go together. If people thought my brother was disabled I couldn’t understand that, because he was my brother. The disability belonged to him, [it] was part of the picture. I still can’t see the disability apart from him.

But it was impossible to tell my friends that Jalbert was ‘just like any brother.’ The best way I found to describe him was to say ‘I have a brother who's blind and disabled but always very happy!’ and I would emphasize the happy part. I wanted people to see him as he was.

Of course, he was not a brother that wanted to play with me, but what I admired in him was that he always saw the positive in people and situations. He will defend anybody and that was more important to me than the fact that he had disabilities. For me it was normal to walk across the street with him on my arm. Yet people would stare at us. Other people always saw the handicap. They never looked beyond the handicap. So that made me doubt myself a lot: maybe I was the one not seeing him for who he was?

For siblings, the hardest thing is that you have this brother that you love and others don’t see him for who he is. Growing older and looking back, I was angry at other parents with healthy children: they had a duty to educate themselves and their children.

Going to visit my brother on weekends became difficult for me from about the age of 12. That’s when I noticed that my friends were having games of hockey or tennis or doing other sports on the weekend in our hometown, and I couldn’t because I had to go along with my parents and brother.

BLOOM: What happened in your teen years?

Anjet van Dijken: As you get closer to puberty, friends start to matter more than brothers and sisters. That’s the case in every sibling relationship, as I show in research included in my book. But because Jalbert was not very involved or interested in my life during those years, I didn’t know what we meant to each other.

I began to think that my brother was of no use to me. And, in fact, he was a drawback: people always saw me as ‘the girl with a handicapped brother,’ not for who I was or wanted to be. At age 14 I sort of decided ‘he’s in a home, he’s not really in my life’ and it was like a rupture in my head.

Looking back, I was starting to form my own identity. I started to separate myself from the role I’d had with him, which was being either the carer or the class clown. I had loved the role of making my brother laugh to bring him out of his world. But at around 14 being the clown clashed with who I was.

At that time I'd started a hobby, working at a local radio station. For the first time in my life it didn’t have any link to my brother. I felt such an energy doing something I liked to do, just for me.

For a long time I felt guilty though, for being so selfish, for growing up and 'mentally' breaking up with my brother. But in retrospect I feel it was very healthy for me to say: ‘Now it’s my turn.’ My mother was understanding. She said ‘You don’t have to come with us every time we go to the summer home’ and she praised me for enjoying my life. More and more on weekends, I would stay with my father or we would go up later on a Sunday.

BLOOM: When you were young, both of your parents died.

Anjet van Dijken: When I was 16 my mother was hit by a car coming home from a school meeting about me. The next day she was declared brain dead.

Three years later, after my dad and I had grown closer, my dad died of an aneurysm. I was three months into university. The only light points were that one, my brother was there—I have one family member left and thank God it’s the one who is always the same— and two, he is taken care of in a home, so I don’t have to leave university.

The first thing I did with my brother after the funeral was to take him on a train trip.

BLOOM: How did he respond to your parents’ deaths?

Anjet van Dijken:
For me, it was all about the emotions, but for Jalbert it was the factual that counted: ‘I counted on my mother, and she went,’ he said. ‘I counted on my father, and he left. Now I only have you. I can’t count on you anymore.’

For the first time I really hated his disability. I was the only family member left and he was going to throw me out too?

And not only could I not share my emotions with him, and memories of what we’d done together with our parents, but I felt an even bigger gap between us. Really, what was our bond? Was my role to be his carer, or was there room left to be his sister? At that point I felt empty. I felt I was expected to be his carer, and that felt wrong.

But that’s what I did for the first couple of years. I mindlessly helped him continue with his life as he had lived it when my parents were alive. I told myself I had to take him on a train trip every two weeks, but from day one I resented it. I don’t think it was fun for either of us.

Slowly, during my university years, I began to see that other brothers and sisters didn’t see each other every two weeks. I decided I should visit when I felt like it and I could sometimes have a day off. I started to say 'this is my life too, and I don’t always come second. '

BLOOM: Why did you decide to write your book?

Anjet van Dijken: The main reason is that I didn’t want other siblings to feel alone, as I had for so long. No brother or sister should grow up thinking I'm the only one with questions, with thoughts, with conflicting emotions.

You can be proud of your brother and at the same time ashamed, and then angry for being ashamed, and then sad because you were angry. My first idea was to write my own story. But then after working at the radio I felt strongly that if I interviewed 36 siblings, readers could ‘see’ that they weren’t the only one.

The other thing is I want to make siblings think about what they want in their own life. I want to show them by reading others’ stories that everyone is wondering about their place in the family and in the future, including their role in their sibling’s life.

Dr. Tinneke Moyson, the researcher who contributed to my book, found siblings tend to put themselves in the background. Out of loyalty, they feel they have to obey their parents and continue putting the [disabled] sibling in the centre of the family.

For siblings, trying to put yourself in the background AND living your life doesn’t work: it catches up with you. Though living your own life is not easy—especially if your parents have different expectations for you—I tell siblings they have to think about what they want first, and then how they’re going to be a part of their brother’s or sister’s life. Only then can you do it wholeheartedly.

BLOOM: You spoke to 36 siblings aged six to 69. What was the most common challenge they faced?

Anjet van Dijken: The first thing I noticed was that 33 out of 36 said they had never ever talked about this to another sibling. They had never met another sibling of a child with disability.

I loved writing the book because there’s no judgment between siblings when you have been through the same experience. Even though one person has a sibling with autism and one has a sibling with Down syndrome, they don’t look at what is different, but where are they the same? What can we relate to?

The common denominator is that you always defend your brother or sister first. If you interview a sibling they will tell you all the positive things first because it’s so important to them that others see their brother or sister as a person. You want them to be accepted. Then, if you feel understood, you will share what’s difficult. But initially there’s a holding back of your emotions.

BLOOM: Were there other common experiences?

Anjet van Dijken: I go to evenings where I speak to about 100 siblings and 80 per cent or more have never heard anyone speak the way I do about putting their life first and daring to talk about their emotions. Not only have they felt alone, but they thought they were crazy for a lot of the thoughts and feelings they have. ‘Now I understand I’m not crazy,’ they’ll tell me. ‘I’m a sib.’

BLOOM: How can siblings best be supported?

Anjet van Dijken: I'm involved in a research project with the Dutch Youth Institute where we hope the Dutch government will set a base of support and information for siblings, because there is none. One of the big problems is that siblings feel loyalty, out of love and respect, for their parents. So if they disagree with something—with the parents’ vision of how the future is going to be and where they fit in—they don’t dare speak out.

The sibling relationship is different than the parent relationship. As siblings, you’re not above or below, you are equal.

One sibling said to me: ‘I can’t tell my mother that my brother acts even more disabled when he is with her. With me, he can make his own toast, but with our mother, no, he just sits there and acts like a baby.’ The other child can see progress that the parent can’t.

Siblings aren’t initially aware that they need support. What they tell me is that they don’t want to go see someone like a psychiatrist. They want to know that there are other siblings and to get in contact with them. After one of our sibling group evenings they will say: ‘Wow, we all have the same thing.’

There are a few sibling groups for young children, but nothing for adults, and that’s my main focus.

Things get complicated when siblings are in their 20s and they have a relationship, or children, or a job. Many sibs spend every Saturday, or every other Saturday, caring for their brother or sister to give their parents relief. So young caretakers become adult caretakers.


But there's more: Our brothers and sisters are, due to advancements in health care, the first generation of people with disabilities who are outliving their parents. In America I read about the 'sandwich generation:' We are the ones raising our children, looking after our parents and taking care of our siblings. The how needs to be addressed, because we're not 'super' siblings.

Anjet can be reached on Twitter @DutchSib or at the Facebook group for her book. She has a Dutch Facebook group for siblings at Lotje@coBrussen. Her book is available in Dutch but she would love to hear from families and professionals who'd like it translated into English. Watch this captioned video of her book launch. The Brothers and Sisters Book is published by LanooCampus: EAN 9789401408844. This is the book cover and a photo of Anjet and Jalbert as children.



When is giving up a rehab goal a smart thing?

By Louise Kinross

Children’s rehab is often focused on improving a person’s ability in a specific area or in achieving functional goals.

The use of  “goal” language seems to be directed primarily at children with disabilities. As a kid without a disability, I don't recall a lot of talk about my goals growing up. I didn’t feel external pressure to “reach my potential”—which seems to be the marker for success placed on every child with a disability. 

The idea of achieving your potential implies that we all have a fixed amount, a certain size of box, if you will, from which we can draw a limited amount of ability. Some have larger boxes, some have smaller ones, but at some point we can measure or see whether a person has made full use of their “box.” Or can we?

I was thinking about this because as my son gears up for a year of full-time co-op—his last year of high-school—I found myself agonizing over the fact that he still doesn’t have a reliable form of communication. What is holding him back in his co-op is the ability to communicate freely with the public. He has a voice app on his iPad—Proloquo—but he doesn’t like to use it. He would rather gesture or have his signs interpreted by an EA. 

His report card noted that he has to start using Proloquo more. That got me wondering whether we should look at a different voice app. And that led straight to hopelessness. Because I’ve looked at all of the devices and spent years trying to find something that works for him. I am sure that full months of my life have been devoted to programming systems that were never adopted long-term.

I keep hoping that Apple will develop a voice app or device that is as intuitive and user-friendly as its other products. However, I’ve been hoping that for more than 15 years. I even began a small campaign of tweets to Apple CEO Tim Cook last year that went unanswered. I think the big computer makers have let our families down in not bringing their expertise to the AAC table.

That said, my son is a young man now, not a small child, so any use of a voice device will depend on it being something that he wants, not something that is thrust on him.

Despite my cynicism, I found myself online looking at videos of children using different voice apps and wondering why my son’s use had never taken off in the same way. It wasn’t for lack of enormous efforts on my part. In my son’s defence, I find them cumbersome and slow and not easily portable. I personally wouldn’t want to use one. 

Last week I saw this headline in the New York Times and got a sick feeling in my stomach: The Kids Who Beat Autism. Has autism become an opponent?

The article refers to two small studies that showed that 10 per cent of kids with autism “shed” their symptoms, but there didn’t seem to be any rhyme or reason as to why (they included kids who didn’t receive intensive ABA therapy). “Recovering” from autism is positioned as the “optimal outcome” and we’re made to feel terribly sorry for the families whose kids don't progress.

(Though there is this beautiful final paragraph where a mother of one of the unrecovered shares her thoughts: The idea that Matthew won’t recover no longer pains Jackie. “At some point,” she told me, “I realized he was never going to be normal. He’s his own normal. And I realized Matthew’s autism wasn’t the enemy; it’s what he is. I had to make peace with that. If Matthew was still unhappy, I’d still be fighting. But he’s happy. Frankly, he’s happier than a lot of typically developing kids his age. And we get a lot of joy from him. He’s very cuddly. He gives us endless kisses. I consider all that a victory.”)

Thankfully, the magazine piece was followed by this post in Motherlode called The Kids Who Don’t Beat Autism, by Bad Animals author Joel Yanofsky, who has a teenage son with autism.  

Yanofsky notes that when he saw the headline—The Kids Who Beat Autism—“I didn’t want to discover all the things my wife, Cynthia, and I could have done and didn’t. That thought keeps me up enough nights as it is.” I think it's dangerous and wrong when parents are made to feel that they control the outcome of their child’s disability. And we don’t need our kids to beat or stand in opposition to something that is a part of their identity.

Recently I was reading Think Like A Freak, the new book from Steven D. Levitt and Stephen J. Dubner, the authors of Freakonomics. In Think Like A Freak, the economist/journalist duo encourage us to take a new approach to solving problems. What intrigued me was their final chapter—The Upside of Quitting—in which the authors argue that giving up unattainable goals is a smart move.

I wondered how this idea might be helpful to parents of children with disabilities like me.

Levitt and Dubner note that quitting anything is tough because of American homilies like: “A quitter never wins, and a winner never quits.” In Western culture quitting is synonymous with failure, they say. And once you’ve invested heavily in something, it feels counter-intuitive to quit. However, “You cannot solve tomorrow’s problem if you are not willing to abandon today’s dud,” they note.

“Civilization is an aggressive, almost maniacal chronicler of success,” they write. “This is understandable—but might we all be better off if failure carried less of a stigma? Some people think so. They go as far as to celebrate their failures with a party and cake.”

They then recount how scientists in an invention lab at a technology firm test out ideas, with the goal of ‘failing fast and failing cheap,’ when necessary. The head engineer prefers the terms ‘failing well’ or ‘failing smart.’

They also reference a series of small studies by Carsten Wrosch, a psychology professor at Concordia University, that found that people who let go of unattainable goals saw physical and psychological benefits.

“They have, for example, less depressive symptoms, less negative affect over time,” Wrosch is quoted as saying. “They also have lower cortisol levels, and they have lower levels of systemic inflammation, which is a marker of immune functioning. And they develop fewer physical health problems over time.”

Of course Wrosch notes that deciding when a goal is unattainable “is the $1 million question.”

There are all kinds of studies showing that mothers of children with developmental disabilities have higher levels of anxiety, depression and chronic stress, as well as reduced immune function and increased cellular aging, than those raising typical kids. They also have poorer physical health.

I’m just wondering what part our “Anything is possible” and “Just Do It”  culture plays in keeping parents trapped in rehab goals for their kids that may not be attainable? I know it won't be a popular idea, but it seems that for many parents “letting go” of a hoped-for, but not practical, outcome could be physically and mentally healing.

The balancing act: Children's rehab is about truth and hope

Dr. Anne Kawamura is a developmental pediatrician in Holland Bloorview’s child development program, working with children with cerebral palsy, autism and other developmental delays. She was hired 10 years ago after completing her fellowship in developmental pediatrics here. In addition to her clinical work, Anne directs the University of Toronto program for pediatricians who train for two years to become specialists in working with children with disabilities. She has three children of her own.

BLOOM: What led you to working in children’s rehab?
Anne Kawamura: A lot of it stems from the fact that when I was in medical school I had a chance to work with children with autism. As part of a research project with Dr. Wendy Roberts I went into the community three days a week as a volunteer to do intensive behavioural intervention with two young boys. It was really hard and I didn’t know what I was doing, though I had some basic training.

The greatest part was just having the connection with both of these kids and to see that even though things were really challenging for them and their families, that you can build a relationship with these children. That was very meaningful for me. People often misunderstand that. You can really get to know a child with autism and they can get to know you in their own way.

I also felt firsthand some of the judgment that families experience. One of the boys banged his head and once he was so upset he gave himself a black eye. I took him to the park and people looked at me, with a child with an injury, as if he’d been abused. I got a sense of how it felt to be in the parent’s shoes.

BLOOM: What is the most challenging part of your clinical work?
Anne Kawamura: I think the hardest days are when families ask me really hard questions, like ‘will my child walk or talk?’ and I know the answer is that the child may never walk or talk. They want something and I can’t give it to them. It could be certainty or a guarantee, or even that they want more therapy, and we don’t offer that level of therapy.

BLOOM: When a parent has a question about a child’s abilities in the future, how do you address that in a helpful way?

Anne Kawamura: You have to balance being truthful about what you know about the condition with hope, and leaving room for change. There have been times when I’ve been really surprised to see what the outcome is. When I was first working here I was on the brain injury team. I’ve seen some really dramatic changes there that I wouldn’t ever have been able to predict. So it’s important to leave the door open.
BLOOM: When I speak with medical students they often ask how they can convey difficult news to a parent in a way that won’t be upsetting, as if there’s a ‘right’ way of doing it.

Anne Kawamura: You can’t follow an algorithm. I see that with our fellows who want to know the right way to approach this.
One of the most important things we need to teach is that it’s a conversation that goes back and forth. You never know what will come back from the parent, so you need a great deal of flexibility.

There’s no perfect way of giving a diagnosis, there is not. And you can make mistakes, you can make a misstep, but the idea is that you can recover from that. You can back up and redirect and reestablish a good connection with the family.


BLOOM: What advice do you give fellows when giving a diagnosis?
Anne Kawamura: I try to teach them to find the strengths in every child, and to focus on those strengths. But they have to truly believe the child has strengths, and to help the parents see those strengths if they don’t already. When you interact directly with a child during an assessment you get a sense of what they’re doing really well, and how those things may help them in moving forward in an intervention or in their day to day life. Focusing on strengths is important in providing a window of hope.

BLOOM: I think it must be difficult for fellows to learn that what’s helpful to one parent in conveying a diagnosis may not be helpful to another, because each parent is so unique.
Anne Kawamura: My gut feeling as a health professional is that when someone is upset or suffering I want to fix it. And some of the most useful feedback is that we don’t need to fix it, we may not be able to offer parents something that changes how they’re feeling. We just need to be there. To listen. To acknowledge how challenging it is. To be an ear. The most important thing is that it’s okay to take the time to really hear where the parents are at, to give them an outlet to express how they’re feeling.

Something exciting we’re doing is running a new simulation program so fellows can practise giving a diagnosis with a standardized patient. We have a family leader who has a child with autism who’s been part of building these practice scenarios and giving feedback to fellows. It’s been amazing having this parent’s perspective.
She can tell us how things felt for her as a parent, and how we could have done something differently. I don’t have a child with autism, she does, and having that perspective is really important. The other important thing is practice and learning how to navigate situations.

Part of why I enjoy what I’m doing is that it’s always a challenge and there’s always more to learn. I’m always thinking back to what I could have done differently to make things easier or better. We’ve done two sessions of simulation so far but we hope to be able to offer it to our fellows regularly during their two years of training.

BLOOM: Have your views about disability changed since you began 10 years ago?

Anne Kawamura: When I first started out I wanted kids to get as much therapy as possible. We all have that notion that more therapy is better. Over the years, through talking with colleagues and seeing a lot of kids, I see that there are other equally important things in life, in terms of going out with your kids and playing, having fun with your kids.
I try to talk to families more about seeing their whole child, not just focusing on one thing, like walking, but to focus on the other aspects of their child’s life where they’re doing well and where they also need support. I try to help them focus on all aspects of their child’s development.

BLOOM: Have you seen any changes in children’s rehab?
Anne Kawamura: I think there’s more emphasis on participation, even in the research realm of things. Before, we were focused on ‘what’s wrong,’ for example, treating the stiffness in the muscle. Now we’re still treating the stiffness in the muscle, but we’re more interested in how treating it influences what the child can do, how they participate in an activity and their quality of life.

BLOOM: I assume your job is stressful because supporting families takes time, but your time is limited?
Anne Kawamura: Peggy Curtis is the nurse I work with and we work really closely together. We have a schedule and demands to get our wait list down, but we try to make it work each day, one step at a time. We never know when a child and family will need more time, and we want to be flexible to meet the needs of the families coming that day. So if someone needs more time, we figure out a way to make it work, even if it means bringing them back for another visit.
BLOOM: What are your hopes for the future?

Anne Kawamura: Right now in addition to my clinical work I’m doing a lot of education overseeing our program for pediatricians who are training to become developmental pediatricians. I’m also doing a master’s in Health Professions Education, which I do long distance through the University of Illinois at Chicago.
I love what I do and I don’t ever want to leave the clinical side. I like working with families and the kids I get to see and follow up over time. To see them growing, changing and maturing is the part I enjoy. And I love teaching too.

BLOOM: If you could give yourself advice when you were starting out, what would you say?
Anne Kawamura: I think having a good mentor in the field is important, in terms of balancing workload and the rest of your life.

There are stressful cases where you feel you don’t know how to help or how to resolve a situation and having someone to talk to is really important. Earlier on I had mentors like Darcy Fehlings or Golda Milo-Manson. And now I could still knock on their doors, but I have other people that cross disciplines, like Peggy and the other colleagues I work with.

You need many mentors and they will be different people at different times.

Filmmaker Kelly O'Brien on grief, siblings and honesty


A recent BLOOM night focused on filmmaker Kelly O'Brien and a screening of Softening, her film about raising her son Teddy, who was born with brain damage and a grim prognosis. 

Softening is a candid story about a mother's love and pain, a sister's magical bond, a father's joy and devotion and a little boy's experience of the world. This Youtube clip is a portion of an interview we did with Kelly following the film. 

A condensed version of Softening that focuses on Teddy and his sister Emma was posted on The New York Times. Thank you Kelly!

A refuge for parents caring for kids in hospital

Once a week Claire Stoten sits on a meditation cushion and focuses on her breathing. “It forces me to stop doing all of the jobs—the organizing, e-mails, research and care for my son,” she says, sitting in her son Felix’s inpatient room at Holland Bloorview.

Felix, 13, who has a neuromuscular condition, had a 10-hour surgery to fuse his spine at the end of March. Prior to that his spine was so curved he couldn’t sit up, his mother says.

For the second week in a row Claire has participated in a 40-minute mindfulness session for parents of inpatients and daypatients. Without the structure of the hospital program, she says, she'd never set aside that time for herself.

“It comes back to that analogy of when you’re in the airplane, the parent is supposed to put the oxygen mask on first, because if they don’t, they may pass out before being able to help their child,” says Anna Marie Batelaan, social worker in the brain injury rehab unit at Holland Bloorview. Anna Marie has been leading a weekly mindfulness session for parents for four months. “They need to take care of their own needs to have more ability and energy to care for the child.”

Mindfulness involves paying attention to the present moment, Anna Marie says. “It’s giving yourself permission to focus on you and focus on the here and now, without judgment. Our minds are constantly busy and this is one way to pause and catch your breath and refocus.” Anna Marie says our bodies are built to focus on the negative, but we can retrain our brains to notice and appreciate the positive.

“This is new to a lot of families, so we’ve been doing multiple short sitting meditations of three to five minutes,” Anna Marie says. “Parents learn how to focus on their breath or we do a body scan and they send loving energy to different parts of the body. We’ve also done walking and eating meditations.”

Research on mindfulness shows that it reduces worry and stress, boosts working memory and focus, makes you less reactive and more adaptive, and improves relationships. “There’s a lot of evidence that it works with anxiety and depression and posttraumatic stress disorder,” Anna Marie says. “A lot of our parents are dealing with the posttraumatic stress of witnessing a child’s accident or illness that changed their child so dramatically.”

Anna Marie says the greatest challenge is to get parents out for a first visit. “When their child is hospitalized they tend to put their own needs way down on the list.”

She usually starts parents with meditations that focus on the breath because “they’re easy to learn and can be done anywhere and anytime. We talk about how you can fit this into your day. A parent will say ‘I’ve done it on the toilet.’”

Claire says she leaves the mindfulness session “feeling relaxed and peaceful.” Then, as a way of expanding the session, “I go to the cafeteria for 20 minutes and have a coffee. And I don’t let myself start any jobs.”


Here are some tips for beginning meditators. Anna Marie can be reached at 416-425-6220, ext. 6353.

The trove of other mothers

Sandra Stein’s life was upended when her healthy toddler fell ill with an autoimmune encephalitis, a condition in which the immune system attacks the brain, and was hospitalized for 15 months. In this poem, Sandra invokes and honours the many other mothers she has met in hospitals and in cyberspace who every day are caring for children with complex medical needs.


The trove of other mothers
By Sandra Joy Stein

I.
Cradling her son
As his body thrashed
Legs like iron rods.

Try to bend them, honey,
Tell your legs what to do,
They’re your legs.


It will pass,
she said, again.
It always passes.

After minutes or hours—she was never sure,
He calmed. Curled. Gazed into the void.


She gazed too.

A giant tear startled her, when it fell on her arm.

Was that his tear or hers?
She preferred not to cry while holding him.

Then another tear, this time most definitely hers
And another.
And another.

He was limp, motionless, breathing, heavy in her arms.

She surrendered.

More tears. Her arm now wet.

He fell asleep. So peaceful. So beautiful. If you didn’t know, you wouldn’t know, she thought. She loved to stare at him while sleeping.

Rest, she said, her palm to his cheek. You rest.

She called out—no, not to some doctor or deity—she called out to the trove of other mothers who at this very moment were, like her, cradling sick babies, and grown babies, and limp and lifeless but very much alive babies.


II.
From behind shadows and tucked away spaces and homes-made-hospitals and hospitals-made-homes
Their forms emerged
Weathered hands, kinked necks, crooked backs, heavy eyes, furrowed brows.
They looked right at her in a way that no one had since…


We see you.
We feel you.
We know you.
We are you.


Like a somber gospel choir they swayed and sang,

No, sister, you have not failed
No, sister, this is not fair
No, sister, you are not alone
Never alone. Never alone.



III.
She blinked back to her sleeping son.
Her arm, now dry, she dug
deeper, yet again.

Two solitudes
















By Louise Kinross

In the last couple of days I've seen parents argue for two radically different visions of how to educate children with disabilities.

In this piece in The New York Times' Motherlode blog the mother of a 10-year-old with an intellectual disability who can't speak says that children like her daughter need special, separate schools. "Alongside her peers with disabilities, she's thriving in a rich, complete school community," writes Margaret Storey, who says she's surprised to describe herself as a "segregationist."

Storey writes about how mainstream classes can become "exclusive and stigmatizing" for children with profound disabilities because they don't have the resources to hire highly-trained staff to provide one-on-one support. "Abstractions about inclusion may fail to comprehend my daughter's needs," she writes.

We still need separate schools, Storey says, and they need to be well-funded.

Yesterday in a new Ted Talk called Disabling Segregation, filmmaker Dan Habib, father to a Grade 8 son with cerebral palsy, says that all children with disabilities should be taught in general education classrooms. 

Habib notes that in the U.S., 56 per cent of students with intellectual or developmental disabilities spend their entire day in a self-contained class or separate school.

This flies in the face of 35 years of research, he says, that show that disabled kids who are included in general education classes have better outcomes socially, academically and behaviourally and do better after they graduate. 

Equally important, Habib says, is that studies show improved grades and social benefits for typical kids who learn alongside peers with disabilities.

What do you think?

Read the Motherlode piece and listen to Dan Habib's talk and let us know.

Immigrant moms hit a service wall


York University researchers Nazilla Khanlou and Mahdieh Dastjerdi (above) share the findings of their study on the experiences of 30 immigrant moms in the Greater Toronto Area and their service providers. Rich findings about the barriers faced and how we can better support immigrant families were offered at this BLOOM speaker night.