July 25, 2017

I Want You to Know

Posted in AMT's Faves, Life's Little Moments, My Take on Autism tagged , , , at 12:31 pm by autismmommytherapist

Dear Care Giver to Justin,

If you’re reading this letter (and I so hope you are) it means I’ve never met you and never will, as I’ve gone kicking and screaming to the Great Beyond (wherever that may be). If you’re perusing this after I’ve just passed I’m sure your co-workers can tell you about me, as I was a staple at your group home, hopefully a help with my homemade chocolate chip cookies and my jambalaya (the only two things I make well) and my frequent visits to check up on my boy.

If you’re reading this thirty years after I’ve gone, I’ll have to believe my legend died with me.

I left explicit instructions to your predecessors about Justin’s lifetime care, hoped with all my heart they’d be honored, and at the very least that all those who care for him will read this missive from me.

It’s good to have hope.

You see, whether Justin’s fifty now or ninety-nine (it’s possible, his relatives have lived ridiculously long lives) I know you see before you a severely autistic man, predominantly non-verbal, with either OCD or just a really strong penchant for perseveration on the side (I gave up caring which it was during the Obama administration). He is fairly tall as was his father, and although now his hair is streaked with gray during his younger days it was a dark blond, like his mother’s before she got to the salon. The last time I saw him he still had a dimple on his left cheek, and his smile is transcendent, no matter what his age.

I know. It only took me four paragraphs to brag.

I want you to know although I love my son passionately I don’t have blinders on where he is concerned. Just so you know a little bit about me I used to teach before I had my kids, and nothing renders you more objective where children are concerned than a stint in the classroom. Justin is kind, and sometimes playful, and generally happy with his life. He is also stubborn, hyperfocused on getting his wants (not necessarily his needs) met, and his OCD (or whatever the hell it is) can drive a person to drink the good stuff.

See, I can be objective.

I want you to know that I am confident at times his care will drive you crazy. It may be that sixtieth pretzel he wants, or a DVD that just doesn’t work anymore that he insists on playing. He may want to leave after half an hour from the extremely fun place all his co-habitors are loving (which got you out of the group home for the day), and there may be no convincing him that a water park in August is more fun than his own living room.

Hell, you may be struggling just to get him out of the house.

Please know whatever manifestations of difficult you see, it wasn’t that his father, myself, and a thousand professionals didn’t try to ameliorate them. Back in the good old days of his toddlerhood (not really so great even with a half century of perspective) I girded my loins and took that kid places, with the half moons of his little teeth marks bearing witness to my pilgrimages. Sometimes I could barely get him in his car seat, but stubbornness like autism is hereditary (yes it is!) and I persisted so someone who weighed less than my right thigh (it’s the bigger one) wouldn’t keep me prisoner in my own house.

I have my limits.

I want you to know we tried. We finally got him to crave sleep (that one took a few years, yes you can thank me now), to eat things that weren’t carbs including two veggies (that one’s going on my tombstone, I am still so proud), to learn how to dial back some of the innate aggression that occurred when he didn’t get his way. We taught him to use a fork (okay, sometimes) and to understand that leaving the house is often fun, and should last more than thirty-seven minutes. I encouraged him to go on errands with me and not try to purchase everything he saw (just a heads-up, that will not work at Walmart or Toys R’ Us, be warned).

My boy has his limits too.

I want you to know I hope he’s good for you, and I wish you patience when he’s not. I want you to know that his primary emotion is joy, and if he’s having a meltdown or a crabby day (who doesn’t) he will eventually return to his happy place.

Yup, I promise.

I also want you to know how many people loved him- family members, our friends, his teachers and therapists. I scrapbooked his entire childhood (almost as therapeutic as wine) and if you have a few minutes, please peruse his life. You will see pictures (and I’m being objective again) of a beautiful baby, a sweet toddler, a handsome teen. You will see photos of an increasingly aging and tired-looking blond chick (who was cute once too) who in most photos is holding him or his hand, and smiling.

I want you to know that smile was genuine, no matter what had just transpired or what challenges we were about to face. I loved him, with all his difficulties, his perseverations, his intransigence. He loved me back, with his daily kisses for no reason, the ten minutes we cuddled each morning before I could get him out of bed, his hugs as I read him his Eric Carle stories nightly even at age twenty-one.

I want to thank you for whatever period of time your paths cross, for your perserverance, and I let myself hope, your kindness toward my boy.

So please, when you’re frustrated with him and thinking you’re just not paid enough for this (and you’re not), please know this. Take it to heart. Remember this, for him and for me.

We “got” each other.

He was my greatest challenge, my soul, my aching heart, my joy.

I loved him.


Follow me on Facebook at Autism Mommy-Therapist

April 18, 2017

Get Out

Posted in Life's Little Moments, My Take on Autism tagged , , , , at 10:13 am by autismmommytherapist

I recently had the joy and pleasure of spending a week in Ireland with one of my best friends, without kids or husband (I know, don’t hate me), celebrating a milestone birthday for the two of us (I won’t say which one but I loved the eighties so you can guess). It was an amazing week seeing the breathtaking beauty of the country, and meeting the ridiculously nice people. For seven days I didn’t have that running list going through my head of everything I need to accomplish on any given day, no chores, nobody asking me to fetch a seventh snack or cup of juice.

It was heaven. It was also freedom.

We were on a bus tour so there wasn’t a lot of time to think about things, but I had a lot of time to process on the seven hour flight home when both me and my friend were finally too tired to talk to each other.

I had a lot to think about.

As usual, when I have large amounts of down time (that would be never) my thoughts turned to my boys, how they’re doing, what the future holds for them. Although they both have autism, the truth is, their futures could not be more different. My youngest son who has mild autism has every expectation of driving, going to college, getting married, and having kids. My oldest son who is on the severe end of the spectrum will need lifetime care, which unfortunately at some point (although I’ll give it my best shot) I will not be around to provide.

As I said, I had a lot to think about.

The truth is, I loved this trip, with its new experiences, its lack of responsibility for others, its summoning of the echoes of my twenty-something self who lived in France for a year back in my college days. Traveling has always been a passion for me, has been when I’ve felt most alive, unfettered. And while I wouldn’t trade being a mother for the world it is something I’ve not been able to do as often as I’d like due to the boys’ diagnoses, which made them difficult to deal with at times.

Okay, yes, that’s the understatement of the century.

Over the years my husband and I have usually managed to carve out one short trip for the two of us annually, and as my eldest son has reached his teenage years I admit I’ve felt a sense of urgency in planning these excursions. In seven years my boy will graduate high school at twenty-one. My mother, who is the only relative able to watch the boys for us, will be in her eighties, so I’m guessing our ability to travel will be limited. You see, the waiting list for residences right now is about fifteen years after he graduates, and even then I’ve been told many of these homes are not places I’d want my son to reside.

The truth is, if we can’t find a good day program for him the day after he graduates he will be home, all day, every day, with me. He will not appreciate this situation one iota. I can tell you, neither will I.

Hence, the sense of urgency.

It really hit me on the plane that my options for fun down the road may be limited. Often I am so caught up in the daily minutiae of autism with two boys that I forget to look at the big picture (which is sometimes a good thing), as I focus on trying to get through the day. I also realized that despite the fact that I am a planner extraordinaire (ask my former teacher co-workers who made me team leader and nicknamed me “goddess”) I have been deliberately not contemplating the not-so-distant future, because while I love my kid the thought of taking care of him 24/7 at almost sixty without a break, is, well, pretty damn depressing.

I need to take every fun opportunity that comes my way and grab it and not let go.

It’s time for me to sign up for those “transition workshops.” It’s time for me to be completely honest about what’s coming down the road- that not every family finds a good, safe place for their disabled adult to go to a day program or to live, or that it might take a long time to find these options. It’s also time for me to forget how tired I am and get out more, recapture that fleeting feeling of freedom when I can.

And the truth is all of us, those who are in the “club” and are lifetime caretakers, need to face up to what’s coming, remain as optimistic as possible, and have some damn fun when we can. The earlier you start, the better.

And as I kick off this significant secret birthday, I’m going to do just that.


Follow me on Facebook at Autism Mommy-Therapist

February 13, 2017

100th Day

Posted in AMT's Faves, Life's Little Moments, My Take on Autism tagged , , , at 2:31 pm by autismmommytherapist


It came home in your folder today, the flyer with the fun graphics from your even more fun teacher touting “100 Day,” where you are supposed to dress up like a centenarian. Within minutes I am rifling through your closet for a button down shirt and a tie, combing your dad’s closet for a suitable hat. You approve your future garb and I put it aside for the next week, moving on to more important tasks like feeding my always-hungry boys, one mildly autistic and one not-so-much, and for a time, the celebration is forgotten.

Later, as I’m washing my hundredth dish that day, I do the small amount of mental math I’m still capable of doing. Living to one hundred gets you to 2107. Realistically, at that point I will have been gone for more than half your life.

As I think of how much you still like to snuggle with me it seems impossible that there will come a day I will no longer be with you.

My goal is to remain alive and cognizant until you’re fifty, a goal which I try to attain by regular check-ups, exercise, and (sort of) limiting that wine intake. My mind stretches out over the next four decades of your life- I hope there is a lovely wife, at least a few of the five kids you’re planning on (remember hon, they’re expensive), friends, a career and independence. If I blur the edges a little I can envision you as a husband, a father, a grandfather. I think how much your boundless enthusiasm for life and your eclectic interests will make you an interesting dad and grandad, how I hope these children I may meet when even walking is a challenge will appreciate you.

I know I do.

Of course, I can’t help but let my mind wander to your older brother being a hundred, and since at least on my side of the family our relatives live a ridiculously long time, that goal may be attainable. I’m hoping to make it to fifty with him too, see him settled in a good group home near his sibling, enrolled in a day program he loves, somehow able to get to those therapeutic horseback riding lessons he adores. I envision there will be frequent visits from his mom and dad (if we can still drive), and that in his own way he will one day be independent of me, although never independent of others.

And that’s where the anxiety creeps back in. I just can’t envision getting him from fifty to death without me.

I’ve written before about him making it to eighty and me to a hundred and sixteen, holding hands as he takes his last breath and I follow along behind him. Rationally I know this won’t happen (even giving up more wine doesn’t make that attainable), but God, I wish it was.

I brought him into this world, and with his need for constant care, I wish I could see him out.

I’m hopeful he’ll have his little brother to look in on him, but I know he’ll be busy with those five kids. They do have a bond between them but I can’t say they’re close anymore. When they were both little we could engage them in games together, but as Zach shed rolling balls back and forth for Star Wars trivia the gap widened, only to be truly breached at bedtime with our communal songs. I am certain my youngest will one day be busy with the trappings of a more “normal” life, may not even live near his brother.

It breaks my heart to think that one day you will be surrounded by people who may like you, but don’t love you.

Even as I pen these words I know for me they’re hypocritical. Although I’m a stay-at-home mom I’ve always been the first to tell friends that day care is not the devil, that there was no difference in the emotional stability of the three hundred kids I taught who’d had outside care or had been home with a parent. Kids need love yes, but maybe they don’t need to be enmeshed in love every single second of their day. Justin will be an adult when he enters a home, will have had decades of love and hugs by the time he moves out. Intellectually, I believe he will be okay.

But this quest for hundred year old garb has made me wonder about his future.

Who will take him to the successors of his fancy neurologist to make sure his meds are right?

Who will remember to spend extra care flossing that gap between the two teeth on the left hand side of his mouth?

Who will schedule (and dear God, do the prep work) for his colonoscopy?

Who will cuddle with my seventy-five-year-old and read him an Eric Carle book (I can guarantee he’ll still want that).

Other than his brother, who will love him?

How do I exit from his life? Do I spend every last possible minute with him, or fade out slowly as it becomes apparent that my time is drawing near?

Hell, will I even have a choice?

When I’m gone, will he miss me, or will the differences in his brain allow a quick fade of attachment?

Yup, being selfless for a moment here, I’m hoping for the latter.

Things have improved lately chez McCafferty. After a long bout with extreme OCD my son’s obsessions seem to have been quelled somewhat, giving us a more “typical” life at home, for which my husband and I are extremely grateful. My youngest is thriving.

We are a happy family. I am happy.

But I share with you that for any family looking toward the future with a severely disabled child, there is always that unknown of what’s to come lurking there, obdurate in its tenacity. Even on a good day, and there are many, my concerns for his future are always with me. On most days I’ve shelved this worry for my sanity, but I know it will always be there. It is perhaps the one thing I am certain of with this life.

And if I make it to one hundred and I still know who I am, I’ll carry it with me too.

Follow me on Facebook at Autism Mommy-Therapist

June 9, 2015

Not Enough

Posted in AMT's Faves, My Take on Autism tagged , , , , , at 1:19 pm by autismmommytherapist

Spring 2015 123

A month or so ago I posted a piece on the Autism Speaks website for Mother’s Day entitled “Ten Things I’ve Learned as an Autism Mom.” The piece got a great response, with many people commenting that the fourth item on my list truly hit home. It reads as follows: “You will worry about what happens to them when you’re gone. This one you will never conquer.”

All I can say is, truth.

This next statement may surprise or anger some of my readers, but it’s my truth too. I wouldn’t change that my kids have autism. I believe at least in our case the reasons are genetic, since all of my kids have the disorder. I believe it’s a fundamental part of who they are. I’m not sure I have the right to change it.

But if I could somehow alter the severity of my eldest son’s disorder, I would.

My youngest son Zach, who is high-functioning, has mild challenges with sleep and anxiety, and moderate challenges with focus and impulsivity. I currently feel (and ask me this again down the road) that the gifts of his autism mitigate the challenges- his ability to read at three, that fact that he remembers everything, his insatiable curiosity, and his hyper-focus when fascinated by a subject. Zach has learned to embrace his differences, at present feels good about them. We focus on the positive aspects of his autism here, and so far, so good.

With Justin however, his type of autism precludes him from living an independent life. And I know I will go to my grave wishing things were different.

Over the past eleven years since Justin was diagnosed I’ve done a lot of soul-searching. When he first received the “a” label I was set on total “recovery” for him, wished for college, love, friends and a career for my boy. I wanted nothing less than an eradication of his disorder. When it quickly became clear this was not in the cards for us I shifted gears and strove for him to be at least independent, able to take care of himself after his father and I are gone.

It’s clear now that wish won’t be granted either.

Still, as time has passed I’ve come to see that Justin is happy as he is, is often the happiest person in our house. I don’t believe he wants the aforementioned things in his life- I am confident he does not know what they are. I’ve accepted he won’t have all of my pretty life options.

I’ve also accepted he doesn’t need them to be happy.

What I haven’t accepted is that the severity of his disability renders him unable to care for himself, which puts him at risk for up to forty years after his father and I are dead. This truth remains, and will always be, unacceptable to me.

In fact, it haunts me.

I shelve these thoughts most days for my sanity. The worries are always there, just looming below the surface, ready to rear their ugly heads when I least expect them. If someone were to hand me a pill that would lesson his symptoms and enable him to take care of himself one day, I’d be first in line at my pharmacy.

And I run fast.

I know some readers will think I’m horrible for wanted to change him in any way. But of my three wishes for him, namely that he spends his eighty years on earth happy, productive, and safe, the last wish trumps all.

I don’t believe even with the few medical advances that autism research has brought about that I’ll ever have the option of lessening his autism. The truth is if I want a modicum of happiness for myself, I’ll have to focus on what we have now- a happy, bright, loving child who at this moment in time is wondrously safe.

I will continue to have to learn to live with that much.

But some days, many days, it’s simply not enough.

Follow me on Facebook at Autism Mommy-Therapist

August 28, 2013

The Great Divide

Posted in AMT's Faves, My Take on Autism tagged , , , , , at 1:24 pm by autismmommytherapist

Summer 2013 056I can never die.

I realize how patently absurd this statement is, although I have multiple family members who have lived obscenely long lives, and I’m hoping to take after them. Truth be told it’s a fantasy wish, one I ponder often as I contemplate having that extra roll at dinner, or that second glass of wine. I’m at least shooting for triple digits, exercising (fairly) frequently, taking my vitamin C (when I remember), and mostly eating a healthy diet. It’s something I feel very strongly about, because the stakes are so high.

You see, I can never die, because my eldest son Justin, who has severe autism, will always need me.

If I’m being completely honest with myself, he may want to dispute that fact forty years from now. Since nobody can completely predict the trajectory of his progress, it’s entirely possible he may one day live in a residential setting where he has gainful employment, good relationships with his caregivers, frequent and enjoyable outings, and no desire for constant maternal care. When I envision his future life without me, those are the images I conjure up mostly to save my sanity- a life where he is happy, productive, and safe.

I create those pictures in my mind because frankly, the alternatives are unbearable.

And this is my sticking point with autism, when I contemplate its gifts and its burdens, one that seems permanently impassable for me. I’ve read beautifully constructed essays extolling the virtues of the non-mainstream life, one which does not include college, independent living or an adult relationship. I’ve reached a point in my own consideration of autism’s path where I can see that Justin, despite (or maybe because of) his severe autism, may absolutely revel in his non-typical path, may even be happier than the rest of us (and some days he is).

I’ve permitted myself to entertain the possibility that he will be just fine for those forty years he’ll grace this earth while I’m in my grave, most likely still attempting to control things from afar. I know, intellectually, that everything could be alright.

And then I read articles like the one that came out in the Seattle Times a few months ago, and my heart just takes a slow, treacherous dive through my body and shatters at my feet.

The piece outlines how in Washington state, the watchdog group DRW (Disability Rights Washington) discovered that in over 3,000 abuse, neglect, and safety-violation charges in residential placements, over 1,000 were closed by the Department of Social and Health Services without investigation. In addition to cases of physical abuse, the DRW also reported on cases where individuals’ lives were put in danger by sheer negligence.

One example of this was in the case of adult autistic twins, where one brother was mistakenly given a double dose of insulin, which could have resulted in his death. Sadly, he was the lucky one of the two- his brother was overmedicated as well, resulting in a comatose state, and permanent brain damage.

I’d like to tell you that articles like this are few and far between, but they aren’t. Every year children and adults with autism are abused and sometimes even killed through sheer neglect, or even premeditation. Quite honestly, for years, no matter how wonderful my days with Justin are, these are often the last thoughts I have before I drift off into slumber.

And that’s the crux of the issue for me, the one I feel separates me from my friends and family with typically developing children, and even separates me from those within my community at times as well. I can’t fathom that when I die, I won’t know the people who will be caring for my boy when he’s old- in fact, they won’t even have been born yet. I can’t quite grasp the fact that he’ll always need intensive care, and his father and I won’t be around forever to deliver it.

I can’t accept that even if things go as well as possible, he just might be lonely for half of his life.

It’s my personal great divide, and after nine years embroiled in autism, I still don’t know how to cross it.

June 21, 2010

Love Letter

Posted in AMT's Faves, If You Need a Good Cry, My Take on Autism tagged , , at 9:16 am by autismmommytherapist

Dear Justin,

I trust this letter finds you happy and healthy. I hope by the time you receive this I will have been gone for many decades, that this last missive in your mother’s attempts to parent you from beyond the grave will be delivered to you when you are old, but still well. Forgive me, but really, why should death preclude me from continuing to control everything?

You may have been wondering all of these years why your brother periodically reads passages to you from me, although if I’m honest I know he’ll never be certain how much you really understand of what you hear, how much of the sentiment of what I write will pierce through your autism and nourish your soul. The idea to pen this series of letters came to me years ago when I read about a young mom, tragically afflicted with terminal cancer. She created videos for her toddler daughter to be spaced throughout her lifetime so that her child would know her just a little, and would at least bask in the certainty that her mother’s love did not end with her death. I wrote all of these letters instead of videotaping myself because I feared that seeing me would confuse you, perhaps incite you to ask for me post-mortem, the thought of which I emotionally cannot bear. I wrote the lion’s share of them before I grew truly ancient, because although most of your great-grandparents lived to be almost obscene ages, you never know when it will be your time. I didn’t want to be caught unprepared.

Planning was your mother’s forte.

It was my fondest desire prior to relinquishing my physical self to the mortal world that your last decades on this earth would be productive, safe, engaged. I am certain that your poor little brother, whom I have pestered innumerable times over the last twenty years to watch over you, will be your stalwart companion, your protector, your friend. You two have always been close in your own unique fashion, a fact I attribute far more to your inherent interest in one another’s well-being rather than any scenario your father and I were able to construct over your collective childhood.

For over forty years I have watched him teach you, defend you when necessary, and stand up to you when the situation called for it as well. We tried to promote a bond between you, to make Zachary see that the gifts that came into his life as a result of your autism far outweighed the burdens that inevitably resulted from it. He has assured me many times that in its own way autism enriched his experiences, imbued him with patience and a facility for compassion he would not have possessed otherwise. He has also shared with me that no matter what the disorder taught him in his life, he will always wish for you that autism hadn’t completely overwhelmed yours.

I understand how he feels.

When I was a relatively younger woman I once read an article about a study conducted in the extremely isolated regions of Sweden, one which contributed to scientists’ collective understanding of the study of epigenetics. After following many families of farmers during several successive generations of feast or famine, the scientists realized this one incontrovertible truth: that everything those farmers ate, smoked, drank, and accepted into their bodies became an integral part of their DNA, their gift to bestow upon future progeny. It turns out that even the choices we make for ourselves prior to our childrens’ births have irrevocable effects, leave lasting impressions on the arc of their lives.

It is my most profound hope that coupled with the choices I made that my love for you, which began long before your cells divided and multiplied in the floating sanctuary of your personal test tube, was passed down to you as well. I hope the strength of my commitment to you became mired in your DNA, a permanent fixture in your cells, a cocoon within which to wrap yourself since I’ve been gone. If there is any vestige of justice left in this world, the differences in your brain will not have permitted you to fully mourn me, to experience the anguish I would have felt at your loss had you gone before me. Instead, I hope you have only remembered the love we had for one another, that unbreakable connection that with luck has sustained you, enveloped you when you were sad, these decades past. I choose to believe that in some fashion I have remained with you, that our bond to each other has transcended death.

So, as I’m writing this last love letter to you I will have to summon some modicum of faith, permit myself to trust that your middle-aged years, your descent into the realm of the elderly, and your arrival there have been for the most part a journey encompassed by hard work, various social opportunities, and frequent visits from those who remain who love you still. I have requested that your brother leave these letters bound in a book for your caretakers to peruse, with each entry marking a new passage in your life, an acknowledgement that you yourself are moving closer to your own final moments. I hope the people who have cared for you, fed you, clothed and housed you, and at the very least enjoyed you to some degree, have read these on occasion. Photos tell a story, but nothing paints a picture more illuminating than words.

If my wish came true, and in their few idle moments they were able to reflect upon these letters that I have left for you as solace and succor in your remaining years, I hope those who live with you will understand this. That before them is an old man yes, one who can intimate an entire conversation with his eyes, but cannot emit one with his mouth. That this elderly gentleman is quite contrary at times, but can be reasoned with, does comprehend the subtleties of demand and request, and will comply in his own time. I hope they fathom your innate intelligence, push you always to accomplish more, solicit from you your best self in all domains. You are capable of so much. I hope that fact has been recognized, and honored.

Finally, my deepest desire in creating this legacy of your life is that your care-givers will be cognizant of how loving you are and were, how affection was always a staple of your personality. I hope my words will convey to them how demonstrating your love for those in your inner circle dominated your days. I wish them to see that once you were an adorable child, toddler, and infant who always eventually conquered his anger and his incompatibility with the typical world with a mighty hug. I hope that my anecdotes of your childhood, the extra time I had to build into our morning routine for your embraces, the way your arms would encircle me at night as I sang your baby song to you and you patted my shoulder in appreciation, will stay forefront in their minds even when you are difficult. I pray that they will see you as a whole being, an entity capable of the full range of human emotion. I hope they will have loved you, even a little.

I do not believe that we will see each other again. Unfortunately, although I’ve tried, my mind has not afforded me the comfort to fully embrace that belief. In the end I think my lack of faith in the afterlife was its own blessing, as it continually pushed me to make every moment we had together count, to elongate and enrich our connection as often as possible. Believing death to be a permanent sleep, which I am certain I will enjoy, made me a better mother.

I have long ago gone into my “good night”, and I wish you safe passage into yours. I will say to you what I whispered in your ear every evening I cared for you, whether you were infant, teen, or grown man. I leave you with this, my forever sweet son.

Sleep well, Justin. I love you with all of my heart, and all of my soul. As always, you are my good boy.