My son has ADHD as one of his co-morbid conditions with autism. He takes a medication called Methylphen twice a day, once first thing in the morning and a second dose between 11:30 and noon at school.
On the weekends, I give him a morning dose but skip the one in the afternoon. He doesn’t have to sit still or focus for anything on weekend afternoons so I don’t bother.
Friday rolled around and just before 2 p.m., the senior tutor called. Fear struck me because it was unusual to hear from her at that time of day. It turned out that she forgot to give my son his second dose of medication. She was over-the-top sorry and asking if it should be given this late in the day to make up.
I figured if he was not too hyper to focus in class it was no big deal. I usually skipped the afternoon dose on the weekends, and I told her not to bother. He just had a PE class and an hour of therapy before going home.
I picked him up after school, brought him to the office and he started therapy. Around 4 p.m., I entered a time warp and went back to when he was three years old.
He had just finished a program and was being reinforced on his old Playstation 2. He began screaming about “motorcycles”, out of the blue, and came running into my office in tears.
Almost instinctively, I picked him up and held him on my lap, giving him hugs. Then, his tutor appeared from around the corner. She had no idea what set him off. As soon as I saw her, I recognized that I was supposed to have her work through the meltdown without my intervention. I peeled him off me and told him to go with his tutor. She led him down the hall but he was screaming, crying and yelling about motorcycles. The game he had been playing was Rock Band and had nothing to do with motorcycles.
For a straight half hour, he melted down like he used to before he ever had any ABA therapy at all. Screaming, crying, yelling. Silence for a couple minutes. Then back to an even louder volume. I could hear his tutor trying to use compliance instructions to bring him back. It would work for a few seconds and then more melting. She had texted our senior tutor for assistance but she had gone into a meeting and was not available.
Twenty five minutes into this ebb and tide of a meltdown, I walked into the workroom and offered to stop therapy. She agreed. I said, “If you say one more word about motorcycles, you will not be going anywhere with me this weekend.” He looked at me and asked, “Clean? Clean?” to wipe his face. I told him to go to the bathroom and get toilet paper. He did it and came out quietly.
I doubt my threat made any difference. He’d had enough. No meds. Friday afternoon after a week of school and therapy. Tired, hungry and done. He knew when I intervened he’d be going home and this was what he was trying to communicate (“accomplish”) all along but couldn’t.
We got in the car. He was silent for the ride home. I got him a Happy Meal. He ate in silence. At home, he perked up. So much so, he decided it would be a good idea to find the noise that was the most annoying to me that he could, and play it repeatedly in my face. Apparently, that was payback for not taking him home soon enough.
I deleted the app with the sound of an audio check tone. You know, the “This is a test of the Emergency Broadcast System. This is only a test…” and then that annoying tone would play – do they still do that? I don’t watch enough television to know.
That whole jarring episode made me realize a few things. Obviously, we’d better not miss those afternoon doses of ADHD medication, especially on Friday. The senior tutor has now set her alarm on her phone so she will not forget.
I was reminded me of how far we’ve come. That kind of meltdown was a regular feature before we ever began ABA or had a diagnosis. There were hours of that same screaming, yelling and crying for reasons known and unknown. Like bad hiccups, just when you thought it was over, it would start up again. But back then, it was hours long. I haven’t seen one like Friday’s sample for about two-three years now.
Back in the day, those meltdowns were not just “his”. Everyone in his wake shared that pain. Hearing him cry on Friday, took me back. I’m just glad it ended when it did.
You might think that it would be a relief that it stopped so easily once I intervened. But that is not the way I see it. Even if he hadn’t got what he wanted with my intervention (ceasing of therapy) I am always the sentry on duty, always “at my post”, waiting for the need to be called to action.
Yes, I’m “one of the lucky ones” in a lot of ways, because he is compliant with me, for the most part.
But when you are the only one, it makes you wonder what is happening when you aren’t there. What will happen when you can’t be there. Who will know the manipulation from the autism? Who will know what to do? Anyone?
He is just six but so far behind in so many ways. I want him to be self-sufficient someday. It just seems like such a huge hurdle right now. So many crossed-wires, inability to communicate. It’s scary sometimes. And I’m on the outside looking in. I can only imagine what it’s like to be on the inside looking out.