What We’re Getting Charlie For Christmas
I am originally from California and, until I went "back East" for college in the '80s, never had a winter coat. (We did "layers" under a jeans jacket or sweater) I do like the changes in the seasons. And, I like the cold, except for the fact that colder weather tempers Charlie's and Jim's bike rides and outdoor activities more generally.
Monday it was cold but not as cold as it had been and they went on a bike ride, breaking a three-day bikeless streak. That's the longest Jim and Charlie have gone without a bike ride since the late spring and summer (and even though it was a very rainy summer—somehow they always seemed to find that window when the clouds parted). Charlie's game to go on walks but nothing beats a bike ride for a good aerobic workout. Charlie and Jim were gone for the better part of an hour with Charlie leading the way the whole time.
There's no question that Charlie benefits from regular (as in a couple times a day) exercise, preferably of a vigorous, aerobic sort. We're wanting to get exercise/physical activity at regular, and frequent, intervals into his behavior plan, as a tried and true strategy for helping him focus and keeping his anxiety in abeyance. On the one hand it seems like such an obvious thing to do.
On the other hand, the difficulties Charlie had in his former placement in a self-contained classroom located in a large public middle school have led to us realizing, you can't spell things out too much and too carefully. And, sometimes a few simple, basic accommodations can make all the difference.
Charlie, as I've noted, takes a number of medications. We started him on some meds when he was 7, and only after a lot of what could be called soul-searching. We still often feel as if giving Charlie anti-psychotics, SSRI's, anti-epileptics, anti-anxiety meds, is still more of an unofficial experiment than a proper treatment protocol, and I suppose it is. Nonetheless, we wouldn't have continued to seek out neurologists to prescribe medication for Charlie if we didn't think they were helping him and they (well, some of them) seem to (just not stimulants like Ritalin). A December 14th Washington Post op-ed by Great Barrington (MA) pediatrician Claudia M. Gold, M.D., approaches the medication issue with caution. Dr. Gold lauds the recent Pediatrics study on the benefits of Early Intervention and, while noting that she has often prescribed various medications for autistic children, calls for restraint and exhorts other professionals not to overdo it:
If we describe Evan [a child on the autism spectrum] as “irritable’’ or “explosive,’’ he might be a candidate for antipsychotics, which have been shown to be effective at eliminating this behavior. But another way to describe the behavior is “dysregulated.’’ These children have a very difficult time with self regulation. They get overwhelmed by sights, sounds, and smells. They may have rigid obsessive behaviors that serve to protect them from the barrage of disorganized sensory input they experience.
Contemporary research integrating developmental psychology and neuroscience demonstrates that children learn to regulate emotions in relationships. Intense experiences that are beyond the capacity of a child to self-regulate can be co-regulated with the help of people close to him.
I was interested to note Dr. Gold's highlighting of emotions and, specifically, of emotional regulation, and dysregulation, in autistic children. The latter is certainly something that Charlie struggles with. Especially when his anxiety, fears, worries, uncertainties are peaking, he seems to manifest his feelings in what he does—and being able to tear down a sidewalk at full speed or pump and pump the pedals of his bike so that he whizzes down the street are certainly preferable to other physical things that Charlie can do/has done.
You guessed it. An exercise bike is at the top of Jim's and my list to give Charlie for Christmas.