Ears Are Really Useful Things

August 2014 046This is not the post I had intended to make this week but, as is often the case, something happened. Ears: I’ve mentioned these before as Dylan has a habit of trying to remove them (other people’s not his own) when he is anxious. I hadn’t realised until this week, however, how useful ears can be.

Dylan is strategic about ear attacks. He wraps his arm around the back of my head to prevent me from moving it then digs his nails into my ear from behind. This gives him purchase on it, allowing him to twist and pull as if to wrench the ear from my head. Quite often, the tip of my ear gets caught in the process. I try to keep Dylan’s fingernails short given this behaviour but even when just cut they are scratchy and often break an ear’s thin skin. My left ear usually comes off worse and has been infected a couple of times since the behaviour emerged a year ago.

wet leaf fall 007I cannot begin to describe how painful this is. There is something very delicate about the back of the ear where the fleshy part meets the skull. I try to keep my humour by calling myself Van Barrett and enjoying the opportunity the ear attacks afford for being creative with a scarf (bandage-style around my head). Sometimes the behaviour disappears for a while. Recently, for example, I have felt brave enough to wear earrings again and to not bother with a scarf. A couple of nights ago, however, I sustained a bad attack. Recording it in Dylan’s log before I went to bed, I noted it had been nearly a month since the previous incident. I have no idea why Dylan pulls ears but am increasingly of the view that there is no single trigger. I continue to think sugar may be implicated in this and I know that Dylan had some ‘banned’ items earlier in the week. I’m also persuaded, however, that the behaviour is a response to anxiety which, for Dylan, can have multiple causes.

This week’s incident happened at 9pm on Friday night. Dylan was in his room watching Thomas the Tank Engine and I was downstairs almost dosing through the Master Chef final. Suddenly things kicked off and the next hour was trauma and distress. When Dylan calmed, eventually, he wanted me to hold him tightly, putting pressure on his ears while he lay on the sofa. Once again I wondered whether his attacks on people’s ears are because his own are hurting. Dylan won’t let the GP near them to look but I made a mental note to myself to raise this, again, when Dylan sees the GP for his Cardiff Health Check in a couple of weeks.

Master Chef was still playing to itself. Dylan doesn’t usually watch TV but he is interested in food and the programme seemed to take his attention and soothe him. I needed to put TCP on my ears and arms but because of the smell of it I waited until I’d calmed Dylan enough to get him into his bath and bed. I could hear him shouting – not in a distressed way, but urgently and with a need – for long hours afterwards.

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IMG_0029 (2)In some ways I wasn’t surprised by the incident. At last, I thought to myself, here it comes: the reaction. For the last two weeks Dylan has been transitioning into the residential home where he is to live. The transition plan is gentle but has still involved Dylan being away from home overnight more than he is used to. Dylan’s time has been divided between his day centre and residential home and as staff from both settings have joined up, people have appeared out of context. On days when Dylan has been at the residential setting, his usual routine has been interrupted. However much care you take, and whatever support you put in place, this is an unsettling time.

And yet so far Dylan has been calm. Everyone has commented on how well Dylan is coping. Alert and happy, he seems to be taking the changes and new experiences in his stride. Already he has achieved things I wouldn’t have contemplated: working in the community shop run by the residential home, for example, and riding solo on the TransPennine trail. When I was told that Dylan had ridden a trike I was alarmed; but Dylan always went on the back of a tandem when we cycled, I said. He doesn’t know how to steer and brake, I explained. The manager sent me this photograph in response: what more reassurance could I need than that smile? But even with Dylan’s achievements there will be anxiety and perhaps the incident this weekend was a sign of this.

books-etc-002Speaking of signs, these may have something to do with the ear attack. Signs (and symbols even more so) are important to Dylan. One of the things I did last year, at the height of Dylan’s anxiety, was to set up a weekly board at home. Although he had managed without one previously I thought it might help Dylan make sense of life which, at that point, followed a complex pattern. It was probably one of the best practical things I’ve done for Dylan. Since then we have established a bedtime routine of talking through what will happen the next day using the symbols. When Dylan removes the next day’s symbols from his board, it is a sign that he has understood the shape of tomorrow. When Dylan started attending his day centre full time and had clearer routines, he was able to put the symbols for the week on the board himself on Sunday evenings. This not only helped Dylan make sense of his week, it created a sense of participation and ownership.

July 15 transition 003Because of their importance in Dylan’s life I encouraged Dylan to take his symbols when he went to his new home for the first time a couple of weeks ago. That week Dylan was travelling between settings. Although he is usually very careful with his things, somehow the symbols went missing. I have hunted through pockets and bags and asked at Dylan’s day centre and residential home but they appear to have vanished completely. As well as symbols and pictures of activities I wasn’t sure Dylan recognised the symbol for, there were laminated photos of key people and places in Dylan’s life. Where, I wondered, was my photograph now? At least I will be smiling, still, I told myself.

While I’ve been trying to locate Dylan’s lost symbols he has been getting quietly agitated. ‘Lost it’ he had said to me earlier in the evening on the night of the ear attack. Standing in front of his empty board he drew circles in the air with his upturned palms (the makaton sign for ‘where’). ‘Lost it’. I made a note to myself: get some new symbols for Dylan. I can’t do this easily myself as I don’t have the necessary software. It’s expensive and parents tend to rely on schools and care settings to produce and laminate such resources. Actually, this has always been frustrating and unsatisfactory and if I had our time again I would probably invest in a widgets package, a photocopier, a guillotine and a laminating machine for the home (in fact I might do that yet).

Interestingly Dylan has added 'skating' on Friday (his usual routine) and some day of the week symbols (not correct order but a good attempt).

Dylan has added ‘skating’ on Friday (his usual activity) and some day symbols (not in the correct order but a good attempt).

After the ear incident I spent a restless night. There was a chance, I decided, that Dylan’s distress was linked to anxiety about the lost symbols as much as to transition itself. So the next morning I made some pictures I thought Dylan might accept as an interim measure: replacement photos and some pictures-for-symbols as well as internet-sourced photos of activities on his programme for the week ahead. The first sign that Dylan was stirring that morning was his voice up the stairs to the attic where I was cutting and sticking: ‘Lost it. Lost it.’ I showed him the pictures I had made. I thought I detected some tension leave Dylan’s body. I fastened the pictures to his board and talked him through his week. I saw him smile for Castle on Monday and Seaside on Friday. Perhaps, I told myself, this is all that was needed.

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When I drove Dylan back to the care home that evening he announced ‘lost it’ as we drove up the drive. Once in the home Dylan took my hand and led me (and a care worker) confidently to the office, saying ‘symbol’. He clearly knew what he wanted and where they were kept. The care worker fetched a box of rebus and Dylan sat contentedly going through the symbols, picking out familiar ones and finding duplicates of some he had lost. I loved the way Dylan pored over the symbols, running them through his hands and pouncing on the ones he liked. It was, I thought to myself, the way I might browse a dictionary or thesaurus.

When I left him later Dylan still seemed a little troubled that he couldn’t find his lost symbols but appeared much happier. The care home are in the process of making Dylan a communication board and we showed this to Dylan, telling him it would be ready very soon. I’m not so naive as to think it will eliminate Dylan’s anxiety enough to stop the ear tearing; if this were the case it wouldn’t have been happening at home. However, not having symbols when you are going through a transition period must be awful. I would hate it if someone took my words away from me at such a time. So I’ve vowed not to leave Dylan without his symbols again, however briefly; I need to set up a portable as well as a fixed system so there is no risk of Dylan losing his only set.

I have a lingering anxiety though. What if Dylan isn’t referring to the symbols when he says ‘lost it’ but rather to what they represent? Might he be trying to communicate to me that he is anxious that he is losing his home and his mooey? What if he is telling me that he’s anxious about losing his day centre? The latter is, of course, the case: he is going to lose it. I have been wondering when and how and what to tell Dylan about the changes. Reluctant to trigger anxiety in him and create difficulties during transition, I have avoided telling Dylan what will happen beyond the day and week we are living. But if Dylan is using the term ‘lost it’ to express the loss of something more abstract than a two inch symbol, perhaps it is time for me to be brave too. On my list of things to do: produce that social story I’ve been writing for him in my head.

So although it was challenging Friday night’s ear attack led me to some useful learning. Firstly, I need to try again to get Dylan’s inner ear examined. Secondly, I learned something about communication: that Dylan’s symbols are important to him at a fundamental level and that he may actually be processing experience at a more sophisticated level than I realise. I need to sort out visual communication systems for Dylan as a matter or priority. But the incident was also useful in alerting WP_20150508_16_19_08_Prome to something entirely incidental. Recently I have been irritated by my spectacles which have felt increasingly uncomfortable. Twice I have visited my optician to complain that they are badly fitted and require adjustment. Both times the receptionists have politely fiddled with them for me in an effort to oblige. Last week when I complained again, however, the receptionist told me that she really could not see what the problem was: they were correctly fitted. Perhaps, she suggested, I just had to get used to them?

Bathing my ears in TCP this weekend I realised why my spectacles have felt so uncomfortable; the backs of my ears are chronically sore from the repeated attacks on them. The arms of my glasses, where they hook over my ears, must be pressing so as to create discomfort. I’m not sure what I can do about this but the realisation will, at least, stop me harassing the optician. And now I know that ears are really useful things: the thought that I need them for seeing as well as for hearing amuses me. Contact lenses would be a solution I suppose if I could bear the thought. I almost prefer the idea of a pince-nez or lorgnette. They would probably style well with a head scarf.

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The piece I had planned to write (which I referred to in my previous post) is coming soon…

And Finally

more garden in may 009I am relieved to report that my request for a place at a National Autistic Society home for Dylan cleared the final hurdle last week and was approved. I’m not sure the implications of this have sunk in yet but it is what I have been advocating for and I am pleased to have achieved this for Dylan at last.

It is two years since I set up this blog. I started it because I was dismayed by the lack of options for Dylan when he left school. Initially my concern was that he wasn’t allocated enough day care to enable me to get to work (which I needed to do as a single parent) but I soon realised the issue was not how many hours Dylan was or was not entitled to but the shortage of appropriate adult provision.

This blog records Dylan’s difficult transition to the adult sector and its impact on us both. My posts during the first year described my attempts to secure education provision for Dylan, having established his entitlement to this through a legal action against my Local Authority. While I waited for a suitable post-19 setting to be developed, Dylan attended two different part-time placements during the week (one social care and one education-funded) and was cared for some of the time by me. That year was confusing and chaotic. The placements weren’t joined up and there was no continuity of care for Dylan. Leaving school was always going to be a difficult transition for Dylan but replacing a full time setting with a mixture of part-time care escalated the anxiety.

garden june 004Who knows to what extent this hotchpotch provision triggered the behaviours which emerged in Dylan at the end of that first year. Since then, my posts have focused on my attempts to understand Dylan’s ‘challenging behaviour’. My search for explanations has focused on physiological as well as environmental factors but the consensus is that the underlying cause is psychological. It seemed to help Dylan when it was agreed he could attend his day centre full time rather than continue with the miscellany of provision he had been accessing. Even with adjustments to his care, however, it was clear that Dylan needed more support than previously in order to stay safe and to access the community.

Within a year of leaving school, therefore, Dylan’s profile and the priorities for his care had shifted from continuing education to continuing health. Some of my posts during the last year describe my attempts to secure health sector funding so that Dylan’s needs could be met. Perhaps my earlier battle for education funding gave me the confidence to challenge an initial decision against health funding for Dylan but I would urge any parent in a similar position to do the same; having to appeal decisions seems to be increasingly standard so don’t expect the first judgement to be in your favour. When I eventually secured health funding for Dylan, more appropriate options for him opened up.

garden june 003When Dylan left his National Autistic Society school in the summer of 2013 a residential home  was being established for school leavers who needed higher levels of care. Dylan was familiar with the setting as he had stayed there overnight occasionally (it was previously used for respite for children attending the school). Some of his peers would be moving into the home and Dylan knew some of the staff too. Naturally I requested a placement for Dylan, thinking it would offer a seamless transition to an appropriate setting.

My request was turned down two years ago, partly because Dylan didn’t have health funding at the time but also because my Local Authority’s policy is to place adults in the community, rather than residential care, and not to fund placements out of city. My request for Dylan to be allocated a place at the NAS home failed against both criteria. This rigid approach is, I would argue, short-sighted. While I understand the ideology (post-Winterbourne) it remains the case that for some young people a specialised residential placement is appropriate. Dylan, for example, needs the customised living and outdoor space which residential care offers as well as access to a team of professionals rather than the single care workers who typically support adults in the community.

WP_20150712_18_21_50_ProFinally, after months of crisis and distress, Dylan’s need for such provision has been accepted; two years (almost to the day) since he left school, the NAS home I originally requested is the one that has now been approved. Although the home lies just beyond the city edge, I would have happily accepted somewhere within the authority had anywhere been suitable; indeed I pulled out of another out-of-city placement partly because I was reluctant for Dylan to leave his community. When I tried to identify a local residential placement, however, there was nothing adequate or appropriately specialised. If local authorities cannot make suitable provision for autistic adults with high care needs, they are not in a position to refuse to fund specialist placements out of city (or borough).

Because the setting that has been approved is a familiar environment for Dylan, transition so far has seemed relatively comfortable  (although I have been warned that behaviours are likely to increase initially). The plan for supporting Dylan into his new home is the best it could be; although the placement started this week, Dylan will be jointly supported by staff from his day centre and residential home and will continue to live partly with me for the first month. A holiday planned for August will mark a natural end to this initial transition period, after which the aim is that Dylan will be based at his new home.

more garden in may 018I know that there will be challenges ahead for us both. Although I was relieved to receive the news I have felt utterly exhausted since and have had moments of terrible doubt and anxiety. I tell myself this is surely natural. On Monday night – the first day of Dylan’s placement – he stayed overnight at his new home so I could fulfil a long-standing poetry commitment. I wasn’t sure this was what I needed on the day as I felt tired and emotional. On reflection, however, it was an appropriate way to mark the start of this next phase of our lives, living more independently of each other. The poetry reading was also useful in distracting me from my anxiety and preoccupation with the new arrangement; better than sitting at home, fretting.

A friend, recognising something of what I was going through and with the wisdom of already having waved goodbye to a grown-up son (though not in the context of autism), sent me a poem yesterday. The piece, Walking Away by C. Day Lewis, ends like this:

I have had worse partings, but none that so
Gnaws at my mind still. Perhaps it is roughly
Saying what God alone could perfectly show –
How selfhood begins with a walking away,
And love is proved in the letting go.

garden june 008I can see that even with the extra challenges confronting a parent of a disabled child the ‘letting go’ still has to be faced and embraced. Our life together is changing, I tell myself, not ending.  Although like Dylan I will live with autism forever,  I will no longer be living with it in the same way. Over the next few months, therefore, this blog will change and in due course come to an end. It has served its original purpose and Dylan and I have grown beyond its focus.

My plan is to keep the blog going, however, while I learn to let go. I have in mind to use it as a diary space where I can record my thoughts and feelings in the first 100 days of living without autism. I’ll start counting when Dylan moves full time into his new home after our August holiday. Before that, however, I have two more posts to write. One is on a difficult subject which I’ve been meaning to confront since I set the blog up; I have been ducking it but cannot any longer. The other post will offer some reflections on what I have learned from this blog and the ways in which it has been a positive force for me (and I hope Dylan) in the last couple of years.

And finally, I want to thank you (yes, you) for reading, for your encouragement, and for your friendship and support.

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Images:
The photographs were taken in my backyard in May and June this year. I have never been a gardener and I don’t have much outside space but recently I have spent more time in my yard and found it therapeutic. I have come to think of this as a safe space where I can let go of some of the anxieties of being a carer. I think I will always associate it with this period of my life with Dylan.

Autism And The Alphabet: Dylan and the ‘W’

Munch 003My last couple of posts have focused on Dylan’s love of paintings and my attempts to understand the role of art in his life. In order to do this I identified imagery which Dylan seems to respond to and constructed a therapeutic narrative around it. A comment on my last post, however, reminded me that I was making assumptions about Dylan’s viewing. How could I be sure Dylan was responding to the images in a painting? Perhaps he was attracted by the light or by a picture’s lines?

My initial reaction to the question ‘why don’t you ask Dylan what he likes about the paintings?’ was that I couldn’t. He (I mean we) don’t have the language. But the question set me thinking. Maybe Dylan was indeed gazing at darkness rather than thinking ‘rock’, or enjoying the quality of contrast rather than the thing I call ‘a cross’. I convert the light and the dark, the colours, shapes and lines to concrete nouns for Dylan but perhaps what he likes about the paintings aren’t the things I give him words for.

Maybe I need to view Dylan’s paintings with the part of my brain which sees spatially instead of with language. Rather than labelling objects in a painting I could offer Dylan the spaces and shade. Such an approach would fit with what I have already learned about the way he sees the world. Elsewhere I have described how Dylan sees hair on trees instead of leaves and tells me that the cheese is crying when I melt it. I have suggested that Dylan’s lack of language might allow him to experience phenomena more intimately and intensely than I am able to because he uses his senses rather than these inadequate words. Dylan’s perception of the world, I have speculated, may be right-brained whereas mine is left; where I see ‘curtain’ Dylan might see silver light spilling from a vertical edge.

See saw

W 005I must have been thinking about this a few days later when I picked up a magnetic letter from Dylan’s bedroom floor. Because I was about to say ‘Oh look Dylan there’s a letter’ or ‘look here’s a W’ when I remembered Elisa’s question ‘Why don’t you ask Dylan what he likes about the paintings?’. Could I be open-ended about the W? Could I ask Dylan what I had found on the floor?

Oh look. What’s this Dylan?

See saw

I stared at him in shock. Then I asked again.

See saw

You should have seen my face :-) I cracked such a grin. What a gift. Dylan sometimes hands me these, unasked for, but I might never have received this one if I hadn’t asked the question that way. The see-saw was my first open-ended gift.

Seeing W

wikipedia.orgDylan’s magnetic W is the same shape as the version produced by a keyboard: not actually ‘double U’ (as the letter is pronounced in English) but rather ‘Double V’ (as it is pronounced in French). Although this version of W is commonplace today, when I was a child it had curves not angles. In handwriting lessons we were taught to practice forming our Ws by joining Us together and moving our hand briskly and freely across the page, line after line.

UUUUUUUUUUUUUUUUUUUUUUUUUUUUU
UUUUUUUUUUUUUUUUUUUUUUUUUUUUU

Just like Dylan I made letters into pictures. My friends and I thought we were terribly risqué when (collapsing in giggles) we decorated our UUs with squiggles and dots to turn them into bottoms and bosoms. Perhaps I didn’t see a see saw because of the cursive way we wrote our Ws but I can’t help thinking that had I looked carefully – as Dylan does – I might have seen a swing boat.

Hearing W

publicdomainpicures.netAs well as the mismatch between the visual ‘W’ and the heard shape ‘UU’ I encountered other problems with this letter as a child. I remember sitting on the back step of a friend’s house on a warm day one long school holiday. We had got the writing bug and were sitting in the sun with paper and pens. I don’t know how old we were – perhaps seven or eight, maybe a little older. I remember my friend asked her dad, working in the drive nearby, for a spelling.

How do you spell daffodil?

D- a- double f – o – d – i – l

I had never heard anyone use the ‘double letter’ device before. I remember I felt anxious about the letters I had heard but didn’t have the confidence to ask my friend’s dad to repeat them. I did my best but something seemed wrong with my word:  Dawfodil. It looked a bit odd. I wasn’t going to question my friend’s dad though.

Suddenly he was hovering above me, looking down at my page: ‘What have you got there?’, he asked, ‘Why have you written a W?’ He had said W I told him. He checked his daughter’s writing; she hadn’t made the same mistake. My friend must have heard the double letter expression before but it was unfamiliar to me; I had assumed a letter with a ‘double’ sound in it meant W. Afterwards I would use the double device triumphantly and often:

M – i – double s – i – double s – i – double p – i

I’d do well to remember the confusion and anxiety I felt about my dawfodil though; it might help me understand just a stamen of being Dylan.

Teaching W

W 003Because the names, shapes and sounds of letters aren’t intuitive or easy, attempts have been made by practitioners and publishers to develop teaching resources and methodologies. Whether or not these help probably depends on an individual child’s learning style. A kinaesthetic learner, for example, might respond to the Steiner approach to learning the alphabet through music, movement and drama. This method involves children physically taking on the attributes of each of the letters of the alphabet and embodying learning through the senses. The magnetic letters which I use with Dylan are also aimed at children who learn through their senses as they can be experienced by touch and smell as well as sight.

amazonw2As a phonetic method the commercial resource Letterland focuses primarily on sound. Available in a range of formats (jigsaw, books, video etc) it works through the association of each letter with an alliterative character (human or animal). So, for example, C is Clever Cat, J is Jumping Jim and W is Walter Walrus (though when my children were small it was Wicked Water Witch). Many children respond well to the Letterland alphabet – I remember my step daughter liked it and it really did seem to help her developing literacy. It doesn’t suit every child though; my daughter was lukewarm about it and it never held any interest for Dylan. Now, perhaps, I can understand why; Dylan doesn’t hear a Walrus, he sees a see saw.

Just as I put a  ‘w’ in daffodil because I thought I heard one, perhaps Dylan visualises see saws in words with w:

Yelloseesaw [Yellow]

Seesawonderseesawall  [Wonderwall]

Seesawindoseesaws  [Windows]

I have been wondering what else Dylan sees in the letters of the alphabet. One day I will ask him but not all at once as it would overwhelm him. I’ve tried to guess though – O could be wheel perhaps:

Twheelwheelkit  [Toolkit]

Wheelseesawl  [Owl]

Mwheelther  [Mother]

W 007Looking again

If Dylan sees letters as objects unconnected with the sounds they represent then it must be very hard for him to make sense of letters as signifiers. To my knowledge the only group of letters Dylan recognises is ‘Dylan’ and this is because he has been exposed to them as a sequence rather than as individual characters. What might be the implications for supporting literacy development in children and adults with autism and learning disability? Based on my limited observations of Dylan I would hazard that for some young people the ‘look say’ method might be a more appropriate approach than a phonetically-based system. Learning words certainly seems more effective than learning letters for Dylan and if I had his early years again this is probably what I would focus on. Then again, that way I might have missed the see saw…

W 014

Images:

The daffodils are via publicdomainimages.net; the swingboats are via wikipedia; the Letterland book is via Amazon and the other photos are taken by me. The picture of Dylan on a seesaw (aged three) was taken in France in 1997.

Dylan’s Pictures: stunned into words

barnes thesundaytimes.co.ukIn his book Keeping An Eye Open Julian Barnes claims that ‘it is a rare picture that stuns or argues us into silence.’ In my last post I noted that the opposite is true for Dylan; a few special pictures can stun him from silence into words. Reviewing the therapeutic approach to art advocated by Alain de Botton, I asked whether such a framework might help me to understand Dylan’s response to art.

june 15 023 Here I explore that possibility by applying de Botton’s methodology to Dylan’s favourite pictures. To do this I identified the pictures in our home which Dylan particularly likes; it is clear which these are as Dylan spends time with (and sometimes talks about) them in contrast to others in the house which he ignores. I then grouped the pictures according to possible ‘function’. Although I have aligned my categories with some of the functions described by de Botton I started by generating my own functions, grounded in observations of Dylan, rather than attempting to apply de Botton’s schema. This seemed appropriate as de Botton’s typology was developed from a neurotypical perspective and art may have alternative functions for an autistic adult. From this process I identified four categories which I discuss below.

a) Remembering: the comfort of mother

june 15 004One summer in Margate I stepped inside a vintage shop wondering if Dylan would be patient while I rummaged through clothes. A print of Tamara de Lempicka’s Mother and Child (1931) on the shop wall caught Dylan’s attention. He stood transfixed by it until closing time when (with difficulty) I encouraged him out. I gave Dylan a print of the painting for his 18th birthday the following year; it hangs above his bed and I think is one of his favourite images. I sometimes wonder if its function is along the lines described by de Botton and that its primary purpose is as comforter. My attention is also caught by the unusual eyes, however; perhaps it is those which attract Dylan to this painting?

june 15 006Some of Dylan’s other favourite pieces involve female forms which I think Dylan connects with mothering. Dylan sometimes names Claude-Emil Schuffenecker’s Madame Champsaur (1890), for example, as ‘mooey’ although I am fairly sure he knows I am not (and was not) the woman in the painting. I have written elsewhere about Dylan’s deep memory of his encounters with this painting while in France and I think he perhaps links ‘the woman with a fan’ to his experience of being a child. Dylan is particularly fascinated by Madame Champsaur’s hands and often says ‘hand’ while looking at the picture. This interests me as when Dylan was young he would frequently take my hand and match my palm against his own, placing them next to each other as if comparing them. He doesn’t do it anymore but I used to think of it as Dylan’s way of working out that he was connected to me.

I could cite other examples of Dylan responding positively to mothers in art; the de Lempicka and Shuffenecker are particular favourites but they are illustrative of a broader preoccupation with madonna imagery. This category aligns fairly well with de Botton’s discussion of William Dyce’s Madonna and Child (which I referred to in my previous post) and with his suggestion that such an image might offer ‘comfort’ to the viewer. In terms of de Botton’s seven functions I would say that the examples I give here are about ‘remembering’.

b) Self-understanding: belonging and community

june 15 014Dylan has other favourite pictures which incorporate representations of the female form but not in ways which he connects with ‘mothering’. When Dylan first paid attention to the figure in this Oxfam poster I thought it might be the representational nature of the image which appealed to him; symbols are easy for Dylan to make sense of and he can find meaning in line and abstract drawings quite quickly. The figure in this print was the first one which Dylan appeared to recognise and respond to when he was young; it is also the first picture which ‘stunned Dylan into words’. I remember my amazement when Dylan pointed to and named ‘knee’, ‘arm’, ‘elbow’, ‘chin’, ‘nose’, ‘eye’, ‘hair’, ending with a triumphant ‘woman’. Dylan still engages in this naming. I sometimes try to change or develop the features Dylan names but he is not having any of it; in this sense Dylan’s engagement with the picture has become routinised. I’m interested in Dylan’s focus on anatomy. Perhaps it is through this he develops a physical sense of self? This poster belonged to Dylan’s biological father so I enjoy the fact that Dylan has such feeling for it.

june 15 017Gauguin’s Breton Peasant Women (1894) is a particular favourite of Dylan’s and one which I often find him staring at in the evening in the dining room where it hangs. At such times the picture seems to induce a trance-like state. At other times, however, Dylan likes to talk to me about the picture, naming its features in a particular order as with the Oxfam poster. What interests me about Dylan’s relationship with the Gauguin, however, is that the things he names are inanimate rather than figurative: stick (in one of the women’s hands); bag; rock; sand; shoe. Here, then, Dylan seems to be focusing on the physical world the women inhabit rather than on the women themselves.

I have described these pictures as developing a sense of ‘belonging and community’ as Dylan seems to be responding to the physical experience and the location of the figures in these pictures. This most closely approximates de Botton’s function of ‘self-understanding’.

c) Re-balancing: the love of order

june 15 005Like others with ASC Dylan can appear more interested in objects than in people. His attraction to the material world is not random and indiscriminating however; he is drawn to pattern and symmetry and to phenomena which shape-shift (such as water and steam). Dylan’s interest in architectural drawing could be considered stereotypically autistic; the attraction of this drawing of Ulm Cathedral seems to be in the number of windows which Dylan likes us to count together.

june 15 020Dylan’s interest in this French exhibition poster, meanwhile, focuses on the car and, more specifically, the wheels. Dylan likes me to name parts of the car such as the lamps and windows but it is the shape of the wheels which seem to bring him particular satisfaction. Dylan has a natural curiosity about the material world and an appreciation for buildings and machines. I’m not sure I realised this when he was younger but I think it is clearly expressed through his orientation to art.

Dylan’s enjoyment of these prints is perhaps illustrative of the impact of neurodiversity on visual orientation and perspective. If I were to analyse what it is that he responds to in these example pictures I would say it is order and pattern. This may correspond with de Botton’s function of art as ‘re-balancing’ us.

d) Growth: nature and spirituality

june 15 003Dylan has what I think of as a spiritual dimension which he often seems most in touch with near water and in light. He has a strong orientation to nature and a particular interest in solitary figures in landscape. I bought this watercolour in 2008 at an art fair in Portreath, Cornwall; I wanted to support a local artist (Beth Edge) and I liked that it depicted a spot where Laurence Binyon is reputed to have composed the poem ‘For The Fallen’. When I chose the painting I don’t think I noticed the detail which would subsequently captivate Dylan: two figures sitting on a bench by the Pepperpot, looking out to sea. I wonder if it is the grandeur of the seascape he is absorbed by as much as the tiny human smudges gazing at it?

Munch 003In Dylan’s very favourite picture a man sits alone at a window looking out across a body of water in moon and lamplight. This Munch painting (Nacht in Saint Cloud, 1890), reproduced as a poster for an exhibition I visited before Dylan was born, is possibly the most important thing in Dylan’s life. It is so crucial to him that I have written into my will that it must stay with Dylan always. I don’t know what it is which enchants Dylan about the image but I have some clues in the words it stuns him to. Dylan asked me, a long time ago, for a word for the reflection of the window frame: ‘it’s a sort of cross on the floor’ I suggested. Later he told me that the diaphanous light at the left hand side of the painting is a curtain. Dylan also fixes on the light above the seated man. All my attempts to offer other details from this dark, indistinct print have come to nothing: ‘Lamp’, ‘Curtain’, ‘Cross on the floor’, Dylan chants.

If I were to apply de Botton’s functions of art to these paintings I would perhaps identify them as addressing the need for ‘Growth’. Analysing their content for ‘the concerns of the soul’ (as de Botton terms it) I might suggest that the metaphysical themes and imagery focus the viewer on the concepts of awe or grace. Maybe Dylan is responding to a compositional aesthetic as much as to a painting’s content, however. An artist once explained the ‘Golden Ratio’ to me and I have sometimes wondered if the relationship between lamp (top), curtain (left) and floor (bottom) in Nacht in Saint Cloud offer Dylan that sort of beauty. Or perhaps he has an intuitive feel for other artistic formulae such as the ‘Serpentine Line’ or ‘Venetian Secret’? The explanation, I suspect, will remain Dylan’s secret.

Rethinking autism and art

‘Art therapy’ usually involves attempts to engage people in producing art. While there are some valuable examples of such work I would argue that it isn’t appropriate for everyone with an Autistic Spectrum Condition. Dylan has no interest in participating in art sessions but, as I hope I have shown in these posts, art is something which is important to him and from which he benefits. It is surely the case that just as you don’t have to play an instrument in order to enjoy music, so you don’t have to hold a brush to derive pleasure from art. An art appreciation model is, perhaps, a therapeutic approach with potentially broader application within autism education and care.

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Note:

Other prints in the home which Dylan enjoys, and which I could have included as further illustration of the categories identified in this post, include La Toilette by Toulouse-Lautrec (1896), a portrait of Vivienne Westwood and a vintage railway poster. Pieces which Dylan ignores include reproductions of work by Schiele, Picasso, Blake, Rossetti and Macke as well as two other de Lempickas, some original paintings by local artists and various posters and maps.

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References:

Julian Barnes (2015) Keeping An Eye Open: Essays in Visual Art. Jonathan Cape
Alain de Botton and John Armstrong (2013) Art as Therapy. Phaidon Press
Grayson Perry (2013) The Reith Lectures, 1-4 [for the ‘Serpentine line’ and ‘Venetian Secret’]

Episode One of Keeping an Eye Open by Julian Barnes (BBC Radio 4 Book of the Week, 22/06/15) is available at: http://www.bbc.co.uk/programmes/b05zhhhy

*  This post builds on my earlier blog post:  Art And Autism:  Psst you. Hey kid. Yes you.

Art And Autism: “Psst, you. Hey kid. Yes you”

In a recent post I mentioned that Dylan enjoys art galleries. Actually I would go further: art is not only a comfortable medium for Dylan, his relationship with it seems essential. In galleries Dylan will stand for long periods before particular barnes thesundaytimes.co.ukpaintings, absorbed by the experience to the point of trance. At home I quite often discover Dylan standing stock still and silent, staring at a favourite print. This love of art is something Dylan is at times moved to share; our most frequent ‘conversations’ are about his favourite pictures.

Listening to an extract from Julian Barnes’ new book of essays, Keeping An Eye Open, on the Radio this week I was struck by his claim that ‘it is a rare picture that stuns or argues us into silence.’ For my son, whose world is mostly silent, the opposite is the case. In this post I consider a therapeutic approach to art and in a linked post I reflect on some pictures which move Dylan to words. In trying to understand Dylan’s response to art I ask whether there is something I might learn from his aesthetic about its therapeutic role in his life.

Recovered words, restored sight

Georges Braque, Barnes informs us, claimed that ‘great paintings need us to say nothing at all.’ Dylan, I’m sure, would agree; when he speaks about a painting it is from a place of joy, not need. What Braque had in mind is the explanatory voice which artists hope their work does not require. As Flaubert reminds us, as well as not needing us to say anything, ‘nothing needs to be said’ about a great painting. It is interesting, however, to watch people read accompanying text in an art gallery. In the Louvre with my daughter a few years ago I was astonished to watch a visitor focus on the explanations of paintings to such an extent that it was the text boxes she photographed rather than the paintings. It often seems to me that the majority of visitors read the accompanying caption before looking at a painting – and I could not claim not to have done this myself sometimes.

perry tes.co.ukGrayson Perry, in the 2013 Reith Lectures, noted that our aesthetic is constructed by contexts such as family, education, nationality and religion and validated by ‘experts’ – artists, curators, dealers and critics. Thus as well as being guided by expert views, our response to art is shaped by what is usually a linear narrative through the socio-economic and political contexts from which it arose. Such organisation is helpful, Barnes claims in his essay on the visual arts, because the ‘conversation’ between successive movements is clear and helps us to understand innovation and shifts in beliefs and practices. When paintings are placed next to each other which are not in conversation, he suggests, the result is an ‘aesthetic squabble’ which can leave the viewer disoriented and confused.

Dylan is not swayed by such considerations. Although he responds to what Perry refers to as ‘familiarity’ (i.e. things he recognises), the broader social and historical context of a painting is of little influence and the views of others (whatever their expertise) of no interest. Perry tells us that curators and art dealers consider large paintings and red paintings of high value (based on sales and consumer demand); although one of Dylan’s favourite pictures happens to be quite large I don’t think this (or redness) is part of his aesthetic. Dylan really does plough his own furrow.

So when I visit a gallery with Dylan there is little point in my attempting to hold to conventional ways of viewing. Because text and sequencing are of no consequence to Dylan, the only thing to do is to follow his path. Thus my experience of the space is his: this room is skipped; this one we walk through backwards with eyes closed; in this room we look at one painting; we check everything briefly in this room; at the end of this space, we run twice from side to side; and here we sit down, on this bench, to stare at a favourite painting for as long as I will allow. We don’t read text boxes. We don’t follow any order except for the one Dylan has constructed for this gallery. In this way Dylan restores my sight and is, sometimes, stunned into words.

Psst, you

june 15 024In Donna Tartt’s The Goldfinch, thirteen year old Theo and his mother are caught up in a terrorist attack while visiting a museum. In the moments following the explosion (in which his mother dies) Theo impulsively takes his mother’s favourite painting – ‘The Goldfinch’ – from the wall. The painting will draw Theo into a world of violence and criminality but also serve as a vehicle for the longing he feels for his mother. Towards the end of the tale Theo’s Guardian, Hobie, reflects on the way a painting can take possession of us:

…you can have a lifetime of perfectly sincere museum-going where you traipse around enjoying everything and then go out and have some lunch. But…if a painting really works down in your heart and changes the way you see, and think, and feel, you don’t think, ‘oh, I love this picture because it’s universal.’ ‘I love this painting because it speaks to all mankind.’ That’s not the reason anyone loves a piece of art. It’s a secret whisper from an alleyway. Psst, you. Hey kid. Yes you. (p.849)

I think Dylan hears that whisper from the alleyway.

Therapeutic uses of art

june 15 023Alain de Botton, in his book Art as Therapy and in his pioneering work at The School of Life, argues that we need fresh ways of thinking about our relationship with art. The problem with museums, he suggests, is that they tend to display art using academic and historical categories rather than grouping paintings according to their essential ‘function’. Art, he claims, has seven key functions: remembering; hope; sorrow; rebalancing; self-understanding; growth and appreciation. ‘A more ambitious, and beneficial, arrangement’ of paintings in a gallery, de Botton argues, would be one in which works were arranged ‘in line with the concerns of our souls, bringing together those objects which, regardless of their origins in space and time, address the troubled areas of existence. ‘ (p.91)

There could be a gallery named Tenderness to help us to understand what the quality is and why it is so hard to preserve in the conditions of daily life. We could meet Donatello here, but his presence would be subsumed under a higher heading and enriched by items from other parts of the collection. There would be space for Henry Raeburn’s portrait of the Allen Brothers, currently marooned in the British room, because it matters less that this work is by a Scottish painter of the European Enlightenment, as the caption tells us, than that it, like the Virgin and Child, has many important things to tell us about how to bolster the more delicate inclinations of our hearts. (p. 94)

When I encountered de Botton’s work it felt like a light bulb. Could this be what Dylan does? Is he curator of his own exhibition, using principles similar to those outlined in Art as Therapy? Although some of the thinking made me uncomfortable, it offered a possible way of understanding Dylan’s response to art. In particular I wondered if de Botton’s examples might help me to identify and understand the imagery which attracted Dylan. He has this to say, for example, about William Dyce’s ‘Madonna and Child’ (c. 1827-1830):

… Such an object is delicate with our longings. It knows that we might still need to be mothered, even though we are adults, and that we might still need a great deal of reassurance and kindness. So much of growing up is about becoming independent and getting by without the comfort on offer here. Being a mummy’s boy remains a stinging insult to our autonomy. This kind of toughness represents an exaggerated repudiation of an important need. The painting offers comfort by proxy. In our imagination we can get close to Mary without needing to give up the hard-won advantages of adult life (and it might help our identification that the baby looks about 27). In art, the longing that might otherwise damage us and undermine our claims to an adult identity, finds a safe and acceptable home.  http://www.artastherapy.com/

This description illustrates the way in which the grouping of paintings by function is subjective and problematic; there is little doubt about the classification of Dyce’s ‘Madonna and Child’ as ‘Early 19th Century’ but we could challenge de Botton’s reading of the painting. While not convinced by his interpretation of the image I did find myself intrigued, not least because the Madonna is one of Dylan’s favourite images. In a linked post, therefore, I attempt to apply de Botton’s methodology to Dylan’s pictures and reflect on the possible ‘function’ and role of art in his life.

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I develop some of these ideas in the linked blog post: Dylan’s Pictures: stunned into words

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References:

Julian Barnes (2015) Keeping An Eye Open: Essays in Visual Art. Jonathan Cape
Alain de Botton and John Armstrong (2013) Art as Therapy. Phaidon Press
Grayson Perry (2013) ‘Playing To The Gallery’, The Reith Lectures 1-4
Donna Tartt (2013) The Goldfinch. Abacus

Episode One of Keeping an Eye Open by Julian Barnes (BBC Radio 4 Book of the Week, 22/06/15) is available at:

http://http://www.bbc.co.uk/programmes/b05zhhhy

Images:

The photo of Grayson Perry is via the TES and the image of Julian Barnes’ book is via The Sunday Times.

 

Why Friendly Can Be Better Than Relaxed: autism, accessibility and the arts

2014-02-22 14.59.39I’ve been wanting to write about accessibility for a while but have hesitated because ‘Tinc’ (who blogs at Tincture of Museum) already does it brilliantly. Tinc is well-qualified to do so; having resigned a career as a librarian to spend more time with her family (which includes a daughter with Aspergers) she now supports a variety of museums as a volunteer and blogger.

Tinc focuses on a range of issues of interest to museologists but her personal experience of autism means that she has particular insight into the ways in which museums can improve accessibility for visitors who are autistic (see for example her post about the London Science Museum). After Tinc generously tagged me in a round-up of blogs on museums and autism I thought I’d offer some reflections on Dylan’s experience of accessing the arts. In this piece I explore the terms ‘autism friendly’, ‘inclusive’ and ‘relaxed’ in relation to a range of artforms and organisations. There doesn’t seem to be agreement, within or across sectors, about the various terms used by organisations so the sense I make of these definitions is my own, based on personal experience. I make only brief reference to museums, however, and refer anyone with a particular interest in that sector to Tinc :-)

Definitions

2014-03-23 14.24.44If I encounter the term ‘Autism-Friendly’ I assume adjustments have been made to a venue or event with specific reference to the needs of autistic visitors. Such adjustments could include the selection of material; trained staff; adaptations to the environment to reduce sensory stimuli; changes to the timing and sequencing of an event; production of autism-specific resources; or ring-fencing of places to the autism community.

An event advertised as ‘Inclusive’ may also include adjustments to the environment and scheduling of an event; while these are often helpful in relation to autism, such events are not developed specifically for autistic visitors but aim to improve accessibility for all disabled visitors. I’ve encountered the term ‘Relaxed’, meanwhile, in relation to live theatre performance. My experience was that the event  did not incorporate significant adjustments to the environment. At relaxed performances, however, the audience is not required to adhere to the usual conventions (for example being silent) and audience participation is encouraged. I suggest that not only are such events not autism-specific, some of their features may be challenging for some people with ASC.

Managing without adjustments: libraries and art galleries

2014-03-08 14.38.38Of course not everyone who is autistic requires adjustments in order to access ‘the arts’. Even with severe autism and a language and learning disability, Dylan manages perfectly well without adaptations in some settings. Libraries, for example, are fine; in fact they are one of Dylan’s favourite places and a regular fixture on his weekly schedule. It might be more of an issue if Dylan needed to access the adult section of a library but the material he is interested in is located in the children’s section which tends to be less formal.That’s not to say issues don’t arise: he has had to learn not to remove library labels from books and to accept that an item he wants might have been borrowed by another library-user. These are reasonable lessons, however, rather than accessibility issues.

2014-03-08 14.37.59Because Dylan doesn’t read or write his interest in books is based on his love of illustration. Dylan’s strong orientation to the visual world means that art galleries are also of interest to him and, as with libraries, he manages these without adjustment. Although Dylan negotiates the space idiosyncratically, no adaptations are needed. Dylan has had to learn not to touch and to accept that if other people are looking then he will have to wait; equally he knows that if he stands too long before a painting I will encourage him to move on. But, again, these are reasonable things for Dylan to learn. I don’t think I’ve ever seen an art gallery advertise ‘inclusive’ viewings and I don’t think this is something Dylan needs. I do sometimes wish, however, that separate sessions could be scheduled for those who look askance at Dylan for being vocal or for moving quick, quick, slow.

Understanding adjustments: managing museums

Although, as the blogs showcased by Tinc illustrate, some museums have become accessibility trailblazers, Dylan has so far managed without adjustments; this is not because he wouldn’t benefit from autism-friendly sessions but because I haven’t as yet been able to visit (these are mostly offered by the London museums). Although there are aspects of museums which Dylan finds challenging he copes pretty well. We make regular visits to local museums and, as with art galleries, Dylan has favourite exhibits. In the Millennium Galleries it is ‘cutlery dragon’ and at Weston Park Museum it’s the Polar Bear, the leaf-cutting ant colony and some local landscapes and portraits. Dylan often performs ritual greetings with his favourite exhibits; in front of Bear’s display cabinet, for example, he repeatedly charges a nearby whale harpoon.

The above examples illustrate Dylan’s preference for natural history and art. He also enjoys machines, particularly those involving steam, so local museums linked to our area’s industrial history are popular. Dylan tends to have less interest in social history unless there is something about the presentation which captures his attention; he loves the carriage ride around a Viking village at Yorvik Museum, I suspect, because the reconstruction feels like a movie set.

What Dylan needs when he visits museums is understanding as much as adjustment; at Yorvik for example it takes him a little while to get in and out of the carriage and he needs help to turn off the audio information. Ideally, we need to ride in our own carriage (and have been able to except for at very busy times). Dylan usually gets this sort of understanding in bucket loads from staff at museums. Although members of the public are also usually understanding, if Dylan experiences an obstacle it does tend to involve other visitors. Although this is sometimes because Dylan’s presence unsettles a member of the public, it is more often the other way around. Perhaps one of the key benefits of autism-friendly initiatives is that they offer autistic visitors a bit of time with the museum to themselves.

Inclusive cinema

thechildrensmediaconferenceSometimes an adjusted setting can be a stepping stone to a regular setting and I have used inclusive cinema screenings for this purpose with great success. Dylan has been passionate about film since he was young but because his habit is to watch alone the cinema did not appear to be an option; after various attempts to take Dylan ended in failure I gave up. The introduction of monthly ‘inclusive screenings’ at a local cinema, however, offered me the confidence to try again.

The first inclusive film we attended was one of the Harry Potter films. Although there were still some challenges for Dylan, leaving the lights on low (rather than viewing in complete darkness) and lowering the sound were adjustments which seemed to make him more comfortable. It helped that it was a film which Dylan knew  – and it certainly helped me to know that people would understand if we needed to leave. But, I told myself, I might not feel the need to leave if Dylan was noisy as he wouldn’t, presumably, be the only one. When he stayed in the auditorium until the end of the film that day it felt like my best birthday ever (it was my 50th).

Canal day 006Having spent the last four years taking Dylan to inclusive cinema he is now able to access regular screenings. The first time I tried this it was motivated by self-interest: The Borrowers had just been released and I wanted to see it. It was half term and the cinema was full with school children. I’d managed to get Dylan’s preferred row and seat (right hand side, four from the back, far aisle) but I felt hemmed in and anxious as the trailers started. Luckily it was a Studio Ghibli production which I think helped Dylan through an unfamiliar film in darkness with surround sound and chattering children. At inclusive cinema screenings I had been modelling appropriate behaviour, encouraging sit and ‘sshussh’. It turned out I had coached Dylan well; he pointed to a noisy child seated nearby and said ‘shouting! sshussh!’.

Since then we have been frequent visitors at a range of cinemas. Some trips have been more successful than others and I don’t ever quite relax; I have to stay alert to Dylan’s impact on others as well as to how comfortable he is. One of the things Dylan always does at the end of a film is run to the front and sprint from side to side of the auditorium repeatedly. It is a stim, triggered by the rolling credits which he loves (at home, with no space to run, he flaps instead). At busy regular screenings – especially when there are small children – I have to manage the timing of Dylan’s run to the front  (if people haven’t noticed there is anything different about us, this blows our cover). And because this can be quite stressful, we still go to (and prefer) inclusive cinema.

Relaxed Theatre

Stratford 038One experience which has not been a stepping stone to mainstream events was a ‘relaxed performance’ of Peter Pan at the RSC in Stratford-Upon-Avon last year. Having had some positive experiences of accessibility initiatives an advert for the production caught my eye. Dylan is a serious fan of Peter Pan and it seemed a wonderful opportunity. I loved the idea of being able to take Dylan to the RSC in the same way that I might take my daughter; this was my dream of inclusion.

So, with friends, I booked tickets for a  matinee performance. Dylan and Ella coped with the production but it was challenging for Dylan. The performance did not appear to have been significantly adjusted in terms of, for example, lighting or sound and there weren’t any obvious time-out areas. The play was also heavily language-based and only loosely-based on the original; there is, of course, nothing wrong with this but I hadn’t grasped from the available information that it wouldn’t be suitable for Dylan.

The audience was also challenging for Dylan; the event had attracted school parties and the theatre was buzzing with chattering children. As the performance had a relaxed approach to audience noise this low level hum continued. Dylan tends to vocalise so a relaxed approach to noise was ‘a good thing’ in a way; however, he finds lots of language distressing so spent much of the time with his arm clamped over his head, stoppering his ears. For some autistic theatre-goers this environment would perhaps be tolerable but for Dylan it was possibly worse than a non-relaxed performance. Also challenging was a ‘Question and Answer’ session immediately following the close of the play. Not only had I been unaware this was scheduled, as there was no break between the curtain call and questions we found ourselves trapped in the theatre in what was for Dylan an inappropriate session.

Friendly West End

The only challenge at an autism-friendly production of The Lion King at The Lyceum in London’s West End the previous year had been that it came to an end at all. This was Dylan’s first experience of a live performance and it set the standard. As I recall, the theatre had worked with the National Autistic Society to develop the performance and certainly for me one of the key features of the event was the way in which the theatre staff appeared to be autism-aware.

Before the performance, for example, I witnessed what could have been a difficult incident in the sweet kiosk handled with sensitivity by a theatre employee. At the interval I was in a long queue for refreshments with Dylan, fretting a little about whether he’d understand that we would be returning to our seats with our ice-creams (not familiar with the interval concept he had insisted on gathering up our bags and coats). I overheard a man I assumed was the event manager discussing the length of the queue with members of staff and deciding that there would need to be a delay re-starting the show; everyone had to be served, he said. On balance this seemed like a good decision to me; an unplanned adjustment based on understanding and good sense.

Debris from the ice cream queue was scattered across the cinema after the interval but staff remained relaxed and smiling. Several melting children were carried in and out by parents; doors were quickly opened for them and those in need were made welcome on bean bags in a foyer (where some families, inevitably, spent the entire show). Our children could make whatever noise they wanted and move around if and as they wished. One member of the cast (Scar, I think) took off his mask and explained to the children that he was only a man pretending to be a lion. The show itself (unadjusted in terms of content and length) was magnificent. It had never occurred to me that I could take pleasure in this; I might not be interested in Harry Potter on the inclusive silver screen but The Lion King in the friendly West End: well, that was really something.

And finally

2014-02-22 14.58.32After writing this I’ve realised that understanding goes a long way to making mainstream settings feel inclusive and that special initiatives don’t necessarily make Dylan feel comfortable. I’m also reminded that language-based arts are challenging for Dylan and that the most inclusive arts tend to be visual. Perhaps not surprisingly, cinema is one of the most readily-adapted art forms where small adjustments can make a significant contribution to the quality of someone’s life.

While this post doesn’t respond to the precise challenge set by Tinc I hope that readers from the museum and education sectors, as well as those with an interest in autism, have found it illuminating. I’ve certainly found it helpful to write – thank you, Tinc!

Images:

The photos were taken by me on visits to Weston Park Museum, Kelham Island Museum, Magna and The Millenium Galleries (all in or near Sheffield). Other photographs were taken in the Children’s Library, Showroom and Cineplex in Sheffield and outside the RSC in Stratford-Upon-Avon and (with Ella) at The Lyceum in London.

The Last Lap And The Car Wash

dylan meltI think this might be the last lap. At least I hope so: I’m not sure I have any reserves left for what has been a two year marathon. Since Dylan left school it has been a frustrating time of dead ends and disappointments. I have coped this far but am exhausted; if the finishing post moves one more time I doubt I could manage another lap.

I’ve been enjoying writing some general pieces about living with autism recently. Such reflections keep my eyes on the skies instead of on the grubbing detail of the road. With things in the balance this week, however, I thought it a good time to record what is hopefully the last bit of the circuit. Who knows whether these reflections will indeed turn out to be my log from the home strait but hopefully they will be illuminating.

Replay

2014-08-05 17.24.48If you’ve been following Dylan’s story then you might recall that my original battle, after he left school, was to secure continuing education. Dylan had been happy at school and was a settled young man, calm and with no ‘behaviours’ other than a liking for letting off fire extinguishers and smashing light bulbs. Initially Dylan wasn’t provided with any post-19 education and the social care funding he was offered for day care wasn’t sufficient to cover more than three days a week. When I won a legal challenge against my local council, Dylan was given a patchwork of provision while an appropriate education setting was developed in the city where we live.

For the year after he left school Dylan appeared to cope with part-time care which lacked consistency and routine and which wasn’t autism-specific. I reduced my working hours so that I could support Dylan as much as possible. It was messy and difficult. I felt stressed from one day to the next, wondering how I would juggle different settings and collection times and key workers. So it’s not surprising, really, that by the end of that first year Dylan started to show signs of distress.

The ‘challenging behaviours’ started last June. Some of my posts in the last year have described my search for explanations and answers. With incidents happening daily I took Dylan for neurological and psychological investigation, attended intensive support services, removed sugar from his diet, banned films with ‘separation narratives’ and asked for help from the ‘sex nurse’ (she probably has a different title but that’s how I recorded appointments with her in my diary). All these roads, it turned out, led to what was likely to be anxiety: the best we could do was increase the structure and consistency in Dylan’s care and adjust his activities.

In the last 12 months I have moved from utter disbelief at the changes in Dylan to a realisation that if you are severely autistic with severe learning disabilities and very few strategies for communication, and if your life changes profoundly so that things which you rely on to keep you comfortable – structure, routine, a calm environment and familiar people – suddenly disappear (as happened when Dylan left school) – well, it isn’t surprising is it? Anxiety can provoke feelings of frustration and anger in any of us. In the context of Dylan’s disabilities, his anxiety must some days feel scary indeed.

U-turns, false starts and golden gates

2014-08-05 18.44.12Unfortunately for Dylan the changes in his behaviour triggered further changes. Although one care setting has provided on-going support, other providers (including Dylan’s respite setting) felt unable to, given the changes in Dylan’s behaviour. Following a separate battle for funding, I had finally secured health care support for Dylan; the challenge, however, was to identify a setting with the necessary expertise to care for him.

A number of my recent posts have described the agony and confusion of trying to choose somewhere to live for an adult with Dylan’s profile of need. There are few such settings. Where they exist they are rarely local. Because of their specification (generous space, adapted buildings, small groups, high staff ratios and individualised programmes) they tend to be expensive. Factoring in economic and practical considerations as well as the desire to keep Dylan nearby, it is not surprising that finding somewhere for Dylan would be so difficult.

And then there are the curved balls that can come spinning. I have described elsewhere the way I pulled a u-turn when I lost my confidence (and my bearings) for a setting which Dylan was due to move into after Christmas. It was brave but possibly foolhardy, I was told, to pull out of a perfectly good placement. So I was relieved to quickly find a replacement which seemed just as good and was closer to home. As I recorded subsequently, however, the plan for Dylan to move there after Easter had to be abandoned following a safeguarding issue. I had let myself believe in that placement; getting a phone call to say we would have to abandon felt like a false start (or finish).

I hardly dare write that I think I can finally see Golden Gates glinting up ahead. Like other writers I observe the rule of not talking about a poem until I’ve written it in case I lose the magic. Perhaps I’ll apply the same rule to Golden Gates so as not to break the spell. Besides, even if there is a gilded tomorrow, today there is still this view from the road.

The road

2014-08-06 16.46.52It’s not an easy road to be on if you are in crisis. Even when a setting has been identified the process of assessment and transition takes time. Something that has made these months particularly hard is the loss of Dylan’s respite. At the point at which I was in need of more support I got less. In fact I got nothing. I have written elsewhere about the contribution which respite plays to the lives of carers; having been without it for nearly six months I can confirm this support is vital.

My last night off was 18th December. Since then I have been on duty every weekday from 4pm to 9am and every weekend from 4pm on Friday to 9am on Monday. I have not had a break during this time; I have not been able to go out or even, given Dylan’s anxiety, to have visitors. This period, of course, includes Christmas and other public holidays and celebrations. As well as having an impact on my ability to work (during this time I have had to reduce my hours and resign a management role) I have been obliged to turn down opportunities to perform at events (as a poet) and to attend social activities.

I don’t mean to sound complaining. I’m not. I accept all of the above as the price of caring for someone who is my responsibility and my world. But to be a carer I need to stay well and healthy which means being able to rest and recuperate. I haven’t been able to do that; I’ve found that trying to rest during the day is no replacement for the benefits which come from having a break from caring overnight. For me they are these: not having to bathe and put Dylan to bed in the evening then stay awake until he is settled; not having to be alert through the night in case I am needed; not having to get up early enough to juggle my own self care with waking Dylan in time to bathe and shave [I often skip this stage in truth – I have a lot of sympathy with men on this one] and dress and feed him before it is time for his bus; not having to pace the house waiting for the bus and willing it to arrive in time for me to get to work.

Gardens, mud and dirt

dylanmelt2Dylan’s anxiety has been acute in the last few weeks and his aggressive behaviour has escalated. I have gone on trying to identify triggers but can’t always predict or head off incidents. I am no match for Dylan physically (21 and more than six foot tall, fit and strong) and after being hurt on a number of occasions I have learned to prioritise keeping myself safe. Recently, I have spent a lot of time in the garden where I go, now, to sit and wait until Dylan has calmed down. Sometimes it is five minutes, sometimes 50. Sometimes I am barefoot, sometimes better prepared. Sometimes it is fine, sometimes raining. Sometimes it is light, sometimes dark. Always I wait with my heart in my mouth for it to be over, praying that Dylan doesn’t hurt himself.

I am better at keeping myself safe than I was; I have learned to make judgements about when I can intervene safely and when I can’t. I have agreed strategies with Dylan’s social worker such as keeping my mobile phone with me and when to call for help (I haven’t so far). Clearly it would be better if Dylan could be helped not to feel so frustrated but for that he needs specialist care and support in an environment with the space he needs. I don’t believe, however, that there is a magic formula which will eradicate Dylan’s anxiety; I suspect he may be prone to it through these difficult early adult years. And because life with Dylan can be so unpredictable (and I must stress that it isn’t like this all the time – we have wonderful joy-filled days too) what he especially needs is more than me.

Dylan and I have always had an active life and I’ve continued these activities at weekends. He needs this: he’s a fit and active young man. With incidents happening increasingly often, however, I have recently found myself in compromising situations where I have been hurt or Dylan is at risk (sometimes both) away from home, in vulnerable locations or public space. Three times I have fallen in the last few weeks when trying to catch or restrain Dylan (without adequate training) in order to keep him safe. One incident a couple of weeks ago left me terrified by the combination of Dylan in violent meltdown, an unleashed dog (with slow-to-act owner), bleeding ear (mine) and fast approaching road.

I’m not sure why Dylan was out of control that day; we were in a familiar valley which we have walked many times. Dylan loves to be near water but it can sometimes lead him into a trance-like state which in turn triggers a violent outburst. This  may have been what happened on that Sunday afternoon walk. It was a wake-up call and a turning point for me; I managed to get Dylan back to the car, albeit muddy and bloody, and the next morning I phoned his social worker.

The car wash

33524547-car-wash-with-soapIt took quite a lot for me to admit that I couldn’t keep Dylan safe anymore. Some people have suggested that I might get more support with Dylan if I didn’t appear to cope so well. You appear too competent for your own good, one friend told me. Well I was perfectly happy to admit, now, that I wasn’t. I couldn’t manage weekends alone anymore, I told Dylan’s social worker. Neither Dylan nor I were safe. For Dylan’s well-being and my own safety, I said, if I can’t access some support at weekends then I shall just drive away. I shall leave. I could hardly believe what I heard my mouth say. I wasn’t even aware that I had thought it. I certainly wasn’t sure I could ever do it. But in the silence that followed my announcement, I thought that this must be how breaking point feels.

We explored various options in the aftermath of that incident but in the timescales it wasn’t possible to put together an acceptable alternative for the following weekend (i.e. last weekend). In the end, therefore, I decided to support Dylan myself but agreed that I wouldn’t  access the community with him and that I would put some simple procedures in place to stay safe at home. I approached last weekend with anxiety and trepidation. Fortunately the weather wasn’t remarkable – it’s easier to stay home, somehow, when it’s raining – and I hadn’t lost my creativity. Racking my head for an idea which bent but didn’t break the rules, I decided to take Dylan for a joy ride in the country and then to the car wash. The car wash would, I hoped, be enough to give Dylan the pleasure of running water but without the danger; it was what I judged a ‘contained risk’. Happily, Dylan seemed calm enough as he watched the water cascading down his rear window…

Postscript

I heard yesterday that some emergency respite for Dylan has been approved for this weekend. Dylan hasn’t had any since December mainly because we have struggled to find a provider who felt able to support Dylan given his needs. I’m pleased to say that the place I refer to in this post as Golden Gates are happy to have him. Dylan already knows the setting and the staff and residents and will have a lovely time I’m sure. I’m hoping that although this is emergency respite, it will be the start of what in time becomes transition. May the finishing post stay still long enough for me to guide Dylan through :-)

Images:

The photographs of fire hydrants and of Dylan curled on one of our local paths were taken by me. They are images I particularly associate with anxiety and meltdown.