3 weeks ago



A Trevor Mind Apart

A Trevor Mind Apart Chapter 9 Trevor Mobiles and “Miracles” “It’s the strangest thing. He could stay in his crib for hours staring at that mobile. It just hangs there, suspended over the crib—bits of colored cardboard strung together with fishing line. I put it up there one day just for fun, and now he looks at nothing else. What could be so interesting about fishing line?” Strange indeed for a toddler now three years old. Alice was a single mother who worked as a pediatric nurse at our local children’s hospital. She had a pretty good idea of what normal child development looks like. She was here today to tell me about her son, Trevor. I knew Alice from her work at the hospital and agreed to see Trevor because she was worried he had autism. “We just had a birthday party for him last week. I invited his grandparents and some kids from the street. He doesn’t know any of them, but I felt I just had to, to see what his response would be. Well, he ignored everybody, even his grandparents. He just stared at the candles on the birthday cake, and once he finished opening up his presents, he fled to his room. I followed him up there and found him staring at that damn mobile. I was so upset I cried. I had to amuse those other kids till their moms came to pick them up. I have never been so embarrassed in my life. What a nightmare that was.” Trevor was lining up the Lego pieces across the table. He had curly blond hair and was dressed in blue overalls with a bulky sweater underneath. It was a cold and wintry day outside, and they had struggled to 133

134 A MIND APART come to the appointment through a snowstorm. I wanted to make the trip as worthwhile as possible. I tried to move one of the Lego pieces, but Trevor cried out in protest. I tried to stack them, and he cried out even louder. I was concerned that he didn’t want to play with me. I decided to quit while I was ahead. “Why don’t you try to play with the Lego pieces with him?” I said to Alice, thinking it would be easier to assess his social play with his mother than with a stranger. She had noticed my chagrin. “It won’t make any difference,” she said. “He will cry with me too. If I pick him up to comfort him, all he does is cry. The only way I can soothe him is to place him in the crib and let him stare at that silly mobile.” It was that awful moment when I realized that she knew, and she realized that I knew, but we couldn’t say anything to each other. “How does Trevor communicate with you?” I asked. “He pulls me by the hand, puts my hand on the fridge or on the crib if he wants to be put in there. He refuses to sleep in a bed by the way. Every time I try he gets incredibly upset and runs around the house looking for his crib. He doesn’t use words yet. In fact, I first wondered whether he was deaf. When he lies in the crib and I call his name, he doesn’t even turn around and look at me. He’s so absorbed in those silly cardboard pieces that hang above him. Yet when I call his name and he’s in the living room, he will turn without a problem. He can’t be deaf.” We went through the rest of the developmental history and scheduled another time for me to do a structured play assessment with Trevor. This was an opportunity to press for social and communication skills using a set of toys that elicit communication acts from the child. He came in a couple of weeks later, and his mother and I managed to do some activities with him. It was clear that Trevor was not displaying age-appropriate social and communications skills. For example, I enjoy blowing bubbles with the kids and it is a useful tool for assessing social–communication skills. When I blow bubbles, a typical child will smile, look at me, look at his or her mom, express pleasure using words or sounds, and ask for more after bursting all the bubbles. Trevor did none of these; he just stood there waiting for me to send the next train of bubbles floating through the air. I also have a remote-controlled car that is very neat. I hide it behind some boxes in the room and set it going while the child is absorbed in some other activity. I called out Trevor’s name while he was playing with the Lego and said “Look”