978-1572305441

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”