3 weeks ago



Zachary 57 not see, the

Zachary 57 not see, the choice that we will not look at this now, will instead focus on something else, is another coping mechanism that saves us from experiencing anxiety all the time. Such freedom to be distracted is simply not available to children with ASD. They do not have the option of “not seeing.” But, then again, we are often denied the privilege of seeing what they see. * * * Little is known about how to treat resistance to change as an isolated symptom. We do know that most individuals with ASD benefit from routine and structure. Presumably this helps them cope with change and the transitions that are a part of daily life. A schedule posted on the wall at school or on the refrigerator at home that outlines each day’s activities with pictures and words is a common tool that makes transitions and change more acceptable. For example, when Zachary was in kindergarten, it was difficult for him to go from one activity to another during the course of the day. Once we understood the nature of his diagnosis, we suggested that the teacher make a set of photographs of Zachary doing different activities that were part of the daily routine. These were then placed in a prominent spot and were shown to him when it was time to make a transition. This led to fewer difficulties in going from one activity to another. We attempted the same thing at home to help with the routine of coming for dinner and going to bed at night. Again he responded well to these simple interventions. But Zachary’s anxiety about change at this point in his life was more abstract, almost metaphysical. A schedule placed prominently on the refrigerator would not help him deal with the changes brought about by death. A more useful strategy for Zachary might be to provide him with a new distraction. His extraordinary ability to become absorbed in a topic could be a viable way of helping him to forget his anxieties. If he could not imagine a new order to things through language, he would need a new interest to get him off the topics of death and replacement. The problem was that Zachary could not distract himself; we needed to do it for him. This new distraction would have to be something special to provide enough impetus to help him leave behind the anxiety about change. Once we shifted his attention, with luck it might fasten onto another interest and leave the anxiety about replacement behind. To maximize the chances that this would work, we needed to take his fa-

Free ebooks ==> 58 A MIND APART vorite current interest and provide him with a new and exciting opportunity to indulge himself fully. I understood from his mother that they would be going on a summer holiday and visiting the Henry Ford Museum in Michigan. Zachary was very excited about this trip as it afforded him an opportunity to pursue one of his passions—cars. This was exactly what we needed: an opportunity to have Zachary pursue one of his interests in an appropriate way by visiting a museum. Like so many other holiday tourists, Zachary and his mom could spend a day or two gazing in wonder at the sights and at the cars, though I felt sure that Zachary would be the only child there worried about the problem of replacement in human affairs. I hoped this trip would serve as a necessary distraction to pry him loose from his morbid thoughts and that he would be less anxious about death when he returned. Granted, going off to museums is not always practical as a distraction, but, then again, a preoccupation with death is not the usual form of resistance to change. * * * Indeed, when I saw Zachary later that summer, he was much more at ease about death and the problem of replacement. He did not scour the newspaper for obituary notices anymore, and he had stopped asking his mother the endless questions about death and who would replace whom on TV. It seemed like the distraction of the Henry Ford Museum had done the trick. He slept better, he did not look as worried, he was able to play by himself better, and there was less pacing around the house. He now even thought that Titanic was a crummy movie— another thing we could agree on in addition to not thinking about heaven. It would soon be time for Zachary to go back to school. I hoped that the bullying and teasing would cease and that he would be afforded some peace by his schoolmates, so he could attend school free of anxiety. There is no escaping the fear of death, but there was no reason Zachary should bear the taunts from his schoolmates as well. He belonged in that world and had as much right to the stability and order that was possible there as the next child. As he left the office that day, I could not help noticing that his bulging pockets were full of small toys. When it comes to being interested in toy cars or preoccupied by death, cars become a wise and attractive alternative.