Autism At Home Series » Featured Articles

The Back Room Kids: Shame, Guilt, and the Autism Myth

William Stillman — Wed, 17 Jun 2009 06:57:51 +0000

Last fall, I made an autism presentation in Los Angeles to a group of 200 exclusively Spanish-speaking parents. They were grateful and gracious, and many made efforts to communicate with me in English (I otherwise had translators). When I stood before them, I affirmed that their autistic children are intelligent, gorgeous human beings entitled to the space they occupy. I was stunned by the collective reaction of the audience: people sobbed in relief; grown men, fathers, buried their faces in their hands; and others gave me their children’s pictures, asked to take my picture, or requested my inscription. I was overwhelmed, almost uncomfortably so. Here was a group of people who, as a minority, are already devalued in many ways; because of language barriers, some may have been perceived as gullible or unaware of their options as parents. They were so appreciative of a positive message, I thought to myself, “My gosh, what have these people been told about their children!” I surmised that each felt shame and guilt for parenting a child with autism.

What drives this kind of reaction? Two things, in my opinion. First, there is still a very prevalent medical model in how autism is defined. It is listed in the Diagnostic and Statistical Manual of Mental Disorders, which immediately sets the negative precedent that autism is a mental illness (it’s not) and requires intensive treatment. This is further perpetuated by some clinicians who are not sensitive or compassionate when making a diagnosis, or who are unaware of quality resources to direct parents to. (Inconceivably, there are still doctors who suggest that autism is attributable to parental blame, or recommend parents institutionalize their children.)

Second, the media often stigmatizes autism as a tragic affliction to be feared or pitied. In addition to Asperger’s Syndrome, I have a same-sex orientation. I would no sooner expect an interviewer to define my sexuality using a derogatory slur because it would be an outrageous violation, yet it is presently acceptable for the same interviewer to describe me as “suffering from a severe disorder.” Until the Rosa Parks of autism emerges, this will persist. At the least, much media representation of autism reinforces antiquated stereotypes, and that is a disservice.

From the outset, many parents are portrayed a grim projection for their child’s future. They are led to believe their children with autism are incapable, unaware and of substandard intellect, a lost cause that will always function at the level of a four-year-old, even as an adult. This often results in parenting approaches of two extremes: tireless endeavors to eradicate autism through high-cost, intensive, one-on-one (adult to child) behavior therapy for countless hours on end (that, in some cases, may involve a regimen of physical restraints and anti-psychotic medications). Or it results in the “back room kids.”

The proper response to autism is to re-envision it as a neurological disconnect relative to those with Cerebral Palsy, Tourette’s, Hodgkin’s, Parkinson’s, Lou Gehrig’s, recovering from stroke, or any other such experience that compromises brain-body connections and impairs movement or articulation of speech. Even though the physical is unreliable or not of good service, the cerebral is intact, thought processes operate at capacity, and mental capability is completely competent (it just doesn’t measure that way through I.Q. scores). There is emerging scientific research to support the re-evaluation of autistics using non-verbal intelligence testing to reveal their true intellect commensurate with, or beyond, their chronological age.

Some parents who don’t foresee true intellect as a possibility for their children, due to the preceding conclusions, have bought into the myth of autism—that is, autism equals intellectual inferiority or mental retardation. In addition to shame and guilt, despair, denial and hopelessness may prevail. The thinking may become that of day-to-day maintenance and minimal standards of caregiving. Hence, the back room kids.

I see them, watching me from their baby-gated existence of the screened-in porch or the distant bedroom at the rear of the house. Many of them don’t have much meaningful connection with their families. They have free-reign to do as they please because parents are afraid to apply fair discipline or have been told not to because their child won’t understand. Some back room kids are overweight, have poor diets and are provided age-inappropriate books, toys and videos. Some are still on bottles and in Pampers at age five…six…nine. This is unacceptable.

When I meet them I think: “I see you there, little one. You with your grubby bag of orange cheese curls and the Veggie Tales video repetitively looping. You with your bright, glistening, welcoming eyes. You with your hunger for knowledge and information beyond the back room, or even your back yard. I see how very smart you are inside. I see you.”

Refusing the myth of autism, building relationships founded upon a belief in competence, and challenging autistic intellect is what will create a cultural shift for the growing numbers of very young children diagnosed with autism each day. It will also yield hope for the adults with autism who have endured in silence, only offered Little Golden Books, Strawberry Shortcake puzzles, and Lady and the Tramp videos.

The regrettable irony is that we have a long and unfortunate history of back room kids—“retarded defectives” as they were once known—only, in another era, the back room was confinement to the basement or an attic. Shame and guilt were very much a motivation for those parents then as much as it is for some parents now.
Isn’t it curious that what’s called for is simply acquiescing our own agendas and compelling ourselves to be more sensitive—to listen fruitfully with our ears as well as our eyes? We’re not only talking about presuming intellect, we’re talking about demonstrating a renewed respect.

A Shift In Understanding

Laurence Becker — Wed, 17 Jun 2009 06:51:51 +0000

The first two essays in this series presented a broad overview of many of the films produced over the past forty years that have portrayed the many facets of the human condition. In this essay I want to focus on several books that have brought about fundamental shifts in our understanding of autism, its causes and its consequences.

Prior to 1964, one of the prevailing and prominent medical understandings of the cause of autism had been articulated by Bruno Bettelheim. Autism was seen as having psychological rather than physiological origins. Bettelheim laid the onus on “refrigerator mothers,” cold and intellectual mothers who had rejected their children. His solution was psychotherapy for the mother and play therapy for the children so that they could rid themselves through aggression of the rejection by their mother.

This psychological understanding of autism was rejected by Bernard Rimland, Ph.D., a psychologist for the U.S. Navy, when he and his wife, Gloria, had Mark, their second child. Their first child, Helen, was neuro-typical, but Mark was autistic. Dr. Rimland reasoned that his wife had not suddenly changed and become “cold and intellectual, a refrigerator mother.” There must be another cause. Thus began his vast reading and research and practical observation which led him to write INFANTILE AUTISM, published in 1964, and he began his life long search for answers. He was led to found and direct the Autism Research Institute (see www.autism.com/ari) and initiate the DAN (Defeat Autism Now) conferences which continue to bring together the best medical minds to share the latest biomedical research and the practical, experiential wisdom of parents. His Autism Research Review International, a quarterly publication, reviews biomedical and educational research in the field of autism and related disorders.

In 2003 Dr. Rimland edited with Dr. Stephen Edelson (the new director of ARI) TREATING AUTISM: Parent Stories of Hope and Success, one of the most important, readable, and useful books I know about. In addition to 30 chapters written by parents of autistic children, many of whom are medical doctors, telling of their success in treating their children, the book also contains a chart that shows the results of over 26,000 responses to a survey on the treatment effectiveness of Drugs, Supplements, Diets, & Misc. Therapies or Conditions. What an incredible source of information for parents and doctors! Write ARI to obtain a copy of the survey and the results or to order a copy of the book. One example of the data is the survey: “Bar graphs depicting the rating of 49 drugs and 8 nutrients by thousands of parents of autistic children note that Ritalin, the most frequently used drug, helped only 29% of the children, while making 44% worse (based on 3082 parent surveys). Compare that with the ratings of nutrient therapies.

In 1978, I was introduced to a small personal account of the mystery of autism (this was the first time I had ever heard or seen the word “autism.”) that described a unique approach to reaching a child with autism. We were living at the time in the tiny fishing village of Bucks Harbor, Maine, and our eldest daughter brought home a copy of SON RISE by Barry Neil Kaufman (1976). A classmate had given the book to Laura who simply said to me, “Daddy, I think you would like to read this book.” Such a simple, synchronistic beginning to my thirty year journey into the fascinating world of autistic savant artists. The Kaufmans’ contribution and approach was to seek to enter the world of the child with autism, to learn how and what his son, Raun, was trying to communicate, rather than demanding and forcing his son to come into the parents’ world. In 1994 the publication of SON RISE, THE MIRACLE CONTINUES, chronicles the brilliant career of this “hopelessly autistic son. Chapter 1, “Birth of a Miracle” (pages 3-26) is an excellent summary of the typical response of the “experts” of the time that autism “is a life long disability. No cure, No complete reversal.” The common advice given the Kaufmans and countless other parents was to “put Raun away, forget him, and focus their attention on their two normal children.” (page 25), The book documents the development of the Option Institute and the Son Rise approach to treatment. See www.son-rise.org or email sonrise@option.org. I WANT WANT MY LITTLE BOY BACK is a stunning VHS documentary produced by the BBC that also presents this method of treatment.

My own journey of understanding continued when a friend gave me a copy of Karyn Seroussi’s UNRAVELING THE MYSTERY OF AUTISM AND PERVASIVE DEVELOPMENTAL DISORDER: A Mother’s Story of Research & Recovery. It is one of the most significant books to enter my life. It reads like a detective story. I was given a copy, and I read the entire book in two days. It brought together some of the people and information that I had gained in two conferences in 1981 & 1982 on “Behavior (Criminal and Violent) and Nutrition” and connected them with autism. The book is the story of a mother’s quest to discover and destroy the monster that had invaded her child’s body. Her son at an early age lost all speech and eye contact. He was diagnosed as a clear case of autism. She discovered that in her son’s case: 1) there had been an overuse of antibiotics for numerous ear infections, 2) he was allergic to both milk and wheat, and 3) he had an adverse reaction to numerous vaccinations all of which together led to the diagnosis of autism. Quick intervention in all three areas led to a re-diagnosis from autism to gifted and talented. It also reaffirmed Dr. Rimland’s statement that “In the past 40 years the most significant research in the field of autism has not been done by men in white lab coats, but by mothers!” I cannot tell you how important this book is. Each Appendix is filled with resources. Page 262 has information about the Autism Network for Dietary Intervention. Both Karyn Seroussi and Dr. Lisa Lewis (author of SPECIAL DIETS FOR SPECIAL KIDS) frequently speak at the DAN conferences and founded the Network for Dietary Intervention. See www.autismNDI.com.

Lastly, in 2008, a small book of only 157 pages entered my life at just the right moment. Again, a mother, not a researcher in a white lab coat, is the expert. Told with the directness and self-confidence of an explorer of new and exciting territory, Kim Marie Lesso in BACK IN MY ARMS details her 13 year journey with her two children on the autism spectrum. Kim was told early on that her son Tad would never speak, that he was un-teachable, and that he would never even recognize her a human being. Her younger daughter, Kaitlyn, has been diagnosed with Asperger’s Syndrome. This small gem of a book is filled with practical, down to earth tips for bringing out the knowledge that her children with autism already possess. Kim learned that Tad could read before he could speak. Yes, at 16 ½ years old, he speaks and attends school and church and is somewhat of a gentle giant of a man/child. Kim can be reached and her wonderful book can be ordered through her web site at www.autismguru.com.

It seems to me that new books and films appear almost daily. I hope these resources will provide you with valuable new information for your own journey. As you discover new and helpful resources, please share them with me. My listing of resources is constantly being updated. I look forward to adding your suggestions. My life has been blessed by so many people, and the synchronicities are almost overwhelming at times.

“If we be TRUE
to
the integrity
of
the moment
who knows, what or where,
wonders, beasts, adventures
will sweep us UP
into their flood!

A Reflection on Synchronicity
Laurence A. Becker

The Musical Brain

Jennifer Buchanan — Wed, 17 Jun 2009 06:31:58 +0000

Music as therapy is becoming the new “it” discussion. With high profile books such as Oliver Sack’s “Musicophilia” and Daniel Levitin’s bestseller “This is Your Brain on Music,” music as therapy is making its’ way into mainstream media. Both books identify music as a very complex brain process while giving the reader a simple understanding of how music is useful and beneficial for our well-being and growth.

Levitin reminds us that music is a global process. Therefore music does not just tap into one area, but in many areas of the brain at the same time. This means that music can transcend neurological injury or impairment, often forging its way through our neuron circuitry and finding the roads that work (through a process called neuroplasticity). Mark Tramo, assistant professor of neurology at the Harvard Medical School started to study how different forms of brain damage interfere with normal perception of music and speech. One subject of a case study lost most of his auditory cortex to strokes. He could hear but complained that music and speech were hard to understand. However, the part of his brain that survived the impact could still recognize his favorite songs.

During sessions at the Association for the Rehabilitation of the Brain Injured (www.arbi.ca) music therapists use the music from the client’s senior high school years as a means to stimulate long and short-term memory. One 40 year-old female who sustained a head injury demonstrates that she has sensitive feelings towards music from the 1980’s. She will often close her eyes during reflective moments in the music and may cry to a lyric or melody that has particular meaning. Although unable to speak she is able to blink once for yes and twice for no. Through this process, and over many weeks, a song was written about people, things and experiences that were important to her.

It seems that there are many different spins on the musical brain. In an article by Mark Wheeler published last month, he wrote of Istvan Molnar-Szakacs who will be using “emotional music” to examine the brain regions involved in emotion processing. “Music has long been known to touch autistic children,” Molnar-Szakacs says. “Studies from the early days of autism research have already shown us that music provokes engagement and interest in kids with ASD. More recently, such things as musical memory and pitch abilities in children with ASD have been found to be as good as or better than in typically developing children.” His research hypothesis is, “if we are able to engage the brain region involved in emotion processing using emotional music, this will open the doorway for teaching children with ASD to better recognize emotions in social stimuli, such as facial expressions.” (online resource: http://newsroom.ucla.edu/portal/ucla/using-music-to-explore-the-neural-49912.aspx)

In study after study scientists are finding correlations between music making and some of the deepest workings of the human brain. Research has linked active music making with better language, improved social behavior and school grades.

Recently I found a reference to Albert Einstein’s grade school years. At one point, teachers told his parents to take him out of school because he was “too stupid to learn.” The school suggested that his parents support Albert in getting a manual labor job. Instead of following the school’s advice, Albert’s parents bought him a violin. Albert had a natural affinity towards the violin and he became proficient on the instrument. He loved the music of Mozart and Bach the most. A friend of Einstein, G.J. Withrow, said that the way Einstein figured out his problems and equations was by improvising on the violin.

I had the pleasure of attending an “open mic” for persons with disabilities who chose to display their musical growth and talent in front of an audience filled with loving friends and family. Some of the performers have autism and/or autistic tendencies. One young woman who performed had been told that she would never be able to learn anything. Not talk, walk, read, or any of the other things that we all take for granted. Not only did she perform two pieces of music….she read every note.

As we continue to discuss music therapy at a professional and community level many more questions will be considered in the area of using music as therapy. There are however some things we know for sure. As the professor of music at Harvard Kay Shelemay states, “All humans come into the world with an innate capability for music.” Perhaps for some it may just take extra time, patience and professional support to unlock the musical brain in each of us.

Cromie, W (2001) Music on the Brain: researchers explore the biology of music. Harvard University Gazette, March issue
Levitin, D. (2007) This Is Your Brain on Music: The Science of a Human Obsession USA: Penquin Group Inc.
Sacks, O. (2007) Musicophilia: Tales of Music and the Brain USA: Knopf Publishing Group
Wheeler, M. (2008) Study uses music to explore the autistic brain’s emotion processing UCLA Newsroom http://newsroom.ucla.edu/portal/ucla/using-music-to-explore-the-neural-49912.aspx

Bending Is Believing

Eric Chessen — Wed, 17 Jun 2009 06:30:25 +0000

During infancy and childhood, there are several pivotal times for the development of gross motor movements and muscular development. Parents are often concerned if a child does not reach a particular age-related goal (walking, for example) within a narrow time frame. Children will vary in their gross motor acquisition, and some may develop later than others. In the case of individuals on the autism spectrum, physiological, or movement deficits can inhibit the development of functionally sound gross motor movements. Whether neurological, physiological in origin, problems with motor skills can result in compensatory movement patterns.

Our bodies evolved to respond to stimuli or “commands” from the brain. The remarkable reality is that our bodies will perform movements regardless of our readiness or ability to safely and efficiently negotiate the action. If we were unable to complete actions our body was not ready to perform perfectly, there would be no pulled hamstrings on the track, no herniated discs at the factory, and no tennis elbow. Muscle compensations occur when there is an imbalance between muscle groups and/or a weak and inhibited muscle. With respect to the young autism population, muscular imbalances can develop as a result of pre-existing movement deficits combined with sedentary daily routines and a lack of vigorous physical activity. Here’s the equation:

Movement Deficit + Compensatory Movement Pattern x Continued Cycle of Inactivity = Muscle Imbalances and Poor Quality of Gross Motor Skills

As discussed in previous FBF articles, physical fitness is a gateway towards a wide range of abilities and options in life. A foundation of poor movement quality will often result in a decreased motivation to engage in novel play or regular physical activity. For younger individuals, both neurotypical and on the autism spectrum, muscular imbalances can be easily addressed and remedied with some smart programming and ingenuity. The majorities of movement imbalances that I come across with my athletes are hip-based, and usually evident in poor gait and posture. The typical “intervention” involves, strangely enough, hip-based exercises and activities.

One of the big gross motor movements is squatting, or a low bending of the knees. This action can be used as both an assessment and as a fitness activity integrated into a physical education program. What we are after is hip-flexion, or a bending motion. Individuals with tight hip-flexors often lean forward when attempting to perform a low squat, or rise up on their toes with the heels off the floor. A compensation pattern I’ve found to be quite popular in the autism circle is bending with straight legs and a rounded back, bypassing the whole leg-bending ordeal entirely. This type of compromise can not only lead to poor postural stability, but to injury as well.

Fortunately, there are PLENTY of different exercises and activities that can be used to develop proper hip flexion. I have found the “Grab Ball Complex” (GBC) extremely effective in teaching children on the spectrum how to perform a squat properly. The GBC is performed by holding a ball slightly lower than the athlete’s hips (about knee level), and having them grab and then pass the ball back to the instructor. Monster walks, which consist of taking BIG steps across a particular area of space, are another great hip-flexion exercise, particularly when used as a warm-up. Having trouble coming up with some squatting variations? Just consider the goal of getting the butt close to the ground with the feet planted on the floor and design the activity around that. Get creative and fun, and make sure the athlete can perform the activity independently before moving on to more challenging exercises. Remember, exercise is something we do. Fitness is something we live.

The Case For Addressing Theory of Mind Deficits in Language Intervention

Diane Twachtman-Cullen — Wed, 17 Jun 2009 06:25:30 +0000

Many years ago Charles Hart, author of Without Reason: A Family Copes with Two Generations of Autism, shared a story about his son Ted that gave me a window both on the social / communication problems that are hallmark features of autism spectrum disorders (ASD), and their relationship to theory of mind. He said that when Ted was approximately fourteen years of age, sitting across the room reading a book, he came across a word that he didn’t understand. He pointed to it and—without getting up to show his father the word—said, “What does this word mean?” Unsure that he had heard his son correctly, his father said, “What word?” Ted again pointed to the word and said, “This word.” According to Mr. Hart, when he informed his son that he couldn’t see the word, and that Ted would have to get up and show it to him, his son seemed puzzled. It was at that moment that Mr. Hart realized that Ted’s concept of the human mind and its contents were very different from that of a person without autism. The analogy Mr. Hart gave was brilliantly insightful. He said that for Ted it was as if the human mind was a universal mind to which everyone had his or her own “computer terminal” hook-up. As such, if there were a word on Ted’s mind (or, by extension, an idea or a thought), it would—based upon Ted’s conceptualization of the world—be on everyone’s mind at the same time. Hence, there would be no need to show his father the word since from Ted’s point of view his father would already know it. Could that type of thinking explain why a child or adolescent becomes inconsolable when you cut his or her sandwich in quarters because you should have known that he or she wanted it cut in half? Could it explain poor perspective-taking skills and the difficulty with empathy that is associated with ASD, particularly since those constructs require an appreciation for the other person’s thoughts and feelings?

Although neither one of us knew it at the time, Charles Hart was describing the quintessential deficit in theory of mind—the lack of knowledge / appreciation that different people have different minds and hence different ways of thinking, feeling, and believing; and further, that these internal mental states have a lot to do with the person’s external behavior. The following examples may help to illuminate these important points.

To have a theory of mind is to be able to attribute mental states to others. In other words, we use mental state terms to try and understand what people mean in order to make sense of their behavior—for example, she’s crying (external behavior) because she feels (internal mental state) sad. People who don’t have autism attribute internal mental states to external behavior quite naturally, using their attributions to guide their own behavior. For example, you wouldn’t ask your boss for a raise if he or she were speaking harshly to someone and hence, in an obvious bad mood! The importance of being able to link external behavior with internal mental state cannot be overstated, since assigning an internal reason for the behavior that we see:

helps us to understand (i.e., make sense of) a person’s behavior (Daddy is yelling at me because he is angry.);

enables us to use the information that is gleaned to predict what a person might, or might not do (If he’s angry he might not let me have dessert.); and,

provides the basis by which we may modify and/or adjust our own behavior to meet the needs of the situation (I’d better not ask him for a cookie right now.).

There is a great deal of research today that indicates that individuals with ASD have deficits in theory of mind, and further, that these are linked to language development. Like autism itself, these deficits exist on a continuum from mild (in the case of more able individuals), to severe (in the case of those with significant challenges).

By “reversing” the content of the bulleted points above one can get an idea how deficits in theory of mind impact individuals with ASD:

If you aren’t able to understand that a person’s overt behavior has a lot to do with his or her internal mental state (e.g., harsh words reflect anger), you will not be able to make sense of the person’s behavior.

If you can’t make sense of a person’s behavior, you are not likely to be able to predict what he or she will do.

Without the ability to predict likely future action, one would not know how to adjust his or her own behavior to meet the demands of the situation.

Joint Attention as an Early Indicator of Theory of Mind Knowledge

Normally developing children, from approximately 9 – 12 months of age, will follow an adult’s line of regard—that is, his or her point or eye gaze—for the purpose of sharing attention. This is called joint attention, and while very few people have even heard of it, joint attention is a critical precursor to language development. In fact, it is actually the gateway to intentional symbolic communication, and very much reflective of underlying theory of mind knowledge. Eventually, neurotypical children learn to use a pointing gesture themselves to attempt to get adults to follow their line of regard, as they quite literally point out items and events of interest to them. Pointing to share attention is considered one of the earliest indicators of theory of mind knowledge. Conversely, the lack, or impoverishment of this type of behavior in children with ASD is indicative of theory of mind difficulty. It should be obvious that given its intimate connection to communication and language development, the competencies involved in the social-cognitive construct of theory of mind should be targeted in intervention activities.

Putting the Horse in Its Proper Place

If one doesn’t understand the concept of theory of mind and how it relates to language development, it is easy to put the proverbial cart before the horse. This happens when we ignore the importance of joint attention and comprehension, and start intervention at the level of language expression. It also occurs when we fail to build in intentionality because we are too busy force-feeding vocabulary. That said, I belong to the “it’s never too late to get it right” school of thought. Human beings are amazingly resilient. Under motivating conditions, it is relatively easy to establish joint attention and to build in intentionality. And, since both of these constructs are foundational to communication and language development that is where the focus of language intervention should always begin.

© Diane Twachtman-Cullen, Ph.D., CCC-SLP

Autism and Competition; She Just Won’t Compete!

Donna Williams — Wed, 17 Jun 2009 06:21:36 +0000

I got a letter from a lovely parent about her teenage daughter, a wonderful long distance runner. Yet the coach was stumped. Why wouldn’t she compete? She’d just let the others pass her, retaining her same rhythmic pace.

Non-autistic people have a consistent capacity to simultaneously process sense of self and other. This is necessary to many things… to imagining what another person might think, to gaining insight about one’s effect on others, to having that insight AND being able to then apply that in altering one’s own behavior, to being fluent in social game playing, to remembering why to say hello, and to holding onto the point of a game, a race, a competition.

But whilst many people with Asperger’s get enough simultaneous processing of sense of self and other to gain some entry to these things, even they may find this cognitively waxes and wanes.

Of course personality figures too. Someone with personality traits which have a high need for admiration or recognition or even a high tendency toward narcissism or aggressive traits driving them to seek power over others or the conscientious trait which desires achievement will be MOTIVATED to strive to retain a consistent sense of self and other. Those with other traits, particularly the idiosyncratic, solitary, artistic, leisurely or devoted personality traits, may just not be designed that way. Then there are those with the sensitive personality trait or the self sacrificing trait may compete just to please or to help others but shirk the glory and achievement.

Environment matters too. In early childhood, my mother invested intensely in the promise that if nothing else I might succeed as a dancer (they don’t have to talk, socialize, they learn physically, musically and by rote) and I felt that my potential as a dancer was often the only thing between me and a Children’s Home. So whether it’s letting others down, pride in the one skill one has, or avoiding serious consequences, environment does also play a part. It may be able to prompt you through developing a skill to the point you compete not by intent but by default. You may incidentally become so highly trained you are just too good at something for others to do better.

So competition or the lack of it is a combination of cognitive processing abilities (often also physical abilities including motor planning), personality and environment.

Now some people with Asperger’s and many people with autism swing between a sense of all self- no other and all other-no self so when in all self mode, awareness of other people’s reactions, one’s place in relation to them or the consequences, can evaporate. In all other-no self mode, one can stop, stare and have little response yet be mapping everything the other person has done even though they may have no conscious awareness or access to what they think or feel about that at that time. So a lack of competition may be very normal for that cognition.

Personally, hierarchy scares me. I love equality. I have little natural desire to compete. I will defend myself… something bullies, abusers, stalkers and trolls have taught me over many years. But beyond the moment, it’s as if they evaporate. And I’m glad my brain works that way, even though it also means EVERYTHING evaporates pretty constantly… the boiling kettle, the cooking toast, the running water, where I put my bag down, who I was waiting for, what I had been about to do or say. And sure, I curse those often frustrating deficits, but fact is they also come with some benefits. I know this incapacity to multi-track means I’m more socially vulnerable, but I can’t help but also enjoy the rest which comes from being unable to stay on track (to a degree).

And I like rhythm, so in walking or jogging, that’s what appeals to me. I have outrun people but only when I fear they’ll grab or touch me and when I haven’t ‘turned invisible’ or into diversions and wished them away. I have playfully outrun people, usually to be the first one to get to do something ritualistic that I’m used to (no, I’ll get it). But the abstract concept of beating people in game or race so I can have the glory of being the best… well when I think of ‘the best’, I lose the part of ‘in relation to whom’. So I am much better at grasping how I’ve improved on my own standards and that’s part of being an artist, striving for what speaks to me through art.

Even in those who can retain a degree of simultaneous processing of self and other, the self-other thing fluctuates. Where for most people, holding onto a simultaneous sense of self and other, is like breathing, for many auties this requires CONSCIOUS EFFORT (this is in The Jumbled Jigsaw and also in Autism; An Inside Out Approach… both published by Jessica Kingsley Publishing ) . Like anything requiring constant conscious effort to hold it, attention, concentration, mental energy to do so, waxes and wanes. Sometimes one’s brain is just built that way (though Glutamine is an amino acid used as a ’smart drug’ which can improve information processing).

I have a heap of skills. I’m great with lists. I’m wonderful at characterizations. I have relatively fluent gestural signing. I have some fluency in French, Italian, German. I learned French in a week. I am an artist, writer, singer songwriter. Other things I need assistance with – anything that involves multitasking, internal mentalizing, holding more than 1-2 instructions, requiring sequencing or sustained attention, things requiring receptive language processing whether spoken or read words, things requiring good ‘real time’ processing or facial recognition, things that involve ongoing social-emotional entanglements or competition with others. So I have a load of skills, even more HALF skills, and some deficits which put me outside of the mainstream workplace. Its important to not commiserate when one has a half-skill. Better to find a quirky, useful place for it where it is valued in its own right for what it is not what it is not.

Vaccinations, Celebrities and The Cure… I Say “What Now”

Keri Bowers — Wed, 17 Jun 2009 06:19:57 +0000

I am positive that vaccinations did not cause my son, Taylor, to have autism. He showed signs of developmental and other delays within the first 4 months of his life – before his course of vaccinations were started and completed. Though I don’t doubt that vaccinations may indeed trigger autism, I do not believe vaccinations in and of themselves cause autism. But what do I know – or does anybody for that matter?

What I do believe is that Taylor and others have a pre-disposition – viral and/or genetic – which environmental toxins and pollutants “trigger.” For me, and hundreds of other women I’ve spoken to over the years, the environmental toxin I can point to is Pitosin. How’s that for left field? Nobody talks about Pitosin, but in my case I am convinced this was Taylor’s trigger. There are many women who agree and can easily point to this particular toxin as well. Do you have a similar story?

Pitosin was given to me in great quantities to induce labor over the course of six (yes, count ‘em) six long days at Cedars Sinai Hospital in Los Angeles. During that period, Taylor went into fetal distress twice, and yet they did not take him by c-section until the 6th day, continuing instead to administer the Pitosin drip throughout my stay. This was circa 1988 and little was known about autism, let alone the fact it was exponentially on the rise. Taylor was born a mere 8 days prior to the release of the movie Rainman, which was all we really knew about autism in the public sector at the time. I call that period the dark ages of autism.

Now, after 19+ years of watching autism grow, I believe it is environmental hazards and toxins in general that trigger autism, and not specifically vaccinations – though I would certainly include them as a possible trigger, I would not say they are the cause of autism. One cannot discount a child that begins to cry for days, weeks or months directly after the shots are given, or that he loses language – we see this happening everyday. But hey people, what about the fact that we stand in front of microwaves, use cell phones, pump gas, and eat foods wrapped in plastic on top of plastic and then put in a plastic bag. Ironically, environmental toxins in the past 20 years have increased right along side of autism, and its not just the vaccinations. For me Pitosin – if you looked around, what might it be for you?

What I do know is this – I agree with Amada Peet’s argument a couple months back regarding so-called “herd” vaccinations being imperative so we do not have break-outs of other, perhaps more severe universally destructive disease and disability such as polio or small pox. I personally came up against the question of vaccinations when my younger son Jace was born 6 years after Taylor. Do I vaccinate – do I not? After a lot of reading and research, I came to see – as Peet has found – that herd vaccinations protect against far greater dangers in our society than the possibility of contracting autism. Fortunately Jace does not have autism, a great cause for concern during my pregnancy with him and the ensuing vaccinations. I’m not saying you need to agree with me at all – so I hope you don’t get that impression. But as Peet said, we shouldn’t just listen to celebrities either just because they are in the lime light. We need to do our own due diligence; speak with as many professionals as we can to decide for ourselves with informed determination.

In the end, we all wonder what causes autism. Well, since scientists can’t say, I certainly cannot. Neither can Autism Speaks, Autism Society of America, or other celebrities who take vitriolic stands against vaccinations, or are hyper-focused on the cure, or even a shock jock such like Michael Savage, whose recent comments made it clear he is clearly ignorant about autism. I agree we need to keep research going, keep looking at triggers, causes, and cures for autism. For heavens sake, why would we not do so as a concerned society? But with all the will and passion in my advocate-encrusted life, I say

MY CHILD HAS AUTISM, WHAT THE HECK DO I DO NOW????

But we don’t see this in headline news so much as we do news about the “cure” or the “cause” rather than looking at funding interventions at a more responsible national level NOW.

Let’s face it, there are too many children living with autism each day that need support and interventions, but the money and legislation to guide us in our practices just aren’t there to take care of and provide education, intensive therapies, and interventions. As an advocate, educator, and mother, it is my opinion that if we spent as much money on “what now,” meaning early interventions, best practices, and education as we do in search of a cure or cause that perhaps will not come in our children’s lifetime, we will raise the bar and options for hundreds of thousands of children living with autism everyday.

Instead, when Jenny McCarthy comes out and calls the director of the Center’s for Disease Control a monster, as she did on Chelsea Lately a number of months back, we set ourselves back and continue to divide an already fractured global autism community. And the truth is, I like McCarthy a lot! I see value in celebrities raising awareness – good for them. But we need be careful how these opinions affect a multitude of parents who are new to the world of autism. When McCarthy says her child is in “recovery”, without a definition of recovery, we need to have a discussion on just what “recovery” is. Parents need to be careful not to put all their eggs into one hopeful basket and exclude other important therapies and interventions (like social and life skills), or forget about the nuances of autism that require a multi-disciplinary approach to improved possibilities.

At the end of the day, I believe we all go through the death of a dream when we are faced with autism. In looking for a way out, or simply a way to live with autism, we should not forget that ASD is baffling and is a life-long disability at this point. Let’s not loose our objectives in “what now.”

When Applied To Behavior

Thomas McKean — Wed, 17 Jun 2009 06:18:02 +0000

One of the first things I learned about after becoming involved in advocacy was Applied Behavioral Analysis. My introduction to this technique was less than stellar in that I learned about it through some old VHS tapes I got on loan from the Central Ohio chapter of the ASA.

One of these tapes, which were very old (circa 1970’s or so), showed a young boy with autism sitting on the potty with his pants down. There was a guy in there with him who kept forcing (and by forcing, I mean forcing) him to drink water through a straw. When at last the boy went, he was given a treat like an M&M or some such. Then he would force him to drink water again. And again. And again. And again.

I remember after watching the set asking the powers-that-be at the local chapter to burn the tapes because I felt they were demeaning, perhaps even harmful to individuals with autism. They refused. This was many years ago, and hopefully the set has since been lost or damaged or destroyed. It may be valuable if looked at from a historical perspective, but as a valid technique, it has no value whatsoever.

In my earlier days on the board of directors of ASA, we used to travel to different states for board meetings. While we were there, we would tour the local residential facilities and institutions for children and adults with autism. This was definitely an education.

Many of these places proudly announced to us board members that they used ABA. This bothered me because of what I had seen on the tapes.

What I didn’t know (but of course eventually learned) was that ABA had changed immensely since those early Lovaas days of the tapes. It had become more humane and less aversive. Still, even after learning this, I was skeptical.
But then, as I began to regularly travel for the conferences, and as I got to spend time with and got to know families, I began to see that ABA was working.

My opinion began to change.

I can now give countless examples of the benefits of ABA. I have seen so many children with autism who have learned to talk and who have learned to be social and who have learned daily living skills just from this technique. As I began to see this more and more, I finally had to admit to myself that I had made a mistake in judging ABA the way I had. I was wrong to do so.

Today the world has changed. Individuals with autism have something they have never had before. They have the internet. This provides support and understanding and a whole mess of MISunderstanding that wasn’t there before. Parents and professionals in the autism field flock to the blogs to read what they have to say. But many with autism are stuck in the past. The ABA they remember is the same ABA I saw on the tapes from all those years ago. They refuse to acknowledge (just as I did for a long time) that ABA has changed.

They scream against the use of ABA and tell parents they are bad parents because of a choice to use ABA as a therapy. Not that one can blame them for doing so…I don’t recall any ABA in my past, but I do know if those tapes had been me, I may well be doing the same thing. These are adults with autism who have been hurt as children by outdated and harmful therapy.

But that outdated and harmful therapy has since evolved into a humane, modern and effective therapy for kids with autism. Keep in mind that after age five or six (earlier if they are smart enough, and a lot of them are), they will catch on to the game and then they will play their own game with you instead. At this point ABA becomes completely ineffective.

If one is to be an advocate for the autistic population, one must be kept current. This includes keeping current with therapies, which not everyone is doing. They are leading parents in the wrong direction because they are not up to date. This can be dangerous.

As a parent, it is your responsibility to research everything. Don’t believe everything the doctors tell you. Don’t believe everything the writers of the Autism Expert Report (including myself) tell you. If you are going to try ABA or DTT or AIT or FC any other acronym therapy for your child, you must research it first to be sure it is safe and viable and valid. Yes, this takes time and energy, but the rewards are well worth it.

As popular as ABA is, you will have many people recommend it to you. This is a good thing as early intervention is crucial.

Please remember, however, to investigate these things for yourself before you agree to them. There are some dangerous therapies out there by people who are all too interested in making a buck. Protect both yourself and your child when choosing a therapy that you think may be right for you.

Autism’s Hidden Casualties: Typical Siblings

Bill Davis — Wed, 17 Jun 2009 06:04:23 +0000

My daughter Jessica is a statistic. She is one of seven million “typical sibs” in America who have brothers or sisters with disabilities. Until recently I truly believed that I had provided a life of normalcy for my daughter, but I have come to realize that Jessica was isolated, fearful and guilty.

Jessica’s emotions ran the gamut from sadness to embarrassment to loneliness. My little girl entertained thoughts of Chris dying from Autism, fear of “catching” the disorder and anger at those who imitated and ridiculed her brother. She constantly craved attention and longed to be noticed. Jessica felt guilty that she was the “typical” one and was extremely jealous of the attention, finances and time that we lavished upon Christopher.

Please realize that we did everything to provide a happy life for Jessica. We included her in all activities, had special days and outings and provided areas to keep her possessions safe and to take refuge in. But the reality of life in our home was a hard one to survive in. Everything we did, we did for Chris. He needed so much, so much time, teaching, therapy and love. Whatever we salvaged emotionally was left for my daughter to pick at. Our home life seemed to have an ever present open wound. Jessica was left on her own to heal.

Chris had a plethora of sensory issues. We had to keep the noise down, especially coughing and sneezing. No eating in front of Chris, the sound of chewing and the site of half eaten food, drove my son to harm himself. No sudden movements, no pets and friends were allowed over for brief visits only.

The Age Equation

Younger siblings seemingly do very well. They have not become judgmental and do not realize that their brother or sister have special needs.

When Jessica was going to elementary school she became very aware of her brother’s differences. She became totally involved with Chris and his therapy. Jessica knew more about Discreet Trial than the therapist from Rutgers. Some siblings go the other way and appear to become totally non compliant.
The teenage years brought rebellion and peer pressure. Jessica loved her brother but began to gravitate away from the family. She still tried to maintain a strong relationship with Chris.

Take Heed—Take Notice——-Take Action!
Here are some red flags to keep an eye on:

Not sleeping
The sib feels helpless
Cutting
Losing or gaining weight
Constant worry
Pulling away from their circle of friends
Anxiety-Irritability
Internalization of one’s feelings
Stomach aches
Self blame
Inability to concentrate
Truancy

Advice and Tips

Please seek professional counseling
Educate them about Autism according to their age and level of understanding.
We know that the sacrifices they have made are not fair, but make them understand that they were necessary.
Monitor interaction with their brother and sister so conflict can be avoided and advice can be immediately offered.
Demonstrate how they can help
Encourage outside friendships and activities
Praise accomplishments
Entertain open and honest discussions
Allow siblings to express their negative feelings
Tell them that embarrassment is a normal reaction
When visiting relatives or attending holiday events, have others help out so the sib can enjoy the day and not act as an adult.
Down time must be guaranteed. Allow the sibling to be alone.
Do not always rely on them; just let them be a kid.
Go to great lengths to allow the sibling their privacy
Here is a very important point. Put aside a secure, safe place for the sibling’s prize possessions. Things seem to get ripped up, destroyed or go missing in the home where Autism reigns.
Try not to have the sibling make to many accommodations and modifications.

Unfortunately I did not practice what I just preached.

We took Jessica to a beginner’s conference so that we could educate her about Autism. I spoke to her class about Autism. Not only did they learn about Chris but they came away with a profound appreciation of what Jessica was going through.

Jessica was screaming at Chris one day because he wanted to take over the TV. My son began to bite and kick her. My daughter turned her anger towards me. “Why doesn’t Chris ever get punished? It’s not fair!” She was right so I sent Chris upstairs for a timeout. A little later I heard Jessica chastising Chris with great passion. I ran upstairs to find that my son had put parental controls on Jessica’s TV. Chris cleverly got the last word and I had to hide my laughter from my daughter.

I found that both my kids loved music so I used songs to bring them together in play. Jessica and Chris would dance together, record music and watch rock and roll. Jessica found that if she left out lyrics from songs that Chris knew, he would fill in with his charming robotic voice. Music brought them very close. So find shared interests and utilize them. Wrestling and tickling seemed to work also.

We were all in a diner, when Chris became extremely agitated attempting to communicate. Jessica took her placemat and a pencil and quickly wrote out the alphabet. “Chris, point to the letters” Slowly, Chris began to touch the makeshift ABC’s. P-L-A-Z, Chris eventually spelled out “Plaza Sesamo”, the Spanish equivalent of Sesame Street. Jessica developed her own way of helping and communicating with Chris and we applauded her every attempt.

Siblings of children with Autism, mature quickly. They grow up burdened with a great deal of responsibility and trepidation. The uncertainty of the future can be devastating. Siblings know that someday they will inherit the responsibility of caring for their brother or sister. Please recognize what they are going through. Psychologists, social; workers and counselors who are knowledgeable about autism, can make a tremendous difference in your children’s lives. Applaud the sib and stay close to them. Remain open, honest and loving so they don’t become one of Autism’s hidden casualties.

Understanding the Mis-Understanding

Rhonda Spellman — Wed, 17 Jun 2009 05:56:24 +0000

“Your son fits into the Autistic Spectrum Disorder.” Her voice was clear yet somewhat monotone. How many times has she said these words to an unprepared parent? I silently cried as her message began to fill hollowness deep inside my heart. I stood and waited for the instruction manual that was sure to come as she continued on with her 45 minute dissertation. “He will need to be on Ritalin by 1st grade, he will need therapy, he will need…” Her voice began to sound distant and hollow.

The remaining portions of my barely functioning mind slowly left my body and began to float up to the ceiling. I realized that I could no longer speak. I couldn’t exhale and I couldn’t see her clearly. I wrestled with the desire to pinch myself and end this hopeless dream.

“He will be able to rely on his is I.Q of 170 to survive…” As if reacting to a dark figure that had just entered my nightmare, I wanted to scream. My vocal cords refused to operate. My voice was stuck inside, along with my fear, like really thick peanut butter on the roof of my mouth.

“He has an I.Q. of 170,” I finally asked… “How can this be? How can I help him to talk again? Where should I begin? What do I do next?”

Her voice sounded like a coffin closing when she replied, “Come back and see me in six months. I’ll be able to diagnose the form of Autism then. ” The form of Autism? What did that mean? Autism comes in “forms?” My only reference to Autism at that time was the very moving portrayal by Dustin Hoffman in Rainman.

I rationalized the steps of Autism in my mind. Based on Rainman, Autism = Rainman. Rainman = home for the disabled. Home for disabled = non-productive life. Nonproductive life = sadness. My heart was splintering into microscopic pieces.

I held out my hand to receive her instructions. There had to be instructions I thought. She shook my hand and turned to go. A dark cloud suddenly appeared over my head and the rain began to fall on my cheeks as I stood there in the hallway of the, now silent, hospital. Everyone faded into the background and I was suddenly lost. My darling son Tanner broke the spell when he dropped his water bottle over the edge of his stroller. It was time to go but I didn’t know where.

Putting on a brave face I ventured out into the murkiness with her words still swarming around my head. “There has to be a better answer out there, somewhere, and we are going to find it,” I told my sleepy son. We had been at the hospital for the better part of the entire day. It was supposed to be a day of discovery and hope. We came for answers. Now, solving the mystery was even more of a challenge it seemed. I had known all along that there was a prodigy in there! The trick now was to get him out!

Back when Tanner was a happy, smiley and talkative baby I never dreamed that I would begin to stay up all night researching terms and conditions that I barely knew how to pronounce! Now, night after night I began to spend every moment searching. I began to realize that there was a vastness to the world of Autism that was not only magical and mysterious but completely misunderstood!

My quest to understand Autism became a never-ending journey. The more I learned the more I realized that to fully understand and help my son I needed to grasp the meaning of Autistic Spectrum Disorders as fully as I possibly could. I was on a relentless journey to find the key to set my son free.

When Tanner saw the first doctor she did not offer any solutions. I now think it was because she really didn’t fully grasp the complexity of Autism. Her medical training, while expansive, did not include caring for children with multi-dimensional disorders.

When Tanner turned four I began to study diets and foods that contributed to behavior problems. Determined to “cure” him I began changing his meals by eliminating all wheat products first. Within 24 hours he was more lucid. Dairy came next and eleven months later we ended up with a wheat-free, gluten-free, dairy-free, soy-free, egg-free, preservative-free, dye-free, oat-free, corn-free diet!

I created recipes for just about everything he wanted. My pediatrician called my diet a “behavior modifying diet” and noted that the change in Tanner was “remarkable.”

Although the improvements were to be celebrated he continued to require assistance with every task and his social skills were very poor. My son needed a program that would do more than mask his symptoms… he needed realistic short-term and long-term goals that would help with the real cause(s) of his multiple problems.

Easy enough, right? It seemed like the right course to take… just figure out why he has a form of Autism and then “fixing” it will be the next step. I felt like a 2nd grader who just woke up in a space ship on auto-pilot to mars! We saw 18 doctors over the course of the next two years, with each one offered their suggestions.

Mind altering drugs and other forms of controlling his behaviors were suggested. Treatment options that came with a $45,000 annual price tag and only a 50% success rate didn’t seem like the right plan. I didn’t know what else to do so I just kept researching. By mid-2008 I had over 7,000 logged hours.

Tanner was eventually diagnosed with Asperger’s Syndrome, a condition known by remarkable I.Q.’s and memories and a wide spectrum of social deficits. People like Albert Einstein, Thomas Edison and many other incredible contributors to our world are believed to have had Asperger’s Syndrome.

Like Einstein and Edison, Tanner enjoys experimenting to “see what happens.” Connecting with his experimental abilities ~ from the spinal cord to the paper ~ can be the challenge! On a regular basis he amazes me with his ideas and well thought-out questions. Recently he asked, “Do you think I’ll be able to figure out how make cars run on recycled stuff?” (At 9 years old.) Note to self: keep a close eye on recycle bins!

Although Asperger’s Syndrome is considered to be one of the main forms of Autism I personally think Asperger’s Syndrome should stand alone. The characteristics of the two disabilities are virtually opposite. This is a partial list:

	Autism	Asperger’s Syndrome
Diagnosed	Early (before 3)	Later (after 3)
Prognosis	Gets Worse	Gets Better
Social / Peers	Very Poor	Poor
Verbal Skills	Very Poor	Very Good
Acute Interests	Less Likely	More Likely
Motor Skills	Okay	Poor
IQ Level	Low	High
Imaginative Play	Less Likely	More Likely
Neurological	More Likely	Less Likely
Repetitive	More Likely	Less Likely

My research efforts grew and opportunities to share our successes grew as well. To my surprise, I received an email and then a call from a representative of the Who’s Who in the Medical Industry one day. Convinced that they were spam I ignored both. When they called again I was surprised that the interviewer knew so much about me and my research. I played along with the interview (it was a real treat to talk about something other than dinosaurs for a change!) but I didn’t really believe it was real.

I had begun to share my program, “Autism Awareness: From Suspicion to Success” with mothers, teachers, doctors, and a variety of groups. She knew about my program but wouldn’t tell me how she found out. “It’s confidential,” she said.

The following week I saw our pediatrician. I told him about the email and calls. “Nice,” he said. “You will probably be receiving more calls than that.” Was it possible, I wondered, that the research that began as a way to help my son might actually help others, too?

Enzymes, whole food mineral supplements, liquid and powdered potions, vitamins C, D and A, Candida eliminators, DMSA chelation, Epsom salts baths, mud baths, detoxifiers, immune builders, “snake oils” ~ we tried enough to open our own store. Some helped, some didn’t. All only helped for a short time.

There had to be a reason why his body wasn’t absorbing the nutrition I was feeding him! After 21 ear infections his immune system surely suffered but nothing seemed to be making it stronger. Blood tests to determine what was “missing” resulted in low uric acid levels, low cell hydration levels, low creatinine levels and a chronic infection indicating liver dysfunction.

Low uric acid levels? Taking one item at a time I started with an article in Pub Med by Dr. Robert H. Keller that stated, “… uric acid is the last antioxidant at the body’s disposal when all the normal antioxidants have been exhausted.” I wanted to increase my son’s antioxidants, I didn’t understand how. I learned that glutathione, the body’s primary antioxidant, is found in every cell of the body.

Because glutathione acts as both as an antioxidant and an antitoxin it just had to help the body’s immune system! I felt like I had stumbled upon a virtual gold mine as I continued to read article after article by Dr. Keller. I read where glutathione improves the liver function and strengthens the immune system. “Why doesn’t everyone know this?” I found several of his websites and researched even more for the next two months.

Tanner took his first glutathione capsule, MaxGxl, on December 17, 2008. I quit giving him all of his other supplements to do a ‘true” test. Within one week there were subtle improvements. His eye contact seemed to be better. Within three weeks there was no mistake that he was thinking clearer.

Now, a full two months later, I can enthusiastically share that Tanner:
• Sits at the table through entire meals (a FIRST!)
• Talks in a normal tone of voice about “normal” subject matters
• Is sleeping well (through the night without being “restless”)
• Is “on task” with most school subject matters and participating with the Gifted & Talented book club
• Is not argumentative as much (hardly at all)
• Is eating MUCH better (trying new things) He is still on a GF / CF diet – for now.
• PLUS – NO more “tics” – he was acting like he had Tourettes – head jerks, eye twitches, rubbing his forehead until he had a rash, twisting his hands and “playing” his fingers a lot… ALL are !

I have witnessed, first hand, how my son’s multi-dimensional disorder has improved beyond what I thought it could simply by boosting his immune system. Who knew that the answer I’ve been looking for (for seven years) would work so well in only seven weeks? For more information about Dr. Keller and glutathione, visit http://MaxGxl.com/158429.

My first book for adults follows my two children’s books. Autism or Asperger’s Syndrome? One Mother’s Journey in Search of Truth will cover our seven year journey. It will go it to editing next week. I want my book to serve as a hand book with the “key” elements that have worked for us.

My story has been like a journey to free my son from an invisible box holding him captive. It has been and will continue to be a journey of discovery. I’ve learned that the only prerequisite to this “job” is the willingness to try, the refusal to quit and the frequent reminder that God doesn’t chose the qualified, He qualifies the chosen.