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Giv' Me Five

—Communicating With An Autistic Child

Majid Ali, M.D.

 

Matthew is a seven-year-old autistic child. He never spoke a single word until he was almost six years old. He suffers from multiple food and mold allergy. When I looked carefully and performed the appropriate tests, all the autistic children I have seen had such allergies. There may be rare exceptions to this. In one follow-up visit some months, after starting our nutrient therapies and allergy desensitization, Matthew's mother tearfully told me that Matthew had started to call her mom and to speak a few sentences.

Encouraged by the news, I told Matthew's mother I wanted to try something different. My approach was simple: Would Matthew respond further if we could find someone to coach him without censorship, with brief but frequent contacts, possibly every day. I knew that, in children with attention deficit disorder and hyperactivity, a similar approach had been reported to be effective by Edward Hallowell, M.D., author of Driven to Destruction, and as other similar books. I asked if she or her husband had a neighborhood friend who might be willing to coach Matthew. That person would only need to make brief one- or two-minute daily contacts with Matthew (or less frequently). During such contacts, the coach would simply repeat to Matthew a few predetermined sentences, then finish by saying something encouraging to him. Next, I explained my hope that the person who agreed to such coaching would establish a bond with Matthew, not only for the boy's enrichment but also for himself or herself. Perhaps then such coaching wouldn't be tedious. Furthermore, I expressed my hope that Matthew would develop a similar bond with his coach and begin to respond to him. I ended by giving Matthew's mother an example of what I meant. The coach could use simple sentences such as: Hi, Matthew. How are you today? What did you do yesterday? What are you going to do today? Matthew, I think you're a great guy.

Profound isolation and inability to respond to common situations of life are, of course, central problems in autism. At least in theory, such an approach toward breaking the barriers of inward isolation of autistic children seemed worth trying.

As simple as this concept might seem to the reader, I found it awkward to explain to Matthew's mother. She had consulted several specialists at the clinic for child developmental disorders at the university who established the diagnosis. She also saw some neurologists who agreed with the previous diagnosis and had essentially told her to simply accept the tough hand dealt Matthew by fate. I wondered how she might react to my suggestion of coaching by a nonprofessional. Even if she was amenable, I recognized the difficulty of finding someone suitable and willing to make such a commitment. She listened to me, first with growing curiosity and then with blank eyes. I began to see the futility of my approach. She nodded, simply to be polite to me, I thought. I moved on to some items about his nutritional plan.

Suddenly, her eyes brightened. She smiled and blurted,

"Oh, my God, so that was it?"

"What?" I asked, puzzled.

"Giv' me five! That's how it worked," she went on excitedly.

"That's how what worked?" I asked.

"Giv' me a five," she grinned broadly.

"What's that all about?" I asked, my puzzlement growing.

"Oh, Dr. Ali, you would love it. I'm sure of that. Once I saw a janitor pass by us at school and Matthew's eyes lit up. I found that strange but thought nothing of it. Of course, until then I had never seen Matthew acknowledge anyone, let alone greet them with bright eyes. Several days later, the same thing happened. I became curious and asked Matthew's teacher about it. She laughed and said that she had also observed it. I decided to talk to the janitor. He was baffled by my inquiry, then explained that all he ever did was to ask Matthew to give him five when he saw him enter the school. At first, Matthew accosted him with the usual autistic indifference. But the janitor persisted with that simple sentence every time he saw Matthew. One day some weeks later, Matthew surprised the janitor by stealing a quick glance at him before walking past him indifferently. The janitor persisted. Weeks passed, then one day Matthew stopped for a moment, looked up at the janitor and blinked his eyes. The janitor was encouraged. Finally it happened. One day when the janitor approached Matthew, the boy slowly raised his hand and gently touched the man's fingers. A current seemed to have passed between the two fleshes. From then on, Matthew always stopped and put is hand in the janitor's when the latter asked for it."

I thought about how much we physicians learn from our patients. I wondered if I knew of any professor of psychiatry at a medical school who could have explained the essence of coaching without censorship more eloquently than that janitor. Was there a psychologist around who could have touched Matthew the way that man with washrags and dirty pails of water did?

I asked Matthew's mother how it was between Matthew and the janitor currently. She told me the janitor had left the school. We spoke some more about the possibility of employing this strategy. Tentatively, I asked if she would discuss the matter with her husband, and if he was agreeable, to look for someone suitable for coaching without censorship. Would their mailman be open to such a suggestion? I finally made the specific suggestion and ended our visit. I wondered if she could persuade her mailman to resume where the janitor left off. She smiled back but said nothing.

List of Related Stories

* The Sword Story

* Soul's Sweat Stories

A Bullet for Hypertension

* Conversations With Angels

* The Bite of the Neck Muscles

* The Bite of the Grey Dog

Do You Think He Heard Me?

Why and How Do Not Matter 

*  An Encounter With Down's Syndrome—a Matter of Perception or a Love Story?

*  How Could I Be All Stupid If God Is Within Me?

Giv' Me Five—Communicating With An Autistic Child

 

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