Tuesday, March 20, 2007

Well, yesterday Bob and I had the long awaited meeting with the psychologist who administered all those tests to Sam a few weeks ago. And interestingly, as we left Bob and I both felt that on the one hand, he didn't tell us a single thing we didn't already know. And on the other hand, he somehow reframed it into a perspective that helps make sense of it.

He said that while Sam's intellect is very high, as we have always known, the area psychologists call "executive function" is much lower. His executive function is not actually low, but relative to his intelligence, it is. The doctor said that only about 10% of very bright kids would have scores as low as Sam on executive function.

Executive function is controlled by the frontal lobe and governs things like working memory -- the ability to hold a set of directions in your mind while working on a project, for example. It covers a lot of self-regulation, the postponing of gratification in pursuit of a long-term goal, time management, planning, etc. Now, these are all areas where we knew he had problems. What we didn't realize was that they are all connected, all controlled by that one area of the brain.

So again, in terms of the labeling that schools and psychologists seem to love, Sam doesn't quite fit the label. Just as we know he has "Asperger's-like" behaviors but doesn't really meet the definition for Asperger's, similarly, he has ADD-like behaviors but doesn't meet the definition for ADD. Which is just as well, especially since we have previously tried ADD meds on him and they produce strong and unacceptable side-effects. (They make him anti-social.)

So the recommended course of action is that we must provide him with external structures that take the place of that internal regulation. For example, when he goes to do a homework assignment, we will now have him show or explain to us exactly what the assignment is before he starts. That will establish whether he knows or not. If the assignment is complex, and it took a lot of coaxing and guidance to get it all laid out, we might write it down, so he has those written instructions in front of him as he works. Then as soon as that assignment is finished, we will review it to see if he completed all the steps.

The psychologist will meet with Sam next week, and with his team of teachers in about three weeks, so that we are all on the same page. I had mentioned to the psychologist how frustrated we and the teachers have been by his apparent loss of motivation this school year, and the doctor was pretty sympathetic to Sam about that. He likened him to a dog that has jumped at an electric fence and been zapped enough times that now, when he looks at the fence, he just sees the pain. Even if someone opens a gate in the fence, he is likely not to notice it. In Sam's case, he started the year trying really hard to do a good job, but in spite of what really were his best efforts he couldn't stay caught up and was perpetually in trouble. So somewhere along the line, he checked out. Why invest all that energy just to fail anyway?

The doctor said in kids like this is it usually particularly hurtful and frustrating to hear, "You're not working up to your potential." Because while they have this great intellectual potential, the frontal lobe issues are just as real, so they have been working to the best of their ability -- their overall ability. But if we can get Sam to buy into building up structures to support him, then he can get past that roadblock and allow his intellect to shine. At least I hope so!

Friday, March 16, 2007

See, I'm doing better: it's only been a week since my last post here. I don't think I've mentioned it in this blog, but again this year I am doing a daily Lenten meditation online. If you're interested in checking it out, go to www.lentendaily.blogspot.com .

Today I had a second interview at The Catholic Foundation. It was with the head of the communications committee of the board, who is also the Executive Director of the New Albany Community Foundation. I felt it went very well, and I have to admit that I'm getting to that point where my hopes are up for an offer. I know I wasn't the only candidate called in for a second interview, but I did get a very good feeling during the interview. I keep trying to remind myself that I'm just trusting in God to lead me where I should be. It's hard, though, because there's a big part of me that wants to prod and poke God and generally tell him how to do his job.

Earlier this week I had a first interview with a company called Mapsys, and it was surprisingly interesting, too. I take some comfort in thinking if The Catholic Foundation doesn't come through, I can still pursue it. But I'm hoping God gives me some kind of clear sign which one is really the right one for me!

Poor Sam is still having a rough school year. In fact, I'd say it is getting worse. Next Monday we get the results of all that neuropsychological testing we had done, and I'm pinning a lot of hope on that revealing something actionable. If it doesn't, I don't know what the next step will be.

There are several different areas of problems. First, smart as he is, he is not performing well in school. That seems to be mainly about not organizing his work and managing his time, but I am gradually becoming convinced that this is not willful noncompliance. I think he has some sort of problem that makes doing so extremely difficult for him. This is a big area where I hope the tests reveal something, and the doctors know some form of therapy or something that can help.

Then there's the motivation issue. Sam seems to have lost all interest in school work and all internal motivation. To the extent that he does perform in school, it is clearly motivated by trying to keep me and the teachers off his back, not by anything intrinsic to him. He doesn't play music for his own pleasure any more, and he doesn't practice his instruments unless pressed to. He hasn't accomplished anything in Scouts (other than showing up) for months. Sadly, for him lately I think just showing up is an accomplishment. More than anything, I want him to find an inner desire to learn and accomplish!

He is having a big problem with one teacher. He says that he doesn't like the way she teaches but moreover, he doesn't like her. He says he has had other teachers where he didn't like the way they taught, but she is the first one he has ever not liked as a person -- and he believes she doesn't like him any more than he likes her. Today I mentioned this with another of the teachers, one I've known for years and trust a lot, and she said she has never seen any indication that the teacher doesn't like Sam. I think part of the problem may be that this teacher is one of those people whose voice doesn't fluctuate a lot, who is even-keeled to the point of almost placid, and I think Sam may read that as a lack of caring. Whatever, I've come to realize it is very intense and real to him and something must get resolved, as he has the same team of teachers again next year.

Of course, social skills are always a problem for him. I don't necessarily think those have gotten worse, exactly, but with all this other stuff going on he hasn't had any energy left to work on getting them better. Still, I am mildly encouraged that he has had some boys over for sleepovers this year, and they aren't just the kids who've known him since they were tiny.

We've begun talking about what summer camps to sign him up for and where we might want to vacation, but this is the point where my unemployment begins to loom large. I'd plan the summer one way if I thought I was still going to be home, another way if I plan to be working full-time. It is my hope that the answer will reveal itself before we get down to deadlines where I just have to make my best guess.

This weekend holds a Merit Badge workshop day for Sam on Saturday, and on Sunday afternoon his team for a Social Studies project is meeting here at our house to cook. Yes, cook. The class is studying Africa, and his team took on the subject of African food. So in addition to their oral report, they are making and serving some recipes from Africa.

There's never a dull moment here!

Friday, March 09, 2007

I don't know to what extent I even actually HAVE readers on this blog, but if there are any out there, you probably think I dropped dead. I didn't, of course, but I have had some big distractions since my last posting.

Most recently, we took my Mom to a cardiologist on Tuesday because she had flunked her stress test a few weeks ago. (About the time of my last post, actually.) The cardiologist ordered a cardiac catheterization. She needed to go to the hospital the next day for her pre-admittance testing, and my sister was already scheduled to work that day, so I drove back to Zanesville on Wednesday (yes, the day of the snowstorm) to take her for a couple hours of tests. Then I drove back over after church choir Wednesday night to spend the night, as we had to be at the hospital at 7:30 a.m. on Thursday.

The procedure went well and Mom seemed strong and fine afterward. It showed two major arteries are blocked 50 to 60%, and the one at the back of her heart is blocked 90%. They don't do bypasses or angioplasty or anything unless it is at least 70% blocked, so they will let the first two ride. And the one at the back of the heart is too hard to get to and too small a vein to be easily treated, so they will let that one ride, too. The doctor prescribed a beta blocker for her and said he will clear her for her back surgery. (That was the start of all this -- she is in pain and needs back surgery.)

So it was a largely positive outcome, except that now we know Mom is at risk for a heart attack. The beta blocker may help reduce some of that blockage, plus now we know to respond quickly to any signs of potential heart trouble. And the woman is 82 years old -- we were only kidding ourselves if we ever thought she WASN'T at risk for a heart attack. It's just a little disturbing being told that she is, somehow.

I have noticed as I've gone with her to all these appointments, the medical community actually treats her with a certain respect. (Amazing, huh?) I can see in their eyes and hear in their voices that they are impressed with what a tough, active little lady she is, and they really want to see her do well. It's quite uplifting, actually.

Last week had its excitements, too. Sam was off school Thursday and Friday, and while he went for neuropsychological tests each morning, we also went to a movie and tried to fit in fun stuff around the testing. He had a friend over for a sleepover, among other things. Christmas break had been like no break at all for him, with three papers due when he returned, so I felt great about him actually getting a four-day break where he could kick back some.

Friday evening and all day Saturday, I babysat for our nephew and niece. Drew is 6 and Paige is almost 4. They are really well-behaved children and just a delight to be around, but even so, by the time I got home Saturday evening I was exhausted!! Keeping up with little people is definitely a young person's game!

Since my last missive, I had an interview at The Catholic Foundation. It went well and I liked the Director there and the job sounded rewarding. The next step was for each of the ten candidates she was interviewing to provide a writing sample. It turned out to be both a writing sample and a brief project plan, but that was fine --- I felt they played to my strengths. Based on the combination of the first interview and the writing sample, she said she would narrow the field and have the remaining candidates come in for a second interview. I received a call Wednesday inviting me in next week for a second interview. So if you're reading this, then send me prayers and/or positive energy next Friday morning!

I also have an interview Monday with a place called Mapsys. I don't know much about them yet -- I still have to do my research. I never sent my resume to them -- a friend forwarded it to someone she knew there on my behalf, and that's where the contact came from. It sounds like more of a pure sales job than I think I want, but it is such a thrill to have someone seek you out that I didn't turn down the interview. After all, you never really know!

After all that driving to and from Z'ville this week, I am really looking forward to hanging out at home this weekend. I have some freelance work that needs my attention from a friend's sole proprietorship, and I'm at the point that just sitting and working on it will be a delight. In between spending some quality time with Bob and Sam, of course.

I'll try not to wait three weeks before I post again!