Thursday, August 30, 2012

Welcome to the Land of Interaction

Ladies and gentleman, on our autism journey, we seem to be crossing from the Land of Avoidance to the not-well-defined borders of Wanting to Interact and Not Always Knowing Quite How.

A little background:

Everyone knows kids on the spectrum struggle in social interactions and playing creatively and with others. What's surprised a lot of Ethan's teachers and therapists is how big that gap has been compared to some of his strengths. (This really shouldn't be that much of a surprise, as autism has this quirky tendency to express itself differently in everyone, but that's another matter.) So for example, Ethan presented himself to them (almost two years ago now!) as a child with a high level of intellect, who also was not too rigid in routines, not prone to meltdowns, not highly impacted by sensory issues (other autism hallmarks), yet had fewer play skills and less of a desire to interact than kids who were technically more "severe" in their autism. During a few visits I would watch him in a group of kids with ASD and while he technically had some of the best language and best behavior, he often wanted nothing to do with the other kids. He didn't even want to play at the same water table. He didn't want to chase the bubbles the paraprofessionals were blowing. He wanted to walk along the side of the school and (all while interacting with mom very happily) check out the air conditioners.

For two years at the library, nearly every time another kid approached the train table, he was DONE. In preschool he graduated to the integrated class and not needing one-on-one support, yet kids still requiring more support seemed to show more of a desire (or less of a fear?) of interaction.

That is changing.

The trend started with adults. I never really thought about it, but apparently adults are "safer" for kids with autism. They meet a child at his or her level. They are better at decoding what a child is attempting to communicate. They are more predictable.

Last year at school was the Year of the Adult. Ethan treated his teachers somewhere akin to rock stars. He would go out of his way to wave and call hi when the gym or art teacher passed in the hall. "What happened to him? He talks!" one therapist remarked at the beginning of the year. Mr. Chatterbox acted downright flirty with the classroom para, whom he adored.

But over the past few months and really, mere weeks, Ethan has become increasingly interested in what other kids are doing. Like, really interested. Like, we about to move into that territory of blurted or inappropriate remarks (as well as behavior) towards other children, which will undoubtedly lead to rebuffs from other children, and perhaps even a growth in his understanding that most kids just might not get, say, his ever-growing interest in girls and boys bathroom signs.

This is a little bit worrisome but mostly exciting.

At the library the other day, Ethan stayed at the train table with another boy playing for an entire hour. This is big. I can't tell you how big this is. However, as I inched closer to see how things were going, I noticed the little boy (maybe 3?) was very bossy, and Ethan was annoyed and reacting in his favorite passive-aggressive ways, like blocking one side of the table or attempting to take all of his trains. Then he'd ignore the boy for awhile or try to move the stop signs when the boy wanted the go signs. This is the type of thing that drives Anna crazy. At other times we've seen him turn requests to play chase or other playground games turn into karate-chopping, pushing, hitting, etc. before the other kid (literally) knows what hit him.

This is typical kid-brattiness, but what I can't explain to other parents, who may just think my child is incredibly annoying, is that it's more: it's also Ethan's response to wanting to be around someone else but not being quite sure what to do; or feeling uncomfortable and unsure; or not quite knowing how to regulate his emotions.

Times like these make me think seriously about social skills classes. Thankfully, we have worked out insurance for Ethan that will indeed cover them, for the most part. To be honest, I haven't been 100 percent "rah-rah" for social skills class, at least in theory. I may be completely overthinking this, but something about them reminds me of this well-intentioned but dreadfully outdated "charm school" type course that I took back during one of my Christian school years. There was lots of "do this" and "don't do that," and a sense of "you must be THIS way or you are not acceptable."

That is the ever-present question: how to make kids with special needs feel okay in their own skin while still giving them the tools to successfully interact in our world? The last thing I want to give Ethan is a set of memorized rules and responses, a list of appropriate chat topics and proper ways to present oneself at all times. I would hate to think as he grows that he is constantly putting the lid on who he is. And yet...yet: isn't it a disservice to not provide him with the resources that might prevent ridicule and heartache down the road?

For now I can't spend all of the time thinking about that. For now I will enjoy the fact that Ethan is enjoying, more than he used to, observing and participating in what other kids are doing. I am glad to be reminded again how many kids out there with autism truly may care about others and you'd never pick up on it, because they just don't know how or what to do. The caring, the longing-to-be-involved part is really a starting point. Rather than look too much at next steps, it's nice to just marvel at the fact that we have gotten to where we are on the journey.








Saturday, August 25, 2012

Ebb and Flow

We were at Ethan's school, on the front lawn at the "principal's picnic" with 50 or more other families. Most people had finished eating their sandwiches or fruit or pizzas brought from somewhere and were brushing the crumbs off their blankets and stretching their legs. The kids had gotten popcicles from the principal and most of them had now taken to the parking area right in front of the school (blocked to traffic) and were doing what kids do: mainly, running around like maniacs.

That was the first thing I noticed.

This seems so simple. This is one of the seemingly hundreds of things that seem so simple unless they are missing. People eat together and then the grownups talk and the kids wander off and just find something to do.

"Go run and play," I told him, and instead of wandering or burying his head into me or squeezing me tight, fraught with anxiety, he was off, running to the opposite curb and then back again...chasing Anna and another little girl...peeking inside the windows to get a glimpse of his new school. There was the hiccup where he translated a boy asking him to play chase to be "karate chop and push me hard," but we straightened that out.

I was reminded as I watched how, while you can work and try and push and encourage a child to interact, you can't force the desire to interact. When that piece of the puzzle is in place, everything else comes much more easily. How or Why the desire to interact forms is still a mystery. Oh, how so many of us would love to decode that piece of the puzzle.

A few minutes later Ethan was back at one of his favorite spots, the storm drain. Here we go again, I thought. Only this time other kids were there, and they were chatting together about what was below. They began working cooperatively to find different objects that would fit through the metal grates.

"Who knew the drain was all we really need for playground equipment?" the principal remarked with a smile. I didn't tell her we used to joke Ethan would grow up to have a home installed with storm drains just for his nonstop enjoyment.

Meanwhile, Anna came behind me in a small voice.

"What is it?" I asked.

"I don't know anyone here," she complained. "I'm older than most of the kids."

Anna used to be the kind of kid who'd walk up to anyone and start a conversation, the type who made a friend at the playground within a minute or two. In recent years, she's gotten more shy and cautious. In some ways, I know it's part of growing up. It makes me a little sad, too. I watch her and see myself, overthinking social interactions and doubting myself. I can't help but hope she doesn't make some of my mistakes, yet also feel grateful I can empathize.

I'm not one to compare one child to another, but I found myself saying it without realizing.

"Anna, just walk up to kids and start playing." I shot a look over at the storm drain. "Ethan doesn't know anyone either and he's over there with kids playing."

Um: seriously?

Were we in The Twilight Zone?

Ten minutes later we were on our way to the car. "Bye," Ethan was saying too softly to the boy he had half-beat-up and half-played-with. The boy didn't answer or didn't hear, but Ethan wasn't phased.

I marveled and wondered. How was it that our girl was leaking confidence, just as Ethan's social skills were beginning to bud? We used to think Ethan was so hard to figure out. Lately we've been seeing, in many frustratingly creative ways, Anna is as well. I think she always was. Really, I think we all are.

Maybe it's to show us that we will never completely understand our kids. We will always have to rely in part on a wisdow beyond our own. While our challenges with one child and then another will ebb and flow, our love can't and won't. Like all of us, they are works in progress. Their everyday lives, our everyday lives, are part of a bigger picture that is never fully complete, never fully formed...but always growing in depth and color and complexity, and hopefully, maturity.

Tuesday, August 21, 2012

Spies Like Us

When in Maine, we spend a lot of time on our camp's screened porch. We eat there, sleep there, sit in rocking chairs and look down at the water, and if people are staying at the camp next door about 100 feet away, yes, we sometimes politely "spy" on what they happen to be doing.

I've always been a people watcher, and I hate to admit I've always been nosy. This must run in the family. My mom, grandmother and I used to love to take drives or walks around dinnertime when it was getting dark, before people drew their blinds, so we could get peeks inside and see what their homes looked like. I used to make up stories about what they were doing in there. I love to see who's having a party, who's gathered in the dining room for dinner.

The camp next door, which is the taj mahal compared to our humble cabin, has a steady stream of people staying from Pennsylvania or Maine. I love to try to figure out the family dynamics. I catch bits of conversation as they dine on their porch, just as I'm sure they hear (probably quite clearly) the screeching of my kids' arguments. This week I noted that whoever was next door liked to go down to the lake and swim at all the wrong times...just before the skies opened into a downpour; around lunchtime before the sun hit the water and warmed it up; right after the sun disappeared behind a thick mass of clouds.

The thing is, I thought these things. I had an internal dialogue about what I was seeing.

Ethan, however, approached the presence of neighbors in a different way...closer to a  radio announcer doing play-by-play of the ballgame.

"Hey, why are they swimming now?!" he'd yell from the porch, watching the neighbors trudge down the hill with their towels.

Or, gleefully, "They're all done. We're going to swim longer than they are!"

Or maybe, "Hey, they are making a campfire over there!"

All announced at such a high volume most likely the people across the lake could hear.

I should mention that these pronunciations from Ethan are becoming more and more common. And as he tries out new words in a sometimes inappropriate context, they become more cringe-inducing. Twice now lately he's announced about passing strangers, "Look at that cute lady!" or "I see that cute boy over there!" Yikes.

Again and again, Ethan helps me see that speaking a language, that being verbal, is so much more than just having words. I never would have realized how many subtle rules there are, how many nuances. And beyond that, I never realized how hard it is to actually explain why some of these rules exist.

"Ethan, use your quiet voice," I hissed, embarrassed, the first few times he started up with his exuberant commentary.

"I can't use my quiet voice!" he insisted in a tone just as loud as before. While he has learned to whisper, I can't say that he's mastered the skill.

The bigger question I could see looming in his eyes was, "Why?" Every other time he is encouraged to comment on the world around him. What's wrong with simply stating what we see another person doing?

As I sat there, I myself began fumbling for answers.

"It's not good manners," I whispered, a perfunctory cliche that I knew he'd heard before but didn't quite understand except to know not having good manners was, well, bad.

My mom was there. "Just tell him it's not nice to talk loudly about people we don't know," she said.

That went into a little more detail and explanation, but still seemed lacking. Sometimes we talk loudly about people we don't know, like the person performing at a show or a firefighter or policeman, someone cool who really grabs our interest.

The real issue came down to the intrusion of privacy, something I happened to be doing myself, albeit quietly. But how to explain: we shouldn't be watching what our neighbors are doing all the time (particularly when I was doing the same thing, and actually, so was Anna)? How to explain the word privacy? Ethan understood the concept in one context -- the bathroom, as in "Close the door, I need my privacy!"

I just couldn't figure out how to explain that in four-year-old terms. I thought of Anna at that age, at the way she must have just learned through osmosis, taking in the entire picture of her surroundings, sucking it in, translating it for future use. Maybe one day she noticed us speaking in low tones about the neighbors, doing our best not to stare or look obvious, and she effortlessly observed and began to apply that herself ("We don't stare. We speak quietly when talking about the neighbors. We don't want them to hear us. That would be rude.").

I know we'll get this thing down at some point. Ethan will learn in his own way. My guess is someday he'll be able to explain his own ways he's come up with teaching himself social rules, and they'll most likely seem a little humorous while still making a whole lot of sense.

For now, well, let's just say we had no good answers. So when we heard something like, "They're getting in their car now!" We just said, "Ethan!" with a warning look that meant, well, something. And he maybe he quieted his voice by about five percent for, well, some reason, for two seconds.

We'll get this. Someday. But I'm ashamed to admit -- I'm probably still going to keep peering curiously (yet subtly) into people's windows. There are just so many good stories out there.


Monday, August 20, 2012

Lessons Learned from Vacation

 Whew. We just spent eight days in Maine, at our camp, then at a national park, then at a relative's house. We're all tired but satisfied. The week wasn't perfect as vacations rarely are. The week wasn't all that relaxing, as vacations with kids rarely are. My car looks as if it's been nuked. But that's okay. We still had fun. And as always, I learned something. I learned a lot of somethings. Since I adore lists, here goes:

1. When trying to act all frugal and like a "smart supporter of small businesses who's going to avoid the expensive rest area on the highway," well, don't. Stay on course. Don't deviate from the interstate. At least not with kids. Not with kids who refuse to eat at all the cute lobster shacks dotted around ultra-touristy towns like Wells and Kennebunkport, towns so evolved they don't have a darned McDonalds or any sort of (the horror!) fast food chain establishment. Oh, and while you're at it, don't assume the roads off certain highway exits have to "lead back to the highway eventually," unless by eventually you mean a half-hour later, after wasting more gas than you would have spent on the hiked up prices at the rest area if you'd never gotten off the highway.

2. Of course it's next to impossible, but during vacation it's wise to at least attempt to keep the kids on a bedtime schedule somewhat similar to home -- or they will turn into the spawn of the devil about five days into the trip.

3. It is possible to finally light a fire after using about 273 matches.

4. If it were up to Ethan, his vacations would involve taking walks, watching DVDs, eating, swimming, and watching more DVDs. He gravitates toward the portable DVD-player like a moth to light. He plays with the cord; he starts asking at about 7:30am if he can watch DVDs. This gets tiring. Prolonging his gratification is a must and is good for him. This year he tried fishing for the first time. He got interested in poking at the fire and roasting marshmallows. He even made a five-minute attempt at Tinker Toys. Pushing and pushing gets exhausting, and during vacation it's sometimes hard to know when to push and when to just let him vedge. But it has helped him crawl just a bit out of his comfort zone.

5. Grandparents should not make up stories about Bigfoot sightings in the state of Maine just before they leave me to stay alone with the kids for two nights before Dan arrived.

6. Looking up and seeing a jillion starts reminds me how small I really am.

7. If the skies open up and it's one of those miserably rainy days when outdoor time is impossible, don't take your kids to see the movie Ice Age part-whatever, unless you have lots of popcorn. And are open to a nice nap in the dark. And I quote Ethan: "How many more minutes until this movie is over?!" 

7. If you are going to take kids to a national park and tell them they may have a chance to go swimming at the campground, but later tell them there is unfortunately not time to go swimming, they will completely forget every cool, scenic thing they saw for the past 10 hours and will sob as if their hearts were ripped out because they couldn't swim in the dinky pool, despite having swum all week in the lake.

8. If you already have a wild imagination and are not terribly fond of wild creatures of any kind, it's probably not wise to read a book called "Night of the Grizzlies," about grizzly bears ripping people out of their tents and subsequently chewing them to death, if you are ever going to go tent camping. It makes no difference that there are no grizzlies in this part of the country. You will awake and hear a rustling in the woods (that turned out most likely to be raindrops dribblinging on the tent roof) and imagine a bear is sniffing the lobster juice from dinner you are still wearing, a hungry bear who will soon be extending a long, sharp claw into the nylon of your tent and going for the kill.

9. Maine whoopie pies are really, really bad but so, so good.

10. To estimate your travel time to or from a destination, take whatever the GPS tells you, and, if you have kids in tow, add at least two hours. The trip will include at least three bathroom stops, a stop for gas, a stop because someone's thirsty, a stop because someone's hungry, and possibly a stop to prevent someone from pounding someone else to smithereens in the backseat.

Farewell, summer 2012. It's time to take on the fall!

Saturday, August 11, 2012

Glory

Ethan has become quite the Bible scholar lately. He's always wanting me to read him the stories in the various children's Bibles we have scattered around the house. The other day we were reading about Noah and the ark when a light bulb clicked on in my head.

"Ethan, did you know we have a Noah's ark toy?" I asked.

"We do?" he answered.

Indeed we do: the Fisher Price Noah's ark, complete with white-bearded Noah and an assortment of animals (in pairs, of course). The ark (or more specifically, the animals) had been one of Anna's favorite toys from around 18 months to age 3. Back then we spent an inordinate amount of time lining them up two by two, making them romp around, even having the animals attending "animal school" and playing on the "animal playground" (made of wooden blocks).

Noah's ark had been gathering dust in the basement for years, along with a good number of other toys. For some reason I had brought it up upstairs and back to the playroom not long ago.

We bopped over to the toys. I presented the ark and took out the animals that have been patiently waiting in small toy bins. Out they came, into their lines of two by two, although probably at least five of the animals are now missing their partners. Can I just say that despite the cliches Ethan hates lining things up? You'll never see him do it. I wanted a nice neat line of animals leading to the ark, but he wasn't having that. We crammed them into the mammoth boat and began sailing it over the carpeted sea...where Ethan then decided we needed to start shooting it with fire bombs. Then a pirate attacked. Sadly, the animals and Noah ended up quite dead, sprawled about everywhere. Funny, I don't remember reading that part in Genesis. 

I can't describe the feeling. I can't describe what it means to wonder (and even believe) your child will perhaps never be able to do something, to in some cases even be told he most likely will not (again, I hear the teachers, "he's just not into play; he'll like video games someday"), but then yet in time watch him prove the skeptics wrong. Something about that makes the experience, makes the littlest, relatively ordinary moment like listening to your child ask, actually ask, to play with a Mr. Potato Head or hear him rifling in the toy box, so rich and so beautiful.

While we sat and played and had our fun, my heart was full. My heart was full from the joy of the moment, absolutely, while simultaneously wanting to burst with longing for those just like me who have prayed and worked with and wished and tried everything for their child...yet still they wait for progress. Still, they wait for words, they wait for something to blossom. Their hearts ache. They don't understand.

The temptation is always there to ask, "Why us?" whether in a negative or positive context, but I don't think that can be the question. I know that these children and young adults and their families are no less loved, no less valuable, no less deserving of seeing breakthrough. There is no logical answer to why we are seeing some dreams realized while others wait...and wait.

Our pastor not long ago brought up something I'd never heard of, most likely because I don't have a deep, historical theological background. He was talking about a certain catechism (a summary of doctrine traditionally used in Christian teaching). Something called the Westminister Shorter Catechism, from way back in 1647, summarized Christian doctrine in this way:

Q. What is the chief end of man?
A. To glorify God and enjoy Him forever!

When I read over those words, when I let them roll around my head and my heart, I can understand just a little.

A friend once had a quote up on her Facebook page, something like, "The question isn't why, but how?"

The question isn't why things are they way they are, but how we can use whatever comes to us to reflect God's glory? 

I know, that sounds so Christian-y. And what does that even mean, to glorify God? That we stand around with pious, serious expressions and discount our feelings of despair because "God has a plan" or "this is God's will?"

I'm no theologian, but in my mind glorifying God means being more like Jesus. And what does that mean? Living a life that's more selfless and less selfish...loving without condition...using our pain to birth compassion in us for others...and knowing and longing for something far greater than this, something so incredibly awesome that the heartache of this world will seem to have lasted just a few seconds' time, in the grander stage of eternity.

I have this idea that heaven has nothing to do with sitting on clouds and playing harps. I see heaven as a place where we see broken dreams healed, where we get to do and see and hear all of the things we so longed to witness on this earth.

We will continue to rejoice in Ethan's progress and pray for those who are continuing to hope to see their loved one make greater gains. I pray my heart remains full -- of gratitude, of grace, of compassion for others. But may I understand that what Ethan or any of us accomplishes or doesn't on this earth pales to the greater glory, the greater story, that is being written and that we will never fully know, while we are still living in this world as we know it.

Now we see but a poor reflection as in a mirror; then we shall see face to face. 
Now I know in part; then I shall know fully, even as I am fully known. 1 Corinthians 13:12


Tuesday, August 7, 2012

Play: Rules of Engagement

We've seen some nice strides at home lately, as far as play and Ethan is involved. In the past few days alone, I've witnessed him play with his Wonder Pets play school, race track, and Thomas the Train play set. He's dug in the toybox for toys and even took out a Mr. Potato Head for the first time in, well, ever. Anyone who knows us knows this is big.

At the same time I've witnessed Ethan at other places, where the change in environment and lack of many available toys means lots of fiddling with cords, light switches, and air conditioner on/off buttons.

This gets me thinking again about expectations and play. I've written about this before because it seems to be a common theme with us. Every individual autism seems to have a few themes that define that particular autism, that come up again and again. For us, a big one is play, and by that I mean pretend play, creative play, social play and independent play.

After two and a half years now of learning more about play than I ever thought possible, I've discovered so much is related to the connection between 1) the child's environment on any given day  2) the type of toy and  3) the child's current developmental level of play.

Kids will obviously be at their highest comfort level in the familiar surroundings of home with the usual toys at their disposal. Kids who have trouble playing and knowing how to play need a play partner when possible. This is the time to introduce play schemes; how to appropriately play with a toy; ideas about how to use toys in creative ways.

Kids will be at their highest developmental level of play in those familiar surroundings and with a play partner (for a fascinating look at play stages, by the way, check out the Westby play scale.). So for example, when I play along with Ethan, he can play at about a four-year-old level. Yet if I leave him to play on his own, he's closer to a two or three-year-old typical child. And if we're in an unfamiliar environment, the ability to play further diminishes. There are too many outside stressors and distractions.

What does that mean in terms of the types of toys our kids play with?  How do we encourage old-fashioned, unplugged, and sometimes independent play? (I mention this knowing some kids with autism only want to play alone, with a few select items. In the past Ethan has preferred to play with someone or not at all.) When do we push our kids and when do we give them a break? The way I see it:

Different toys require different sets of play expectations, and different settings require different sets of play expectations. Preferred toys (which in Ethan's case are electronic; the ones that don't require much thought) are best given 1) as a reward 2) for those times we really need to get something done and can't focus on what he's doing and 3) as a comfort and stress-reliever in different or unfamiliar places. We've learned to introduce more creative, open-ended toys first with a play partner, who can demonstrate ways to use them and show how they might be fun and interesting.

If I'm playing with Ethan, I'm going to push the boundaries a little bit. I'm there to help him recover if he gets frustrated, so I'm going to up the ante, introduce an idea that's a little different, throw up an obstacle, introduce a creative idea. If I'm asking him to play independently, there's a different set of expectations. In addition to the standard electronic stuff, we have what I'm going to call "safe toys." What's a safe toy? It's something a little more creative than electronics but a little less stressful than a completely open-ended toy, like cars or trains or little superhero firgurines. To encourage Ethan to play on his own without having the usual crutch of something with a screen, we started with some of Ethan's favorite, safe, open-ended toy and expecting him to play with them alone in only small increments; say, five minutes. For us, Ethan's safe toys are things like books, puzzles, stringing beads, Light Bright, the Perfection game, and his toy piano, to name a few .

The goal is to help kids learn to want to explore and be curious with toys, and not always have to have someone playing with them. The moment I see Ethan's okay playing on his own, I step back. At the same time, one thing we have to be aware of with autism is that kids tend to lose interest very quickly and also get frustrated very quickly. This is why, while I encourage independence, if Ethan takes out a brand new or unfamiliar toy, if at all possible, I zip over there to help him out before he has a discouraging experience and decides he doesn't want to go through that again. Ever.

Case in point: this morning Ethan wanted to play with the potato heads. If he'd been playing with them for awhile, I would have identified this as a perfect "safe toy" activity and urged him to play on his own. However, in the past Ethan has gotten extremely frustrated with not being able to push the pieces in hard enough and having them all fall out. He literally wanted nothing to do with Mr. Potato Head for two years. This morning was an opportunity I didn't want to miss, so we sat down and played together. Of course, this is life, and that's not always possible, but it's good to keep in mind as a general guideline. Right now he's playing with play-doh on his own. By himself he repeats the same thing over and over. If we were to sit down and play together, I'd make the experience more creative. But that fact that he'll use it on his own for awhile makes play-doh, at the very least, a safe toy option. The more of these we can have, the better our sanity as caregivers, and the more possibilities our kids have to expand their play repertoire.

Ethan may play like a 4-year-old with me, a 3-year-old on his own, and a 2-year-old somewhere else. Why? Comfort level. A child who has trouble generating ideas naturally is more stressed and aimless when left alone to play with toys. When a child with autism visits a house with, for example, few toys that are familiar or few toys at all, his world is rocked. As it is, just taking in the new location, with its different sights, sounds, smells and textures, can be overwhelming. Ethan will wonder why certain fans are making certain humming sounds, or why the kitchen smells different, or why the light switches aren't the same. Sensory overload and social anxiety means we need different expectations. These are the places to pull out the computers and electronics. Comforting, fun, familiar objects can provide a welcome relief from stress just when they need it.

I write all of this not as an expert or as someone who has this all figured out, but as a constant thinker and analyzer who has seen some progress and wanted to share in case anything here helps someone else. This is our situation, and our story, and I'll be the first to acknowledge that every child is an individual. But sometimes there are common themes, and sometimes those common themes have common solutions.


Wednesday, August 1, 2012

The Bathroom Question

It's an issue you rarely think about until you have kids: when are they old enough to go to the bathroom alone in public places? And what do you do when you have a different sex/parent child in a public place and have to use the bathroom? This issue get really thorny for some special needs families.

We started letting Anna visit the restroom on her own in restaurants about a year ago. There was a lot of trepidation on my part. Anna takes after me in that her sense of direction in new places is a little weak. Dan hasn't had to taken Anna inside a bathroom with him since she was about 4, which seems to be the age when things get uncomfortable, particularly if you're talking about a girl in a men's room, where things are, ahem, a lot more out in the open.

Little aside here: I remember once being in a Barnes & Noble bathroom with Anna when she was maybe three, and she began wailing when she realized Daddy was using a different bathroom. "He's a man, he has to use the men's room," I explained, to which she yelled, at the top of her lungs echoing through the toileted chambers, "It's not fair! I want to be a man!"

Thank God we were already in the bathroom, because I was laughing so hard I nearly peed my pants.

So now we come to the issue of Ethan and public bathrooms. I've noticed the ladies are more understanding about little boys in public bathrooms, probably because 1) We always seem to need to use the bathroom more often than men, which makes it more likely we're going to have our kiddos with us and 2) We worry. We fret. We're women. We know there are weirdos out there and we want to keep our kids with us for as long as possible.

Ethan is 4 but looks like a kindergartner or first grader, but he still hasn't gotten any looks of disdain yet. You know -- those looks from women that betray their discomfort and displeasure at a member of the opposite sex being there.

A typical kid at some point obviously reaches that threshold and can use the bathroom alone. We still aren't quite there yet with Anna in really busy public places, like amusement parks. But at some point, we'll trust her.

But what about kids, what about adults with special needs?

I have several friends with boys who have autism who have dealt with the issue first hand. It's not always pretty. Women see a boy nearing teenager-hood in their bathroom and don't know what to think. In some ways, the more severe and obvious the disability, the more understanding people are. But sometimes autism can be invisible. These young people look perfectly capable, yet emotionally and mentally, there can be all kinds of issues if they are in the bathroom on their own. Some will go in and not want to come out, preferring to play in the sink. Some might have a deathly fear of the sound of the toilet flushing or hand dryer and need someone there to walk them through the process. Some might forget about privacy and closing the door and not quite be discreet, opening themselves up to not only ridicule, but possibly abuse. It is not a safe world out there.

So now we come to Ethan, who has recently come to the realization that he is in fact different from mom and Anna, and when it's just the three of us, sees using the men's room as some kind of status symbol.

"There it is!" he'll say, after looking like a hawk for the little man's picture. "That's the man's room. I want to use that room."

"Um, you can't today, daddy's not here," I'll tell him, which is incredibly confusing. Why is it okay when daddy's there but not to go in there alone? "You're too young," I tell him, although I let him use the bathroom in Toys R Us once. And in the library. These deviations only create confusion, however.

All of this has made me think, really think about the skills necessary for using the bathroom alone. To me, it all boils down to:

The child needs to know how to go in the bathroom, discreetly go, wash hands, and come directly out. For Ethan, apparently the one thing he doesn't have down is the "discreet" part. I found this out from Dan, who told me he's not using the urinal quite right, or being as "subtle" as he should.

"What does that mean?" I asked him, not that I really wanted details. "This is something you're going to have to teach him. Isn't it one of the manly arts?" (We have this ongoing joke about "manly arts." It was an article Dan read in Equire magazine, covering what every man should know how to do, like changing tires).

So Dan's going to work with Ethan on that part, since I'm obviously rather and rightly clueless.

The other issue is more subtle. What about the whole social aspect? What about not commenting on what other men are doing in a very public way, or responding if someone did speak to him, or not barreling someone over to get to the paper towels? These are the nuances that can't necessarily be taught, or may take years to fine tune.

I was with the kids in Wal-Mart the other day and was still in a stall after the other two had finished. Things did not go well. Ethan started pounding on Anna for no reason other than that he wanted to be an annoying little brother. Then a lady came in and I heard Ethan say loudly, "This is a LADIES room!"

"Ethan!" Anna was hissing at him. "Did you say that because you thought she was a man? That was a lady!"

I'm not sure why he said it. I think he was just acknowledging his place, that his lot in life at that particular moment was to stand around waiting in the ladies rather than mens room. Although he does tend to assume most women (particularly if they have short hair and are rather masculine looking) are indeed men.

I write at length (too much length, I'm guessing!) about this, and I try to bring in a little humor, but for some people, this really isn't funny. I am fairly confident that within a few years Ethan will be able to use most public restrooms on his own. For others, it is an impossibility. And for those families, I pray for grace and most of all understanding from others. I pray that people will think before giving a glare or making snarky comments. For some it's not just a bathroom break, it's a stressor, another time they know they will endure stares for being different. That should not be.