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Liane Kupferberg Carter

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Next Steps For An Adult Child With Autism

Posted: 04/05/2012 2:52 pm

This week began with World Autism Awareness Day, created five years ago by the group Autism Speaks as a locus for fund-raising and spreading the word. It comes at the start to National Autism Awareness Month, which was created by Congress back in the 1970s. In commemoration of both, Huffpost Parents is looking at autism through the eyes of parents all this week. Each day we will run an essay about a next stage of parenting a child with autism, starting with the moment of diagnosis, and going through school years, and teens, and entry into the adult world.

I don't know how to do this.

There's no book for taking the next step. No Fiske Guide to Colleges. No Barron's. When our son Jonathan was preparing to leave home for college, we had a whole shelf of books to guide our family.

There's no book for our autistic son Mickey, who is turning twenty. No U.S. News and World Report ranking best vocational opportunities; no handbook rating residential programs for developmentally disabled young adults. We're making it up as we go.

Graduation fever is spreading through Mickey's class. Parents and students are itching to leave the security - and the restriction -- of our public high school's self-contained life skills class. Most are opting to send their children to residential programs far away. I'm feeling coerced into making decisions I'm not ready to make; I roil with fear and uncertainty.

Petitioning the state for legal guardianship of our own child before he turned 18 was heartbreaking. Getting him Supplemental Security Income and entering the labyrinth of federal bureaucracy was nightmarish. But this step - preparing to leave high school, and the world of what the government promises every disabled child, a "free and appropriate public education," isn't just unnerving. It's terrifying.

Mickey too has caught the fever. He has been a twelfth grader for three years, and he is asking to leave. Loud and clear. "I'm not going back to high school next year. I don't want another yearbook. I'm graduating."

He has always loved his yearbooks, memorizing the name and face of every person in the building so that when he walks down the hall he can greet everyone by name. I have secretly ordered a yearbook for him. Just in case he changes his mind.

"Everyone is ready to go to college at a different time," my husband Marc and I tell him.

"I'm going to college!" he insists.

Does he even know what college means? He knows his brother and cousins have gone; he sees classmates leaving. He understands college is the step that comes after high school. "What do you think you do at college?" I ask him.

"I don't know."

"Do you go to class?" I persist.

"I. Don't. Know."

Does he think it consists of eating out, hanging with friends and watching televised sports in the student union, as we did when we visited Jonathan? Or perhaps he views it as extended sleep-away camp?

"Can we look at colleges this week, Dad?" he persists.

"Sure, Mick," Marc says. Later he tells me, "What do you think he's expecting to see?"

"I don't know that it's anything specific," I say. "I think this is his way of telling us he wants more freedom."

We say, "College." But it won't be. He's too cognitively challenged for that. "College" will be what we call whatever he does next.

Mickey is legally entitled to one more year. Parents of older children with disabilities advise us to keep him in school as long as we can. "Take whatever the public school system can still give you and hold them accountable," one advises us. Another warns us that once a child turns 21 and exits school, services for disabled adults are abysmal. "In school you're used to having people with master's degrees working with your kid," cautions another parent. "Once you leave school, you're getting people making $10 an hour."

"But they have high school degrees, right?" I ask.

She laughs ruefully. "If you're lucky."

Marc and I aren't ready to take off the training wheels yet. "Residential placement seems so permanent," Marc says. "Camp is one thing. Kids get really grubby there, but we always know we're going to pick him up and clean him up again. His voice cracks as he asks, "Would you pack a six year old off to boarding school?"

But Day Hab sounds like a dismal option. The programs are funded by Medicaid. I've heard parents describe it as "glorified babysitting." I think about the first special needs preschool class we ever visited. Seventeen years ago, and I can still see that impassive teacher who never left her chair or looked at us. How bored she'd looked. Is that what day hab offers? I picture a warehouse. Indifferent, untrained staff. Keep-busy activities. Coloring. Stringing beads. A room full of disabled adults, parked in front of a TV for hours.

Adolescence and the onset of epilepsy have made him emotionally labile. He can be belligerent when thwarted. Are these normal adolescent mood swings, or the harbinger of a seizure? We're never sure. Anger and irritability can occur hours or even days before one strikes, like the hissing whistle of a sky rocket before it explodes. We've learned how to manage him, knowing how quickly he can flare up and spin out to that angry place, and how difficult it is to reel him back. But the world isn't going to tiptoe around Mickey. It is he who must learn to control his temper.

To this end, we enlist the aid of the school psychologist. "Mickey is intelligent," he says. "He really has some insight into his behavior." It makes me teary. No one else at our public high school has ever said my child is intelligent.

Intelligent despite the terrible standardized test scores; despite profound language deficits that even now cause him to mix up his verb tenses or use scripted speech; despite three sedating anti-epileptic drugs that dull him down. We no longer question whether he is innately intelligent. We know he is. We hear it in the observations he makes, in the questions he asks, in the way he cuts to the emotional core of things. After the death of a great-aunt, he tells us, "I feel so sad. All our people are disappearing." When his class throws a party for him, he tells the teacher, "I feel loved."

And he is. Even when he isn't easy to be with, he is still lovable.

We have felt cushioned and cocooned by school the past sixteen years. We haven't always been happy - in fact we've been profoundly angry at times. But being in school has meant that we've known where he is every day, and that he is safe.

And that's the crux of our fears. We can't keep him safe anymore. We know our son needs to be stretched and challenged. But the world isn't safe. How will we protect him, when we are no longer there to absorb the blows?

Does Mickey realize that he will never be able to go out into the world unattended? Never ride a bus or train alone? He will never drive a car; epilepsy has seen to that. Living with seizures is like living with the threat of terrorism. You have to stay vigilant, because you could be struck anywhere, any time. A seizure leaves him so profoundly disoriented that he will walk into oncoming traffic. More than once I've cradled him in my arms after one of those episodes, only to have him ask me, "When are my parents coming to pick me up?"

Other parents look forward to their empty nests, to reconnecting as a couple. We have micromanaged every hour of Mickey's life for nearly 20 years. How do we ever shut off our dependency on his dependency?

Will we feel free? Or unmoored?

Then we get lucky. A space suddenly opens at an autism school half an hour from home that has a transition program. They will take him for his last year of formal schooling. They want him immediately. They will work on cooking. Laundry. Emailing. Office skills. Money management. Travel training. Our school district will bus him there. We describe it to Jonathan.

"Is this a marriage of convenience?" Jonathan asks.

"This is a good place," Marc assures him. "And it buys us breathing room."

We cross our collective fingers. Mickey glows when we tell him he has done so well at high school that he is graduating into a program that helps kids get ready for college. We make the switch.
After his first week in the new program, Mickey writes Marc an email.

Dear dad

Yesterday I went to gym and do volleyball. Then I went for a walk.
Then I worked on the computer. I feel great about my new class

Love
Mickey

When a baby is born, someone cuts the umbilical cord for you. How can we possibly loosen the thousands of threads that bind him to us? It's an endless unraveling, this process of letting go.

But we must. And we will figure out what comes next. We will do this just as we have done everything else these past twenty years. Pulling together as a family.

Read more essays by parents of children with autism here.

 

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This week began with World Autism Awareness Day, created five years ago by the group Autism Speaks as a locus for fund-raising and spreading the word. It comes at the start to National Autism Awarene...
This week began with World Autism Awareness Day, created five years ago by the group Autism Speaks as a locus for fund-raising and spreading the word. It comes at the start to National Autism Awarene...
 
 
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10:12 AM on 05/29/2012
Thank You, this story made me cry. I have a 25 y/o Severely Autistic son that lives at home with me. He has been denied a medicaid waiver for group home placement because of some "wording" in the Alabama mental health laws that states "you must be dx with MR prior to age 18" for a Medicaid waiver. Todd was not. I have written the Governor & Senator who say he sounds like he qualifies and needs placement, then Mediacaid says oops sorry no can do. I ffel as though I have been banging my head against a brick wall for several years now, friends and family say they understand but unless you've lived it you just can not know. Todd has become more and more violent as he gets older, medication does not help. From the look of his pupils I believe he is having a seizure when these "violent fits" happen. but because they don't show up on EEG's the Dr's say no they are not and that I should practice "Behavior Modification" I am to do this while he is biting his arm, hitting me and then bangs his head on the wall. Best thing to say about it is that he is a multi tasker?
Thanks again for your story sorry I rambled but sometimes I just have to get it out, and no one close to me really understands.

http://www.youtube.com/user/hasenpfefferwho?feature=guide
03:00 PM on 05/31/2012
Margaret,
I understand your frustration. Sometimes my son's seizures haven't shown up on the half-hour EEGs in the doctor's office either. Have they done an extended EEG (multi-day) in the hospital with video monitoring?
11:29 AM on 04/13/2012
thank you for posing this as a mom of 2 children with autism i am concerned on their next steps and also what is to happen when i am no longer around its not pleasant to think of but you have as a parent of children with disabilities everyday i think of these issues and im hopeful that one day i will have the best ans 4 my children
03:28 PM on 04/13/2012
That's true, Linda, it's something we all worry about every day.
11:18 AM on 04/12/2012
@Cafebeege --
I know exactly what you're talking about. Doesn't matter how many studies have never found any causal link between vaccines and autism. In the absence of any real answers, people will believe what they choose to believe. And as you said, unfortunately some of the worst mother-bashing comes from other mothers.
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sharonlmomofthree
03:46 PM on 04/11/2012
I have a 15 year old son with autism who currently resides at a tuition based "autism school." I have no idea what my son, Matthew, will do after his school years are behind him. He has okay language skills, but can barely read and does have over-stimulation problems so I don't know about holding a job, especially in a public setting.

But I sure don't want him at some group home, sitting in front of the TV all day, or some other equally mindless thing. And I worry about him even having a place to stay where he can be taken care of. A place where he is accepted entirely for who and what he is. A place where he doesn't always have to come into everybody else's world, but they come into his. He seems to like where he lives now, and he is well taken care of, but the funds from that could dry up any time.

I'm amazed at the amount of hostility that comes from working people who resent anything going to adult with disabilities. Like anyone would choose autism? "Well, you can't expect the govt. to take care of you." My son is unable to drive a car, balance a checkbook and I'm not sure he even knows what the concept of money is. But, I will work to make sure there is a place for him in the world in which to live his adult years.
05:42 PM on 04/11/2012
Sharon, it sounds as if your son is in a good place for now, but I understand your fear about losing funding. it scares me too. And I'm often surprised -- and disheartened -- at the hostility you mentioned too. Cultural shifts happen slowly; we certainly have our work cut out for us. Thank you for commenting.
SapientiaAudit
Tempus Dicit, Sapientia Audit.
03:15 PM on 04/10/2012
Thanks for writing this article. As an adult with high-functioning autism I have had to overcome many challenges and I am just beginning to become a fully functioning member of society. I turned 33 today, and for the first time in my life on my birthday I have permanent employment, a stable living situation, and my outlook has never been brighter.

I have spoken to parents with autistic children and have found that I have much to offer in the way of insight into how their children think, act, and react in various situations. I would like to help more, but I'm leery of organizations that claim to speak for people like me yet mostly consist of neurotypicals.

I was wondering if you had any suggestions on where I might go, and what I might do to help parents of autistic children, and the children themselves better understand and cope with their condition?

Thanks again.
05:09 PM on 04/10/2012
First, thank you so much for sharing your story. I'm so glad to hear that you are thriving.

Are you familiar with the website Thinking Person's Guide to Autism? They are featuring "Slice of Life" conversations with autistics of all ages -- kids through adults -- throughout April's Autism Acceptance Month. It's a great blog, and many parents read it. It might be a good forum for you, if you are comfortable writing about yourself. -- and not just in April. Anytime. There's a "submissions" tab at the top of the blog.

TPGA's goal is to help readers understand that autistic people are people who have interesting, complicated lives and who are as diverse and varied as any other population united by a label.

This is taken from their website:

"We are the people in each other's neighborhoods, and the more we know about each other -- the more visible autistic people and children are -- the more common autism acceptance will be. That is our hope."

Thank you for commenting, I really appreciate it.

http://thinkingautismguide.blogspot.com/
04:57 PM on 04/07/2012
My experience is a bit different, and a bit later. I am not really cognitively disabled and only have "mild" Asperger's and a traumatic brain injury (and about a half dozen other things, but those aren't as important). Because of this I was able go to and complete college with a pretty decent GPA (a 3.1 at a small liberal arts school). Then I went to grad school because I wanted to get my Master's in Special Education so I could teach other young aspies.

Here is where the story takes a turn for the worse. I aced the classes (well all but one), I aced the internships, but NOBODY is willing to give me a real chance to student teach. They believe autistics have no place teaching in the classroom, and aren't going to budge. The second chance they pretended to give me, I even passed every review (which are biased by the way, your ability to maintain friendships with your coworkers is graded 15 times, your ability to effectively teach, 3 times) with flying colors, only to be dismissed 5 weeks in. Now I sit here with my Master's in Special Education, but no certification, which means there is very little I can do with it. I need a little help, some services to help me get a decent placement where I can get a real chance, that just doesn't seem to exist here in Phoenix, and even if it did there is still the ASU problem.
03:07 PM on 04/07/2012
I find it interesting that the author posts that there was an opening at an "autism school" a half hour from their residence but fails to mention the name of the school. I have found in our 18 years of traveling this maze that so many people when posting of their successes with one program or another will never mention the program or the location or give any details. I believe that people do this because they don't want "their program" overwhelmed by applicants because it might somehow "dumb it down". Has anyone EVER seen an exhaustive list of schools and programs broken down by state or city? I highly doubt it.
03:07 PM on 04/07/2012
As a parent of a 24 year old child with a spectrum of challenges - and mild autism is also in the vocab - I know that once a child with any disability turns 18 - the information runs dry! I believe those 'out there' with the 'so-called knowledge feel it is easier to take care of the younger children...which is ok of course - but a young adult is till a kid - and a child with a disability will always be a child in many arenas! It is very hard....and yet it is wonderful and uplifting to read positive stories to know that you can uncover a 'pearl' in a sea of empty oysters! We can't give up! We just need to help one 'starfish' at a time...and we will! Watch for our recreation center that will be up soon in Southern California....Myself/my boyfriend (who has a severley autistic son)...and his other son and fiancee who work in this field - along with my inspirational son will have something for you...and generations to come ...SO IT WILL BE EASIER FOR THE ANSWERS WE NEED! Takes money/donations - but with bavy-steps will will get this done for all of us to work together as a community!
02:44 PM on 04/07/2012
I really feel for you. I am the younger sister of an autistic 67 year old man. When our mother died 6 years ago, I was suddenly in charge of his care. He had lived with my mother and worked in a sheltered workshop for over 20 years. Before that he never had the chance to be mainstreamed but he had gone to a boarding school for the "mentally retarded" for 30 years, which is all that was in the 1950s. Now all he talks about is going to college like I did. He has taken the GED many times and of course never passes -- he gets the minimum score because he knows how to write his name. I did get lucky and find a residential program near our home that is truly wonderful. My brother still talks about going to college, but of course he never will. I feel sad that he will never get to "move on" as he says. But the truth of the matter is that even when he is angry that he can't move on, he remains optimistic that he will someday. So while I am sad that he can never be like everyone else, I am comforted by his determination and optimism. In fact, I am a little jealous of it -- I wish I could maintain that outlook the way he does..
12:23 PM on 04/08/2012
Beautifully stated and I wonder if there's actually an online course at a Community College he can take. God Bless
03:23 PM on 04/08/2012
Thank you for commenting, and for your suggestion.
02:44 PM on 04/07/2012
My experience is a bit different, and a bit later. I am not really cognitively disabled and only have "mild" Asperger's and a traumatic brain injury (and about a half dozen other things, but those aren't as important). Because of this I was able go to and complete college with a pretty decent GPA (a 3.1 at a small liberal arts school). Then I went to grad school because I wanted to get my Master's in Special Education so I could teach other young aspies.

Here is where the story takes a turn for the worse. I aced the classes (well all but one), I aced the internships, but NOBODY is willing to give me a real chance to student teach. They believe autistics have no place teaching in the classroom, and aren't going to budge. The second chance they pretended to give me, I even passed every review (which are biased by the way, your ability to maintain friendships with your coworkers is graded 15 times, your ability to effectively teach, 3 times) with flying colors, only to be dismissed 5 weeks in. Now I sit here with my Master's in Special Education, but no certification, which means there is very little I can do with it. I need a little help, some services to help me get a decent placement where I can get a real chance, that just doesn't seem to exist here in Phoenix, and even if it did there is still the ASU problem.
11:25 PM on 04/07/2012
How frustrating and unfair. You mentioned you're in Phoenix -- could SAARC provide any assistance with job placement? http://www.autismcenter.org/
04:27 AM on 04/08/2012
I tried contacting them, they seemed quite unwilling to help if I am not going into their "fields". ASU has a place that is willing to help, but costs several 1000 to get in the door. That basically leaves me with DDD, which I am considering, but I don't entirely trust them either.
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SithRose
Mommy, I need Cthulhu. He keeps bad dreams away.
07:38 PM on 04/10/2012
That's...absurd. There's a CRITICAL shortage of mental health professionals in this state who know how to deal with autistic children, especially high-functioning ones. There's almost NO support for adults with HFA at all, and there's a lot of very nervous parents in the Greater Phoenix Autism Society as our children get older.

I see that you've mentioned SARRC...Have you tried contacting CARD or the Melmed center yet? You might even want to try contacting the Autism Society of Greater Phoenix at http://www.phxautism.org/ - They might have some advice too. People like you are really the BEST source of advice for OUR children as they transition from child to adult!
03:51 AM on 04/22/2012
Thank you. I actually got DXed at Melmed Center. The problem with many of these places is there just aren't a ton of openings. Melmed is probably the best source for job opportunities as they have SO much going on (not a week goes by where they aren't advertising something new), sadly as I trained as a teacher and not really a mental health care provider, the opportunities are generally limited or non-existent in places like those.
04:14 AM on 04/22/2012
P.S. #2 I really don't like how EVERYTHING CARD seems to do is ABA related. I don't dislike ABA as much as some people, but I don't think it is the absolute only treatment style that works, and have never really bought into a behavioralist model of learning being the most effective.
02:22 PM on 04/07/2012
every time I read one of these posts by a parent of an autistic adult I feel so inadiquate thet I feel like killing myself, there are no such "autism schools" in my neck of the woods, I sometimes feel my 21 year old son is stagnating and just going through the motions, he stays at home all the time, rarely goes outside, video games and television are his "babysitters" his only emotions are anger and frustration which come to the surface all the time. We need help, but none is available in our neck of the woods, really don't know what to do and we (his mother and I), feel guilty all the time because we KNOW he is not ever going to want to leave, it's just a constant guilt that wieghs you down and makes you feel like crap all the time. I really son't know why I commented, but I felt good at the start of the article, but not now.
03:15 PM on 04/07/2012
Scott, so many of us understand and feel this guilt. It comes on like a tidal wave sometimes. We read about ALL the things people are doing for their children and feel like we should do or should have done more. Let me tell you, WHATEVER you have done is what you have done. The fact that you feel this inadequacy speaks VOLUMES about the love you obviously have for your child. Some years ago there were so many snake oil salesmen out there claiming momentous victories over autism (Secretin anyone? Gluten free? Casein free? Mega doses of B12? Magic pills?) that we felt that we should "do it all". After that (Secretin) debacle we decided that WE would decide what is best for our son. I have seen EVERY "treatment" work on some and NOT work on others. It just leads me to believe that our kids are our kids. We can't force the autism away just like we wouldn't be able to force the blonde color out of their hair if we were so inclined. It is simply who they are. I cry sometimes when I see my son in his solitude but then my wife comes to my rescue and tells me "it is who he is...he is NOT unhappy"...
01:37 AM on 04/08/2012
thanks Tim, it helps to know there are a lot more people out there that have the same fellings, our son is also happy, I sometimes think he's missing out because he doesn't have a girlfriend or didn't want to go out for a beer on his 21st birthday, or didn't show any intrest in learning how to drive, but just when I think all is lost, we'll be at the grocery store or at the mall and he'll see one of his friends from school and his face lights up and he becomes almost another person as he's interacting with a friend, that reassures me that he's gonna be OK. thanks again
02:03 PM on 04/07/2012
Thank you for sharing your story, Liane. I am also mother of a 20 year-old son with Autism. Living now in Seoul, South Korea, I feel not an inch different from what the parents of young adult children with Autism in your country. Without apparent "next steps" for the future, I do agree with your saying " We're making it up as we go." I have been a volunteer for Autism Society of Korea for 3 years and trying to do what Autism Speaks and other Autism advocacacy groups have been doing on behalf of people with Autism and their families. I would like to share your wonderful story with parents in Korea.
01:38 PM on 04/07/2012
Thank you so much for writing this important piece. My son is only nine, but still on the verge of adolescence, and far enough along in his development that the view from here is one of a lifetime of continued support. Like your son he is loving and intelligent, yet has language processing issues and a general obliviousness to safety that would necessitate a near miracle for him to negotiate true independence and navigate the world alone. I have been thinking and talking and writing (and worrying) about his future for some time now. Thanks for lighting the path ahead.
06:37 PM on 04/07/2012
I too am a mother of a nine year old and a five year old with Autism, and worry so much about their future my life is dedicated to them. My husband and i are 23yrs old, and this is so overwhelming, but we always try to look at the positive things about the situation learn and accept them for who they are. Parent and guide them the best we can and give them all the love they deserve. I think about the future all the time and used to be depressed all the time, but finally looked at it in a positive way, if we always look at the negative things about it we will be unhappy and so will our kids. God bless us all, wish you all happiness and peace in your hearts.
03:26 PM on 04/08/2012
Varda, your son may surprise you. We have seen great growth with our son between the ages of 9 and 19. Thank you so much for commenting.
12:32 PM on 04/07/2012
All parents with sons and daughters who have moderate to severe disabilities face a frightening future when you look at the statistics...wait lists forever, sub-par services, no jobs...we have to work together, working with our children to help create meaningful futures. One big piece to doing that is to have a PATH or some kind of facilitated, person-centered approach. PATHs allow us to dream together and then create an action plan to work towards those dreams. It is very difficult to get out of segregated settings without a tool like a PATH.
03:27 PM on 04/08/2012
What does PATH stand for -- is it an acronym? I'd like to hear more about it.
07:12 PM on 04/10/2012
It is an acronym that stands for Planning Alternative Tommorrow's with Hope (Pearpoint, O'Brien, & Forest, 199)3 and is a facilitated group process that puts the person with the disability at the center of the conversation and process. Instead of trying to access services based on what is available, it turns around everyone’s thinking and first asks, "What do you want?" Then using the answers to guide all decisions in a natural, creative and totally individualized way, they build from the person’s preferences, interests and strengths.
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Mary Poe
07:06 PM on 04/06/2012
Thank you for sharing this poignant experience. As an early childhood special educator, it is perplexing to hear about the lack of options for parents who have young adults in this position. Undoubtedly, parents will need to collectively swarm Congress with ideas about how to support their children; not just financial support, but educationally challenging programs.