Thursday, March 29, 2001

Respite TV

Ho hum. Another study says TV is bad for kids, too violent, causes irresponsible behavior, blah, blah, blah. Honey, could you turn down that wrestling show so that mommy can read this?

Sorry, I know we need to take these things seriously. With high schools turning into shooting galleries and societal aggression at a somewhat unmanageable level, violence in media is legitimately a hot-button issue. Just so long as you don't tell me my kids can't watch TV anymore. In which case, I'll have to pound you.

I freely admit that, at this particular time, the children in my house watch too darn much television. And that, because I am a lazy parent and a bad person, I am really enjoying the peace that comes with two children in a two-TV house each happily lost in their program of choice. Ahhhhhhhhh. No squabbling. No neediness. Time to myself to, oh I don't know, peruse a magazine, read a book, take a nap, write essays for strangers and post them on the Web.

Perhaps people who have children with extra needs appreciate that peace all the more. My daughter, with her learning disabilities and frequent cluelessness, needs so much help studying and learning and figuring out what to do with herself most minutes of the day; but she doesn't need any help to watch TV, and I think that's a relief for both of us. My son, the hyperactive, impulsive FAE boy -- well, to have him sit for an hour or two, pretty quietly, pretty still, flipping through channels but no more than his father or I would do ... well, as that commercial we see every five minutes would say, it's priceless. Forget about medication; if they would just bolt a TV to his desk at school and keep an endless loop of "Rugrats" going, he'd be a docile boy.

Yes, yes, I know, I know, it's bad, bad, bad. We should be using that time to engage in enriching family activities. And we would, if my husband and I didn't fall asleep whenever we sit down for more than a minute. It's so nice that the TV stays awake.

Fortunately, neither of our kiddos is hot to watch wrestling, or MTV, or HBO. They pretty much stick to the Nick-Disney-Fox Family axis, with occasional forays to PAX for "It's a Miracle," the cartoon channel for Scooby Doo and the food network for Emeril. His "Bam!" is about as violent as it gets. I don't think my daughter can get into too much trouble with Disney's ultra-earnest fare, and the Nick-toons that my son enjoys, like "Hey, Arnold," "Rugrats," and "The Wild Thornberrys" are fairly gentle stuff, with the odd moral sprinkled in. It's good news for my daughter especially that she's no longer watching Barney at age 10, and I like to think that watching all this TV has raised her pop-culture developmental age. Then again, she adores "DragonTales," so we still have work to do.

I do try, though. I try to get them away from the TV. And onto, say, the computer! Or the Gameboy! Have some variety in your screen-staring! And once the warm weather comes, they'll want to play outside, and my period of peace will be through. Please excuse me if I enjoy it if I can. I'm pretty sure it won't turn them into mass murderers. Zombies, maybe.

Wednesday, March 28, 2001

The puberty gene

Early puberty is in the news again, but this time the theories don't have anything to do with environmental pollutants or lack of exercise. This time, researchers are speculating it's all in the genes.

According to a report on InteliHealth, scientists first looked into the genes responsible for the production and utilization of estrogen, but found no connection. They hit the jackpot, though, with a gene whose responsibilities include producing a liver enzyme and breaking down testosterone. A particular variation on that gene seems linked to early puberty: almost all girls with two copies of the variation start developing breasts before age 10, while half of girls with one copy and 40 percent with none begin that early.

The researchers posit that by reducing testosterone, the gene triggers the rush of estrogen that gets puberty going. Since the gene is vital in other ways, there's no call to start tinkering with it. But the possibility does exist that scientists may be able to screen girls to find out early whether they're at risk for early puberty onset, so that special measures such as making sure they stay active and keep their weight down can be taken to stave off the inevitable.

Why worry about early puberty? For one thing, it can cut inches off a girl's final height, since vertical growth slows after that developmental landmark. (Of course, since I'm only 4'10", I can reassure parents that indeed, there is a full and productive life under 5 feet.) For another, longer exposure to estrogen means a greater potential for breast cancer later in life. And for another, some people are just distressed by the thought of second or third graders with breasts and periods. (Well, I have a third grader with breasts, and as she would say, it's not the end of the world. Of course, she is almost 11, and so entitled to them. But I can't say I'm too upset at the idea that some of her younger classmates may prematurely join her.)

Anything that increases our knowledge of what's going on with our kids is good. And anything that can prepare families to anticipate problems in a pro-active way is good, too. But when I hear about screening girls for the early-puberty gene, all I can think about is those overambitious adoptive parents who want assurances that they're not going to bring home anything the least bit out of the ordinary. I imagine them writing to international adoption forums and asking if their prospective adoptive daughter can't be screened for the gene, because goodness gracious, they wouldn't want to deal with early puberty.

Anything that increases our knowledge is good; anything that makes a child undesirable in return is bad.

Tuesday, March 27, 2001

Non-coercive parenting

I recently reported here about a small behavior management victory in getting my son to eat with a fork. I am happy to offer the update that, after a few week, the reward of a Capri Sun in his school snack is still sufficient motivation for him to "eat neat." The fact that this problem we have struggled and worried and yelled over for years has been resolved with a lousy bag of juice still boggles my mind, but it confirms my idea that, especially with neurologically compromised children, it's better to change what you're doing or find the right positive consequence than to struggle, worry and yell.

This past Saturday, I had what may turn out to be a breakthrough with my son's other big behavioral challenge, staying quiet in church. Like the eating, this is something he has legitimate trouble with; his sensory integration problems and basic impulsiveness make prolonged quietude especially difficult. But at Mass last weekend, I had him sucking on Jolly Ranchers candies through almost the whole service. As soon as the candy ran out, he started talking; when another candy went in, he stopped. We've tried candy before, but never so consistently throughout the hour. I think I may be on to something.

"Mothers with Attitude" reader Jean Z. of Boston, MA had a behavior management triumph of her own recently, and sent me the following e-mail to share the good news and talk about "non-coercive parenting." That certainly sounds like something useful, especially for parents of special kids for whom coercion is blazingly ineffective. Since she tells her story so well, and I'm too tired from two late nights to write much today, I'll let Jean take over here:

You might enjoy (if only for the wild contrast it presents to such things as "holding time" "ferberizing" "ezell method" "tough love") looking at the Web sites "Taking Children Seriously" and/or "Gentle Spirit."

Both talk about "non coercive parenting." I though I was fairly non coercive, but it made me realize I had a lot of communication habits (preaching, judging, dismissing, trivializing) with our son that were impediments to true communication. TCS really places a lot of emphasis on treating children like you would a respected friend, and thus trying to find out what's really "bugging" them and sometimes changing your own viewpoint as to what's really important and what you "can live with."

I was pleasantly surprised the other day after our son (age 4) yelled "NOOOO! I HATE THE DENTIST! They're STUPID! Everybody there is STUPID!" when he found it was the day for a check up. I consciously repressed the urge to say "We don't talk like that in this house" and "It's not a big deal, just a check up" and "A big boy like you will do fine" and "They have those toys and pizza certificates when you're through" and "OK, don't go, if you want your teeth to fall out of your head" and "Going is NOT an option."

Instead I did that "active listening" stuff that sounds silly when you read about it, and "fed him back the feeling." Like "Yes, the dentist can be really stupid ... and scary. I agree with you." The trick I think was taking him seriously, listening, and acknowledging the feeling (fear) which underlay the angry talk.

"Yes" he said "and I don't like the machine." Then, "When the chair goes back too far it hurts my neck." Then (this amazed me, the previous visit was 6 months ago) "And last time, I picked a little truck toy from the basket and Daddy said 'We have too many of those, pick something else' and I had to put it back. But it was different, it was a zipper pull truck, and I wanted it." Then, "The cover they gave me for the toothbrush was too small and I don't like yellow." And, finally, "And I picked the blue toothpaste but it was sting-y and I wanted the chicken toothpaste instead."

"Wait a minute" I said, "let's write these things down and tell Daddy too, and think of what would we could change at the dentist and what's okay."

We did, and talked a little bit together about asking for a little pillow for the chair, not censoring his toy choice, and asking for less tooth polish time with "the machine." Five minutes later he was getting dressed to go, in a good mood.

Seems like things always go better in our house when we talk about the feelings.

Monday, March 26, 2001

Just call me Grumpy

I'm barely entering the IEP phase of this school year, and already I'm grumpy.

I'm grumpy because I just had a lousy visit with my son's neurologist, complete with long waiting-room wait, terrible conduct by the small boy, and differences of opinion on diagnosis and treatment with the doctor herself. I like this neurologist, always have, and I look forward to seeing her every six months to show my guy off. And here he's had a stellar six months, doing wonderfully in school, making progress in so many areas, and he goes in there, the day after his eighth birthday, and displays all his worst and wildest behaviors. Here I was trying to argue that ADHD was an inaccurate diagnosis for him and that neither his teacher nor I thought medication was advisable at this time, and the kid is doing everything but swinging from the light fixtures. The doctor now thinks maybe I need some medication, too.

Disagreeing with professionals is not exactly an unfamiliar experience for pro-active parents who take the time to read and write and learn about what makes their children tick -- but it's exhausting, isn't it? Why doesn't everybody just take my darn word for it. I imagine the professionals, in turn, wonder why I even bother to bring my kids in if I know everything myself. And the answer is: I go so they'll agree with me, and then I'll feel validated and reinforced. If they don't ... I still feel right. But grumpy.

The prognosis for my next few weeks looks grumpier still. Tomorrow, I have a meeting with my daughter's teacher, in which I need to hear that my girl is doing well, and the teacher agrees with everything I'm going to demand from the Child Study Team leader, with whom I am meeting on Wednesday. If she doesn't ... grumpy. The Child Study Team leader is going to give me all the good reasons why, although my daughter did fine in regular-ed third grade with no special supports or modifications, she's going to need resource room a few hours a day in fourth grade. I'm going to try to convince her to give my daughter a chance to succeed before preemptively assuming she's going to fail. I want no resource room as long as her grades would be passing for a regular-ed student -- that is, Ds or better. I'm hoping we can come to this agreement in a small, friendly meeting, so I won't have to debate it in that daunting, intimidating and foregone-conclusion-ruled gauntlet that is an IEP meeting. If not ... grumpy.

Next comes my son's visit to the pediatrician, with whom I have to pick a fight about her directions concerning ... well, I won't give you the gory details, but let's just say it involves the care and hygeine of uncircumcised boys. Her advice goes against my good sense and the opinions of many Internet sites. And you just know she's going to love hearing that I believe information from the Internet more than information from her. No doubt she's going to have a long chat with the neurologist afterward about mothers who are too big for their britches. Is it any wonder I'm grumpy?

From there, I have my daughter's IEP meeting, which better be peaceful and agreeable to myself or my grumpiness will scorch the room. Then my son's IEP meeting, which better be free of surprises. I'm seriously not in the mood for conflict here.

In the end, I know it will all work itself out. My opinion will prevail, as it did, for now, with the neurologist. But sometimes feel nostalgic for those days when I believed everything doctors told me, and let the special-ed folks do whatever they wanted because they knew so much more than me. Though in retrospect I don't agree with some of the decisions made, it was nice not to be the one who had to make them. I wouldn't go back to ignorance and trust, but sometimes the pressure of being the ultimate case manager does weigh on me. If I'm the one forcing things through, and things turn out wrong -- and why shouldn't they sometimes, because I'm neither a doctor nor a professional educator -- I will have no one to blame but myself.

That makes me grumpy, too.

Friday, March 23, 2001

Zero tolerance for zero tolerance

Another week, another school shooting.

Sometimes, lately, it doesn't have to be another week. It seems that every few days the news comes out that some misfit somewhere has taken up arms against a sea of troubles. Yesterday it was a high school near San Diego, in the same district as the school where two students were killed last week. Despite all the punditry and policy and zero tolerance, the shootings continue.

As a parent who drops my two precious kids off at school each morning expecting they'll be safe, I'm naturally horrified by the violence. But as the parent of one little misfit, I think I'm honestly more worried about the zero tolerance policies. Anything that gives administrators leave to deal with kids in a by-the-book, cookie-cutter fashion is not going to make matters any better. If there's no discretion built into the policy, you get things like kids being suspended for bringing in nail clippers. And if there is discretion, I wonder if this all becomes a convenient way for schools to get rid of their most difficult students.

I'm not the only one worrying about this. The Civil Rights Project at Harvard University has found that zero tolerance punishments disproportionately target minority and special-needs students. As reported in Wrightslaw's July newsletter, "Under the IDEA: 'If a child's misconduct is caused by the disability OR by the school system's failure to provide appropriate services and supports to address the disability, the system's power to impose discipline is limited.' But the Civil Rights Project found that "in many circumstances, school officials are ignoring the law, and parents and students are unaware of their rights or unable to enforce them."

As a parent of a boy whose misconduct is certainly caused by his disability, and has often been worsened by the school system's failure to provide appropriate services and supports, I have to wonder how he's going to make it through the system without falling afoul of somebody's idea of intolerable behavior. He's not a bad kid or a violent kid; he is an impulsive kid, a kid who sometimes doesn't have a clue where other people are coming from, a suggestible kid who will do silly things that others tell him to, and a kid who repeats lines from TV shows perseveratively. My readings on FAE do not give me confidence that he will increase in judgment and control as he ages. Right now, at age 8 and looking and acting much younger, protected in his self-contained classroom with his one-on-one aide, he probably can stay out of trouble. But can I see him one day saying the wrong thing or imitating the wrong cartoon-channel action and causing some overzealous administrator to see him as a threat? You bet.

And in the larger context, as we see so many children turning to violence because they don't fit in or they've been tormented by their more popular classmates, I'm not at all sure that just cracking down on any hint of violent behavior is the most effective way to stem this tide. Clearly, the bullying and torment that goes on in schools has to be addressed, too, and not in a way that makes the misfits the problem. That, of course, would mean having zero tolerance for the things that the "good" kids, the school leaders, the football players, the cheerleaders, the shiny happy students that make the school look good get into. And certainly also having zero tolerance for teachers and administrators who brand certain kids as trouble before they've even caused any.

Absolutely, I want my kids' schools, and our nation's schools, to be safe. But I think if we're going to get there, it's going to take more tolerance for the misfits, not less. And certainly not zero.

Thursday, March 22, 2001

Scary pregnancy stories

It's been one of those weeks in health news that makes me feel a lot better about infertility. Pregnancy is looking downright dangerous.

First came a bulletin from InteliHealth revealing that pre-eclampsia is on the rise. You know pre-eclampsia -- it's that condition the mother had in that memorable episode of "ER" in which Dr. Greene tries and tries to save the patient and everything goes wrong and she dies. Yikes.

The condition only occurs in 5 percent of pregnancies, but the rate rose by a third in the '90s. It's suspected that part of the reason for that is the increase in older women having babies. "Older" in this context means over 35, which is pretty depressing right there.

Speaking of older women having babies, HealthScout reports on a study that reveals that ... well, I'll let them say it: "Older moms are more likely to give birth to boys with deformed penises." Yikes, again. How much better for us geriatric over-35s to adopt than to risk something like that.

And speaking of pre-eclampsia, although it's long been supposed that women who had experienced pre-eclampsia during a pregnancy could pass the susceptibility to their daughters, YahooHealth now reports on a study that says that men whose own birth was complicated by the potentially fatal condition are twice as likely to see it come around again when their own children are born. Note that, of course, the men here do not get the condition; the women who bear their children do. They're carriers. Perhaps this is a good question for women to ask on the first or second date: "Oh, by the way, did your mother have pre-eclampsia when you were born?" Honey, cut your risks.

It also might be good to ask if he has any homicidal feelings when he sees pregnant women, because Reuters reports that murder is the leading cause of death for pregnant women. Not complications, not the stress of childbirth, but murder. A study of deaths in Maryland found that 20% of deceased pregnant women were murdered, while only 12% of non-pregnant women met the same fate.

Certainly, pregnancy is a joyous and wonderful time of blessings and miracles -- but I don't read news stories about that. Hey, if non-adoptive parents only want to read bad stories about adoption, I'm happy to retaliate.

Wednesday, March 21, 2001

Eight's great, but my boy doesn't look it

Today, my son is eight. I guess it's normal for parents to marvel at the passage of time and not quite believe how old their children are getting, but it's especially amazing with my little guy because he's still such a little guy. He doesn't look anywhere near eight, and that's a good thing, because he doesn't act anywhere near eight, either.

He's certainly made a world of progress since we adopted him at age 21 months, a near-two-year-old who didn't yet walk or talk. He's doing plenty of both now. His cognitive skills are surprisingly close to age-appropriate, and his language development is rapidly appoaching it. But from there, things get slippery. Fine and gross motor skills lag significantly, and emotionally, socially, and behaviorally, he's still pretty much off the charts.

His inabilities in those areas are noticeable to anybody who spends much time with him, but not as noticeable as they would be if he really did look eight. And to strangers -- well, I can't quite imagine that the people who think it's so cute when he asks for their keys and identifies the kind of car they drive would be quite so charmed if they knew that that very precocious preschooler they thought they were talking to was really in second grade.

Or the folks in church last weekend who saw us struggling to keep him from moving too much and making noise, and who offered a smile and a "he's fine." Did they think, "There's an eight-year-old laying stretched out on the pew, rolling around, singing songs during prayer time, putting his hands down his pants ... but that's okay, his parents should calm down." Somehow, I think not. He does the best he can within the stressful situation of forced stillness and silence, and we do the best we can to help him. Goodness knows I'm grateful when people appear to be understanding ... but my heart sinks a bit when I think what they'd say if they knew his true age.

There have been some leaps forward this past year. He's started noticing what his friends at school are doing and wanting what they have. He's stopped watching Nick Jr. and started watching Snick. He seems to be acquiring some genuine feelings, or at least imitating them more skillfully. He's picking out clothes and dressing himself, doing his homework with a small degree of independence, helping with chores. He's coming along.

And he is growing; the distance between his pants hems and his sneaker tops attests to that. He's looking less and less babyish and more and more boyish. But eight? No, he doesn't look eight. And I hope that his appearance stays behind is age level for as long as it takes for his many developmental stages to get in synch. It helps him get away with a lot, and goodness knows he needs every advantage. We'll still put eight candles on his cake.

Happy birthday, small boy.

Tuesday, March 20, 2001

Letter to the teacher: On poor phys-ed progress

Well, my still isn't passing phys-ed, which proves more than any genetic connection could that he is indeed my son. After a long phone discussion with the teacher, in which I tried to explain what might be going on with him and why it's all probably a gross motor issue as much as a behavior issue, and he is after all a special-ed student, and the fact that the district no longer offers adaptive gym even though students like my son so obviously need it is not his personal fault. She seemed understanding. She has made an effort to at least keep the youngest students in self-contained classes from being mainstreamed for gym, and that's a tremendous help.

But now, here comes a Physical Education Progress Report warning me of his poor progress, and marking the following areas of concern: Improper performance of exercise (warm-ups); Not knowing what to do (attention, listening); Wasting time during skill practice sessions; and Wasting time of others (selfishness). I am told that if my son makes a conscientious attempt to improve, he can still get a passing grade. And I am apparently expected to do something about it, even though the only way most of this stuff is going to improve is if a fairy godpersion comes down and zaps him with her wand and exchanges his nervous system with that of a normally functioning child.

And so, I am doing what I do whenever school personnel ask me to solve a problem that has mostly to do with my child's neurology or the school's way of doing things, and therefore largely out of my influence: I'm inundating her with paper. About 10 pages of the excellent Building Bridges through Sensory Integration to be exact, and the following note, which I am printing here mostly because it took all my dispatch-writing time yesterday to put together, and I'm running late today, and it will probably be of more interest to the folks who find this Web site than it will, in truth, be to the teacher:

Hi, [teacher name] --

Thank you for the progress report. I'm not sure how much we can really do about this from home, but one thing I will commit to is trying to find him some physical activity for him to do outside of school to possibly practice more controlled movements and waiting his turn. We're looking at a gymnastics class, because he has shown some ability and willingness in that area in the past. The problem we run into, of course, is that he is about as poorly behaved there as he is in your class, but private providers are not obligated to put up with him. We'll try it again. He has been doing one-on-one therapeutic horseback riding for the past eight weeks (concluding today), and in eight weeks will start again with one other child in his class. Not too much misbehaving he can do when he's stuck on the back of a horse.

I've been thinking since our discussion about what might be going on with him in gym and what could be done about it. Miss L. confirms that he is not sleepy every morning at 9 a.m., just mornings when he has gym, so I think there's probably a connection. We agreed that it might have to do with there being so many transitions in a row on those mornings. He often does tend to shut down when he's overwhelmed. It's also a nice, passive way to keep from doing what he doesn't want to do. You may be able to talk or joke him out of it by suggesting that if he's too sleepy to do gym, he's too sleepy to do something he likes to do. Or that if he's so sleepy, he should go to the nurse's office and lie down. Or that you'd better call me to come pick him up and take him home and put him to bed for the day. This will most likely perk him right up.

I don't know how much of his neurological profile you've been given, but I can see a few things that probably make gym seem difficult for him and therefore drive him to distraction:

+ Low muscle tone. This makes it physically difficult for him to be still, balance, or hold a position. His movements are generally headlong and disorganized because he's going on momentum to keep him erect. This is a kid who was able to walk before he was able to stand unsupported. Any activity that involves stillness, balance, or specific positions -- even as a small increment -- will be hard for him. And more importantly, he will perceive it as being hard, or impossible, and will look for any distraction or evasion. Or he may have trouble getting past the part of it that's easy and comfortable for him to do if he feels that the next step is something he can't do. Having something (or someone) to hold on to or lean against may help, if at all applicable.

+ Sensory integration dysfunction. He has particular problems processing information from his proprioceptive and vestibular senses, and generally seeks input to those areas rather aggressively. I've enclosed some information about sensory integration in general and proprioceptive and vestibular dysfunction in particular. What applies most here, though, is the fact that he needs a certain amount of motion to remain alert. Unfortunately, he seems to have a very thin band of optimal alertness surrounded by very wide areas of understimulation and overstimulation. My theory is that he is basically understimulated, and so constantly seeks out movement and stimulation in an attempt to make himself more alert; in doing so, he ricochets to overstimulation, and we all know what that looks like. It may be that since you have made efforts to keep him from running around uncontrolled, he is slipping into an understimulated state, and then when you allow him opportunity for movement, he goes overboard. It's rather like when your foot falls asleep. You could, with a great degree of self control, walk normally or do specific movements someone else instructs you to do with your foot abuzz, but your strong desire would be to just stand there and stomp the thing. My son, at this point in his development, does not have a great degree of self control. And at some point, he may feel that regulating his nervous system is more important than any incentive or punishment.

+ Motor planning. I've also included a sheet on this. My son has trouble translating an idea into the appropriate movements. And he still has a very quick shut-down mechanism for things he feels are too complicated. Happily, fewer and fewer things are too complicated for him. But an activity outlined in gym, when he already has a certain amount of distracting stress from being in a big echoing room and having made a transition from the classroom, may appear too complicated -- even if he is physically able to do it. So again, he will seek distraction and evasion. Breaking activities down into tiny, tiny pieces and repeating them excessively may help, but may be impractical with other kids to deal with.

+ Impulsiveness. Due to his neurological condition, the part of his brain that knows the rules and wants to follow them, and the part of his brain that has the impulses, do not communicate particularly well. As his stress level rises, that communication gets worse and is sometimes nonexistent. So by the time the message gets through not to do something, he's already done it. He can know the rule, tell you the rule, break the rule, and be genuinely contrite. One side of his brain literally does not know what the other side is doing. It's still disobedience, but it may not always be willful.

I recently attended a workshop sponsored by the special-ed department about eliminating unwanted behaviors, and the theory presented there was that in order to shape a behavior, you have to change either the antecedent or the consequence. The antecedent is the who, what, when, where of an activity, and the consequence should if at all possible be positive. This is something that has always worked well for us with our guy, and I wonder if we could figure out a way to implement it in gym. I don't think changing the antecedent is possible -- this would be something like changing the timing so gym isn't the first thing in the morning, or partitioning off a corner of the gym so that he's not distracted by that large, beckoning, echoing space. These might be effective for him, but impractical for you.

However, there may be something to be done with positive consequences. Is there any activity he enjoys that you could let him do if he does what you want? I know riding the scooters is his favorite thing, and theoretically you could say that if he acquits himself well for most of the period he can finish on the scooters; but then you'd have to do that for everybody, and that may be impossible or undesirable. I wonder if there's some way he could do a controlled run -- maybe around the very edges of the gym, right up against the stage and bleachers -- while he's waiting for his turn, or go in a corner and jump, or hang from a bar, or -- ? Something that would be a legitimate phys-ed activity, but might give him some self-determined movement to get all his systems in line. It may be that Miss L. can think of something that would be a positive consequence back at the classroom if he gets a good report from you. He can't wait too long for a payoff, but he might be able to wait that long.

This strategy has worked well for us at home, but I do realize that the dynamics of a classroom and dealing with a number of children, all with their own needs, makes this sort of thing more difficult. I'm not really suggesting or asking that you try any of this, just hoping that something here might give you an idea that will work. Thanks for all your efforts with him; they will undoubtedly pay off down the line, but sometimes it is very hard to wait.

So will any of this sway the teacher? At the very least, it will probably cause her never to send me Physical Education Progress Reports again, and that's okay. And if my guy never does get a passing grade in gym, that's okay, too. He'll be following in a long, proud family tradition.

Friday, March 16, 2001

Dyslexics beware: Learn English at your peril

As if we need more proof that English is a screwed-up language, gratuitously difficult to learn, here comes a new study showing that dyslexics who speak English have a harder time of it than dyslexics who speak Italian. Same disorder, same level of impairment, but much greater struggle in learning to read. And all because of the language they grapple with as kids.

The trouble comes down to sounds and spellings: English has more of the former and way, way, way more of the latter. So while Italian schoolchildren have to learn 25 sounds, represented by 33 spellings, their English-speaking counterparts have 40 sounds to distinguish, spelled a whopping 1,100 different ways. If you have an impairment that makes it difficult for you to associate vocal sounds with printed letters, your problem gets exponentially bigger as the number of different combinations increases.

So since Italian-speakers with dyslexia have significantly fewer sound-letter correspondences to cope with, they learn to read more easily. A mild case of dyslexia can easily go unrecognized among them, while the same case would be glaringly noticeable in someone struggling with English and trying to understand why "mint" and "pint" vary only by their start letter, but sound entirely different. How come "lead" sometimes sounds like "led" and sometimes sounds like "read"? How come "night" and "knight" sound the same? How come "pear" sounds like "pair" and "pare," but not like "ear," while "tear" can go either way? Are there no rules here? Did somebody purposely make this language up to put our brains on the spin cycle?

You know, I learned English like the wind when I was a kid. I had no language or reading problems at all, and I took all the language's idiosyncracies for granted. But as I see my kids fighting their way through the grammatical thickets now -- neither one is dyslexic, but both have significant language delays, and my daughter has a language-based learning disorder -- I have to admit that it ticks me off. How does anybody ever learn this stuff?

Too bad the language has been around for so many hundreds of years, or there'd be a great class-action lawsuit in this.

Thursday, March 15, 2001

Small victories

Alright, I'm feeling kind of smug today, so at the risk of inviting a jinx, I'm going to talk about my latest small victory in the behavior management arena. I realize that whenever I talk like I know what I'm doing, my son immediately proves otherwise, but I'll take that chance.

I've written here before about my son's grotesque eating habits, which mostly involve grabbing great fistfuls of food and shoving them into his mouth, then doing his little tic-like hand-shake thing and strewing bits of rice and vegetable all over the kitchen and sometimes into Mama's hair. I've also written about the recent behavior management seminar I went to that advocated changing behavior by changing the antecedent or changing the consequence. Easier said than done, I concluded, and what a pain to have a constantly full bag of tricks.

My particular magic bag had run out on the eating issue. My husband thinks I'm too understanding, but I do know how hard it is for this boy to wield a fork. With his much-delayed fine-motor skills and low muscle tone, it must seem to him a ridiculous way to get at that food he wants so much. Part of his stuff-and-run strategy must be to get as much food in his belly as he can before someone gives him a time-out. I try to explain to my husband that he would probably do the same thing if he had to eat with chopsticks every day. But the fact is, the boy is almost 8, and really, he's got to start eating neat.

I tried changing the antecedent by ordering some "plate bumpers" that attach to a normal plate and give an insecure fork-user a place to push the food against. While waiting for them to arrive, I thought about consequences. What possible thing could this kid want that would override his deepseated antipathy to flatware?

Then it hit me: Capri Sun Coolers.

Those are three words I hear daily, hourly, constantly. My son wants them, bad. He wants them for the cool foil pouch. He wants them for the tasty juice inside. But mostly, he wants them because all the other kids in his self-contained class have them, and when snack time rolls around he's way jealous. Every time a Capri Sun Cooler commercial comes on, every time we go to the store, every time I make his snack, I hear it: "Mom, can we get Capri Sun Coolers?"

And my answer, consistently, has been no. No way. They're loaded with sugar, and frankly, giving an impulsive boy juice in a squeezable pouch sounds to me like a recipe for disaster. Plain old square 100-percent juice boxes for you, bucko.

But I've come to realize that this is the perfect positive consequence: Something the child wants badly and the mother would just as soon he not have. Too often, positive consequences are more important to parent than child, and negative ones more punitive to the parent. But this -- this is perfect. And so we made a deal. If he eats with his fork and not his fingers at dinnertime, he gets to put a Capri Sun Cooler in the fridge for his snack the next morning. If he earns one for his snack at dinnertime, he can earn one for his lunch by being quiet during prayers and helpful in the morning.

So far, it's working pretty well.

We started Sunday night, and he got his cooler on Monday, Wednesday and today. Monday dinner did not go so well, but better than in the past. He's definitely trying. And just the trying, even if it's not followed by succeeding, is a big step forward.

Well, maybe a small step. A small victory. Every little bit helps. We hope he'll learn that the fork is his friend, and in time he won't need bribes. More likely, he'll decide that he doesn't like Capri Sun Coolers all that well after all, and we'll be back to watching him strew food about. At any rate, I'm going to bask in progress while it lasts.

Wednesday, March 14, 2001

Adoption's more popular than we thought

There certainly seem to have been a lot of articles lately on adoption -- positive stories about celebrity adoption and citizenship, negative stories about international adoption and attachment therapy, some scary, some glossy, some simplistic, some glaringly incomplete. It's enough to make you wince when you hear another one's coming down the track. But here's one that takes an altogether different view of adoption: a scientific one, in Discover magazine of all places, as to how adoption defies Darwinian theory and messes with supposed biological imperatives.

I'd say it was a pretty dispassionate dissertation on the subject, but really, it's not; the author is an adoptive father completely smitten by his adopted-from-China daughter, and while the prose is in the reasonable tones you'd expect from Discover, there's no doubt that, Darwin be damned, the writer thinks adoption's just dandy. And the interesting thing to learn here is it's not just he and us and generations of humans who think so.

According to Darwin, it shouldn't be. Apparently, the imperative of any individual is to further his own genetic line. Those who can't reproduce are obligated to use their nurturing and resources to enhance the chances of their near relatives, thus ensuring that the line will continue successfully. Furthering someone else's line by nurturing their offspring makes no evolutionary sense.

And yet, everybody's doing it. Humans have been adopting since ancient times, though it's certainly gone in and out of fashion. Mammal mamas in general will often take in a pup or a cub that's not theirs; sometimes it's a relative's, sometimes not. There are birds who plant eggs in other birds' nests, and fish commonly make up their family out of whoever's eggs are around. Somehow, the need to parent seems to be a stronger biological imperative than the need to extend one's genes.

That's a nice thing to hear, and one you don't hear much. For all adoption's long, cross-species tradition, it still doesn't get much respect. As infertility treatments go further and further in pursuit of desperate line-continuing measures, and birthparents seem able to reclaim children at will just because their genes match, and grown adopted children make a personal mission out of finding their biological forbears, it's hard sometimes for an adoptive parent not to feel like chopped liver. We hear a lot about birthparents' rights, and a lot about children's rights and their best interests. But when's the last time you heard anybody talking about adoptive parents' rights? It would appear that we don't have any.

And I struggle with that, because on the one hand, I don't really believe that anyone has a sacred right to parent a child -- any child in particular, or any child at all. I think it's a privilege, and one I am blessed to have, but "right" seems the wrong word. And yet, I think that to reduce parenting just to the gestation and bearing of children and undermining the value of everything that comes after is a travesty. At some point, how can a person who did nothing but give birth claim to have more of a "right" to a child than somebody who has loved and nurtured and raised that child? The genetic bond seems to be valued above all others, and I just don't get that.

I think of the decisions I make every day, every week, every school year that affect, for better or worse, the way my children learn and grow. I think of how much their time in a Russian orphanage affected the way they learn and grow. If they had been loved and nurtured from birth, they would be very different children today. And if somebody else had adopted them at ages 4.5 and 2, they would be very different children now at ages 10 and 7. Maybe they'd be better off. Maybe not. But to say that they are no more than the sum of the genetic material they got from their birthparents is mindboggling to me. As in so many things in life, it's not what you're given, it's what you do with it. And at this point in their young lives, what they've done with it belongs to me.

Take that, Darwin: There are more ways to leave a piece of yourself behind than simple propagation.

Tuesday, March 13, 2001

Send in the clones

So now they're talking about cloning humans, and who do you think is lining up to be the first experimental prototypes? Megalomaniac bad guys in need of Mini-Me's? Eccentric millionaires seeking immortality? Evil dictators looking to create genetically perfect armies?

Nope, although those folks are probably watching the story closely. Who we really find out there on the bleeding edge of science is a whole lot of infertile couples looking for one more way-out-there option in their quest to conceive. And boy, have they found one.

The Italian doctor who's causing the current cloning furor is an infertility specialist previously best known for helping a 62-year-old woman become pregnant. He sees this whole path to reproduction as just a nice way for infertile men to become fathers without having to use somebody else's sperm. How much better to just lift your own DNA and implant it in an egg?

According to a Reuters report, some 700 couples are lined up to participate in the experiment, with more hopefuls turning up every day. So determined are they to have children that resemble themselves that they are willing to overlook the severe ethical questions surrounding cloning.They're willing to put aside fears that the procedure won't work at all, or will produce a severely deformed child. And you can bet that they're willing to shell out a whole lotta lira.

You can also bet they don't watch many horror or sci-fi movies, because man, people, you don't just go cloning yourselves. Nothing good will come of this.

I'd like to say I can sympathize with people who just want so badly to have a child. I've certainly been there, though I've never been there -- at that place where you will do anything, anything, regardless of cost, life disruption, messing with Mother Nature. My husband and I stopped fairly early in the infertility-treatment process. That process already goes further than it ought to, and now it's just going to go right off the deep end.

So as I say, I'd like to sympathize, but I can't. I'm deeply uncomfortable with this notion that everybody has a sacred right to create a mini-them, no matter what it takes. I'm uncomfortable with it on moral grounds, and I'm uncomfortable with it on the grounds that there are lots of perfectly lovely children already born who could use some parents but don't have the bucks to clone them a set. What happens to them when everybody's out Xeroxing their offspring?

If cloning works, and becomes the instant answer to everybody's infertility needs, it will be a tragedy for waiting children. And if it doesn't work, or work well, it may create a whole new class of needy children, born out of a bad idea and saddled with special needs we can't even imagine. Really, do we need to be that desperate?

Saturday, March 10, 2001

Baby pictures, family trees

Call us lucky: Somehow, we have missed the dreaded "baby picture" and "family tree" assignments that send so many adoptive families into tizzies. Some parents protest the fact that their child should be given any assignment that they can't complete due to the very circumstances of their birth; some get creative and adapt the assignment to those circumstances, resulting in projects that may not relate very closely to the original purpose of the assignment, but get child and parent off the hook. Either way, it's an awful lot of ado over an exercise that doesn't have all that much academic value to begin with.

As I say, we've been lucky. The only time anything along these lines has come up was during our kids' first few months home, when my daughter's 5th birthday came up and her preschool teacher told me how the kids usually mark that day. Usually, she said, they would bring in baby pictures. She felt the awkwardness of that request in our case, and said we were perfectly entitled to not bring in pictures at all, or bring in different pictures, or talk about the adoption, or not talk about the adoption. As it turned out, I made up a little poster with pictures from Elena's first months home, and she shared that with the class. Of course, at the time, she spoke and understood very little English, so she couldn't hear if anyone made a rude comment or asked, "But where are your baby pictures?" I suspect the whole thing sort of rolled by her without much understanding.

That's still a problem. My daughter's 10 now, still significantly language delayed and comprehension compromised, and I can't say that she understands adoption all that much better than she did at 5. We talk about it, but I can see the words going over her head, brushing back her hairline a little but otherwise leaving her unruffled. It's an awfully abstract concept, adoption, and my girl is the Queen of Concrete. Could she, even now, get up in front of a classroom and explain the joyous story of her adoption? I don't see it.

Not to mention the fact that getting her to do an assignment differently than the rest of the class, and differently than the teacher outlined, would be difficult, difficult. Her great strengths in moving from self-contained special-ed to a mainstream class have been her desire to fit in and please the teacher. We have had homework battles wherein it is clear to her Papa and me that the math problems should be done one way, but she is so certain that the teacher said to do them differently that she is willing to do far more work to please her. The thought of possibly doing them another way had her trembling. So to say, "Honey, I know your teacher talked about bringing in baby pictures, and your friends are all bringing in baby pictures, but since you don't have any baby pictures, we're going to do something completely different but very special for special you," would not likely meet with approval. More likely, tears.

So I hope those assignments hold off. Maybe because our school district is seeing an increasing mix of ethnic groups and family situations, the curriculum committee has put the kibosh on "this is what children look like, this is what families look like" assignments. And hurrah for that. But if one does slip through, to tell the truth, I'd still feel somewhat lucky to be an adoptive parent and have an excuse to give it a skip. Because knowing me, if I had actually given birth to a child, I probably wouldn't be able to find where I'd stashed all those baby pictures anyway.

Friday, March 09, 2001

Birthday boy

Anybody out there have a great idea for a birthday party for 10 multiply disabled special-ed kids? Anybody? Contact me, quick.

My son's 8th birthday is coming up in a few weeks, and unlike last year, when the kids in his class were all bigger and older and meaner than him, this year he has a group in his self-contained special-ed class that's pretty appropriate peer material. Unlike last year, he'll have a party. Since there are only 10 kids in his class, we can easily invite everybody. But where shall we invite them to?

The birthday boy's first choice was a children's museum about half an hour away, but that seems an awful long way to ask people with special needs children to go. For one, you're adding a round-trip hour in the car with a hyped-up kid to the evening, and who needs that? For another, I know at least one mom in the group doesn't drive, and maybe more. So. Faraway, somewhat difficult-to-find museum is out. Chuck E. Cheese is choice #2, but aside from the fact that it is a humongously overstimulating place (for me, too), the kiddos tend to scatter on entry and not play together so much. If Andy's going to entertain friends, I'd like them to stay with him.

So that brings us down to Burger King, which has a small play place, and bowling. Are 7 and 8 year olds too old to play at Burger King? Even really immature, developmentally delayed 7 and 8 year olds? My son would love to play at Burger King; will the other kids think that's weird? And, conversely, if you're going to have a bowling birthday party, shouldn't the birthday boy like to bowl? My guy's sort of neutral on the sport, and with his ultra-low muscle tone, throwing a heavy ball can be kinda challenging. Not to mention the loud noises. Still, he's hung in at his sister's bowling parties. So maybe.

I'd like to be the kind of mom who could just have that whole passel of younguns over to the house and entertain them for an hour or two. But I still remember the time I had my daughter's whole special-ed class over for a party, and it's a wonder there weren't holes in the walls from all the energy those boys spent bouncing off them. Man, oh man. And that was nominally a "higher functioning," as they say, group than my son's class. If we could have the party outside, that would be one thing. But a party outside in March in our part of the country is a thing fraught with peril.

So I'm thinking bowling. Bowling. Bowling's okay. Everybody will smell like cigarette smoke after, and my son will get his hands all dirty from the bowling balls and then put his fingers in his mouth, and I'll run around like a crazy person trying to keep everything rolling in the right direction. But it will be okay.

Unless anybody out there has another idea. Anybody? Anybody?

Wednesday, March 07, 2001

Fight the power

Should we be afraid of power lines? Toasters? Microwaves? Refrigerators?

Many parents have long felt uneasy about these sources of electromagnetic fields and their possible link to childhood leukemia and other cancers. The school my kids attended for their special-ed up until this year was located under a nexus of power lines, and there were parents who would not allow their children to go there. There were teachers who weren't so hot to be there, either. I always brushed it off, more interested in good classes than bad fields. The stories I'd hear about people who allegedly got cancer from prolonged exposure to power lines, I'd pass off as coincidence.

Still, it's one of those nag-at-the-back-of-your-brain concerns. The kind of thing you'd expect medical researchers to look into and either prove or dis-. And sure enough, here comes a report based on nine studies conducted since 1994. That's a lot of research, and, presumably, a lot of research money. So does it put the fear in us, or put our fears to rest? Does it answer our questions about electromagnetic fields once and for all? Do we now know whether to avoid power lines, sticking our heads in the refrigerator, sitting in front of computers for long hours writing meaningless essays for Web sites?

Well, no.

The conclusion of all this research on the question of whether magnetic fields cause cancer is a resounding: Um, Maybe.

There was an increased risk of childhood leukemia in homes with very high electromagnetic levels -- 0.4 microTeslas. But American homes average about .09 microTeslas. And the majority of the homes with the highest levels were not located near power lines. So go figure.

Appliances must fall under suspicion if the power-line connection fades, but the report found that 30 percent or less of a house's electromagnetic-ity is accounted for by such household electronics. So don't fear your TV, don't shun your toaster oven. But what then accounts for that other 70 percent? Bad wiring? Electromagnetic mice in the walls? Plates in people's heads? Nobody knows.

And so, we're really no closer to proving or disproving a connection between big bad power sources and cancer than we were before these studies were even conceived. Sheesh. Where's Erin Brockovich when you need her?

Tuesday, March 06, 2001

Mama's night out

I went to hear a speaker last Tuesday night (yes, that's right: I actually left my house on a school night and went somewhere alone!) on the topic of "Stopping Inappropriate Behaviors, Supporting Appropriate Behaviors," sponsored by our school district's special-ed department. I think, in the six years my kids have been in special-ed, this is the second such evening they've sponsored. I wish they'd do more; the turnout was pretty good, and goodness knows the parents of special-needs kids need noble excuses to get the heck out of the house.

The speaker was the educational director at a local school for autistic, emotionally disturbed and multiply disabled kids, and clearly he knows how to handle them. His ideas were good, although nothing I hadn't heard or used before. The problem, as always, is not in the ideas, but in the consistent execution thereof. I do pretty well. But any special kid worth his or her salt will present with behaviors that do not respond well to theory.

This particular night, the theory was that to change a behavior, you can change the antecedent -- something that precedes the behavior, whether it's the who, what, when, where, why, or how of the activity -- or change the consequences -- which should almost always be positive consequences. The idea was that a parent or educator would have an enormous bag of positive consequences, from stickers to snacks to Gameboy time, and keep trying until the proper motivator was found. And that's a good idea, in general. As is the idea that if a behavior is causing problems, you change something that you're doing, and keep changing until the behavior is shaped to your liking.

These are all things I've been doing for years, mostly under the guidance of books like "Raising Your Spirited Child" and, more recently, "The Explosive Child." And mostly, it's worked with my son, my little fetal alcohol-affected bundle of impulses. But sometimes -- whoo, boy. Sometimes mom runs low on creativity, and sometimes that bag of tricks gets empty. Who knew that to be an effective special-needs parent, you had to be a magician, too?

The problems come up when my son, normally a guy of good will, finds himself in a place where protecting his fragile nervous system is more important than any consequence, or when he feels he is so unable to do a task to our liking that it is easier to step forward and accept negative consequences than to try to do the impossible. And as luck would have it, these tend to be situations in which changing antecedents is difficult or distasteful. And so, we fail to stop inappropriate behaviors, support appropriate behaviors. And yell a lot.

Most of the folks at the meeting that night didn't have problems like that. Most of them had clear defiance issues, and many had kids who weren't classified. What were they even doing there? I guess you mention the word "behavior," and parents come out of the woodwork. If I ever write a book, no matter what it's about, I'm going to put the word "behavior" in the title, and it will be a best-seller for sure. These people weren't worried about kids whose fine motor skills were so limited, they ate like slobs; or kids whose impulses were so strong, they couldn't be quiet at church; or kids who completely lose control of themselves at times of high stress, or release from high stress. The inappropriate behaviors they were concerned with were things like, "She leaves her papers all over the place and then can't find them"; or "Her teacher says she's too shy in class"; or "He takes two hours to do his homework, even though he's very bright." (If I had two cents for every time a person with a troubled kid took time to point out how bright he was, I would be a rich woman today.)

It was a frustrating evening, listening to this person with special-ed knowledge solve the paltry problems of the normally but moodily functioning. And no, I did not ask about my problems, because I knew what he would say and, unlike these poor folks unused to being magicians, could figure things out myself. Still, there was one highpoint of the evening, and it involved those folks above who fretted over the time it took their son to do his homework. I recognized them; their son had been in my son's self-contained special-ed class for a few weeks last year, before they huffily pulled him out and mainstreamed him. I particularly remembered the Back-to-School night for that class, in which this very mother had chewed out the teacher to such a degree that she made the woman cry. The issue that so enraged the mom? The teacher wasn't giving out enough homework, and the homework she gave was too easy.

Talk about being careful what you wish for.

It's so rare that you get to actually be there when what goes around finally does come around, but it's a gratifying experience. Worth a night out, for sure.

Thursday, March 01, 2001

Doctors know best

Interesting times on the TV show "ER" these days for people interested in children with special needs.

I say "times," though of course I mean "60-second bursts," because that's all the time this ADHD show has to devote to issues these days. And I say "interesting," though of course I mean "infuriating," because that hyperactive pace leads to pat answers to questions that are anything but.

Consider, for example, the recent vaccination story line. A boy is rushed from his preschool to the ER with fever, seizures, an odd rash. Could it be ... measles? The doctors are shocked. Who on earth would not vaccinate their child against measles? What parent would be so irresponsible? The mother turns up, and, sure enough, says she has deliberately not vaccinated her children. You can tell by the condemning looks the docs give her that this is not going to lead into a thoughtful discussion of the relative risks and merits of vaccines, and possible ties to autism, and how a parent goes about weighing those risks and possibilities.

Because, don't you know, there are no risks! There are no possibilities! We have it from good-guy Dr. Carter himself. As the mother of the ailing child tries to explain herself to the haughty medical professional (and boy, haven't we all been there), she says she's researched this on the internet and in magazines and talked to her pediatrician. Carter tells her flat out, vaccines are safe. What about ties to autism? she asks. There are no ties to autism, Carter says dismissively. Well, phew, good to know. One less thing to worry about. Big thanks to the "ER" writers for researching that and delivering such a definitive answer to the show's very large viewing audience.

In better days, I think, the show would have allowed a little ambiguity here. Allowed the mother to shake the doctor at least a little bit with statistics. Had her mention a nephew who had developed autistic behaviors right after getting his MMR. Even had Carter mention that she could have had the vaccinations delivered in individual doses instead of all at once. Some small bone to indicate that this is a very real issue to very many people. But no. Carter cuts her off. The boy dies. The mother killed him by daring to have an opinion. Next case!

The mother in an earlier storyline fared a little better. This was the snippet that had Dr. Benton befriending a young girl hiding out in a hospital closet, because she's scheduled for a medical procedure she does not want to participate in. Benton comes to find out that the procedure is giving something -- bone marrow? blood cells? I'm forgetting; it's been a while -- to her cancer-stricken sister, and that indeed this particular adorable little girl might have been conceived for the purpose of providing that something. Because everything is simple in his moral universe, he is outraged. Tries to keep the girl from having to go back to the procedure. Questions the mother's motives and moral righteousness.

In this case, thankfully, it's the mother doing the cutting off. But again, there was no discussion of the really rather interesting issues here. Since Dr. Benton is one of the "good guys" on the show, and the doctor defending the parents and gathering up the girl for the procedures, Dr. Romano, is about the only unequivocal "bad guy," we are clearly meant to feel that the mother is a monster. But let's see now: The other option here is that the sister would be dead and the adorable little girl would never have been born. Is that really better? Should children never be conceived for less than the most noble reasons? What about Dr. Benton's own son, who was not exactly planned at all. Do the circumstances of his conception affect the doctor's ability to love him now? Can a child who was born to save a sibling never be loved in her own right?

And on another tack, one wonders how Dr. Benton feels about embryo research? Is it okay to create life at that level for the purposes of medical advancement, but not okay to go all the way to having the baby for the purposes of one particular medical rescue? How does he feel about animal testing, generations of innocent creatures born to suffer and die for the health and safety of humans? Furthermore, as a parent, would he give his life to save his child? If so, why is it so wrong to create life to save a child? Is it because the baby has no say in whether he or she will participate in the salvation? Who among us ever gets a chance to comment on the where or when or why of our birth, or the circumstances we find ourselves in?

I'll grant, I'm not sure how those questions should be answered, and the storyline did make me somewhat queasy, with shades of the suspicion Russians are said to have that Americans only adopt their children for their organs. I can't say that what this family did was right. But I sure don't think I'd be able to decide it was wrong in 60 seconds.

A somewhat similar question -- whether and how a child should be saved -- cropped up in another storyline in which a teenager who needed a transplant confessed to Dr. Luka (alright, I know that's not his last name, I just always think of him as Luka) that what he really wanted to do was die. He did not feel his life would be worth living, always sickly and taking medications and looking weird. And since we all know that teens have a rock-solid grasp of what makes life worth living, Luka set about trying to get the boy released from the life-saving surgery he did not want. Once again, the usually loathable Dr. Romano was the voice of reason, a sure sign that we are to think otherwise. But -- geeze! Are we honestly supposed to condemn these parents for the sin of wanting their child to live?

For my money, the most satisfying MWA-related storyline lately was Dr. Chen giving up her baby for adoption. For weeks, I watched in fear that she would change her mind. I ached for the prospective adoptive parents when it looked like she might. But in the end, she did not. And please, I don't know how long a birthmother has in Chicago to reclaim her child, but writers, Do Not Go There. Really.

On the other hand, I imagine that people concerned with adoptee's rights and birthmother's rights and the desirability of keeping babies with their birthparents found the delivery of the child to the cooing adoptive parents disturbing. I imagine they found the affluent, educated, capable birthmother's reasons for giving up her child reprehensible. I imagine they found the whole storyline to be, well, pat.

But I ain't them.