Genetics

With spring break week drawing to a close, it's surreal to think that my "baby" girl will turn "double digits" on Monday.  I cannot remember not being a mom to these four children.  But, every day it gets more difficult to remember the frenetic days of babyhood and accompanying nights of sleeplessness, the never-ending diapers and pull-ups, the twelve incarnations of strollers, toddler-dom, Little People everywhere, Blues Clues, preschool, Buzz Lightyear and Bob the Builder tents, and Build-a-Bears...  parenting four kids under six, in most meaningful ways by myself, was a whirlwind.  It was fun, I worried about safety and making playdates and paying for preschool, sports, and lessons.  Now, while they have active social lives and are avid readers and iPod users, I worry about things like internet safety and how to pay four college tuitions.  And, then there is Andrew.

2005

Given the special "gifts" of my children, mostly Andrew's autism, our family is a genetic researcher's dream.  We'd be ideal if not for the fact I have zero family history to provide, being adopted from Mother Theresa's orphanage in India as an infant.  

As part of an NIH-funded genetic research study, I had the parent response tool of the ADOS administered for the second time in Andrew's 12 years.  Gosh, I forgot how sad and lonely those tests can make any mom feel.  The questions focus on everything he can't do; thinking back to when he was 4-5 (the age the testing tool asks you to describe his social functioning at in addition to current day functioning).  The reality is that he isn't that different today, at 12.5, that he was then.  Interest in peers.  None, perhaps less.  Meaningful conversations?  Sometimes, with highly familiar adults.  Stereo-typical behaviors? Yup, still there, although changed.  He's gone from spinning wheels and full body flapping to "running laps/pacing" while vocalizing, and finger-tapping.  Recounting all of this, my heart dropped in the window-less conference room.

Why did I do it at all?  I participate with the hope that maybe someone will be able to find genetic markers in siblings and that children will be able to access intensive intervention earlier and hopefully have better outcomes.  As completely uninspired as I am with "Lighting it up Blue" nowadays (sorry, fellow autism moms), this seemed a way to help the smart people find some answers, if indeed there are answers to be found.

As I sat with the genetic counselor, the first question was easy to answer.  How many pregnancies have you had?  I answered "4".  Next to each number, a name, sex, birthdate, birth weight, gestational age, and mother's age at conception were filled in.  However, it asked about pregnancies, not just live births.  And, yes, they wanted to know if there were pregnancies which did not lead to live births (the PC way of stating miscarriage or voluntary termination).  They wanted to know the gestational age at termination.  I went a bit numb, but I added the accurate data.  There became a row 5 and 6; 6 is what broke my heart. 

It had been a very long time since since I even thought about it, more or less cried about it.  (Note to genetic counselors:  autism moms may be strong, but we are vulnerable as hell, and adding other factors in, you might want to keep a box of tissues on-hand).   When I think of the 6th, in the context of an autism study especially, I can feel the pain all over again.  When you mix the genetic material of two parents, both of whose immediate families have been severely affected by autism, the odds don't seem high you would create a child who either does not have ASD or isn't highly susceptible to having the diagnosis.

Being a mom has been the great joy in, and accomplishment of, my life.  While it's true that my kids have their challenges, I can not imagine my life without them in it.  My oldest was medically fragile, with a diagnosis, at age 3 months, of something no one could pronounce.  Andrew was diagnosed with  PDD-NOS, an autism spectrum disorder, at age 2.5.  I'm not sure why his little sister was so anxious to get "out", but she decided being born 7.5 weeks early was a grand idea, hence I'm a member of the emergency c-section/preemie club, too.  My baby has learning disabilities, in many ways more pronounced than the others, since she is in inclusion.  She struggles so much; it's getting harder as she's getting older.  Thankfully, after some careful advocacy, she is using an iPad or laptop for much written output and her work is being modified to meet her needs and allow her to feel more successful.

Now

I celebrate a decade of Sarah- her joyful spirit, big brown eyes, creativity, and love.   Yet, I am thinking about Row #6 on the sheet the geneticist filled out.  I wonder what it would be like to have a preschooler again.  I remember the horrifically painful (physically and emotionally) experience of expecting a little boy and then not being pregnant any longer, seeing him, and then consenting for a local hospital (part of the Autism Consortium) to utilize his body (called a fetus, of course) for research.  Now, my blood and Andrew's are being used by the same group of researchers, for the same over-arching purpose.

I truly hope autism will someday have a cure, but first we need to find a cause.  On Monday, my daughter will turn 10.  Tomorrow, we will enjoy a red velvet cake with cheesecake in the middle to celebrate (her request).  She will beg to see "The Hunger Games", wanting to be like her big sisters.  I will say no for a variety of reasons, including the fact autism chains us to our home on weekends, and autism and big birthday parties definitely do not get along, at least at the age of 12.5.

Hope.  That's what you have to have as a mom, for all your kids, hope that you are doing a good job and that they are growing and learning and will someday be respectful, kind adults who make a bigger difference in the world than certainly I have.  You also have to have a lot of love.  The latter, I possess in spades.

This is a time to put work away and play with my kids and ENJOY them.   Have a fabulous weekend and hug your children.