Since last Saturday, we have been giving Charlie half as much of one of his medications, Zoloft, after our visit with Charlie’s pediatric neurologist. Charlie has been taking Zoloft in varying dosages since February of 2004, since he also takes Risperdal. The doctor had first recommended the Zoloft because we had often observed Charlie showing signs of anxiety (tense shoulders, making certain worried sounds, moaning) before he head-banged. Charlie has been taking Risperdal since the spring of 2005 and—coupled with the right kind of educational program—-this has helped to get the head-banging under control.
Giving these medications to a child, and a child with very little language—and, in particular, without the language to say “My head hurts” or “I have a stomachache”—has always seemed a risky business to me. Jim and I have to observe everything Charlie does and write it down and explain it all carefully to the doctor; the doctor had once asked us to videotape Charlie when he was in the middle of what we wondered was a seizure, but (as the doctor acknowledged), it was not very easy to get the camcorder out at those moments (this is meant to be an understatement). Since starting his current in-district public school program last June, Charlie has been doing well, making small but solid strides in his academics, learning to write words beside his name (Charlie’s very long journey to learn to write his ABC’s is the subject for a post unto itself), liking school and being generally peaceful-easy feeling.
On the basis of all this, we thought it worthwhile to see if we might decrease Charlie’s Zoloft dosage with a view to taking him off it completely.
Charlie woke up smiling this morning, went “up-stairs!” and opened the refrigerator. “Chock-lett!” I explained that it was rather early for dessert and suggested some bread, which Charlie quickly ate. “Chock-lett.” “How ’bout an orange?”
An attempt to give Charlie an orange when he had calmed down resulted in a flying orange and “No orange! No orange!” We tried to start Charlie on a puzzle, which he swiped away after a few minutes.
Screaming and banging.
Charlie started to work the puzzle a second time around and gagged down a few pieces of orange (I took it—looks like we’ll be finishing the oranges) before retiring to a chair with the chocolate and a spoon.
Jim and I added up a few things: Charlie’s almost meltdown on Wednesday when he and I got stuck in rush hour traffic and he said “SQUISHY BALL” over, over, and over. The alarmed—verging on frantic—look in Charlie’s eyes for the past few days whenever we have not been home and he said “squishy ball”: He has been very worried about where it is when we are not home. Charlie’s teacher noting that, on Tuesday and Thursday, he had flop-down-bang-on-the-back moments of a minute over wanting to do a certain puzzle. And, this past week, I recalled Charlie’s worried insistence on eating certain foods—the chocolate pudding, various sauces in jars which he calls “hummus.”
We remembered, the original reason we started Charlie on Zoloft was for his anxiety. We decided to give him the dosage (which is not a large one) that he has been on for over a year.
So how did the rest of our Sunday go, and how much can be attributed to a half-pill more of medication? how much to Charlie, now that he is getting older, pulling himself out of a tantrum, a “behavior squall” and are forgotten? how much to something else? to a combination of numerous factors? (This last gets my vote.)
Charlie led Jim through the streets of our town on a quick bike ride before his piano lesson at which (this is a real quote) his piano teacher said “I’m just flabbergasted” when Charlie played the C and D notes with his left pinky and ring finger with complete ease. For the first time, Charlie went to the teacher’s suitcase of supplies, said “open” and looked through several toys (including a mini-massager with a flashing light and a set of metal blocks). While I was talking to his teacher, he ran back down the stairs and told me (also for the first time—Charlie has a hard time knowing when to say “upstairs” or “downstairs”) “Mom up.” And this evening, while looking at a show of beach photos on Jim’s computer as Jim and I talked and laughed over another weekend in Autismland, Charlie (as always listening in, regardless of what his face might suggest) suddenly said,
I don’t think I can one-up Charlie on that.