Monday, May 12, 2014

And so it begins....


Matthew was seen for neurologic follow-up and was accompanied by his mother. He is a 4-year-old boy with significant developmental delays. Testing today has not provided a clear identifiable etiology. He continues making nonspecific noises. He has not had much interest in peers. He still finger feeds. He puts carpet strings in his mouth. He has hand regard behavior. He likes watching computer screen showing the image of a certain level of a game for up to half an hour. He sleeps about seven to eight hours and smears stool. He gets speech therapy twice a week and attends school four days weekly for 3-1/2 hours per day. He has an attendant.
Today’s exam finds a weight of 18 kg, height of 105 cm and head circumference of 54.5 cm. He makes nonspecific noises while jumping and pacing around the room. Eye contact is inconsistent. Overall tone is unchanged. No words are heard. He has no focal neurologic deficit.
Matthew continues to have significant developmental impairments. I agree with his father that he clearly shows some features within the autistic spectrum. This label can be useful for identifying his areas of need. He has had some other lab tests, results of which will be checked. He will continue with his school programming. Family will call if there are problems, otherwise follow-up will be in one year.
Max Wiznitzer, M.D.
Pediatric Neurology
(Amazing how something can be so concisely worded but not even come close to the depth of what we would experience in the 10 years following. Here's how it should have read:)
Mr. and Mrs. MacNair;
I believe that your son exhibits characteristics consistent with those on the autism spectrum.
HA HA HA HA HA HA HA!!!!!!!!!!!!!!!!!!!!!

You had ideas, goals and dreams for your son? Toss them in the crapper my good friends. Your new life begins today, a life filled with ambiguity and unknowing. What causes autism? We don't know for sure. How should it be treated? There are various and manifold ways, not all working the same for every child. Is there anyone who can help you navigate the waters? Sure, there are several people with various areas of expertise, and they will all tell you something different. Then there are the people with no expertise- amazingly they seem to have more to say than the educated ones. It's a jungle out there, Mr. and Mrs. MacNair, and I've just handed you a butter knife. Have fun navigating the forest.
Welcome to the wonderful world of autism, my friends! BWAHAHAHAHAHAHAHAHA!!!!!
Max Wiznitzer, M.D.
Pediatric Neurology


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