Anthony sneezes more often than the rest of our family. Now that I take the time to think about it, I realize that the cause may be our inability to teach him to blow his nose. Whatever the reason, we try to take precautions to keep him from spraying us, food on the counter, or our meals at the dining table, including when we do go out as a family to eat.

My wife created what we, for lack of imagination, refer to as the "sneeze blocker" for use when we eat. She bought a cardboard tri-fold and covered it with fabric. The inside material is a pattern of ladybugs, butterflies, bees and daisies originally meant to be used for a dress for our daughter when she was younger. The outside has caricatures of all the states with their capitals, chosen for the benefit of our other two children. Unfortunately, despite the inside material having no "up" or "down" that we can discern, Anthony invariably turns it upside down, diluting the educational value to his siblings.

We put the "sneeze blocker" in front of Anthony's place setting and hope that he will not be leaning around it when he does sneeze. He is also large enough now physically that we do have concerns about him sneezing over the top, although that has yet to happen. Because he doesn't care for having his view obstructed, however, he bends down the corners of the tri-fold, reducing its potential effectiveness. Having it in front of him also makes it difficult to know what he wants when he sticks his hand around the side toward us, since we can't see his plate or cup.

We went to a church dinner function a few months back, expecting to find a section of seating we could stake as our own to ensure that Anthony would not sneeze on us or anyone else. The event was apparently a hit, to the extent that nothing was available in that regard. My wife found a little table that was holding a display of some sort, and Anthony and I sat there. At a subsequent church dinner, we actually took the "sneeze blocker" with us to be safe.

If only we could teach him to cover his mouth when he sneezes. We tried some years back, and he actually did it--once. We were quite happy to see that, and were hopeful of more to come, but that has not materialized. Following the recent IEP wherein the school staff said they could see greater intelligence than we knew, I have put more effort into dealing with Anthony as though he really understands what I tell him. Without getting upset at him (because that approach hasn't worked in the past), I am telling him that he MUST cover his mouth when he sneezes. He seems to be developing a rudimentary understanding of the concept. He isn't yet covering his mouth, but he does sometimes put his hand over his mouth AFTER he sneezes and we look at him. Perhaps perseverance on our part will improve his timing.

We have stopped giving Anthony the medication that might promote aggressive behavior. Yet . . . .

Anthony attacked his teacher last week without warning, and continued to try to hurt her even after he had knocked her down. Another teacher had to help to restrain him. I was told that his teacher's shoulder was rather sore after the incident.

A couple of days ago, the same teacher was outside with another aide and Anthony, and noticed behavior that signaled he might again be about to become upset. She warned the aide to move away from Anthony, but the aide apparently did not recognize the imminent danger. Anthony bit her on the back of her upper arm. The school nurse said she had never seen a bite doing as much damage. We have to take him very soon for blood work to ensure that he has not transmitted any serious diseases. We took him once previously for the same issue, but it has been more than a year so new data is necessary.

Between these two incidents, my wife met with the teachers and principal at his school for an "IEP", which stands for Individualized Education Program--I think; everyone refers to it by the acronym--required periodically for students with disabilities. Interestingly, and curiously, to me, his teachers said they could see proof of intelligence above that of others in his class. Among other indications was the ability to arrange visually words in a sentence they gave him verbally. The level of complexity that he achieved each and every time was such that they were certain of real cognitive abilities. They feel that his violent outbursts are probably due to some tactile trigger(s) that we do not yet understand.

I do not know what to think of this. It is frankly rare for me to see evidence of cognition in him above the level of a small child, and I think we treat him that way. But perhaps that is a very small part of the problem: if he does have some abilities to think like a normal person, I can understand that he would not want to be spoken to as though he were very young. I also find myself regretting the way I have reacted to him at times. I have, for the most part, dealt with Anthony in ways that I have thought were suited to his behavior, as I have done with my other two children. I am now beginning to wonder if I have been far off base and, in fact, been contributing to our difficulties all this time.

Earlier this week, Anthony hit the door to our younger son's bedroom hard enough to rip the lower hinge off the frame. I was upstairs and could hear Anthony getting upset downstairs, but was not aware that he had hit anything until our younger son came to inform me. I am still unsure how one pulls off the lower door hinge while leaving the upper hinge intact, but at least it is a little less to fix.

A couple of days after this incident, we were told that Anthony had grabbed a chair at school, the type with the molded plastic seat and aluminum(?) leg frame, and slammed it on the floor with sufficient force to render it unusable.

One of the side effects of the medication Anthony has been taking is increased appetite and, naturally, weight gain. We dealt with this issue to an even greater extent with a previous medication a few years ago. A heftier Anthony is not a more welcome Anthony. There is the obvious issue of clothing becoming too small and necessitating time and money spent looking for larger sizes. Of more concern, though, is the increased severity of injury when he attacks someone. An analogy comes to mind with boxing: a match between a heavyweight boxer and a lightweight boxer would generally be a mismatch in favor of the former.

Thus, the doctor has recommended another medication in combination with the one he has been taking to lower his appetite. However, a potential side effect is. . . increased aggression. If we continue to see this, I imagine we will not be using the new medication for long.