I experienced firsthand today what Anthony's assigned staff member at the service provider did last week.

Anthony had been a little on edge at times yesterday, and had not had a bowel movement.  My wife and I discussed whether it would be all right to take him to church this morning, and ultimately decided to do so with the idea of taking him home immediately if he started acting up.

Since I'm always looking for ways to get him (and myself) more exercise, I chose to walk with him to church. This 15-minute trip isn't terribly unusual for us when the weather is reasonable.  My wife and other two kids were planning to come a few minutes later by car.

Within three or four minutes, Anthony started trying to hit my arm as we walked; that is an indication of dissatisfaction.  I didn't give it a great deal of thought because he hadn't been completely happy yesterday either.  After a few more minutes though--but still a few from our destination--he had progressed to the highest level that I customarily see, wherein he lowers his head and tries to butt it against my elbow multiple times.  We were now closer to the church than to home, so I tried to just keep him at a distance, use a stern tone with him, and get him to keep walking.

However, he next swung his clenched backhand and hit me in the jaw. I have never seen him do that before, but I am certain this is what his handler described to me as his punch.  At this point, I abandoned designs of making it to church and turned around.  But Anthony was now in full attack mode.  I was simultaneously concerned with getting him home; keeping him from attacking me; keeping him from wildly flailing himself into traffic--we were by this time out of the purely residential area onto a main street, albeit two lanes--and hoping I wouldn't end up with a ripped suit through it all.

I tried staying behind him and directing him to walk; I tried walking a little away from him to the side; I tried walking in front of him.  But rather than getting him to return home without further incident, he instead charged at me every few moments, head down, trying to butt me in various places.  He succeeded in butting me in the chin (the same spot he got me with his backhand), the elbow, and the wrist.  My elbow doesn't feel anything to speak of, but my chin and, to a lesser extent, my wrist, are somewhat sore.

I tried calling my wife but got voice mail--probably because she was trying to get the other kids out the door.  Anthony and I were by now back in the residential area.  A lady and her daughter or, perhaps, granddaughter, were crossing the street in front of us while Anthony was howling because I was doing my best to stay away from him.  I called out to them, "Please keep your distance.  He's autistic and he's really upset right now!" Anthony was so unpredictable at this juncture--kicking a water meter cover, throwing himself on a lawn next to the sidewalk--that I just didn't know if he would have any sense of reason if other people were nearby.

My wife and other kids finally showed up in our smaller car rather than the SUV (as I anticipated, which was why I tried to call so they would change vehicles).  We discussed whether they would return home and get the SUV or go to church since they were running late, and then have my wife drive home and change cars.  We decided on the latter.

Perhaps due to the break in the action, so to speak, with me talking to my wife while Anthony was standing a way apart, after they left I was able to get Anthony to walk with me without charging.  He was still howling quite a bit and clearly not happy, but I managed to keep the distance AND get him to come along without another attack.  Because of this, I called my wife again and told her I thought we would get home without her needing to come retrieve us.

As I was outside with Anthony, at one point putting him in a headlock to reduce his ability to butt me (while in a suit!), and then later after we had gotten home, I realized this incident would not have gotten very far had we been in a controlled environment.  Here at home, I would have gotten him into the headlock as soon as his intentions were clear.  I would have wrestled him to the floor and, possibly, leaned on him to make it uncomfortable to breathe.  Those strategies have worked well enough for me in the past, effectively taking the fight out of him after a while.

But those tactics aren't available outside.  Even if I weren't in a suit, I would not have wrestled him to the sidewalk.  And it's even worse for those working with Anthony, because they would not choose the same tactics--even though I would give them permission to do so--because of perceived potential liability issues. It is little wonder that the police officer put Anthony in handcuffs the other day.

The overarching aspect of all this that is particularly unsettling to me is the escalation beyond anything we have seen previously.  I have never really feared Anthony before, but I did a little today.  Of course, I was not in the position to use the usual tactics at my disposal, as I wrote above.  But my wife agreed with me that if it had instead been her walking with Anthony, the ferocity of his attack would have left her crumpled on the sidewalk with a concussion.

Naturally, this opens a new can of worms for us.  When upset, Anthony has always been willing to attack if he thinks he can hurt someone.  That has uniformly precluded adult males.  But if he has gone beyond that, and if he continues to be even more aggressive than in the past, that will change entirely the way we look at who he can be with, and when he can be with them.  It is altogether possible that we will be without alternatives to either keeping him at home or getting him into a facility that is designed to handle those who are dangerous to others on a regular basis.

Anthony had another seizure this afternoon.  It's been just a little over six months since the first one in September.  Interestingly, I had been thinking recently that if he could go for just a little while longer without one, we would probably be in good shape.  One week beyond six months is statistically insignificant, I'm sure, so I'm guessing we shouldn't be surprised to see more in the future.

I was again here when it happened, and was happy for that coincidence so my wife didn't have to deal with him; I also recognized what was occurring immediately whereas she didn't see it happen previously.  This time, he was sitting on a chair rather than standing when it came on.  I managed to get him off the chair quickly, lay him on the floor on his side, and get our other son to bring a pillow to place under his head so he wouldn't hit it on the floor.  I thought about trying to get him to his bed after it ended but my wife talked me out of it, so he went to sleep with the pillow in a walkway.

He lay there for four hours, intermittently sleeping and waking up.  We weren't sure about when to intervene, and did so only when he started to lift himself up and then turn to lie down again.  We're hoping he will be able to sleep without waking us up in the middle of the night.

My wife and I discussed whether to send him to school tomorrow, as we are of the understanding that we should be watching him for the next 24 hours.  However, we did subsequently send him to school when this happened before without incident.  We have decided, however, not to have him go to his service provider after school, just in case something were to happen there.  Given the handcuffing incident on Wednesday, they can use a break from more issues with Anthony again so soon.

I realize today that it has been four months since I last posted.  During that time, I could (and probably should) have written about asking people at church to redirect their thrift store clothing donations to us to try to keep up with Anthony ripping his clothes apart.  We were extremely grateful for the overwhelming response, and thought we would be set for quite some time.  Unfortunately, Anthony has picked up the ripping pace again after a lull, so supplies are thinning out much more quickly than we were hoping.

I also could (and probably should) have written about Anthony's new obsession with taking his dishes to the sink and trying to wash them.  That doesn't sound like a bad thing, but when he doesn't understand the concept and gets upset on being prevented from playing in the water for half an hour, it's not so great.  To make matters more interesting, we have also determined that we will need to put the knives away instead of letting them dry with other dishes on the counter; it's a good thing he didn't recognize their potential use as weapons when he grabbed one. 

And, I won't deny that it was likely something approaching laziness that kept me from writing about Anthony getting suspended from school for violence, my obtaining permission to work from home for a couple of days to stay with him, and then him getting another brief suspension the next week.  My wife met with his teachers to emphasize that telling Anthony, "No!" is effectively a provocation to attack.  When necessary, we do yell his name to get his attention, but then we do everything we can to push/pull/drag him away from whatever situation we deem undesirable rather than saying, "No!".  

But, after all my shirking, I really felt I had to write today.

My wife called me about an hour before I was scheduled to leave work, asking if I could leave right then.  After some discussion, I closed down my work and explained the problem to my manager, who offered to have others finish my few remaining tasks.  I didn't think that would be necessary, but I reconsidered later as I was driving.  In the interim, the policeman who had been called to the scene had gotten my number and called me directly to ask if I was coming to get Anthony.  I told him my wife had briefed me and that I was on my way.  The officer told me a medical unit had been called as well to attend to Anthony because of the contusions he was inflicting upon himself by banging his head on loose gravel.  I told him the last thing I wanted was more medical expenses with Anthony, and that, based on experience, I was certain he would not need medical attention.  I called my wife--who was closer--to try to get her there quickly to prevent anyone from working on him.  

Thankfully, when I arrived, the policeman was gone and there was no sign of a medical unit.  My wife was speaking with Anthony's school principal and staff from Anthony's service provider.  Anthony was already seated in his customary third-row seat of our sport-utility vehicle, the one we consider necessary to prevent him from reaching over and attacking the driver.  My wife traded keys with me so she could go to pick up our younger son and go to a scheduled parent-teacher conference.  

Anthony's assigned staff member (I'll call him "Kevin" to make things easier) told me that, as he was driving Anthony to the service provider after school, he had his hand on the gear shifter in his car when Anthony put his hand on top.  Kevin lifted his hand off, and Anthony tried to start pinching his hand, then punched him.  Not with a great deal of force, to be sure, but certainly with enough to be a cause for concern.  He then started banging his head against the window.  Kevin pulled to the side of the road in a rural residential area and got Anthony out of the car.  Someone driving by saw the commotion of Anthony attacking and Kevin trying to subdue him, rolled down his window, and called out, "I'm going to call the police!" Kevin said, "Why??", and the passer-by said, "Because you guys are fighting!"  Kevin tried to explain the situation, but a police officer showed up shortly thereafter nonetheless.  

According to Anthony's principal, the officer has been to Anthony's school and is familiar with special-needs kids.  However, because Anthony was unruly and looking as though he would end up in traffic as he tried to attack Kevin and the officer, the officer handcuffed Anthony and forced him to the ground.  It was some time after this that he called to tell me Anthony was banging his head into the gravel leading to a driveway.  Thankfully, my wife got there before I did.  It turns out that police backup had been requested; my wife tells me there were five or six officers there by that time. However, there was no medical unit. Hooray for that! 

So, when I got there, Anthony had already calmed down, had been released from his handcuffs, and was sitting quietly in our vehicle.  I spoke at length with his principal and service provider staff, discussing why he might have gotten upset--I am fairly certain Anthony wanted to move the gear shifter as he did in a previous instance--and other aspects of his behavior and care.  The service provider staff reaffirmed their commitment to doing whatever necessary to work with him (for which I am extremely grateful), and we said our goodbyes.  

And then I, with Anthony, went to pick up my daughter, half an hour late.  

I rarely, if ever, post again so soon, but I thought today warranted it.

I got home from work as usual about half an hour before Anthony was scheduled to return from school.  No one else was home due to outside time commitments.  I was really tired and knew that I wouldn't get the chance to rest later, so I lay down with the anticipation that I would be getting up within 20 minutes at the sound of Anthony's approaching bus.

Instead, I had barely started to relax when I heard the bus, fully fifteen minutes ahead of schedule.  I hurried to the door to assure the driver that I was here so that he wouldn't honk the horn; I can't imagine the neighbors care for that.  Instead of waving at me, however, he motioned for me to come out to the bus instead of letting Anthony off to come in on his own as usual.  Now it was making sense, I thought; Anthony must be upset so they detoured to bring him home first.

Since I didn't have my shoes on, I closed the door briefly to put on them on, but, alas, I was too slow--the driver honked his horn thinking (I imagined) that I hadn't gotten the message.

I got out to the bus and, as I climbed on, said, "Anthony's not doing well today, I guess?" But the driver surprised me by motioning to Anthony and responding, "He's ripping off his pants!"  He and the bus aide had not seen Anthony do that, I surmised, so while they were consternated over him exposing most of his underwear, I simply said, "Yeah, he's doing that a lot these days."  I got him off the bus and hoped that no neighbors were watching, but, if they were, I imagine they would understand.

I keep planning to schedule a trip to the thrift shop, and my wife had actually intended to buy him a couple of things as well recently but forgot while addressing the rest of her shopping list.  We'll just have to bump it up the priority list a couple of spots; I doubt there are any nudist colonies nearby.

Anthony is getting even worse with ripping fabric.  A couple of days ago, he ripped apart two pairs of shorts.  Today, he came home from school having ripped the shirt he had worn to school, plus an additional one in his backpack as a replacement, and his undershirt.  And, to seal the horror... he got off the bus wearing a sweatshirt supporting my alma mater's bitter rival (cue "Psycho" theme music).  Well, beggars can't be choosers, I guess.

And we could well end up beggars at the rate we're going.  As I have written in the past, we frequent a thrift shop for much of Anthony's clothing because of his relative indifference to what he wears, combined with his propensity to stain or damage things quickly.  But even then, if we're looking at $20, $30, or more every month, that will certainly start to add up.  Even more than the money involved, though--since ultimately we can divert from other expenditures to cover if that becomes necessary--is the added stress of having to replace clothing constantly.  We face the real possibility, for instance, of Anthony temporarily being without pants to wear if he keeps ripping things and the last remaining articles are in the wash.  The thrift stores we go to are not particularly close, and trips to them require planning to fit in with already very busy schedules.  And while closer big box discount stores may be on the inexpensive end for a new clothing item or two, they will often be twice or more the cost of what we would pay secondhand.

We're in one of those stretches with Anthony that seriously challenge us with regard to coming up with solutions or sufficient patience.  But maybe we need to think "outside the box".  Instead of always worrying about clothes for Anthony, perhaps there is a nudist colony that would take him off our hands....

"Dad, have you seen the spray paint I was using?" I knew my daughter was working on a project for her group date to a school dance that night.  "No, I haven't.  I guess you've asked Mom?" In many households, Mom can find anything, and my wife is no exception, but in our household Mom also has an amusing/maddening compulsion to immediately put away anything that is not where she deems it should be.

But Mom, who was out running errands, denied being the culprit in this instance.

I knew I had seen the spray paint in question, and thought I knew *where* I had seen it, so my thoughts then turned to Anthony.  What would Anthony do if he saw that can? First, if it had a label he could possibly remove, that would be gone.  And then....

I opened the trash can.  Nothing.  I rummaged down further, and there it was: a label-less metal can, easily avoiding detection by a scan of the contents at the top.

My daughter, who was by this time approaching a state of despair due to time constraints before her friends arrived, had Mom on the phone discussing the matter.  I, feeling highly satisfied with my sleuthing abilities, proudly produced the can and handed it to her while she was yet on her phone.  And then it came, through gritted teeth: "I. Hate. Anthony!"  I tried to get her to lighten up and joked that we just have to try to mimic his thought processes.

But while our daughter doesn't always "hate" Anthony, the rest of us understand her sentiment.  Later in the evening, I heard my wife exclaim, "Nooooo!" It turned out that Anthony had ripped the tag off an article of her cherished exercise clothing, ruining it.  And between those incidents, Anthony ended up with wet pants when my wife arrived with him at our younger son's soccer game, despite having taken him to the bathroom before the game--I'm guessing he didn't go--and making him wear a diaper.  I am resigned to thinking we're at the point where we would be surprised if Anthony did not cause us problems like these regularly.

My wife took Anthony to see a neurologist today as recommended by the doctor at the emergency room last week.  She called worriedly to ask if I could somehow leave work--I ended up finishing at home--to join her at the doctor's office because Anthony was showing signs of getting violent.  Thankfully, we didn't have an incident there.

The doctor told us, somewhat differently from what we heard at the emergency room, that the chance of having a second seizure is in fact 50% within the next six months for people in general, and higher than that for those with autism.  If Anthony makes it past six months without one, the likelihood for another episode goes down significantly.  We were grateful to have clarification about that, as well as information about what to do in general if it happens again.  We will also be getting an emergency nasal spray prescription that can stop a seizure if it goes excessively long--we learned that a seizure that lasts five minutes, for instance, is just as likely to continue for ten, and clearly intervention would then be in order if possible.

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As I have mentioned before, we are at a loss about what to do with Anthony wetting himself.  He has completely regressed to not even considering going to the bathroom on his own before doing so.  Maddeningly, he will come out to us or go into the bathroom immediately *after* he has done it, and it is apparent that he knows we won't be happy with him.  We don't know what to think.  It's almost as though the blessing we felt of him suddenly learning to go on his own at five years of age--after nothing we tried worked--has just as suddenly been revoked.

This impacts us not only in time lost due to dealing with him once, twice, and even thrice a day with the washing, changing, cleaning, et cetera, but there is an additional challenge for us, and part of it is almost amusing: we have to scramble to find pants or shorts for him to wear because things are constantly being soiled and waiting to be washed, and I realized today that the stack of plastic bags we get from stores for our garbage has been depleted because we keep using them for Anthony's wet clothes.  We will have to stop being ecologically friendly and ask for more plastic rather than paper bags for the time being, I guess.

I had been thinking I needed to follow up on the last post--we ultimately do have to find another service provider--as well as write about Anthony continuing to defy all attempts to stop his urinating problems, but today we experienced something new: he had a seizure.

As today was a holiday, I was off work.  And as fate would have it, I did not sleep well last night, so I had not yet gone outside to work in the garden as I had planned.  My wife and younger son were out, so only my daughter was with me when Anthony began making a commotion in his bedroom indicating something was seriously wrong.  My daughter's own initial reaction was that she was hearing an earthquake, but she quickly realized it was only in Anthony's room.  I rushed in to find him convulsing on the floor with a heavier chair on top of him, and called my daughter in to help me get the chair off him.  In the same small area, he has a table where he sits to work on puzzles; we moved that away as well and tried to sit him up as he was beginning to turn blue.  I realized the gravity of the situation, and both my daughter and I had brief thoughts that the unthinkable might be happening before our eyes.  Thankfully, I did manage to get him up and breathing again.  But Anthony is heavy, and trying to lift a limp body of that size is not an easy task.

My daughter ran to the computer to search on what to do when someone is having a seizure, and told me to turn him on his side and cushion his head.  We did that, but he was on the floor and it didn't look very comfortable, in addition to the fact that he was also lying on scattered puzzle pieces, so I tried to lift him without success to get him on his bed.  My daughter said a person who has just had a seizure will also be very groggy, and that was indeed the case with Anthony, but we did manage to get him to climb onto his bed, after which he rested nicely for about three hours.

Later, after some discussion and considering advice from others, my wife and I took Anthony to an urgent care section of the hospital, where they determined it would be best to have him go to the emergency room to run some tests.  The doctor said the results showed nothing out of the ordinary and, more importantly, told us that of those who ever experience a seizure in their lifetimes, 80% will never experience another.

On a personal note, hearing that figure was a tremendous relief to me.  For a few hours today, I was revisiting the struggles I had years ago to separate lack of control with regard to Anthony's condition from other areas, including professional, of my life.  I am grateful to likely not have yet more stress to combat.

We learned at the hospital, by the way, that Anthony weighs 215 pounds.  We now have a renewed determination to get him to lose weight, just in case this ever happens again.

We received a call from Anthony's community support provider on Friday saying Anthony had gotten violent, and asking us to come get him rather than them bringing him home as they normally would.  We are of course never particularly surprised to get such calls, and I went to pick him up without giving much thought to it.  I had not heard the details and casually told the waiting male staff that Anthony probably needed to have a bowel movement; I would take him home and have him sit on the toilet.

The full story was rather more serious than that. It turns out that he tried to rip a tag off another boy's shirt--yes, we are still dealing with that, along with the urinating problems--and a female staffer tried to stop him.  Anthony got upset and slammed his head into hers, sending her to the hospital with a concussion.  We were asked to keep Anthony home Saturday and Monday while the staff re-evaluates how (or whether) they want to proceed with him.

Anthony is in some ways more difficult to deal with than many other autistic individuals.  Because he is pretty easy-going much of the time, he can lull his handlers into a false sense of security around him.  We are always quite specific about the dangers associated with him: he doesn't get violent often, but when he does, he will do anything he can to hurt his handler if he thinks he can get away with it.  The special needs school that he separately goes to, for instance, has a male staffer that they immediately call when Anthony gets upset.  But we understand that if a staffer sees Anthony for an extended period without a violent episode, he or she might default to thinking Anthony does not require as much diligence as do others.  And then something like this can happen.

Since violence with Anthony ultimately is a matter of when rather than if, we would prefer that he have an episode soon after entering a new environment to let people see that we weren't kidding about him.  Sadly, we don't have control over that. Perhaps we need to consistently reiterate what Anthony is capable of doing until they see it for themselves.

We are going through one of the more difficult stretches we have had with Anthony.  Along with his self-wetting not abating regardless of how diligent we are in having him go to the toilet in a timely manner, his oft-noted obsession with peeling and ripping things has been taken to a more destructive level: he now wants to rip tags off fabric.  That fabric might be towels, or it might be clothing, and depending on how he rips the tags off--as his only concern is doing it rather than taking into consideration the status of the article afterward--we have had several items of clothing ruined in the process, some of them of reasonable worth.

I think the combination of these two problems reasonably qualifies for "at wits' end" status for us.  Anthony wetting himself and whatever surface he is on can happen at any time like it did late last night when we were already very tired and past bedtime, or it can be during the period after taking him to the bathroom after a meal and before he has eaten or drunk anything else like today.  Because of his limited comprehension of speech, trying to talk to him and explain what we need from him is about as effective as saying the same things to a pet, although I do try.

With regard to the tag-ripping, if he gets his hand on an object, it's too late.  Amazingly, he *does* understand when we raise our voices and tell him to stop, but it doesn't matter; so strong is his desire to do it.  We have to be constantly vigilant about keeping him away from closets or laundry or any place else he might find something to rip, and that is just not always feasible.  Short of locking up all clothing and other fabric at all times, finding him ripping yet more items is very likely an eventuality.

Yet even with the negative aspects of these things, there is often a bit of lightheartedness.  My wife asked which of us were going to grate the cheese for our homemade pizza today.  My daughter jawed with me to try to get me to do it instead of her.  I was quite ready to make her a deal: I would happily make the admittedly-considerable effort to grate a lot of cheese, if she would clean up the sofa cushion Anthony had wet.  Surprisingly, she didn't take me up on my offer....