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"Swiss cheese" development & frustrating conversations

Posted Sep 01 2008 12:00am

I'm pretty sure that's not a technical term, but I remember reading a while back about how children with autism exhibit "swiss cheese" development. The idea was, compared with their NT peers, kids with autism often have at the same time, areas where they are quite advanced and areas where they are significantly delayed.

We've seen that with our twins, and we're seeing it with Little Bitty. While other kids his age are doing the 6 or 12 piece puzzles, he can breeze through one with 36 pieces in a few minutes. He can recognize / read some words (ok, mostly names of Thomas characters, but it's a start) and the other day he even spelled the word "Thomas" all by himself! He can count at least to 20, and knows his letters and shapes.

On the other hand, most kids his age can speak clearly in short sentences, express thoughts and ideas, create elaborate pretend play scenarios, and color with ease. Little Bitty still struggles to express even basic wants and needs. He's doing better every day, but so much of his speech is still babbling, and it's hard to figure out how much of it really is babbling vs. actual words that we just don't understand. Yesterday I felt so bad because I could tell he was trying to tell me something, he kept repeating the same word over and over but for the life of me I couldn't figure out what it meant. :(

The words that we do understand are still often approximations of the word, although there are some words he can say pretty clearly. It has only been in the last few months that he's started imitating. That was a huge step! When he wants something, he is still more likely to try to physically manipulate those around him than to talk (like today, he wanted me to color so he kept jamming his marker into my hand and pushing my hand to the paper).

I know based on the cool stuff he can do that he's a bright guy. But sometimes I find myself wondering just how big our communication gap is, how much does he really understand? Just when I think things are going pretty good, we have a conversation like the other night. It went like this:

LB: [screaming, having a fit]
me: I... want... [that's the prompt for him to fill in the blank which he doesn't always do, sometimes needs a LOT of prompting]
LB: "crwah" [that's Bitty-speak for "cran," his word for cranberry-apple juice]
me: Ok, you want some cran?
LB: [shaking his head] NOO! [he starts screaming again]
me: Ok... let's try again. I... want...
LB: "treh" ["trains"]
me: You want your trains?
LB: [shaking his head again and giving me the 'what is wrong with you woman?!' look] NOO!!
me: Ok... I... WANT...
LB: "D-D?" [DVD's]
me: Do you want me to get your DVD's?
LB: [looking at me like I was an alien] NNNOOOO!!!
me: I'm confused
LB: digga digga digga... diGUH diGUH diGUH!!!!! [he returns to his screaming fit]

Sigh. I'm pretty sure he knows what "no" means at this point (as compared to "yes"), and I know he knows what "cran," "trains," and "DVD's" are. So why the contradiction? I can only guess it was the result of a tired, cranky Bitty who probably didn't really know what he wanted, and so he just kept saying the names of his favorite things. But somehow when he heard me repeat them back, he knew that wasn't it so he just got more upset. Eventually, after another hour or so of screaming, stripping down (totally, when he gets really upset he doesn't even want his pull-up on), rolling around on the floor and trying to kick the door down, he finally settled down and went to sleep.

Thank goodness he was in a better mood when he woke up the next morning.

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