I strode across the small hallway, towards the rooms that always seemed to hold the babies nearest and dearest to me- Sandra included. The children with special needs always ended up in there for one reason or another. I had decided to look in that room last. I knew from speaking to Juan Pablo that Sandra was gone, as were almost all of the others.
An additional crib had been wedged into the room, crowding the small space even further, and complicating my efforts to peek inside each crib without waking anyone. I spotted Magaly, sleeping soundly in the corner crib, curled up on her side with one shoe on and one shoe off. Her shiny black hair hung straight across her face, obscuring my view of her almond-shaped eyes and petite nose. Only her tiny pink mouth peeked out.
The crib to my left held a healthy-looking girl with familiar features. I took in her large ears, beautiful eyes, button nose, rosebud mouth, and full cheeks. She looked at me, smiled, reached her arms up, and began to fuss. Could this be the same little girl I spent an entire month coaxing just one smile out of? The little girl who was so disinterested in people and toys? The little girl who was so frightfully thin and frail just two months ago?
I reached my hand between the bars and stroked her cheek.
Alison. Chica linda, tu me recuerdes? She briefly stopped fussing and looked at my eyes before continuing her impassioned treatise for me to pick her up.
As I lifted her from her crib, I was delighted to feel the weight she's put on. Compared to her former self, she's downright chubby now. Compared to a typical American baby, she's still likely a bit underweight.
Developmentally, she has made some progress, though she continues to present with very significant delays. A fellow volunteer reported that they feel she may have autism, although I don't agree. I still feel strongly that there is an underlying issue impacting her development beyond "simply malnutrition," but autism it is not.
Alison is still a timid, cautious baby who is reluctant to touch toys and fully explore them, but she displays some promising progress in her social skills. Alison frequently made eye contact with me; she delighted in watching me pull Legos apart and made eye contact expectantly when I paused between each block as if to say, "come on! do another!"
She is aso beginning to initiate play, though only in the few activities that she seems to prefer. She showed a particular affinity for the Sesame Street Shapes board book I had donated during my last tenure as a volunteer, and loved to turn the pages and point to the pictures. When I put the book down and tried to move to different toys, she several times handed me the book, made eye contact, and fussed until I began to read it again. Her social skills are delayed, but no more than her play, motor, and cognitive skills appear to be delayed at first glance.
At such a young age (under two), given her global delays, I think it's impossible to look at her and say with any certainty that she could have autism. Is she off? A little funky? Absolutely. A lot of parents and caregivers become concerned with autism if a child isn't interacting as they should socially. If all of a child's skills are at a certain level, consistent with their general development, the delays in social functioning are likely reflective of a bigger issue, rather than the sole issue impacting them.
A very well-respected doctor with years of experience diagnosing autism in children under age three delivered a presentation at the hospital I used to work for; the most prominent marker she noted for autism at that young age was a lack of initiation of social interaction. Alison makes eye contact and engages in reciprocal interactions and, although unable to communicate verbally in any effective way, does attempt to initiate those interactions.
For those wondering how Magaly has fared since her surgery- quite well! Her mother wasn't at the center, and I'm hoping that she is safe and well considering the domestic abuse she was staying at the center to avoid in the past. Magaly's legs are certainly stronger then when I left; the muscles holding her femurs into her hips are tightening up and she isn't so loosey-goosey legs out wide all the time any longer. She can stand with assistance and loves taking slow, laborious steps when held beneath her underarms to get toys from the basket (which we did a lot of today!). She fatigues easily, but has come so far from the little girl in the giant cast that she once was. I can only imagine the freedom she must feel.
There aren't currently any children with cerebral palsy or any obvious neuromuscular issues, but I imagine there are at least one or two like Alison. I have to admit that I spent much of my time today with her, "catching up" and bonding again. I've signed up for a few shifts over the next week to ease back into things and hopefully get a better sense of where the kids are, developmentally speaking. There are 19 kids there now- a full house! Pictures soon- I promise. :)
My visit to Casa Jackson, while a welcome one for me, was rather unexpected. Intending only to meet the new coordinator Heather and discuss joining the volunteer schedule, I had walked to Nuestros Ahijados after lunch and found myself waiting at the entrance to Nuestros Ahijados with the afternoon volunteers when Megan and Heather arrived at the gate. Heather had been mugged on her walk back from her apartment in La Candelaria, in the southern part of Antigua. She was visibly shaken and would not be going to Casa Jackson just yet.
Megan asked if I could take the new volunteers to Casa and run them through the brief orientation. Just like that, I was walking down the dusty road that stretches from Antigua to Jocotenango, talking to a high school senior traveling with her mother who was interested in pursuing a career in physical or occpuational therapy upon graduation, describing the myriad of issues that the kids at the center often present with. It was almost like I'd never left.
I did have an opportunity to speak with Heather when she arrived, looking far less distressed, later in the afternoon. Heather mentioned that her primary interest is actually in community outreach and working directly with the families rather than just the volunteers and institutional setting. She said she saw no issue with me working on implementing some training for volunteers whenever I was ready to do so, and fully supported any community visits I may want to set up. While I thought that would be the case, it's such a relief to get the official green light from the new coordinator- and also to learn that she sees the community work as as much of a priority as I do.
Casa Jackson- game on. :)
No comments:
Post a Comment