TL;DR just go buy some cowboy boots.
There’s all sorts of hemming and hawing about when exactly you can diagnose a child with autism. I’m skeptical of a lot of it, despite my eldest son appearing to have a mild form. We’ve suspected this since his one year check-up when we marked “no” to enough developmental survey questions that our pediatrician raised an eyebrow. Similar trends continued in years two and three. The diagnosis remains to be officially blessed by a high priest of autism.1
The first thing we noticed is that he never responded to his name. After a few months most kids at least turn their heads when someone calls them by name but he still doesn’t. He doesn’t talk much, either. When we take him to the park he ignores the slides and swings and spends most of his time looking at individual pieces of bark or flowers. I did similar things. If he inherited his mental distance from anyone, he got it from me. I remind myself that I also liked being alone with my thoughts from a young age and back then this constellation of behaviors was called, “that’s just the way that he is.” It’s harder on the days I see him around other kids his own age.
We think it will be mild because while he doesn’t have easy back and forth communication with anyone, he does respond to things. We sometimes count to twenty together. He will semi-reliably say certain phrases so we try to give him every opportunity to do so. If I chase him, he runs. If I make my hands into snakes to bite him, he fights and giggles. And every now and again he bursts in with a really funny joke. Something we didn’t even know he knew how to say, and it always seems like he surprises himself when he does it and can’t figure out how to do it again. He peed on the couch last week and my wife called me down for help and when I asked what part he’d peed on, he burst out laughing, “You’ll see!”
We think he understands most of what is going on around him but can’t find the right words to respond.2
I was in denial over the whole thing until we took him to something called a “Sensory Toy Store” and watched him become the happiest child who has ever lived. Which for him meant sitting down in front of something called a bubble wall and looking up at it as if he’d seen an angel. I looked at him and all the other kids. I finally admitted that for whatever reservations I had about the appropriateness of putting all of these behaviors on the same “spectrum,” it’s a thing. It’s a thing that maps to real people and real behaviors that are inborn. All those kids at the store behaved like my son.
I say the science on this is poor because people will offer you all kinds of things to “help” with what by some definitions is the fundamental personality of your loved one. Most of these “treatments” sound to some degree like utter horse shit. Still, if it’s cheap and low risk and it’s addressing some kind of skill or capability your child needs, you’ll give it a try. My wife swears he is more receptive to her when she gives him some probiotic drops she saw on TikTok. I did enough diligence to ensure they weren’t poison but I don’t really notice any changes. My focus is on interruptive play, where I engage with him and force him to interact with me as something outside of his control. I try to find ways to do this that are fun rather than frustrating. His speech therapist3 says this is the best thing I can do, and I love to play with him anyway.
Language is going to be a difficult challenge and while his brain is still in its formative stages we want to try to get him to use it as much as possible. That doesn’t mean I give up on looking for easy solutions.
My son also walks on his tip toes all the time, like a ballerina. You can’t get him to stop. Even if I take him on a mile long walk of the whole neighborhood, his toes will stay pointed the whole way. He trips and falls all the time but as soon as he’s back on his feet those heels go up again. I didn’t think this was a big deal but his legs are forming into their forever shape the same as his brain. His pediatrician said we’d need to go to yet another specialist for help. I asked what it is they could possibly hope to do other than fit him in braces all the time or tell us to buy yet another weighted vest. I’m very involved in his life and I can’t get him to stay flat footed for more than a few minutes so what was one hour a week going to do? I didn’t want to make him miserable.
Then it hit me. My son loves horses.4 The whole cowboy aesthetic thing is right up his alley. I didn’t want to take my son to some specialist who was going to force him to wear some special kind of brace or shoe. I didn’t want him to be miserable and have to endure yet another long car trip every week. I just went and bought him some cowboy boots. It was something like $100.
It worked perfectly the moment we put them on. He was instantly flat footed and walking around with a cute little toddler mosey. The only hiccup is that we had to find a pair that zipped up in the back so they’d be convenient enough my wife could get them on his feet in the mornings. Most importantly, he likes to wear them. Wearing cowboy boots is fun because if you’re wearing cowboy boots as a toddler, you’re basically a sheriff.
He still tries to do tip-toe walking on occasion but the boots force this to be radically less than in the past. I’d say it’s something like a greater than ninety-percent reduction. And that remaining ten percent is maybe him going a few centimeters off the ground rather than full ballerina foot. The behavior outside the boots also seems reduced although it’s marginal. Maybe a ten or twenty percent reduction. From his perspective he’s been walking like that his whole life and it’s the cowboy boots that are unnatural so we’ll give it more time.
I’m sharing this in case you know anyone with a child who has the same sort of problem. I’d like to see cowboy boots sold in every Sensory Toy Store right next to the weighted vests and weird hermit tents.5 I don’t see any reason why this wouldn’t help every kid who does this. Nobody told me this would work, it just came to me one day while we were driving to Costco.
Broader than that, I think there’s deep value in really loving someone a whole lot and thinking about their problems all the time so you can find a way to help them that doesn’t feel forceful or painful. Indeed, I think quite a few of our problems can only be helped by another person caring for us in such a way. You need people who love you. I’d encourage you to apply this same kind of care to the people in your lives and maybe that will help them to one day do the same for you. Maybe someone you love needs a pair of cowboy boots and they don’t even know it yet.
His primary pediatrician was just certified to give the diagnosis, and led my wife to believe it was a foregone conclusion.
Taking him to the doctor used to be a pretty giant ordeal because the second they’d try to touch him with anything he’d go full fight or flight mode. But when I started doing soothing speech the whole time it got a lot better. For instance, when I say “Don’t worry if they take your temperature. They’ll give it right back when they’re done” he doesn’t seem to mind them touching his head with a thermometer.
Wide range in skill is the problem with a lot of these therapy approaches. You want a grizzled fifty year old veteran who invented the science, but all that you can find as available is a twenty-four year old who just graduated and got certification.
I am convinced that all horses have autism, somehow. Don’t ask me how it works. It’s just their energy. This is why when you soothe horses with whispers you should be whispering about really crazy hypothetical philosophical experiments that are totally beyond the pale.
The hermit tents are weird. Let’s be honest with each other.
when we were going into the meeting to get the results of my son’s ASD/ADHD screening, i fully expected them to say “ADHD, but no autism.” instead, the first thing out of the doctor’s mouth was, “Well, he definitely has autism . . .”
i was genuinely surprised. my immediate thought was, “No, he doesn’t have autism. He’s just the same way I was, and I don’t have au- . . . I- . . . Oh shit.”
fast forward a few years and kiddo is doing fine. it’s a mild case. the biggest challenge has been behavioral issues at school, which have been mostly resolved through painstaking cooperation with teachers/administration.
i’m also skeptical about various aspects of autism diagnosis/treatment, though i agree that the term definitely describes a real and significant thing. what throws me is the sheer range of severity. the difference in symptoms/impairment between mild and severe cases is so significant that i sometimes find it difficult to see them as the same condition.
anyway, it sounds to me like you guys are going to be fine too. you’re both obviously tuned in as parents, and the cowboy boots thing is a minor stroke of genius. i wonder how one would get that into clinical trials.
I don't really understand the whole "autism" diagnosis. How can a kid that can really focus down on something or be a bit what we used to call "quirky" be called the same thing as kids who have no language and can't care for themselves be the same thing? I don't like the spectrum either because aren't we all on that spectrum?