An appointment with a psychologist

I met a psychologist last week. At least, she told me she was a psychologist but in fact she looked and talked like a sixth former from the local school. Perhaps she was both, who knows?

I'd gone to a meeting of a group of parents with children with autistic spectrum disorders and this psychologist/school girl, to discuss the training these children need to get them ready for the real world. It was an informal affair and we sat around a large table. I carefully manoeuvred myself to sit next to her, so I could monopolise her attention. In the end, she had little to say, so my careful effort was wasted but it is always nice to confirm that I can subtly manipulate things to my son's advantage when I need to. It's a skill that only the most hardened and determined carer achieves; I like to think of myself as a black dan in proactive caring. Social workers probably do as well and leave me well alone, knowing that whatever support they can come up with will always be inferior to mine.

But back to the meeting. There was a new couple at the meeting, with that haunted look about them that comes from a life of coping with a difficult child and helpless caring professionals. Both of them were there and both of them joined in the discussion, which to my trained eye means that the father is not significantly disabled by the curse of Asperger's Syndrome himself or that the child is not his biologically. Years ago, I came to realise that people with Asperger's tend to produce children on the autistic spectrum. There are a few notable cases of mothers with a level of Attention Deficit Disorder, with or without the hyperactivity. They tend to have children with a degree of attention deficit in their disability. I include myself in this. It is incredibly mild and barely noticeable but it is there. It explains my early problems with paying attention to detail and finishing work but years ago I must have unconsciously realised the problem and set about correcting it. Generally, it is the father who shows the greatest degree of affliction with Asperger's Syndrome. It can be subtle, so for example I once attended a meeting for parents of children at Pip's school. One father sat at the back, facing away from the speakers and ate danish pastries throughout the meeting, actively ignoring the activity at the front of the room. That response would have been subtle but he then ruined it by asking a barrage of questions at the very end, which showed he hadn't listened to the talk. It can be more obvious, for example, I have seen fathers of children monopolising their wife's attention at significant meetings, demanding answers to trivial and unrelated questions they fired at their spouse, like a two year old child anxious for reassurance from its mother. In all the years that I have attended meetings and met parents of children with autistic spectrum disorders, I would say that I have met fathers who exhibit autistic tendencies in all but four cases. Two of them were unrelated to the child they called son. The experts put that figure at fifty per cent. I feel quite smug that I know more than the experts.

During last week's meeting, the father was incredibly normal and well tuned in to his son's needs. I assumed the boy had been adopted, but it soon transpired he was the father's step-son. It was the age old problem of a child with Asperger's, who grows up 'different' to everyone else, the parents make incredible accommodations for his behaviour (in this case he moved out to live with elderly and childless relatives very early on, to ensure that he was given plenty of individual time). Unfortunately, in my limited experience, these children carry on until one day when a relatively minor incident occurs and they suddenly explode. The parents are left shell-shocked, with the dawning realisation than there is something incredibly wrong. In this case, this child's explosion, in his mid twenties, led to a prison sentence.

John Bercow wrote a report on the state of support for communication disorders in Britain a number of years ago. I'm sure he wrote that the prisons are full of a huge number of people with these disorders, so I knew people with Asperger's Syndrome are far more likely to go to prison but I had never come across such a case before. Of course, the mother was ashamed of her son's record but she was so full of confusion and worries that she had to empty out all the skeletons she had accrued in her cupboards. Our psychologist sat quietly at my side. I tried to reassure this mild mannered couple that anger and temper tantrums go with the condition, that John Bercow's report had identified the likelihood of a criminal record and that most of the group, if they were being honest with themselves, could be telling the exact same story.

Our psychologist, with her mild, uncertain manner, girly looks and behaviour and ignorance of some of the characteristics of Asperger's, failed to impress the assembled group. I felt sorry for her, untouched by the pain of caring for an autistic child, embarrassed by our confessions, unsure of her knowledge and a stranger in a group of people united by a common experience. I turned to her and asked her about her qualifications, expecting her to reel off an impressive list of degrees, experiences and in-depth knowledge. She told me she had a degree in psychology and had helped out in a nursery for children with autistic spectrum disorders. I was surprised by her honesty but needed some reassurance so I probed deeper. Was her manager more experienced? Did she have support from experts? What were her views on some of the books written by experts? She simpered through the questions, replying with half-answers. I moved to the problems people with Asperger's Syndrome face, their difficulty in recognising their limitations, their inability to formulate solutions and their slowness in adapting their behaviour to camouflage these problems. I cited the example that Pip has had the same class target for the last four years; not to call out in class, and how, after four years of rewards and consequences, support and feedback, he still insists upon disrupting classes with inane and random announcements. How could any organisation invest the time and the money working on life skills which could take years to develop? She told me she sets a target and gets her client to commit to it and provide their own feedback. Simple really, and well within the capability of all the women present. I asked her how long she had been working with the clients, she replied a few months and no, she hadn't successfully completed a project yet. I could see my fellow group members rolling their eyes significantly, but she was looking so earnestly and anxiously into my eyes that she missed their response.

I turned to the new couple; 'are you interested in getting support from this organisation?' 'We're desperate, we need help from everyone who can provide it.' I brokered a firm commitment on behalf of our under-age psychologist, to phone the couple up within the fortnight, to offer help to their son or explain why she couldn't. I looked her in the eyes and explained how much they needed that phone call, dramatically recalling what it felt like to be let down by support services. She promised faithfully.

At the end of the session, she left to attend another meeting, apologising for going. I sat back and watched my fellow carers. The tension and shyness drained out of them and they became an angry mass of women. The room buzzed with questions, directed at anyone who would listen; 'who does she think she is?' ,'what experience was that?', 'what does she think she is going to achieve?'. But beyond all of this anger, I felt quite optimistic. In the past, I have dealt with caring professionals who have become jaundiced by their lack of understanding of this unique condition and their inability to spend the time and money. Here was a new kid, with all the optimism of ignorance. She had been so easy to control and so open and honest in her responses. Pip is too young to access her support, but when he becomes eighteen, I will contact her, give her clear instructions of what he needs and watch her closely, to ensure that she provides a service which is effective and appropriate. That girl shows promise.

As the parents slowly filed out of the meeting, I walked over to the kettle and made myself a cup of tea, waiting for the arrival of Gary. Sure enough, as the group dwindled, he walked in and sat down, as anxious to talk to me as I was to talk to him. Gary is my lifeline, a young man with all the obvious characteristics of Asperger's Syndrome; a technical degree, anxiety, a lack of social graces and an indifference to his looks which still staggers me. But underneath it all, Gary is a gem. He doesn't work, so has plenty of time to work through his limitations, reading up on his condition, contemplating his behaviour and identifying his oddities. He prefers plain talking, so I ask him painful, blunt questions totally unadorned by the niceties I would have to think up for normal people, occasionally explaining that I need to know how he thinks for the sake of Pip. He answers with the honesty and cruelty that Asperger's produces. I'm glad he doesn't mean anything to me emotionally but he is a brilliant friend. As we sat back in our chairs and dismissed the usual greetings as mindlessly as we could, I got to business. 'Did you see the psychologist, the young girl with the notepad?' 'Oh, yes, I was watching her.' 'What did you think of her?' 'She doesn't know anything, she is too dressed up and she can't help me.' That was it, my flowery and partially-formed opinions were condensed into a quick sentence. Pip wouldn't take well such a feminine and sweet-natured psychologist. I would have to beef her up a bit before she could be useful.

Gary had provided me with what I wanted, I wriggled myself comfortable and prepared to fulfill my part of the bargain 'Tell me your new computer's specification' I heard myself say, as I drifted into a dream world, ready to spend the rest of the afternoon listening to a shower of bits and bytes, RAMs and ROMs.