A Safe Place for Joey (18 page)

“Well, there’s no way of being positive that Ben’s problems are only
genetic.” I turned toward Mrs. Aylesworth. “Your high fever and nausea during your pregnancy may have had something to do with it, too. That’s one of the frustrating things – no one is sure about causes.”

“Is it like a disease?” Mrs. Aylesworth asked. “Can it be cured?”

I shook my head. “No. A learning disability is not a disease. It’s a kind of neurological dysfunction. Some very
brilliant, famous people have had similar problems – Winston Churchill, Charles Darwin, General George Patton, and John Kennedy among them. You don’t cure it, but you can learn how to compensate. And Ben can learn to read and write. I can guarantee that. I also think Ben has a lot of sorting out of his emotions to do, and he should see Dr. Golden by himself for a while. I think you both should continue
seeing Dr. Golden, too. It’s not easy to bring up a child who has learning disabilities, particularly when there’s so much emotion involved.

“It’s true that it’s not good to baby him. It’s also true that it’s not a good idea to put too much pressure on him.”

I turned toward Mr. Aylesworth. “Dr. Golden will be a help on all this – how much is too much, things like that.

“The last
thing I want to say is that Ben is at a very vulnerable time right now, and he badly needs a good male model. He needs to start moving away from his mother, becoming less dependent, more independent. And you can be such help.” I nodded to Mr. Aylesworth. “You, more than anyone, can understand how he feels. Your problems sound as though they were more severe than Ben’s, and yet you’ve been enormously
successful.”

“Do you know what that success has cost me?” Ralph Aylesworth replied. “I live in a cold sweat all day, all night, counting the days till I can retire. Move away. Do something else.

“Well, at least Carol knows now. I don’t have to pretend in front of her anymore.” He reached for his wife’s hand, and they stood up together. “I suppose in a way I have Ben to thank for that.”

I smiled at him, liking this man who suffered so many of the difficulties that my children did. “Just try to spend time with Ben,” I said. “Don’t feel you have to teach him anything – just listen to him. Let him know that you value him for being who he is and what he thinks. Do whatever is fun for you to do together.”

It was after eight o’clock, and we were all tired and cramped from
tension and sitting too long.

“You will be working with Ben, won’t you? You do think you can help him?” Mr. Aylesworth asked.

“I think we can help him,” I said, emphasizing the “we.” “Yes. I’d like to try. I’d also like to speak to his teacher. If she’s agreeable, I’d like to talk to her on a weekly basis so we can coordinate what we do.”

“Wait now. Don’t go too fast,” Ralph
Aylesworth said. “I’m not sure just how much I want the school to know.”

We had reached the front door. I put out my hand. “Well, we can talk about it and then decide, and please call me whenever you have questions, particularly if there’s anything you don’t understand when you get the report. And I’ll call you tomorrow, Mrs. Aylesworth, about setting up Ben’s appointments. I want to go
over the test results with him, too, before we start working together.”

I saw Ben twice a week for two years, and Phil Golden worked with both Ben and his family. Ben’s reading improved quickly. His visual memory was so strong that he acquired new sight words relatively easily and learned to use techniques to speed up his reading without losing concentration. His testing scores rose because
of this and because he no longer was frozen with fear, sure of his stupidity. We worked on phonetic skills, using specific techniques developed for children with Ben’s kinds of learning problems. And when he was taught in short-sequenced segments, he slowly learned to decode unknown words and also to improve his spelling.

Most importantly, he was no longer alone. We all worked with him,
making it clear that while we wouldn’t do the work for him, he didn’t have to do it alone.

It made a difference. Enough of a difference so that “Banana Brain” faded from the school picture as Ben emerged.

At the beginning of eighth grade, Ben went off to a New England prep school experienced in providing individualized education for bright adolescents with learning disabilities, and
I’m certain he will go on to college.

And now, Ralph Aylesworth comes to my office every week, determined that he, too, will learn to read and write as well as his son. He arrives early in the morning, before he goes to work and when there’s no chance of being seen. He wears his hand-tailored pinstripe suits; I wear my jeans.

He cancels often – when he’s out of town (with Helen, of
course) or at a board meeting. His problems are far more severe than Ben’s, and more deeply entrenched, but he is learning to read. His last test showed his silent reading comprehension at a fifth-grade level. He works hard, sweat pouring down his face, swearing as he sweats. He’s defensive and manipulative, but he’s also intelligent and courageous, and I’m as proud of Ralph Aylesworth as I am of
his son.

“I hate her,” Alice sobbed. “Hate her! Hate her! Hate her!”

She was sitting sideways on the couch in my office over our garage, knees pulled up under her chin. Now she put her head on her knees, and her long, straight, light-brown hair fell forward around her face so that tears dripped from an invisible source, making dark blotches on her long, grey flannel skirt.

“Oh, Alice,” I said, sitting down beside her, handing her the box of tissues. “What’s wrong? Who do you hate?”

Alice sobbed on. “Both of them, that’s who. My stupid mother
and
my stupid teacher. I don’t even know which one I hate the most.”

I was surprised at the depth of Alice’s emotion. On her first visit she had sat as still and silent as a rock for most of the time. But, I loved
having Alice in my office. While I enjoyed my boys, there was something special about having a girl there.

I lifted Alice’s feet into my lap (she had shed her shoes on the way in the door) and waited. There was no need to ask questions. Since the first visit, words had tumbled out of Alice – there was no language problem here. For a fifth grader she was more than verbal; she was a veritable
fountain.

“Nobody ever asks me what I want,” she said, mopping her face. “They just run my life as if I wasn’t even here. Just because that doctor said I should take Ritalin, Mom assumes she has the right to stick it in my sandwich in my lunchbox. Well, I hate it – never knowing which bite it will be in, having the other kids stare, waiting for me to choke on the pill. She says I’d forget
to take it if it wasn’t in the sandwich. Maybe I would. But it’s my life, not hers. Anyway, I just throw my sandwich out – I’m not that hungry, anyway, and that was fine till stupid Mrs. Robinson decides it’s her ‘duty to tell your mother.’ She called Mom into school, and now there’s a whole big hassle and I’m supposed to show stupid Robinson my empty sandwich baggie and swear I’ve eaten the sandwich
and the pill.

“Well, I won’t. I’m not some kindergarten baby. I don’t care what they do. I don’t even want to go to the dumb school anyway.”

“I know,” I said. And I did. Dr. Volpe had sent me a copy of Alice’s copious file before he sent me Alice, and there was a detailed family history along with reports from various doctors and teachers.

The Martins had arrived from Kansas
during the previous summer. Mr. Martin had been promoted and transferred to the New York home office of a large insurance company.

The Martins were reportedly thrilled by the “move up the ladder” and delighted with their picture-book pretty home in a nearby affluent community.

However, it was immediately evident to everyone that Alice’s previous schooling had in no way prepared her
for the highly academic program of this achievement-oriented town, which prided itself on its standards of education and high national ranking.

The small private school in the little midwestern city that Alice had attended had a curriculum based on “developmental milestones” rather than standardized levels of achievement. It was considered to be innovative and less pressured than the public
schools, and since Alice had been “high-strung” from the beginning, the Martins thought it was the better option for Alice. And it may have been, but it had left her poorly prepared to enter any other type of school.

Even in her special school Alice had difficulties, and while she was still in kindergarten the school psychologist had tested her.

Her highest scores were in reasoning
and abstract thinking. Her lowest scores were in arithmetic and visual moto tasks. Her full-scale IQ score on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) was 113; the Verbal IQ was 126, the Performance IQ 103 – a 23-point spread. The Bender Gestalt was reported to be “difficult” for Alice, and her drawings showed “signs of stress.” Her teachers reported that Alice’s feelings
were “easily hurt” and that she was often on “the verge of tears – and needed more than the usual amount of encouragement to perform.” On the basis of the teachers’ reports and the tests, the school psychologist concluded that Alice’s difficulties were due to “emotional rather than physical problems” and advised “a more relaxed attitude and less pressure from the parents.”

The psychologist
never did explain the 23-point difference between Alice’s Verbal and Performance scores.

Alice continued to have trouble during first grade, and her teacher noted that she had “awkward left-handed writing, trouble cutting with scissors, and that she reversed letters.” However, the teacher said she was not concerned, because she felt these difficulties were simply because Alice was not yet
“ready.” Since the philosophy of the school was based on “readiness determined by developmental milestones,” this was also the advice of the school director, who pointed out that Alice’s molars were slow in coming in and that her other problems were undoubtedly related to this fact. Consequently, her parents waited patiently through another year. But when there was no improvement, Alice was taken
for a neurological examination.

The pediatric neurologist’s report stated that while Alice was slightly older than most first graders – seven years, four months during the spring of first grade – she looked more like a kindergarten child, with “awkward posturing of the hands and fingers accompanying all of her gait performances and twitches of the hands and fingers when she is trying to
hold still in the eyes-closed, posture-holding position.” The neurologist also noted a “marked mixed dominance with a 50–50 percent left and right in terms of destination of tasks performed with one hand or the other, although the traditional writing task is done with the left hand. There is mixed eye and foot dominance.”

The neurological summary concluded that Alice showed signs of a “patchy
minimal brain dysfunction marked by unevenness in development” and that while she was “not hyperactive she exhibited elements of the dyscontrol syndrome in terms of lack of organization, lack of self control and low frustration.” The neurologist’s report further stated that the “emotional problems are secondary reactions to the MBD syndrome” and recommended “intensive remedial help over the
summer.”

The Martins were understandably confused. The neurologist’s findings seemed to be the opposite of the psychologist’s. They were relieved that Alice’s problems had a physical cause and were not due only to pressures they had applied. Their difficulty lay in the fact that they were not quite sure what kind of “intensive remedial help” was required, and instead of contacting the neurologist
for clarification, they followed a neighbor’s suggestion and enrolled Alice in a perceptual training program run by an optometrist assisted by graduate students from a nearby university. The optometrist assured the Martins that Alice’s basic problem was “divergence excess,” and this could be “cured by practice in eye-hand coordination, eye movements, visual memory, and balance.”

Alice disliked
these weekly sessions and the assorted roster of graduate students, and resisted additional practice at home. She developed gastrointestinal trouble, which increased on the days when the perceptual training was scheduled. Finally, after more than a year, still with no visible improvement, the training sessions were dropped and Alice (and the Martins) struggled along alone through third and
fourth grade. Although Alice was absent often and for increasingly longer periods, her academic grades – based, of course, on “developmental milestones” – remained surprisingly high, except for arithmetic.

Now in fifth grade at Bryant Elementary School in Brentwood, New Jersey, not only did Alice have gastrointestinal problems, but her new school psychologist felt there was a “phobic resistance
to attending school” and referred her to a Dr. Volpe, psychiatrist. Dr. Volpe confirmed the “school phobia,” noting that Alice’s symptoms were “always worse on Monday mornings or following a school vacation and were accompanied by hysterical crying and protestations of dire consequences if she were forced to attend school.” Alice also had increasing difficulty in concentrating, paying attention,
and not forgetting what she had known the day before.

Interestingly, the parents revealed to Dr. Volpe a fact that they had not shared before. Alice had been adopted at five weeks of age through a Catholic charity. A year after Alice’s adoption, Billy, a natural child, was born as “quite a surprise” to both parents.

Alice’s overall intelligence scores done by the school psychologist
had dropped slightly between kindergarten and fifth grade, but the same patterns were evident – full-scale intelligence in the bright average range with highs in abstract thinking and vocabulary, and lows in spatial and perceptual tasks as well as those calling for rote memory. Dr. Volpe commented on Alice’s “rigidity, caution, and self absorption,” as well as the fact that she appeared “younger
than her chronological age.” The Rorschach, a projective inkblot test used by psychiatrists, showed “good attention to detail, considerable compulsiveness, constriction, and guardedness.” His recommendations were for “family therapy sessions for all members of the family,” for mild stimulant medication (Ritalin or Cylert), for Alice to be monitored by her pediatrician to help her maintain focus,
and for “specific expert remedial help in the main area of schoolwork where she is weak, namely math.” Dr. Volpe gave the Martins my name.

I was far from an expert; I had had my own mathematical struggles, but I was enchanted by Alice. She reminded me of a watercolour illustration in an old black leather, gold-rimmed book of my grandmother’s. Her brown hair was almost waist length, held
back with a tortoiseshell headband. She was slim, small-boned, and fine-featured. On her first visit to my office she was dressed in a white blouse and an ankle-length blue pinafore that again seemed from another age. There was an overall misty quality about her, almost a physical aura, as if indeed she might have stepped out of another time and place. It was hard to imagine the hysterical storms
described in Alice’s file.

But appealing as Alice might be to me, I knew she’d be a joke at Bryant Elementary School. Jeans were not allowed during the school hours, but any and every other style of pants were – and this particular year, the tighter they were, the better. This was not only the world of achievement; high fashion began in second grade. Hair was styled, not cut, at sixty dollars
a throw. Designer labels bloomed like daisies, nails were long and polished, and hair was streaked. By fifth grade, childhood was a thing of the past.

Alice was a walking anachronism, a terrified one at that. I wasn’t sure of how best to go about helping her, but I was sure I was not going to begin by doing an evaluation. Valuable as diagnostic sessions are, it was clear that Alice had been
tested enough. The neurologist’s report made sense to me. And while we no longer used the term MBD – minimal brain dysfunction – I believed Alice did have some type of neurological dysfunction resulting in what would now be called dyscalculia, or an inability to calculate by ordinary classroom methods, as well as an accompanying dyscontrol. In my practice, language-based problems were far more
common than perceptual ones, and, for whatever reason, more girls have difficulties in spatial and numerical tasks. It seemed to me that the major mistake the Martins had made was entering Alice in a perceptual training program, rather than providing her with specific help from a trained learning disabilities specialist.

On Alice’s second visit, she wore a dark red pinafore that was an exact
copy of the blue one she had worn the time before. I asked the usual questions – address, phone number, parents’ and siblings’ names, pets.

“Yes,” Alice said. “I do have one pet.”

“Good. What kind?”

“He is a rabbit, a brown and white, intelligent rabbit. His name is Sigmund.”

“Sigmund,” I repeated. “That’s an unusual name.”

“Not really. I thought it would be amusing
to have a resident rabbit psychiatrist in the house.”

I’d listened to hundreds of eleven-year-old kids, but Alice sounded more like she was entering graduate school than fifth grade. And yet she was “school phobic” and failing math – and a social innocent.

“Is he as insightful as his distinguished predecessor?” I certainly wasn’t going to talk down to Alice.

She looked up quickly,
surprised, and said quietly, “Sigmund doesn’t often share his insights with me, Mrs. MacCracken.”

“Discreet,” I said.

Alice nodded, and then she smiled at me. “And besides, he’s only a rabbit.”

And blip – we’d made our connection. There was no need to be careful any longer.

“Dr. Volpe told me you were having some trouble with math, Alice. That’s why he suggested that you
come here. But I don’t know what kind of trouble it is, and I really don’t want to give you any tests right now. Could you explain it to me more clearly?”

Alice shrugged and studied her hands again. “I don’t know,” she said, “everything just comes out wrong. Besides, I don’t care if it does. I hate school, anyway.”

My sophisticated conversationalist of the moment before had reverted
to total childishness. Now it was easy to see why the psychologists and neurologist had seen Alice as a much younger child.

“Yes. I heard that you did,” I said. “Do you hate all of it? Or are there some parts you like?”

“The whole thing. Well … maybe not every single thing.” Alice peeked up at me. “The library really is very nice. It’s much larger than the one in my old school, and
they let you take out three books at one time.”

“You know my idea of heaven?” I said. “An enormous bed with lots of squishy pillows, a mug of hot coffee, and every conceivable kind of book stacked all over the floor and table and bed right within my reach.”

“And Sigmund could sleep on one of the pillows,” Alice said as I laid out paper, pencil, rods, and blocks and began to explain
basic arithmetic concepts.

But now things seemed to have gone from bad to worse, and Alice was dissolved in tears, engaged in battle with both her mother and her teacher. Certainly a solution had to be found for the pill-taking; I agreed with Alice that she shouldn’t have to struggle with medication in public. She was enough of an oddity as a new student dressed in out-of-date clothing.