Alpha School Case Report:  The Boy with the Pencil

August 2007

The week ends with a bang on Friday as we enter the Alpha School for Learners with Autism! Noise abounds, footsteps echo off high ceilings and stairwells; pots and pans clang and clatter in the kitchen; raised voices reverberate greetings and admonitions, songs and laughter, tears and tantrums.

Among the 65 days students, who are predominantly boys between the ages of 5 and 18, most (85%) come from disadvantaged homes.  What all have in common is autism.  The spectrum is pretty wide.  Some can language, read, and count; others do not speak.  Some have a ‘high functioning’ label, while others need help with basics, even the toilet.

Our CST outreach program focuses on children under 12.  Teachers and their aides are a tremendous resource, generously sharing information about what happens in the classroom and on the playground when we are not there.

This is R’s story, ‘a lethargic boy with a dislike of gross motor activity,’ as described in a 2005 psych report.  Back then he was often anxious and tearful on the school bus,  becoming sullen upon arriving at school.  He might scream for up to 20 minutes at a stretch twice a day.  He would hit himself during tantrums on the floor.  At home, bedtime was problematic. R would often lay awake for three hours before falling asleep at 11pm.  He could dress and undress and use the toilet.  He was not fond of sharing.  He was able to use scissors and a pencil.  He would examine objects obsessively.

I met R in November 2005, when he was 9 years old, and began working with him in the classroom.  While his teacher read a story, I supported R’s right kidney.  He would not allow contact with two hands.  After the story R wanted to go home, though when I asked permission he said I could come back to see him.

Soon after the 2006 school year began, R’s teacher said that his tantrums had stopped and he was showing a marked improvement.  I met with his parents in February and explained CST to them.  They were keen for R to continue in the program.  By this time, R was allowing more contact for longer periods during CST sessions.  I could hold his liver and kidney areas with no fuss, though he continued to be less enthusiastic about cranial contact when I tried to hold his frontal bone, sphenoid and parietals.

Early in March 2006, R came to school very charged.  That day he refused treatment, saying ‘GO AWAY! Not today!’  Not to be deterred, I sat beside him briefly, offering verbal support without physical contact.  I promised to return in a week’s time.

The next few days would bring a devastating loss to R and his family.  On the evening of R’s 10th birthday his dad was struck by a taxi and killed instantly while riding his bike home from work.

The following Friday, R did not want me or CST, but his teacher insisted.  A classmate supportively held R’s hand and accompanied us to the OT room.  There R leaned against me and stared blankly at the colourful posters hanging on the wall. Moving onto a big red physio ball, I gathered him into my lap, rocking gently.  My hands made a sandwich of his mid-thoracic spine and his heart/solar plexus.  After 20 minutes, we joined his classmates on the playground.  He sank onto the picnic bench, leaned against me and cried.  Another 20 minutes passed and R gazed skyward, lifted his arms and became very agitated.  We walked back to the classroom, where he began to settle.

We enjoyed a couple of good sessions before the winter holidays, but by the time Term 3 began, R’s tantrums had begun again.  Concerned, his classroom teacher, the school psychologist and I paid a home visit to the humble cinderblock cottage bordering the airport, where we listened for two hours to his mom’s non-stop story. It was clear that the entire family was in crisis.

I was just a volunteer practitioner working with one family member.  That would have to be enough.

Since that home visit, I created a routine when working with R.   I announce my arrival at school to R and ask his permission to return in a while.  For the next year and a half, on good days I would sit beside R and watch him draw (he’s becoming quite the artist!).  If I’m lucky he allows contact somewhere on his back for a brief period, and in rare circumstances on the cranial vault.  I ask about his family.  On a not-so-good day, R tells me to go away! On those days I sit beside him without touching... but I DO NOT GO AWAY!!!

When R’s class was invited to join in an art program at a nearby school, R refused to participate, even though he loves to draw.  In his collapsed world, venturing into unknown waters is too threatening. 

On a rainy Friday in August 2007, I arrived on time to see R’s classmates filing into the media room to watch a video.  R had stayed behind in the classroom to draw on his own.  His teacher said R did not sleep the night before.  I pulled up a chair and remarked that he must be exhausted.  It was just the two of us, the room was quiet.  R wore a track suit made with slippery fabric, and I decided to try massaging his back, neck, shoulders and arms.  No protest.  For the next 35 minutes, bent over his desk, R surrendered to cranio sacral therapy... cranium, spine, sacrum.  At one point he relaxed the grip on his best friend, the pencil, melting into the moment.  The silence was exquisite.  When I left I whispered a promise to return next week.  I’ll be there!

Mary Hegarty is a cranio sacral practitioner in Cape Town. Email: mary@uninet.co.za

 

The following is a poem I wrote this year inspired by R...

 

*Kwansaba: Curious Boy with the Pencil

Curious Boy grips the pencil too tight

 his silent friend during dark feral nights

these days nights last all day long

taxi smashed bicycle... dada’s dead and gone

guns shoot outside, mummy’s on her knees

pencil draws blue sky, happy birds &bees

bad lines rubbed out before anybody sees

 

Mary Hegarty

24 January 2009

 

*KwanSaba is a cross-cultural poetic form dedicated to Kwanzaa. Each poem addresses one of the seven principles of Kwanzaa: Umoja (unity); Kujichagulia (self-determination); Ujima (collective responsibility); Ujamaa (cooperative economics); Nia (purpose); Kuumba (creativity); and Imani (faith), and consists of seven lines of seven words each.  Every word used contains no more than seven letters.