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Article of Interest - Book Review

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Bridges4Kids LogoWill My Kid Ever Be Normal?
by Delia O'Hara, Chicago Sun-Times, January 5, 2004
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Boston pediatricians Perri Klass and Eileen Costello couldn't find a comprehensive book to give parents who feared their children had begun to veer off on a tangent, away from the "normal" developmental curve, so they wrote one: Quirky Kids: Understanding Your Child Who Doesn't Fit In (Ballantine Books; $23.95).

Quirky Kids addresses the bewildering and distressingly common array of what Klass calls "new names for old problems" -- autism-spectrum disorders, Asperger's syndrome, pervasive developmental disorder and sensory integration disorder, among others -- that keep parents up nights wondering if their children will ever have friends, a way to make a living, families of their own.

Every adult remembers some of these "odd ducks" from his own childhood, Klass says. Some of them perhaps went on to be computer geniuses; others got "chewed up" along the way.

Recent medical advances mean that many more of these children can be helped to realize their potential, but where to begin?

"We noticed we were talking a lot about these kids, and about this overlapping, fascinating universe of quirky kids, and to a great extent, it seemed that parents and pediatricians were left to figure it out on their own," Costello says.

Readers will quickly hear the voice of the loving parent coming through the professional advice, because the authors, both mothers of three, have quirky kids of their own.

They, too, have had "the experience of lying awake at night trying to figure out, 'Is something really wrong, is something not really wrong?' We had to promise when we set out to write this book not to tell tales out of school, but we come to this with parental experience," Klass says.

"We've been around the block," Costello says. "We've been around a number of blocks between us."

Klass, an author of both fiction and nonfiction and a columnist for Parenting magazine, and Costello have known each other since their medical residencies in Boston. They are both on staff at the Boston University School of Medicine and practice together at Dorchester House, a community health center. This is Costello's first book.

Quirky Kids takes parents from their first vague worries -- or even "a major red flag, like a child who has absolutely no language by age 3 or who cannot stand the feeling of his own skin, or can't interact with other children or with toys in a way that brings pleasure," Costello says -- through a discussion of the types of specialists they might consult and the diagnoses they may receive. Then, onto choosing a school, how to navigate the perilous waters of a quirky kid's social life, to therapies and medications that parents might be called on to consider.

As parents will quickly learn, "There's a huge cast of characters assessing, evaluating, helping these children. Depending on what age the child is and who he sees, the diagnosis can be any number of different things. It's a very confusing world for parents when they're just starting out," Costello says.

Getting to the proper professionals is important. As Klass puts it, "If you go to Midas, you're going to get a muffler. People will see your child through the lens of their professional training and experience."

Parents have to arm themselves with knowledge just to understand the context in which their children will be viewed.

The authors would like to think that pediatricians can help parents, but have come to believe that "most pediatricians, like most teachers, don't know nearly enough" about quirky kids.

"Pediatricians are great ones for the tincture of time," the idea that children will outgrow most early problems, Costello says. But she and Klass have come to believe that while waiting often is the best plan, there are many children who benefit from intervention at an early age.

For those children, not only is greater improvement sometimes possible while the brain is more plastic, but "getting help in the first decade can really pay off in the second decade, when parents have less control over their day-to-day life," Costello says.

On the other hand, therapeutic interventions have become big business, and it's easy for worried parents to get drawn into expensive therapies for which there are no solid scientific underpinnings.

"There are organizations in every major city in the United States where you can bring the most typically developing child in the universe and get a diagnosis [of one of these conditions]. It's hard to tease it out," Costello says.

Even "reputable therapies" often heap a "load of guilt" on parents, adding to the guilt family members who don't grasp the situation may already have piled on these parents. "There's no end to how you can push parents' feelings," Klass says.

Costello and Klass interviewed more than two dozen parents for their book, and a recurring theme was the importance of finding one person, perhaps at a child's school, who understands the child's condition and serves as that child's "champion," advocating for her with teachers and other professionals. Says Klass, "There are many good people in the schools, but you have to find them."

Klass and Costello note that while it often seems that these conditions are on the rise, to an extent that is because some other diagnoses, notably mental retardation, are on the decrease. That is, more children are getting more accurate diagnoses and help toward useful, happy lives.

At the end, the book brings the quirky kid into adulthood, which for higher-functioning individuals can be calmer than childhood.

"We're so much more tolerant of quirky adults than we are of quirky kids," Klass says. "We have such high expectations of children now. There's a lot of pressure to be good at everything.

"Our field, medicine, is full of these people -- people with poor handwriting, poor social skills, peculiar obsessions. Many quirky kids have special skills that they can build into careers."

As for the parents, "It's a long, hard job being your child's advocate," Klass says. "But then, no parent gets to look back over his child's life and think, 'I did everything right.' "

Quirky kids

Pediatricians Dr. Perri Klass and Dr. Eileen Costello chose the term "Quirky Kids" for the title of their new book because "other people in the field were using it, and it's an affectionate term," Klass says.

"Some people were offended by it; some people thought it wasn't serious enough. We wanted to focus on the positive," adds Costello.

Some of the best parts of Quirky Kids have to do with everyday life with these "interesting, often charming" kids, as Costello calls them. But the authors, who have quirky kids of their own, take some flat-footed stands on controversial topics in the book:

* Quirky kids should get a full and honest picture of human sexuality in the language they'll hear on the street, including a presentation of masturbation as a normal but private part of life. "It's hard to talk about these things, but we believe in erring on the side of spelling them out. These kids are very literal-minded; they're not going to pick up subtle hints," Klass says.

* Parents need to demand that their children's schools address bullying, so that, among other responses, bullies meet with "retribution, swift and terrible." Says Costello, "Bullying is huge for these kids." They belong at a school that treats bullying as a serious problem, with serious consequences, the authors say.

* Mothers of quirky kids should work, at least part time. "Just as you don't want to reduce your child to the diagnosis, you don't want to reduce your own identity to 'the mama of the diagnosis,' " Klass says. "You need to be attentive to your own needs."

* Therapeutic treatment should not be allowed to swamp a family's activities together. "Your child has to have a childhood. Your family has to have a family life. You have to ask, 'What's reasonable? What's helping?' " and families should reassess the answers to those questions on a regular basis, Klass says.

-- Delia O'Hara


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