阳阳三岁，看儿医和神经科医生

上午带阳阳和玫玫去看儿医。等了一个多小时，医生才来，但阳阳还要去看神经医生。儿医只是匆匆看了看玫玫，说她的耳朵好多了，又说阳阳也有 ear infection, wheezing，发烧 101 度。让我下午带阳阳再回来。

我把玫玫撂给阿姨，就带阳阳去神经医生。已经十二点多了，阳阳还没吃饭，吃了点饼干什么的。他本来就病了，又困又饿，还等了一阵才见到医生。医生说等阳阳病好了才能做 full evaluation，这次先给个 diagnosis，好明天给 school district 的 IEP 看。

She asked me some questions, and then examed yangyang briefly.

Doctor: Is he still fixed on cars?
Mom: He still loves cars, but he knows that he can't play cars at home, so he is getting better.

D: What is he fixed on now?
M: He went through a phase of letters, but not that bad.

D: So the psychologist diagnosed him with autism, why?
M: She went to observe him in school, and said that the whole time he did not initiate conversation with others.
M: Since then, I have observed him more closely. He would talk to us at home, and to his best friend.

D: Initiating conversation with parents or best friend doesn't count. Does he talk to others? What about kids in the playground?
M: No, he would approach them if they have cars. He is also interested in older kids when they are doing activities.
D: Then he is interested in the activities, not the kids.

D: Does he point out things he sees on the street?
M: Yes, he often says, "there's a dump truck!" "I see a blue MINI."
D: That's just labeling things. That's not joint attention.

(Yangyang pointed at a lego set on the top shelf, not talking)
D: Does he talk? What does he want?
M: He wants the lego set. He get very anxious at social situations and he cannot talk. His speech get stuck sometimes.
D: He needs speech therapy still.
M: But he talks a lot at home, with long and complex sentences.
D: Speech therapy can help him talk in social situations.

D: How's his hand use? Does he still favor left? What about OT and PT?
M: He still uses left hand predominantly. OT and PT are through CCS, and they keep dismissing him, saying there's nothing much they can do for him.
D: He needs OT and PT, because he has abnormal MRI of the brain. He should do it through insurance.

(after observing Yangyang running up and down the corridor)
D: He still has a weakness on the right side. He doesn't swing his arms correctly.

M: People keep telling me that he is just shy, and he is fine. Autism is over-diagnosed anyway.
D: But he has abnormal MRI. Also, autism means three things: fixation, speech, and social. He has all three, so he needs help.

M: People say that because we talk about him having autism, it messes him up.
D: No. Do you think so?
D: Do you want him to grow up like this? Or do you want to help him?

D: We will speed up his MRI scheduling. I will see you in two weeks for another evaluation.

从医生那里出来，已经1:10，离儿医下午开门的时间还有50分钟，回家睡觉恐怕是来不及了。我就开车慢慢在街上转，去 drive through 买了午餐。快到儿医那里，阳阳睡着了。让他在车里睡了半个小时，就去看儿医。

接到学区的电话，说对不起，忘了给阳阳 PT evaluation，但不要紧，以后可以补。明天开会，阳阳是 qualify for continuing service through the school district。

这回没等多久。医生做了体检。身高 39 1/8，体重 33.2。正常。半夜惊醒恐怕是因为耳朵难受。吃饭不要逼迫，每天三杯奶足够，零食给点 cheese 或高蛋白东西。potty train 成功。神经医生的诊断好。School district 接受他，医生听了很高兴，说阳阳需要接受特殊教育。我们校区可能让阳阳上 RB 的 Washington School。同意 Seasprites 不好，Growing Garden 不适合他。

给了消炎药，和 inhaler alternative。

明天早上去 IEP。这关系到阳阳之后几年的成长和教育。希望他能够接受适当的帮助，克服他的多重恐惧，健康成长。