End of School Year
As another school year comes to an end it was time for Monty, aged 11 with ASD,’s end of year grades and the parent teacher meeting. Monty attends a small mainstream international school with his own assistant.
This year is particularly interesting because we have the same class teacher, Miss B, this year that we had three years ago (prior to starting to develop Monty’s autism Polypill). So if anyone can judge the impact, it should be her.
In the English system Year 4, is where you find 8-9 year old typical kids and equates to 3rd grade in the US system. Monty just finished Year 4.
After completing Year 3 first time round with Miss B three years ago, with a traumatic several months of aggression and cognitive and behavioral regression, we put Monty to start Year 2 again. At the end of the first term in Year 2 (second time around) he started Bumetanide.
Year 1
Year 2
Year 3 Miss B
Year 2 (repeated)
Year 3 (repeated)
Year 4 Miss B again (current year now ending)
Year 5 Next school year starting Sep 2015
First time around with Miss B, Monty could not really follow any instruction from her and he was entirely dependent on his 1:1 assistant.
At home, in the afternoons and holidays, he had learned to speak, read and write using ABA. At school he was assessed on simple tasks like being able to change into his indoor shoes independently, or with prompting. Academic assessment was all customized for him; no attempt was made to use the same assessments as his classmates. Assessment was extremely basic, like adding one to a single figure number.
Some children are diagnosed very young with autism and by five years old things have changed so much that they have lost their diagnosis. Monty is not one of those. He was diagnosed at three and a half and continued to get more autistic. Using PECS and ABA he gained basic speech. With 40 hours a week of 1:1 assistance he learned to read and write, but we did not even try and teach numeracy.
We were following the standard trajectory of classic autism; no learning followed by (very) slow learning.
After initiating pharmacological therapy, we now have had nearly three years of skill acquisition at a rate similar to a typical child, of average IQ.
This distorted learning trajectory is one reason why I feel that Asperger's should remain entirely separate from classic autism; calling them both "autism" does justice to neither. In Asperger's there is no language delay and no impaired cognitive function, resulting in quite different people, with very different issues. I am beginning to feel that when you treat classic autism, as far as you can, the result will be something not dissimilar to Asperger's. What happens if you treat Asperger's?
After initiating pharmacological therapy, we now have had nearly three years of skill acquisition at a rate similar to a typical child, of average IQ.
So Monty finished Years 2, 3 and 4, had the same assessment as the NT classmates and is not at the bottom of the class of 12 kids, in any subject. Monty is certainly not a “straight-As” student, like his big brother is; he is now more of a C student with some Bs. But as I told his teacher Miss B, the great achievement is that we are even discussing the results of standard assessments at all.
Pleiotropic effects?
Sometimes drugs seem to have broader beneficial effects than intended, these get called pleiotropic effects.
It looks very likely that one or more elements in Monty’s Polypill have some pleiotropic effects, or some synergistic effects.
There is a study showing the effect of ten months of Bumetanide treatment.
My feeling after 30 months of Bumetanide treatment is that it provides a critical step-change in cognitive function. Following this one-time gain, things seemed to progress faster cognitively only when other elements were added.
The following papers on pleiotropic effects of drugs in the PolyPill do not refer to autism, but are interesting.eiotropic Effects
PLof
Future progress
As I told the teacher,Miss B, a good plan seems to be to just keep following the regular kids and keep going until the end of year assessment might put Monty at the bottom of the class. Should that happen, we can just repeat that year again.
This is not the advice you will likely find anywhere else regarding educating a boy with classic autism in a mainstream classroom. Indeed it is pretty clear that in mainstream schools “inclusion” just means a class within a class; so the child with autism and his assistant are doing one activity, while the class teacher and the other kids do something entirely different.
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