When Emma was a toddler she got a little scratch from the tag on the back of her shirt. It seemed so insignificant, hardly worth noticing, except that Emma screamed as though her entire body had been scalded. I remember at the time thinking it strange, her response seemed so extreme for such a tiny scratch.
There were other incidences, which also caught my attention for the very opposite reason. She would get scratched by the cat or have a huge knot in her hair, making it difficult to untangle without hurting her, none of which would cause her to even gasp.
When she grew older I was terrified of the day when she would start to lose her baby teeth, convinced this would set off such cries of pain, with no remedy other than to wait until the tooth came out of it's own accord. However this was not to be the case. In fact, Emma grabbed hold of the loose tooth and simply yanked it out of her mouth, dropping it to the ground, as though it were nothing more than an irritant, like a pebble in ones shoe. Evidently the floor of her school bus is littered with her baby teeth, as she would board the bus in the morning with a loose tooth only to come home and announce, "Threw it away," when asked what happened to her tooth.
"Where? But where did you throw it?" we would ask.
"On the bus," Emma replied matter-of-factly more than once.
About six months ago Emma was reported to have said to her therapist, Joe, "Joe! Pull it out!" and then opened her mouth so he could remove the offending tooth, which he didn't. So she did. Joe intercepted the tooth before she was able to toss it in the gutter.
I don't think we have more than two or maybe three of Emma's baby teeth, despite the fact she's lost at least eight or more by this point. We tried to tell her about the tooth fairy, but she was utterly uninterested and wandered away before we had finished. The idea a "fairy" would come to gather up her loose teeth, leaving behind money, was not a concept Emma had any use for.
Last Friday Joe called to tell me Emma was whimpering and saying her ear hurt. I immediately called the pediatrician. The last time I'd taken Emma to the pediatrician because her ears were bothering her, only to be informed that in fact she had strep, yet again. Remembering that time, I looked at Emma's throat before we left. Sure enough there was the tell tale white spot on one side of her throat.
"No say AHHH!" Emma said, pointing at her throat, meaning she didn't want to have the doctor swab the back of her throat.
"Well, let's wait and see what the doctor says, Em. Does your throat hurt?"
"Yes. Ears." Emma replied.
"Your throat and your ears hurt?" I asked.
Upon our arrival I proudly stated that I was sure it was strep and went on at length about how I couldn't believe Emma had somehow contracted strep again, making this the third time since the school year began. The pediatrician smiled and nodded her head as she examined Emma who kept insisting, "No AHHHH! Just ears," Emma said repeatedly.
The instant the pediatrician looked in Emma's left ear she looked up and said, "Raging ear infection."
"What?" I asked, thinking I'd misheard, so convinced was I that Emma had strep. "But she's never had an ear infection, what about that white dot on her throat?"
The pediatrician shrugged. "Could be food, not sure, her throat isn't red at all, but her ear is bright red. An ear this red should be extremely painful," she said looking at Emma. "I'm surprised she isn't complaining more. It's a really bad infection."
I watched as Emma played cheerfully with the doctor's stethoscope. Observing her, one would never know her little body was host to a horrific ear infection.
By the time I had procured the prescription and the children's Advil and returned home, Emma was running around, playing happily.
"Hey Em. How do you feel? Does you ear hurt?"
"Yes." Emma said before racing off down the hall with Joe in hot pursuit. Shrieks of laughter could be heard.
Many children with autism have what some specialists in the field call sensory integration issues. They can range from hypo to hyper and are often a mixture of the two. In Emma's case she has both and we still cannot anticipate which one we are witnessing.