At the meeting, the medical doctor’s results were covered first. James
definitely had ADHD, and his medicine was helping keep it under control. The
doctor tested him for Fragile X syndrome, because James had presented
characteristics. He was cleared. Claire was not surprised at these results. Next, the
autism specialist diagnosed James with pervasive developmental disorder-not
otherwise specified (PDD-NOS), which was a category of an autism spectrum
diagnosis. This was not what Claire had expected to hear.
Little was known in the 1990s of the range of characteristics a person with
autism could have, and the prevalence was less than 1 percent of the population.
Autism is a developmental disorder that presents in a wide variety of ways and
levels of severity. It affects a person’s ability to communicate and interact with
others, and often comes with difficulties in executive functioning. Although she
was not prepared for this answer, she felt at least there was a direction the school
could move toward when it came to educating James. The school teacher, speech
pathologist, behavioral therapist, and motor experts spoke next. They confirmed
what Claire already knew.
Based on the psychological and psychiatric evaluation results, the expert
suggested James had oppositional defiant disorder (ODD). The disorder is typically
diagnosed in childhood and is characterized by frequent anger, vindictiveness,
argumentativeness, and defiance, especially directed toward authority figures.
Again, Claire was not shocked by this diagnosis.
The next words out of the psychologist’s mouth will forever be etched into
Claire’s mind. She was told, “Because of your son’s behaviors, his PDD-NOS, and
that he is retarded, we suggest a residential facility as the best placement.”
Claire felt as though the floor had just given out underneath her, and her
entire world was crumbling around her. She had a multitude of thoughts run
through her head. What did they mean when they said, “...he is retarded”? No one
had ever said those words before. Where was this coming from? She knew he was
delayed, but never had anyone suggested he was that delayed. He was not
stupid—slow, maybe, but not retarded.
Wait, did they just suggest sending her eleven-year-old son away? She could
not do that to him, or to herself. She was all he had. His father was a jerk and had
basically abandoned him; she could not do that to him too. All those schools had
rejected him, and she always told him it was his behavior and not him personally.
What would sending him away do to him? What was happening? Was this a
nightmare? They could not be right. He could disconnect and hook up the video
cassette recorder correctly, he could take things apart and put them back together.
This was not right. His behaviors were causing him to lag behind, not his
They just needed to find the key to manage his behaviors, and then the
academics would catch up. Every time she asked James’s doctors, they just said he