It Was Never About Toothless

“Would you like a coloring sheet?” the doctor asked.

“Yes!” my two youngest children chorused.

“I want one with Toothless,” said the youngest one, who has been answering to that name for the past month.

“I can get you some dragons,” said the doctor. I felt a knot form in my stomach. She hadn’t fully understood my child. She didn’t want just any dragon; she wanted a particular dragon. She clearly said she wanted Toothless.

For those who don’t know, Toothless is a dragon from the series How to Train Your Dragon.

A few minutes later, the doctor returned to the treatment room carrying a handful of coloring pages, and my heart sank. I knew there was going to be a battle.

One of the pages depicted a dragon who is Toothless-adjacent, though not exactly Toothless. My youngest immediately rejected it, flipping through the rest of the pages. While she was checking out the other dragons, my middle child took the Toothless-adjacent dragon and began coloring.

Now the youngest child was furious because she didn’t get what she wanted. The doctor kindly offered to get another copy of the Toothless-adjacent dragon, but my youngest said no. She wanted Toothless.

“I’m sorry. I don’t have Toothless,” the doctor replied.

She was being entirely reasonable, and my child’s response looked ungrateful, but I instinctively knew what was going to happen and felt powerless to stop it. Before I could intervene, my child grabbed the handful of coloring pages and tore them in two.

“Too bad,” said the doctor. “That was all we have.”

This just made my child escalate.

Half of me was embarrassed that my child seemed so rude and entitled to expect exactly the coloring sheet she wanted. The other half wondered if it really would be that hard to find a coloring sheet of Toothless.

I knew this wasn’t really about Toothless. Unfortunately, I wasn’t sure what it was about.

Big Shoes to Fill

All of me wished we were with our usual primary care provider, who always seemed to know how to calm my children and always had words of comfort and encouragement for me.

Unfortunately, my insurance company stopped contracting with our regular clinic, so my entire family had to establish care with new providers. I found someone for my kids who looked great on paper. They specialize in neurodivergent children, have longer than usual appointment times, manage behavioral health issues, and the clinic diagnoses autism, which is something my eldest child still officially needs.

There are few things more overstimulating for my kids than meeting new doctors, especially when they don’t have specific medical concerns to be addressed. Unfortunately, this appointment was just about establishing care, which requires being asked about a million personal questions.

I don’t know if it was just the feeling of being overwhelmed, but none of my three children warmed to the new doctor. To be fair, the old doctor has big shoes to fill, but it seemed odd that none of them would engage with her. My eldest spent his appointment sitting cross-legged with his head in his lap, refusing to answer questions. My middle child was polite but entirely silent. My youngest child lost her ever-loving mind.

Why Didn’t I Say Yes?

To her credit, the doctor asked me if I wanted to end the appointment with my two youngest children and reschedule sometime over telehealth. I should have said yes. Why didn’t I say yes?!?

Instead, I opted to keep going, not willing to let my kids derail the appointment. As soon as the doctor began to ask me questions, my youngest child reached up to cover my mouth. She didn’t want me to answer any questions about her.

Now there were a couple of yellow flags that gave me pause. Unfortunately, they involve private information about my kids, so I can’t explain. Just suffice it to say, I too was a little wary of the doctor out of the gate. But nevertheless, I continued with the appointment because that’s what you do, isn’t it?

The doctor asked my child to stop putting her hand on my mouth because I needed to be able to answer questions. While she didn’t say anything judgmental to me, I definitely felt on edge. Like my child’s behavior was a reflection of my parenting and showed me to be lacking.

Share

The Explosion

I tried to mollify my child by holding her in my lap and calming her while I spoke to the doctor, but then she tried to bite me. At first, I attempted to ignore the behavior like it wasn’t a big deal, but then the bite really began to hurt. I pulled away from her and asked her to get off my lap. Things spiraled from there, and by the end of the appointment my daughter had attempted to break the set of crayons, ripped up the paper on the examination table into little pieces of confetti, and attempted to throw a stool across the room.

All because she didn’t get a picture of Toothless to color.

Now I’m aware that dysregulation in AuDHD children is never as straightforward as A caused B. It was clearly more than just the picture that led my child to unravel. She didn’t want to be at the appointment, she was nervous about meeting a new doctor, she didn’t like me talking about her, it was summer and she’d rather be at the wading pool, and who knows what else. But from the outside, it looked like a spoiled child throwing a fit over a coloring page. That’s the tricky thing about neurodivergent kids: the thing that triggers the explosion is rarely the thing that caused it.

When Good Parents Panic

I was embarrassed. I felt defeated. More than that, I felt judged, even though the only person doing the judging may have been me.

Neither of my two youngest children would allow the doctor to examine them physically, so we wrapped the appointment up early. As I was attempting to grab the stool from my daughter’s hands before she hucked it across the room, the doctor asked me, “Have you considered ABA therapy for your youngest?”

Caught in that moment of embarrassment, I felt I needed to take the advice and consider it despite having heard negative things about ABA. That’s what shame does. It convinces you that everyone else can see your failures as clearly as you can. Instead of asking whether my daughter was overwhelmed, I immediately began asking how to fix her behavior.

Clearly what I’m doing to parent my children isn’t working. At least, that’s what I told myself in that moment. Children should be able to attend the doctor’s office without completely melting down, shouldn’t they?

I was so embarrassed that I started looking for a solution to my child’s behavior before I had fully understood the problem. The recommendation immediately sent me down a rabbit hole. Depending on whom you ask, Applied Behavior Analysis (ABA) is either life-changing or harmful. The more opinions I gathered, the less certain I felt.

The Wrong Question

My understanding of ABA is still limited, but from what I’ve heard from autism advocates, it is akin to abuse. I have one friend who says it worked wonders with her child, but otherwise everyone else I’ve spoken to has nothing but terrible things to say about it.

I asked about ABA on Substack this week, and the response was resoundingly negative. Today I asked our family therapist what his perspective was on ABA, and he just shook his head. I also reached out to our provider at Seattle Children’s to get her perspective on ABA, but I’ll have to wait another two weeks for an appointment to discuss it at length.

In the meantime, the new doctor didn’t just give me a recommendation and a list of ABA providers, she sent a referral directly to a provider who called me out of the blue to set up an appointment for my youngest. This is another potential yellow flag for me. What autism-related service doesn’t have a months-long waiting list? It seems too good to be true.

The full jury is out on whether we will attempt ABA. It really depends on what my provider from the autism clinic says about it—though I’m skeptical because if she thought it was necessary wouldn’t she have recommended it along with the half-dozen other programs she recommended for us?

The more I think about the three yellow flags, the less certain I am that this provider is the right fit for our family.

Looking back, what strikes me isn’t whether the recommendation was right or wrong. It’s how quickly I accepted the premise that my daughter’s behavior was the problem to be solved.

Behavior Is Communication

The next time I will try to be more thoughtful about how I undertake the appointments. Perhaps I’ll take them one at a time and take them out of school, so they feel like it’s a luxury and not a distraction from their summer fun. I’ll certainly leave as soon as one of my children has a meltdown. I won’t expect us all to behave like neurotypicals, because we aren’t.

I’m also embracing the idea that behavior is communication. My child was clearly communicating that the appointment wasn’t working for her. I simply wasn’t listening.

The more distance I get from that appointment, the less I see a spoiled child and the more I see a frightened one. The same is probably true of her mother.

It was never about Toothless. It was about a child who was overwhelmed and a mother who was too.