But it left me deeply uncomfortable that perhaps she was enjoying a musical world while I sat in frustrated silence. I had little to worry about, however, as Sam soon made clear to me that she wasn't just happily listening to music. How did she make this clear? She started to fall asleep! I insisted that she had to stay awake in order for the session to "count." Again she reluctantly agreed, and opened her eyes, but promptly began to flag. We spent most of the rest of the session with me calling her back to consciousness every few minutes and wondering if this was what I'd spent five years in graduate school to learn to do. What was wrong with this kid? What was wrong with me that I couldn't find a way to even communicate with this young woman who was so obviously in pain and in need of help? Was I a fool to be devoting my life to helping those who didn't even want to be helped? I would eventually learn that in some ways I was right in thinking Sam's behavior was related to her brain development. But the brain development in question wasn't what I thought it was, and it wasn't a reflection of any sort of brain underdevelopment. Quite the opposite. What I finally saw in Sam was a part of adolescence that does appear to be hardwired--that is, universal across time and culture. Indeed, we even see it in the juvenile members of other primate species, including juvenile chimpanzees. It's the striving for independence, self-direction, and autonomy--the striving to move into adulthood, and it largely appears designed by evolution to propel development forward. And it's a force that we ignore at our own peril. I nearly misunderstood these strivings with Sam and was literally on the verge of giving up on her. But fortunately she didn't let me. Addressing this autonomy challenge was ultimately the key to helping her. "It's not you."

The first three words she'd spoken to me in almost a month came at the very end of another silent session, and I had to reassure myself that I had heard Sam correctly as she was walking out the door. I'd reached my breaking point with her by this time, and I'd said so in that session. "Look, Sam, I'm not sure why you're not talking. I'd really like to try to be at least a little bit helpful, and I know you have to come here anyway. But if you don't want to talk, I clearly can't make you, or even convince you. So I just don't know what to do." In retrospect, she had felt sorry for me. And indeed, as a young, novice therapist, I had degenerated into a state of blathering helplessness. But the irony is, my helplessness had given Sam a dose of exactly what she'd needed: a chance to show some autonomy and to step outside of the care-receiving role. She helped me out with that remark and we both knew it. I came into the next session eager for more, and Sam quickly gave it to me. "Are those my records?" she began, pointing to the large chart on my desk, filled with reports from her numerous placements. "Yes," I answered hesitantly. "Can I read them?" This question--a challenge, really--was similar to many of the questions that followed. Each had a laserlike focus on one issue: Would I be willing to treat her as something other than an erratic kid and give her some control of our interaction? Ultimately, I let Sam read her files (she'd have had the legal right to demand this in a matter of months anyway), but I insisted on reading them with her, a few articles at a time, and talking about what was in them. The Christian Church talks about separating the sin from the sinner, or hating the sin but loving the sinner. I'd say that's very good advice, especially for parents who don't want their children growing up to be defeated perfectionists. What do I mean by separating the sin from the sinner? Well, suppose that at the end of a hard day you go into your daughter's room to discover that she has been lying on the floor using her finger paints, with the result that paint has spilled on the carpet in several places. What's more, you have a very strict rule that finger paints are to be used only at the dining room table.

A typical response might be something like, "Joanne! What in the world do you think you're doing! I've told you and told you and told you that you're not supposed to paint in your room, but as usual, you just ignore me. You are so irresponsible, and you make me so angry ... I just don't know what I'm going to do with you! I don't know if you're not listening to me when I tell you things, or if you're just dumb!" How does little Joanne respond to this? By thinking, Mom's right. I never listen to her and I never do anything right. I'm a bad girl, I'm stupid, and now she hates me! But, if Mom had been able to separate the sin from the sinner, or the act from the actor, she would have simply addressed the problem. "Joanne, you know you're not supposed to paint in your bedroom. See, you've gotten paint on the carpet, and that's exactly why you're not allowed to paint in here. Because you've disobeyed me, I am going to take your paints, and you won't be allowed to use them for a week." This response doesn't let Joanne off the hook. She still knows she's done something wrong, and that she will have to suffer the consequences of her actions. But it doesn't damage her selfesteem, and it doesn't make her feel that her mother is rejecting her. Sure, she may complain about having her paints taken away, or ask her mother for another chance, but deep down she knows that she has done wrong and respects Mom's decision to take her paints away for a time. After a particularly trying day of Elliot trying to escape and me trying to corral him, it crossed my mind that I should do what Doris Day did in the old movie Please Don't Eat the Daisies. When she had a kid who got into everything, she put him in a cage that had multiple locks to keep him safe. I considered it ridiculously funny when I first saw the movie, but now it was neither funny nor ridiculous. Parents are supposed to keep their kids safe, and Child Protective Services or any sane person would never understand why this idea of locking them up was actually necessary.

However, if Elliot were safe in a cage, I could take a break. I thought about that a lot. Although we still didn't realize he had it, Elliot's behavior was typical of severe autism. Nor did we know that our survival instinct to avoid anything that made things even more stressful was also typical for families with a kid like ours. Our reaction to Elliot's never-ending, bizarre behavior was to avoid anything that set him off. We gave him anything he wanted to improve the probability of more tranquility in our home. Elliot was our little autistic mess. His sensory issues expressed themselves in so many ways, and in so many ways we were totally unaware of what and why things happened as they did. An example is our misunderstanding about clothing. Elliot didn't really have clothing preferences; he had clothing needs. He needed clothes to feel a certain way and fit a certain way. If these needs were not met, he could not cope. When he didn't cope, we didn't cope. It was that simple. No one explained sensory integration disorder to us. We had never heard the term. We didn't realize A-Club kids have increased or decreased sensitivity to sensory input from each of the five main senses, and a couple more senses that science was just starting to study. We didn't understand that some kids crave more sensory stimulation, and others are sensory aversive. We were so clueless. So, we continued to battle with him over buttons and zippers day after day.

Likewise, no one explained what restricted interests (another symptom of autism) means in real-life behavior. A fascination with locks, keys, and anything mechanical to the exclusion of anything and anyone else was yet another warning sign that we missed. Love affairs with objects, rather than people, were just one more sign of his social disconnect. Transitions were difficult for my son. One of our biggest problems with Elliot's behavior was he was rigid and insistent on sameness and routine. Again, this is a classic sign of autism. Clearing out your home allows for new thinking, and lets new opportunities present themselves. You may realize that you are ready for a more drastic change, possibly a move from the city to the country, for example. Working in an office may no longer appeal to you and you may decide to re-train as a therapist or work with animals. Now that you have got used to living with less, you may feel you want to take it a stage further. Do you feel you still have too much furniture? One way of cutting down on furniture in the home is to exchange some items for multifunctional pieces. If you are using your spare room as an office, for example, and don't want a bed in there, think about having a sofa that converts into a bed in your living space. Perhaps replacing two sofas with one large one with a corner return would give you more space. Some single beds fold back into seats or side tables. Ingenious coffee tables can be converted into dining tables by adjusting the legs. Need more storage? Buy a chest that doubles up as a coffee table. To create more space in the center of your living room, buy a nest of tables, which can be stored by the wall and pulled out when needed. Some versatile shelf units have one side for articles and accessories, and the other, narrower side for storing DVDs and games.