"Autists are the ultimate square pegs, and the problem with pounding a square peg into a round hole is not that the hammering is hard work. It's that you're destroying the peg." Paul Collins

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XIII. Ability

Maddie had made it to school without a tantrum on Tuesday and Wednesday and was now only out of school because Sophie needed to take her to the paediatrician.

No matter how hopeful Sophie had felt this week, she was absolutely shitting herself with anxiety about what the doctor and the psychologist would have to say once they assessed Maddie.

Maddie hadn't seen her paediatrician since she was five, when she had her injections before starting school. Perhaps they wouldn't have tested for autism then when she wasn't throwing tanties left, right, and centre. If ever Maddie was ill, Sophie took her to the GP.

The paediatrician's office hadn't changed. It was still decorated in offensively bright yellow and orange and littered with toys that looked about three generations old.

Sophie, holding Maddie's hand, walked up to the receptionist's desk.

The receptionist was still the same, too. Sophie remembered her bringing in Maddie's a lollipop when she'd been grizzling about getting her needles.

"Good morning," she welcomed.

"Hi, good morning," replied Sophie. "I've got an appointment at nine for Madeleine Cartwright."

The receptionist clicked her acrylic nails on the keyboard and smiled when she found the booking. "Yes, you're right here. Have a seat, why don't you? The doctor will be with you in a moment."

Sophie sat down on one of the tired, fraying armchairs, and pulled Maddie onto her lap. Maddie could have sat in one of the other chairs, but Sophie didn't want her to. She wanted to hold her. Sophie smoothed Maddie's ponytail, and retied her maroon scrunchie. She was wearing her winter school uniform for the first time since March. She looked ever so smart in her shirt, tie, and tartan skirt, finished off with a pair of white tights. She looked like a normal little girl, and it was going to break Sophie's heart if a doctor told Sophie that Maddie was going to have something to make her life harder.

"Mummy, can I have another piano lesson after school today, please?" Maddie asked politely as she leaned back into Sophie's chest.

Maddie had already had two lessons this week. Her arranged lesson on Monday, as well as one that Maddie managed to sweet talk Noah into yesterday afternoon.

"Noah's got to work, sweetheart. He can't be giving you lessons every night," Sophie replied softly.

"Please?"Maddie whined, wriggling in Sophie's lap. "Please, I really want to. It's my favourite!"

Sophie sighed, and pulled out her phone from her back pocket, adjusting Maddie as she did. She then saw that she had missed two text messages while they were on the train.

Holly had sent through, "Mads has got this!" alongside a thumbs up emoji.

Noah had sent her a message, too. "Maddie is amazing. Nothing anyone can say is going to change that."

As she was about to reply to them both, the door to the office opened, and Maddie's paediatrician, Dr Lisa Edgeley, stepped out into the waiting room. Dr Edgeley was dressed casually in a floral blouse and a pair of black trousers. Sophie was quietly glad that she wasn't wearing a doctor's coat or anything intimidating.

"If she gives me a needle, I will scream," Maddie whispered in Sophie's ear.

"You're not getting a needle," Sophie hushed, gently pushing her off of Sophie's lap.

"Maddie!" said Dr Edgeley cheerfully. "It's been a while; look how you've grown!" she observed.

Maddie eyed the doctor suspiciously. "I'm older, that's why," she replied cautiously. "You aren't allowed to give me a needle, Mummy said so," she added, embellishing the truth.

Dr Edgeley and Sophie exchanged a glance, and the doctor looked at Sophie reassuringly. "No, no, no needles today," she promised. "You're just here for a visit."

As they got into the office, Sophie saw that Dr Edgeley and laid out several activities on her floor area. There was colouring, blocks, Legos, and dolls. Her anxiety started to pick up again as she wondered which one meant Maddie had autism. Did her choice determine it?

Sophie already knew that Maddie would choose colouring. Was that bad?

Dr Edgeley walked over to her scale, and waved Maddie over. "Jump up on here, Maddie," she instructed. "Let's see how much you've grown." She recorded Maddie's updated weight, and then measured her height, before adding them into Maddie's file. She then told Maddie that she could choose one of the activities laid out for her.

Maddie, of course, went for the colouring immediately. She organised the crayons in rainbow order, like she enjoyed, and proceeded to colour the picture of a butterfly.

"Is that bad?" Sophie asked Dr Edgeley fearfully. "Should she have picked dolls?"

Dr Edgeley frowned and shook her head. "Dear God, Sophie no," she said calmly. "There is nothing bad, and nothing wrong, about any of this," she promised. "The activities are there to keep the children occupied so that I can speak to the parents. Autism Spectrum Disorder screening starts with me asking you some questions."

Dr Edgeley could still sense Sophie's immense anxiety, and she went over to the water cooler and poured her a cup. Sophie accepted it gratefully.

"Autism awareness and support is so much better now than it was ten years ago, even five years ago," Dr Edgeley promised. "It's not a disease, it's not a disability, it is a spectrum, on which people struggle on varying levels with social interaction, communication and behaviour. Can I make an observation without you panicking?" she asked.

"No," Sophie blubbered.

Dr Edgeley smiled reassuringly. "Sophie, I have seen hundreds of children who presenting with symptoms far more troubling. Now, Maddie's behaviour with the crayons, ordering them as she did. Is that something she always does?"

How desperately Sophie wanted to say "no". "Yes," she nodded.

"Okay, well, that is one of many, many ASD characteristics. Lining up objects, ordering objects, is very common in ASD children." Dr Edgeley collected her clipboard and a pen from her desk, and clicked it, no doubt making a note about Maddie's ordering behaviour. "Now, does Maddie have any other behaviours that you would classify as unusual or repetitive?"

"She's had trouble with school refusal," replied Sophie honestly. "She would throw tantrums, scream, lock herself in the bathroom, all to keep herself from going to school. When she gets her way, she is happy. I've only been getting her to school this week without a fight because she has started piano lessons. She likes them, is obsessed with them really, and it's been good motivation."

Dr Edgeley recorded Sophie's answers.

"I think she is really bright, though," Sophie added, a hopeful tone in her voice. "I think her memory is excellent. A friend of mine, her piano teacher, actually, thinks that Maddie has an eidetic memory. She's learned to play the piano professionally with only a handful of lessons. What child can do that? That has to go in her favour, doesn't it?"

Dr Edgeley put her clipboard down. "Sophie, there is nothing wrong with an autism diagnosis. I can completely understand how scary it might be, not knowing how your child might cope. I haven't even begun to properly assess Maddie, but should she be diagnosed, if you let autism be her label, then that is how far Maddie will go. But if you help Maddie to see her autism as an asset, to use and develop what makes her special,then she will reach for the stars." 

Sophie did her best to answer every one of Dr Edgeley's questions as detailed as possible. Maddie didn't fit a lot of the criteria. She didn't struggle keeping eye contact, she did respond when someone tried to get her attention, her voice had expression, and she didn't have sensory sensitivities.

But she did struggle in developing social relationships. She did have trouble interacting with people who did not share an interest with her. She did have trouble understanding how other people felt, or how her actions affected others, and she did get annoyed and angry as a first response.

Maddie's obsessive behaviour was another characteristic of ASD, according to Dr Edgeley. Children with ASD tended to have limited interests and did tend become obsessed over them.

"Have you heard of Mozart, Sophie?" Dr Edgeley asked Sophie as the appointment came to an end.

"Yes, of course," replied Sophie.

"He was a child prodigy. Unparalleled musical ability. God-given, some said," she explained. "Would you agree that he was a brilliant success?"

Sophie nodded, unsure of what she was getting at.

"Maddie seems to love music. You seem to have uncovered a passion, and something that she is terribly good at. Mozart, modern psychologists believe, was on the autism spectrum." She smiled calmly, reassuringly. "He had an eidetic memory, incredible musical gifts ... and possible Tourette's, ASD, Asperger's, ADHD, OCD ... the list goes on." She put a comforting hand on Sophie's forearm. "Maddie's got a superpower. It's your job to make her feel that way, and it's my job to make sure that whatever the screening concludes with, Maddie goes on to develop just as she should."

***

Sophie wasn't allowed in the psychologist's office. The paediatrician had called on ahead and had passed on whatever notes she had taken to the psychologist. Sophie was forced to wait outside.

Maddie wasn't diagnosed yet, but Sophie could feel in her bones that Maddie would be. Call it mother's intuition. And she had taken what Dr Edgeley had said to heart. If Sophie let autism be a label for Maddie, then that is all she would be.

Maddie needed to feel as though autism was her superpower, and Sophie needed to be her number one champion.

Sophie replied to Holly, but Holly didn't message back. On a Thursday morning, Sophie knew that Holly would be in one of her uni classes. Sophie decided to call Noah.

He picked up almost immediately.

"Hey," he answered, his voice sounding concerned. "How are you? How's Maddie doing?"

"Did you know that Mozart was autistic?" Sophie asked suddenly.

"No, I didn't," Noah replied, sounding surprised. "Really? Wow."

In the background, Sophie heard Noah begin to play, and if she was a betting woman, she would have said it was Mozart.

"Piano Sonata Number 11 in A Major," Noah uttered quietly as he played. "Composed by a freaking genius."

Sophie didn't reply. She merely listened and closed her eyes.

Noah finished his piece, and Sophie heard him sigh.

"I don't want her life to be any harder than it already is," Sophie whispered. "She's got a moron for a dad, and he's not remotely interested in her. She's got me, and I'm useless most of the time –"

"Sophie, cut the crap," Noah interrupted firmly. "You useless?" he repeated challengingly. "I know I haven't known you that long, but I've never seen someone try harder for her kid. "Maddie is lucky to have you. You're an amazing mom, and no matter what the docs say about her, I know Maddie's going to be fine because she has you."

Sophie's eyes welled with tears. Jesus, she needed to hear that.

"Are you crying right now?" he asked.

"No," Sophie whimpered, her voice giving it away. "I told you I always cry."

Noah chuckled. "I know."

"She's in with the psychologist now," Sophie managed to stammer. "The paediatrician says she has quite a few of the social traits."

"Well, no matter what they say, you know what a kid like her is capable of. Look at Mozart. Is he remembered as the autistic guy, or one of the greatest composers to ever live who happened to be autistic?"

"Thank you, I appreciate this," Sophie said sincerely. 

"You're a wonderful mom, Sophie. I really admire that about you," Noah said kindly.

Noah had never seen Sophie screaming through the bathroom door while holding onto the door handle for dear life, but she did really appreciate the sentiment.

At that moment, the door opened, and Maddie came out escorted by the psychologist. Maddie still looked so sweet in her winter school uniform, and Sophie forgot for a millisecond as to why they were there.

Elaine Woodley beckoned Sophie over with a kind smile. Sophie immediately grabbed her handbag and crossed the waiting room over to them both.

"How did it go?" Sophie asked, half in hope, half in anxiety.

"Well, I do think Maddie possesses quite an extraordinary memory," she reported. "It's possible a lot of Maddie's ... outbursts could possibly be attributed to cognitive overload. However, I do also see several characteristics that are consistent with ASD. I'd like to continue to see and observe her for a few more sessions before I give you a confirmed diagnosis."

Sophie nodded. "Yes, or course," she agreed.

"Maddie's been telling me all about these piano lessons," Elaine continued.

"Mummy is going to ask Noah if I can have another one after school today," Maddie said excitedly.

"She's a clever cookie, this one," Elaine nodded down to Maddie. "I look forward to seeing you next week, Maddie." She grinned down at her. "If you'll see my receptionist, she will sort you out with an appointment." She pointed over to the reception desk.

Sophie took a staggered breath. Okay. What had she just learned? Maddie's tantrums and outbursts could be caused by cognitive overload. She could just be overwhelmed. Okay. But there were still behaviours that were consistent with ASD. Okay, Sophie could deal with that, too. It wasn't bad. It wasn't a label.

Mozart, Sophie said to herself. Maddie's potential would not be limited. 

"Sophie," called Elaine.

Sophie snapped out of her own thoughts. "Yes?"

"You have a wonderful daughter," she complimented, "and I would be letting you know if I was worried about her."

Sophie managed a small smile, and she and Maddie made their way over to the reception desk. The receptionist flipped over her large diary to the following week.

"What day were you thinking?" she asked. "We have the same time available next Thursday."

"That's fine," agreed Sophie.

She watched as the receptionist wrote down Maddie's name next to the appointment time. She then wrote it down on a reminder card for Sophie to keep.

"Now, do you have private health insurance?" she asked, clicking onto the computer and getting out the credit card machine.

"No," confessed Sophie. This was why she was working the extra shifts.

"Okay, not to worry. I'll just set you up as a new client. There is a five pound new client fee on top of your session cost."

Sophie sucked in a breath. "Okay," she agreed.

"I'll need your name, date of birth, and mailing address as guardian, and then Maddie's name and date of birth."

"Sophie Cartwright, fourth of April, ninety-four. We live in Unit 4, 5 Carrington Lane, Gunnersbury, London W4 5PT. Maddie's full name is Madeleine Cartwright. Her birthday is fifth of June 2012."

The receptionist typed their information into the system. "And just a contact number and an email address?" she then asked.

Sophie gave her that information as well.

"Okay, lovely. That'll be eighty-five pounds for today then," She pushed the buttons on the credit card machine and then turned it around for Sophie.

It physically hurt Sophie to put in her PIN number. She did not think she had spent eighty-five pounds on anything before, except for of course rent and utilities. But this was necessary, and she was willing to do whatever was needed.

And what she needed to do right now was to get Maddie back to school so that she could get back to work to earn enough to pay for her session next week.

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Hope you enjoyed it!

I'm not sure when the next upload will be. Friday, most likely! I'm sorry as you're used to daily uploads but I need to get back to work!!

If you give a kid any kind of label, not necessarily ASD, it does stick with them, and if you treat them like they've got a label, then that is all they will be. Limitations can be turned into strengths with the right motivation, the right tools, and the right attitude.

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