Four words

It comes home in his backpack. A manila envelope: To the Parents of. I take a deep breath, catch my finger in a corner, and tear a ragged mouth open along one edge.

Within: a stack of white papers. Heavy with ink, thick with import. Four sections, each stapled carefully in the top left corner. Each bearing his name and his date of birth. The name of the school system. And in a deeper shade of black, "Three-Year Reevaluation."

This is a function of necessity. Of law. Per the Commonwealth of Massachusetts:

Education Laws & Regulations: 603 CMR 28
Section (01)(d) Upon referral, school districts shall evaluate children who are two and a half years of age and who may be receiving services through an early intervention program. An initial evaluation shall be conducted in order to ensure that if such child is found eligible, special education services begin promptly at age three.

Section (03) The school district shall review the IEPs and the progress of each eligible student at least annually. Additionally, every three years, or sooner if necessary, the school district shall, with parental consent, conduct a full three-year reevaluation consistent with the requirements of federal law.

Twenty feet away, my living room is a riot of activity. My son, turning 6 next month, runs in circles around the room. Screaming in mock terror. Close behind, his twin sisters chase him — arms extended, plush sharks clutched in sweaty little hands, soft teeth and red felt mouths opening in anticipation of the feeding to come. An exercise in predatory stalking. Every third or fourth circuit, he leaps onto the couch. Into his mother's arms, and the presumption of safety. And she gently chides the girls: "Don't eat your brother."

The girls pause. Waiting. Their eyes wide with excitement, their smiles broad. Their teeth gleaming. Waiting for the sea lion to reenter the sea.

A moment later, he leaps back into the fray, and the chase begins anew.

I stand alone in the dining room. Gather myself. Then sit down, and begin to read.

Physical Therapy. A synopsis: history, summary, reason for evaluation. A 5 year 10 month old boy, who received a diagnosis of autism in September 2005. Re-evaluated at Children's Hospital Boston last spring; diagnosed with PDD-NOS and ADHD. Sensory modulation difficulties. Now attending Kindergarten in an integrated public school classroom, with paraprofessional support from the Special Education team.

(Only the briefest glance at the summary. It's been almost four years. The scars are layered and thick, if not immune to sensation.)

The section is five pages long. Single spaced. Black type on white paper. It is, largely, a positive summary. "His performance of familiar motor skills has been more consistent across sessions; however, it continues to vary with attention. He has difficulty with motor planning of novel gross motor activities, for which he requires physical prompts and breaking the unfamiliar task down into smaller tasks."

Ah. The core of it. Breaking down unfamiliar tasks into smaller, discrete pieces. Training, step-by-step. Mastering each one, then proceeding to the next. Until all the pieces work. Until all the pieces work together. Gathering data, applying analysis, retooling the program to help him put the pieces together. To help him find a way to make it work. This is the heart of Applied Behavioral Analysis, one of the core methodologies for teaching children on the autism spectrum.

For parents of 1 in 150 children in America, ABA is as familiar a shorthand as CPR. They are letters that give life. In the words of a friend of mine - a Harvard-trained physician at one of Boston's major academic medical centers - "ABA is magic."

(There is no magic. It is work. Hard, relentless, difficult work. My son has worked harder in four years than I have in almost forty. Nothing worthwhile comes easily.)

(But. I know what she means.)

I finish the report. Feel fine. I know: PT is the easy one. The next is Occupational Therapy. I sigh as I begin reading, hoping my wife will not hear.

Overall, he is able to complete the tasks presented to him, but experiences difficulty visually attending until task completion... he scored in the borderline below-average range on the visual-motor skills assessment. In relation to his peers, he shows definite differences in auditory processing and movement processing, and probable differences in visual & touch processing as well as behavior. His ability to learn is challenged by his avoidance of eye contact, difficulty tolerating changes in routines, occasional perseveration and difficulty in registering auditory input from teachers and peers.

The report is extremely thorough, and well-written. I think, we are lucky to be working with professionals like these. I ignore whatever is breaking inside of me. There are more reports to read.

Third report: Speech-Language. For half a second, I consider skipping this one. It would be easier for me not to read it. But: easier is an option I do not have. Twenty feet from me, my children squeal, attack and consume one another. The bloodletting is punctuated by sweet peals of laughter. It sounds a thousand miles away.

There are multiple tests referenced. In single-word receptive vocabulary, he scores at 4 years. In single-word expressive vocabulary and word retreival, he scores at 4 years, 8 months.

In auditory language comprehension in vocabulary, grammatical morphemes and elaborated phrases and sentences, he scores at 3 years, 9 months. His expressive communication scores are comparable.

He turns 6 in April.

(There is not enough air in the room.)

The report is measured, and fair. It very clinically and accurately reflects the significant challenges he faces. It lays the groundwork for his program going forward, both short- and long-term.

I hear him in my living room. Pleading. "Mommy, I don't want for the sharks to eat me." His words sound muffled, and I realize it is because my own breathing is heavy and labored. I read through the summary and recommendations, and see, "(he) performed at low averge to poor range for receptive and expressive vocabulary, common word classes such as noun, action verbs and adjective and relationships... he has difficulties with formulating sentences and ideas for classroom-based tasks and peer interactions without the support of pictures and scripts. His attention and focus difficulties may hinder the amount of information he is able to receive in a large classroom format, and his expressive limitations significantly impact his classroom performance."

It is surprising, how easy it is to forget. To think, he's doing well. To forget the sensation of something ragged and new being torn within, across, throughout you.

The final report is an overall program summary. It notes his few great strengths - his early reading skills are second grade level! - as well as the areas where he matches his peers. And the many others where he does not. It is largely analytical, but there is an undercurrent of warmth. It is clear: they adore him. And they will continue to help him.

I finish reading, then pull the reports together. I shuffle them into a neat deck, and then gently slide them back into the manila folder. I think: I hope my wife does not read these tonight.

Finally, the sharks swim away. My daughters settle on my wife's lap, and she begins to read a Martha book to them. Talking dog. Eats alphabet soup; the letters go to her brain, instead of her stomach. The girls are rapt with attention. My son sits near her feet, listening to the cadence of her voice as his hands guide buckets of Lincoln Logs into graceful farmhouses and ranching fences.

Twenty feet away, I sit quietly. We are all of us here, together, in our warm home. Tomorrow, I will put the kids into their winter parkas and walk them out to our car, buckle them in tightly, bring them to school. I will talk to them about dogs and ballet class and show and tell. I will will myself to focus beyond the four words that I pretended I never dared to hope for. Four words that have never felt so impossibly distant. Indistinguishable from his peers.

I will hold it together.