Foreword

Our Greatest Allies

When a family has a child with an identified condition—whether diabetes, Down Syndrome, or autism—there is a very real danger that the child will be labeled and then treated like an object that is broken and needs to be fixed. A diabetic, a Down’s child, an autistic. The disease takes precedence over the child’s humanity. Whole medical and therapeutic systems of care confirm that the child “is” their condition. The family, in their desperate need to help their child, buys into the “therapies,” and all efforts of the family are directed to “cure,” “fix,” or help the child “recover” or “reach his or her full potential.” Too often the result is burnt-out caregivers, neglected siblings, and a marriage strained to breaking. In my developmental and behavioral pediatrics practice, I have seen it so many times.

But how does a family not do everything possible without feeling guilty? How can a child be helped in a way that does not treat him like a label, but respects his intrinsic motivation and deepest needs by understanding his biological and psychological complexity? How can a family survive intact as they search for and find the best ways to be helpful to their child? Read Our Greatest Allies and find out.

This tenderly written book is like having two wise and experienced companions accompany you on that universal “long and winding road” that begins with grief for the loss of the child you wished for, and ends when you have fallen in love with the child you have. Told in alternating chapters by Matty’s mom, Lauren O’Malley, and Matty’s occupational therapist, Maude Le Roux, OTR, this insightful and helpful case study covers the critical first six years in Matty’s life.

As I read I wondered: How is this working mother of five children going to pull this off? Lauren is a very good writer who, in her chapters, is able to articulate her internal process as she takes those inevitable steps down the road—the first suspicion, then knowing something was not right, waiting for a diagnosis, getting a diagnosis, starting intervention, searching for the best intervention, and finally finding her allies. Parents who read this book will be heartened by Lauren’s ability to be open and honest in the face of grief, anger, confusion, disappointment, and uncertainty—and still make strong decisions based on her gut level perceptions of what Matty needs, what she needs, and what her large and complex family needs. As Lauren says, “need trumps guilt!”

This is a nail-biter of a book. It is not clear in the beginning how Matty O’Malley will fare given the severity of his condition. Matty and his allies face a series of critical decisions that are filled with uncertainty even for the very experienced Maude. And it won’t ruin the suspense to say that Matty does well. The real suspense is in how, at each critical juncture, his family and team helped him to do well. As Lauren exclaims toward the end of the book, “Oh how our children would thrive if we could create a culture of process rather than our infatuation with product…when you cultivate a child’s connection to purpose and process, learning and growth flourish naturally.”

So this book is also about a set of interventions that really worked for Matty and his family. Maude Le Roux, who eventually becomes the team leader (and a great ally) for the O’Malley family, summarizes the plan this way, “The only solution to meet the true needs of the child is to look at him from all vantage points of a developmental perspective, and with a unified team approach, consider the place where the child needs us to start building his developmental support.”

Based on the pioneering work of child psychiatrist Stanley Greenspan, MD, this book is a testament to a developmental, individualized, and relationship based (DIR®) model that honors and respects the child’s uniqueness. Maude’s clearly written chapters describe this playful and yet powerful developmental approach in detail. We learn about the importance of respecting the child’s feeling life, while honoring his need to “keep the world the same” or risk causing him profound anxiety. We learn about the sensory profile of the child and how, by understanding his unique way of sensory processing, we can help the child integrate sensations to make sense of the world. Maude’s description of “sensory processing” is one of the best I’ve ever read. She’s even convinced me of the value of Tomatis® Sound training.

We learn that by establishing a secure sensory-perceptual base, we can then help a child make sense of the world. This leads to the most important of functional abilities—connecting with others through gesture, routines, and ultimately words. Each of Maude’s chapters builds on the previous one until, by the end of the book, the reader has been schooled on how to organically apply a set of therapeutic principles to a particular child. In this regard, Our Greatest Allies will be of real interest to professionals as well as parents.

Let me end with a new word I learned from Matty’s mom: lagniappe (pronounced LAN-yep). It means “a small gift,” usually given by a storeowner as something extra beyond what was purchased—a little luxury, a little taste. When we honor our child’s uniqueness and accept him for exactly who he is, we paradoxically help him make the most progress he can. We have solved the original dilemma of how to help him without turning him into a project or object. We become less anxious; we enjoy just being with our child; we experience the gift of everyday life. We give ourselves and our child a little lagniappe. So relax, find a comfy place to read, open the first pages of Our Greatest Allies, have a little taste. You’re going to like it. You’re going to learn a lot.

Rick Solomon MD
Medical Director
The Ann Arbor Center for Developmental and Behavioral Pediatrics