Thanks,

What is he missing out on? First, he isn’t under the care of a specialized doctor or anyone who can direct his overall program. We, his parents, are responsible for identifying his challenges and finding people or activities or interventions to meet them. Perhaps I idealize the kind of support we would receive back in the States, but it would be wonderful to have someone just tell us what we need to do! At the moment, we lack OT, speech therapy, and a special needs classroom.

What we do have is a wonderful preschool where our son is absolutely cared for by loving teachers. Although the classroom environment initially proved challenging for him, his teachers gently guided him through his first few months. Now, he functions well at school, although his interactions with other children are minimal.

One interesting sidenote is that I’ve found the social environment here to be a boon. Because most expatriate families arrive on one spouse’s (usually the husband’s) job, there are many, many stay-at-home parents. The result is something of a throwback to the fifties. Playdates are a cinch to arrange, and our afternoons are filled with outings to the playground with other children or trips to the beach with neighbors or classmates playing in our living room. My son does much better in a one-on-one situation, and it takes lots of time (several playdates) for him to really warm to and interact with another child.

I found that arranging playdates back home was much less spontaneous. But I think the availability of friends in the afternoon has really helped with his overall social skills.

The thing is that change in routine really triggers anxiety in my son and actually causes him to backslide. The move out here was one such upheaval. By the time we received his diagnosis, he had finally settled himself into the new routine. His newfound comfort with his surroundings weighed heavily into our decision to stay. But I know of families who have returned home from this place because of the lack of services and many more who don’t (or aren’t allowed) to come because of it. Happily, we’ve found our niche, and our son is genuinely thriving at the moment.

If I may ask, when do you return to the US? Is it possible to come back sooner? And what resources would be most useful to help you son?

For our son, we’ve managed to find a wonderful ABA therapist who has worked with his preschool teachers to create supports in the classroom environment. He has improved remarkably since we started a very simple reinforcement program at school.

But for so many children with such pressing needs, there is little help to be had. In a country where most middle- and upper-class families can afford to have full-time maids, out of sight is out of mind when it comes to “difficult” children. The parents don’t have to deal with their kids on a daily basis and lack the incentive to teach them. Those who do want to intervene find themselves in a literal desert of expertise. The only English-language speech therapist in town stopped working after her visa expired. Did I mention this is the richest city in the world??

Happily, the situation is changing. There’s greater awareness of the needs of autistic children and of the impact that early intervention can have. And the government is starting to take more proactive steps towards addressing the problems. For our part, we’re looking forward to the return home.