The Crunchy and the Smooth:

Everyone said that spring arrives in Missoula on Mother's Day weekend, and they were right. In the course of a few days, everything changed with a big blossomy bang.

Heath had been patiently tracking the progress of his seeds -- now we could put them outside.

The garden that was covered with snow when we moved in turned out to be full of tulips and beautiful perennials.

Heath has had a few new beginnings of his own this month -- pedaling a trike, drinking independently, and starting to use a rolling pin with both hands.

Other things weren't caught on camera, like spoon-feeding himself 11 bites of food out of the blue this morning! After months and weeks of saying, "No, mama" whenever I offered him the spoon.

Heath's developmental leaps are inevitably surprising, sudden, a little bit miraculous. What just happened in there? I always wonder. We might have encouraged or demonstrated an action over and over for a long time with no apparent response from Heath other than tolerance of our moving his limbs and digits around. Sometimes he has a negative response, as if to say "I don't WANT to drink from a cup on my own! Don't make me!" And then one day, one moment, he makes the choice to attempt something entirely on his own, unbidden by us, and for reasons that are hidden to us and urgent to him. At those times, he makes the greatest leaps into new territory.

After two years of watching therapists work with Heath, I'm still fascinated by the enormous role played by his own motivation, which is unpredictable, mysterious, and rarely focused on what I think might be important to work on today. The best therapists know how to flow through a program that challenges Heath in key areas (balance, muscle weakness, muscle coordination, conscious control of muscle tone, and learning new motor patterns, plans, and habits) while responding to his own need to experience fun, variety, social interaction, and success. We are grateful to have found Ed and Paula in Missoula, two good-hearted people who give a great deal of thought and energy to planning their sessions with Heath while keeping him laughing, or at least engaged, interweaving and alternating hard work with delightful play, songs, and silliness.

Their work and ours guiding Heath through the movements of crawling, squatting, standing, kneeling, walking, eating, etc., builds on neural motor programs designed to unfold like a flower in all developing babies. For Heath, these the built-in developmental imperative is fainter and more scattered due to his injury, which creates neuronal communication challenges akin to static on a telephone wire. By assisting him over and over, we can reinforce a pattern he can access later when he is ready to try something out for himself. If an action is too hard for him, he will abandon the effort and might not try again on his own until weeks or months later. If it is within his reach, he will try again and again, as he does these days trying to write a letter "M", press cookie cutters into play-dough, put on his hat, or walk while we hold one of his elbows.

What I have learned is that Heath and we are involved in a dance. We lead, then he leads. We attempt to guide, instruct, demonstrate, and challenge in the most entertaining and engaging way possible. And then we step back and he shows us where he wants to go. He is influenced by what we show him is possible. And we are influenced by his passion to blaze into new territory all on his own, at the time and place of his choosing. This dance requires that we trust Heath to get where he's going, just as parents of typical kids can trust that theirs will walk and talk. His timetable will be different and his ways and means will vary, but the longer I know Heath the more I am convinced that he knows a thing or two about the proper course of his own learning and development.

I have given up bribery. It used to be six chocolate chips for six crawling laps across the dining room. Do this and you'll get that. And then I noticed that his intrinsic motivation to pursue crawling was flagging. I was sending him the message, "Crawling honks, therefore I have to give you goodies to get you to do it." I wasn't seeing him flop down to give army crawling his best shot on his own anymore. What good was that? reading Alfie Kohn's exhaustively researched book Punished by Rewards made me realize I was treating Heath like a lab rat. Which is not surprising really, since we have been wielding pop behaviorism techniques on children and workers since before B.F. Skinner came along -- he just made it seem more scientific. But Kohn trots out study after study showing that systems of reward and punishment may bring short term compliance but fail consistently over the long term at bringing out the best in people -- the best behavior, learning, creativity, or productivity. What people really want are not rewards, but choice, autonomy, meaningful activity, and collaboration.

How to discuss all this with a two-year old? Hmmmm. Back to the dance. On the therapy side, we have to explain to him as best we can and as respectfully as possible that the therapeutic activity which may tire and annoy him is important to his own goals of independence. We need to offer him choices whenever possible about how to undertake that activity and even when to let it drop. And we need to be alert to what is meaningful to him on a given day and help him achieve it on his own if possible. We have to let his inner reward system of pure satisfaction work for him. Rather than overwhelming him with praise every time he gets the peg in the hole, we have to sometimes allow a silence in which he can hear his own little firework bursts of pride inside. Because that's really where it's at.

Ultimately, it's up to us to put him through his paces and up to Heath to make the big moves. No chocolate chip in the world is big or tasty enough to compete with his own primal desire to change and grow. We can trust that desire, we can inspire it, we can encourage it when it falters, but we aren't the source of it. And he doesn't need us to be. All we can do is find honest ways to connect with his intrinsic desire to crawl, (or eat with a spoon or break out of his walker one day) which are more powerful than any extrinsic motivator we could devise.

And maybe we save a piece of our relationship in the process. I worry that in addition to being Heath's primal source of love and security I am also his Olympic coach, for part of the day. It is my duty not to leave his body to its own devices during crucial childhood years of ultra-neuroplasticity and rapid physical growth and development. He will go further with guidance, habit-building, therapy, and strengthening that he would without these things. So, I need him to comply.

If I rely on manipulation as a technique to gain compliance for a week, that's one thing. But if I do it for years, I fear we will pay a price in terms of lost trust and respect. Maybe we won't get as many reps done tomorrow without M&Ms as we will with truthful explanation, but maybe Heath's long term enjoyment of exercise and exceeding his limits will be greater. Maybe one day he will surprise me, as he did this morning feeding himself bite after bite of cereal, by saying, "Hey Mom! Let's do weight training!" Or, "I think I'm going to learn to ski." Or whatever he sees on the horizon as his own next possible adventure.

I hope we're making the right call where all this is concerned. Parenting is a balancing act like no other. Sometimes I think there is a right answer: either we're pushing him too hard or we're not pushing him hard enough to reach his physical potential. Other times I think there is no either/or, no way to measure a "best" outcome that doesn't include a sense of rightness, love, trust and mutual respect.

Happily, trusting Heath to make his way is as easy as trusting the tulips to come up in May. They do it because they need to, they want to, and because it's giddy, exuberant fun. Same with parenting (and grandparenting! ) this incredible boy. It just happens, in phases and seasons, with something much bigger guiding us in turn. Somehow, I'm fairly certain, it works.