Where Do the Screams Spring From

February 14, 2019

I realized that I could write about Robert’s screams only because during the last few weeks he was much calmer, happy really, than in the previous few months. So, it was easier to hypothesize about the causes of the cluster of behaviors that included loud noises, slapping his own face, and, sometimes, stumping his feet. The starting and the finish points were clear and easy to define. 

Very often, the screams sprout from confusion.

It was no later than 7 PM. I was not feeling good.  From my bedroom I called to Robert to bring me a bottle of water.  Robert was sitting on the sofa and seemed reluctant to move.  I asked again, and then I dozed off.  A few minutes later I woke up and asked Robert again to bring the bottle of water. Robert didn’t move.  But he produced a few short screams, the sounds of impatient irritation.  Only then, I noticed that the bottle of water was already on the nightstand next to my bed. Robert brought it when I was sleeping. Thus when I asked him for water that he had already fetched, he became confused.  He didn’t have tools to address that confusion. He couldn’t say, “I brought the water already”  or something similar. Even though he knew all the necessary words, he couldn’t recall them and string them together to respond properly. So he replaced words with the sounds of frustration. The screams subsided when  I said , “Robert, you brought the water already.  Thank you, thank you!”

They spring from pain.

He screams, stumps his feet, and hits his cheeks.  His eyes are red from desperation and powerlessness. I don’t know how to help him. He cannot tell what hurts.  I suspect that when he is in pain, he feels that he did something wrong and doesn’t want to admit it. I suspect that for him the pain is something that attacks him from within and thus he feels guilty that he brought it upon himself. I can only  guess that his pain  is related to his digestive system, as his belly  feels hard and bloated.  He tries to calm down, but cannot really.  He holds his breath as if holding air would alleviate his discomfort. Then he exhales in a heavy, artificial way. After a few minutes, the screams return. We are still baffled about origins of pain.  One doctor stated that he had spastic muscles in his face and neck. Sometimes I suspect it is related to asthma. I suspect it is because of gases. I suspect his eczema flare ups drive him mad. I suspect everything cannot confirm anything. So, I try to massage his cheeks, even though Robert moves backwards from me and keeps hitting his them. I give him additional pill of Zyrtek in case it is allergy.  I give him inhaler in case it is asthma related.  I give him Metamucil crackers in case of gases.  And I give him Advil if it is something else.  He looks at me as if he couldn’t understand what is happening to him and why I don’t help him. When he is in pain his eyes scream too.

They erupt from mixture of disappointments.

Last Friday, Robert had pretty good morning.  We went together to his physician to pick up permission slip. On the way home, we stopped in two supermarkets.  We did some learning together. Robert’s horseback riding lesson was uneventful.  However, after we came home, Robert began screaming and hitting his face. Everything was going wrong. He felt cheated and disappointed.  I didn’t buy him buttermilk sandwich as I often do after the riding. (Well, he asked for taco which we did buy.) He learned that Tim, who usually comes on Friday afternoons, won’t come that day.  He also learned that there wouldn’t be any skiing that weekend. “Ski, ski, ski” he kept repeating. “We will go skiing next week”, I told him and pointed to the date on the calendar.  Robert took a pencil and wrote “ski” on the calendar space for the following Saturday. “Tim, Tim”, he kept repeating.  “Tim will come next Friday”  That was not the answer Robert waited for.  He screamed again.  Finally , he asked for coke.  But there was none at home that day. So, Robert screamed louder.

Robert was clearly angry. His emotions formed a volcano from which shouts erupted,  But then,I am not sure, if the pain was not not an additional factor.  It might be that he had allergy to something as the back of his neck got very red. And his breathing seemed different.   It is possible, that the salsa he used with his taco irritated his stomach.

So it could be the unidentified pain attacking him from within. It could be.

But then, when Jan told him, that he that he would go skiing after all, Robert became his happy, charming self again.  So, maybe he didn’t feel any pain after all.

And of course the screams are Robert’s way to tell us something when the words – the tools needed for the construction of tunnels of communication – don’t.

All Robert’s screams are caused by his  lack of ability to communicate verbally reasons for his distress. Precisely because of that lack it is important to find the causes. Different roots call for different approaches. If I could understand the origin of Robert’s anguish I could not only offer a solution – for instance take Robert to a doctor- but also teach him the proper ways of expressing himself.  I could teach him and practice with him the simplest sentences or phrases, “Stomach hurts” ,”I am angry” . “I did it already” which  he could use in lieu of screaming.





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