"It’s uncomfortable standing behind the one-way mirror. It extends from the drop ceiling to about chest height, so the gray metal chairs aren’t high enough to view the clinic room. The air tastes stale, marked by a tinge of glue once ladled under the blue-grey carpet. I watch through the mirror, my two graduate students standing beside me.
A six-year-old boy walks through our clinic room door, pauses, then continues toward a few toys scattered by a bin and a squat table near the left wall. I see wooden blocks, a plastic action figure, and a small pillow that looks like a smiling locomotive. He picks up several blocks and brings them to the center of the room. A clinician in her late 20s enters the room followed closely by a man and a woman. She gestures toward two small plastic seats formed like ice cream scoops, perched on thin chrome legs, better fitted for children. The boy’s parents sit down, side-by-side. The clinician sits down on a small chair by the wooden table. Knees high, she writes on the cover of a light blue pamphlet. The boy sits on the red-orange carpet, one leg curled below him, the other extended to shield the blocks.
The clinician reaches toward a blue polyurethane bin, its lid faded under the fluorescent lighting. Scrawled on its surface, as if there were no thought to its semi-permanence, reads, ‘ADOS Kit Complete: Autism Clinic.’ She wades her hand through the bin and draws out a bulky translucent plastic bag, opens it, and lets toys tumble onto the table.
“Jason, I have some toys here . . .”
On the floor, the boy turns a block, cradles it in his fingers and drops it, turns another block, cradles it in his fingers, and places it on the carpet.
An autism diagnosis is nuanced. Clinicians find children as “on the spectrum” if they repeat certain behaviors or thoughts and have difficulties with social interactions and communication. Each child on the spectrum tacks on a different orientation. One boy sways back and forth by the front door. A girl twirls all day by the living room window. A boy, anticipating a toy, looks down and flaps his hands like a baby bird, elbows in, wrists hinged, fingers cupped, and stepping high-kneed, in place. Repetition can also be a mental predisposition. A child might repeat the name of every state capitol, another every president’s birthday or the location of every yield sign in town."