There are many opinions on what causes spectrum disorders.? Environmental factors, genetics, brain injury, and even immunizations (though the FDA will strongly disagree with that and that particular topic is not one I care to engage in).

 

In Ty?s case, I don?t spend a lot of time wondering about this because I strongly believe the story of his birth holds all the answers we need.

 

Ty was born prematurely at 25 weeks and 2 days gestation.? His lowest weight was 1 pound 14 ounces and he was only 13.5 inches long – unbelievably tiny.

 

In the first few hours after Ty?s birth, we were warned by his neonatologist that the most devastating outcome for Ty would be if he were to get intraventricular hemorrhages due to extreme prematurity and/or the trauma of his birth (footling breech and then c-section).

 

An intraventricular hemorrhage of the newborn is when there is bleeding into the fluid-filled areas (ventricles) surrounded by the brain.? IVH falls into four groups called grades.? The higher the grade, the more severe the bleeding.

 

Grades 1 and 2 involve a small amount of bleeding and do not usually cause long-term problems.

 

Grades 3 and 4 involve more severe bleeding, which presses on or leaks into brain tissue.

 

(Source:? National Library of Medicine:? http://www.nlm.nih.gov/medlineplus/ency/article/007301.htm)

 

We were cautioned in the NICU that if Ty were to get bilateral (meaning both sides of the brain) high grade hemorrhages that we should discuss ending life support because of the potential for a poor quality of life due to associated issues with grade 3 and 4 bleeds.

 

As it turned out, on Ty?s 10^th day of life, we got the dreaded news.? Ty had a grade 3 bleed on the left side of his brain and a grade 4 bleed on the right.? (Note:? later ultrasounds downgraded the left side IVH to a 2).

 

To complicate this further, Ty then developed another serious condition called Periventricular Leukomalacia.? PVL is characterized by the death of the white matter of the brain due to softening of the brain tissue.

 

When Ty was six months old he received a PVL diagnosis based on a brain ultrasound.? His neurologist explained that the right ventricle of Ty?s brain maintained its swelled position from the IVH even after the bleed itself had dissolved.? This happened because while it was swollen it effectively killed off the surrounding white matter.? The brain will not allow for ?dead space? so the swelling of that ventricle never resolved (and never will) because it is now filling space that no longer exists.

 

The question I had had in the last seven years is not what CAUSED Ty?s spectrum disorders.? No real mystery there.? The bigger question has been in the identifying of the subsequent disabilities as a result of this brain injury and even more so?how to help.

 

The brain is an amazing organ ? ?so complex and organized.? It is difficult to get clear answers and understandings when it comes to researching neurological issues.??? Because of its complexities, I think it can be difficult to determine exact causes and effects but an understanding of the basic ways in which the brain is organized at least gives us some clues.

 

I found this chart (source:? http://www.singsurf.org/brain/rightbrain.php) to be so interesting.

 

 

When you consider that Ty did have damage to some degree to the left side of his brain but more so on the right, you will see how these issues align very well with the different spectrum disorders I will be writing about.? Fascinating isn?t it?

 

Where Ty is concerned, I can certainly see his strong left hemisphere attributes.? He does communicate well, spells decently and is oh so happy. ???There are some that do not apply as well (skilled movement) but that could be for any number of reasons including cerebral palsy.

 

The right side of the brain that sustained the more significant amount of injury is responsible for the emotional/social side of things.

 

I would also note that where motor skills are concerned, the right side of the brain is responsible for the left side of the body and the left side of the brain is responsible for the right side of the body.? For this reason, we always have expected to see Ty have more difficulty on his left side.

 

In a book I am reading (The Complete Guide to Asperger?s Syndrome ? Tony Attwood), I took note of a section that discussed specific areas affected by damage to the right side white matter of the brain.?? Again, since I know this to be the area affected in Ty?s case, I was not surprised to read the following:

 

Deficits in visual perceptual organizational abilities, complex psychomotor skills, tactile perception, mechanical arithmetic, social perception, social interaction.

 

Assets are:? Auditory perception, word recognition, rote verbal learning, spelling.

 

I am inserting this section in my ?Ty?s World? posts because I think it can be difficult for people to conceive the notion of a social disorder as opposed to intentional anti-social behavior.? When you see though, the way that the brain is organized and how each part affects different cognitive areas, I think it helps explain why brain injury to these areas renders a person without the necessary tools that they need to socialize ?appropriately? in the ?normal? world.

 

(Note:? I can?t resist the temptation to put the word ?normal? in quotes because I often wonder what is so wonderful about ?normal? anyhow ? I think Ty is some kind of wonderful)