If you have a child like mine, then your child will alternate between loving you unconditionally and screaming, I hate you Mommy!!! when he doesn't get what he wants.  If you have a child like mine, he will fall peacefully asleep while watching his favorite movie...after an eventful day of shrieking and hitting himself on the head repeatedly.  If you have a child like mine, then he has hit you more than once, fallen on the floor screaming when his father tries to take him out of the room, or gotten so upset that he has made himself throw up.

If you have a child like mine, then he is the loudest child receiving psychiatric services at the children's hospital.  If you have a child like mine, he flies into a rage if you brought the wrong toy to the hospital, then yells at you to leave.  A child like mine will sit in your lap and tell you silly jokes, plant a garden with you, go for a walk, help you cook in the kitchen, draw pictures.  A child like mine will make up songs for every person he knows, and his smile is like the sun.  A child like mine will also scream at you when you ask him a simple question.  A child like mine is complicated.

I wish that "autism awareness" really was "autism awareness".  Because it's not.  They are not all savants who can play Beethoven's 5th after hearing it once at the age of three.  They are not all catatonic mutes who stare at a corner all day, unresponsive to any outside stimuli.  Many of them are like my son, where the lines between "autism" and "co-morbid disorder" get blurred in a serious way. For us, autism is not a "different way of being" as so many people like to describe it.  It's something we manage, because we know that on good days, our son is there, waiting with his gorgeous smile.  On the not good days, he disappears and he's replaced by this screaming child who cannot be calmed.

Eventually you come to the realization, as much as you've tried not to, that you cannot do this anymore.  You realize that the crisis mode that you, and your family, has been living in for years has spawned a plethora of other problems.  You are tired all the time.  You hurt, physically, all the time.  You do things to "escape" from the situation, like shopping or spending time outside the home or working yourself to death.  Your other children become affected by it too:  they don't come out of their rooms, and chaos management becomes the norm.  For years.

But what else could you have done?  The one person in the house who needs the most help, all the time, is also the one that is the most unaware of all of these issues.  Eventually, he becomes too hard to control, even for you, because sometimes, love is not enough.  Even though you thought you could do that.  That if you loved him enough, and gave him everything, then maybe, just maybe, the screaming would stop, and somehow, he would understand that he shouldn't hit you.

So, after his latest incident, you take him to the hospital, where a kind, soft-spoken family therapist gently leads you to the inevitable conclusion:  your son needs more help than you can give him, anymore.  Perhaps you would consider putting him in a longer-term treatment facility?

And you agree.  Because you are tired, because you know, that if the situation continues in the same manner, someone will eventually get hurt.  Because you are tired of living in a fox hole, waiting for the next round.  Because you hurt for him, and underneath all the screaming and the raging you can also hear his confusion and frustration, and try as you might, you cannot sort that out for him.

What this means is that when a space opens up, your child will go live somewhere else.  It might be for a week.  It might be for three months.  Who knows.  And if he can't get the help he needs at this place, then you may have to face the possibility that he can't live with you anymore. That his time with you, in your home, is limited.

I've had many people tell me that this must be a heartbreaking situation.  It is.  But sometimes you have to love someone enough to do what's best for them, even if it's not what you would have wanted.  Sometimes it's the only option left open to you. The ideal outcome would be that he goes and gets the help he needs, and that afterward, he's able to come home.  We may not have an ideal outcome.  It's too soon to tell.

I don't know what's going to happen in the future, with my son.  I can only imagine that there are hundreds of mothers like me, faced with these circumstances, who don't get the help they need.  I don't know what these mothers do.  I know that eventually, their children grow up, and they go to live in a group home somewhere else.  What I do know, is that no matter where he is, or what has to be done in order for him to be taken care of, I will never stop loving my kid, and I will never, ever stop fighting for him.