5

      Do everything you can in life to avoid ever visiting a developmental paediatrician, particularly one in the NHS. It is not that they are wholly incompetent, nor that they will state flatly everything wrong with your baby, although either one of these may be the case. It is first that you must arrive at a car park lined with tall, rusting chain-link fences set into the untidy grounds by means of cement posts. You then put yourself through a gate that has a tricky lock placed high on a wall so that none of the children can escape, and pass through a series of anonymous hallways with cheerless chipping paint, linoleum floors that smell of disinfectant, posters about various sorts of conditions – dyslexia, Down’s syndrome, schizophrenia – until you enter playrooms full of badly damaged children. These children do not often smile, cannot easily speak, play not with each other but with objects that are not toys. And if you are there for the same reason as I am, today, you see in every one of these children the shadow of a person you love more than you can describe, and who is just three years old and has only this to look forward to in his life.

      Daniel has begun to collect disc-shaped objects, which at first I thought was a good thing because it meant less attention to Thomas the Tank Engine. He has taken to balls and balloons and coins and draught pieces. Milk bottle tops and metal washers and clockfaces, the lids of mayonnaise jars and shining CDs. He holds as many of these objects as possible along with his Thomas as we walk through the nursery at the Frilman Centre, where we are to visit Dr Margaret Dodd about what is being called a ‘developmental delay’. Daniel keeps dropping a coin or a lid or a marble, which means we have to stop, retrieve the object, give it back to him and toddle along again, until he next drops something else. At this excruciatingly slow pace we make our way through the car park and the cement garden that leads on to the main building. By the time we reach the nursery, I have to pick him up in order that his revered objects do not get pilfered by the other children, who seem similarly disposed to carrying around useless items, or at least behaving very oddly toward their toys. One girl has a plastic Barbie she keeps hammering against a table, then flinging through the air, then hammering on to the table again. A boy with remarkably quick movements carries an armload of cars in a manner disturbingly similar to how Daniel is carrying his own assortment of cherished garbage.

      Dr Dodd has Daniel’s notes in front of her. She is a woman hard to describe. Her face seems entirely without form, as though her features have receded with her advancing years, so that you find yourself regarding her in terms of what she is not. Not tall, not voluptuous, not thin, not short, not extremely old but definitely not young, and not terribly interested in Daniel. While she interviews Stephen and myself, another woman attempts to entertain Daniel with a table of toys that he is to name and make do things. Dr Dodd wears a white coat and a name tag. The name tag is the most definite thing about her. She speaks in the perfunctory manner of a dental hygienist and jots all our answers on to a form that she has clipped to a board on her knee.

      When did he first sit up? Crawl? Walk? When did he first speak? When you say he has a few words, does he use them together or just as single words? Exactly how many words does he have? Does he have trouble with changes in routine? Does he ever engage in ‘pretend’ play? What does he eat? How often does he sleep? Does he seem particularly worried by loud noises? Does he spin? Does he perseverate, do the same thing over and over again?

      The pitiful answers to these questions are that he was perfectly normal until sometime around nineteen months when we noticed he didn’t talk. We could remember him saying ‘ball’ which he applied to anything round, including Clementines and buttons. He then began to use the word ‘help’ but dropped the word ‘ball’. Then he didn’t say anything at all. He is ingenious at undoing locks, switching on televisions and unfastening car seats, but not so clever at playing with toys. We can’t get him past the lights-and-sounds plastic baby toys he had as a nine-month-old, and no, he doesn’t sleep at night. Or really, much at all. As for loud sounds, I am unable to use a public restroom because if somebody presses the hand dryer he goes screaming in terror. All loud sounds, from barking dogs to doorbells, send his hands flying to his ears, where they remain as he runs blindly away from the noise.

      Because Stephen has an appointment later in the day, he is wearing a Jermyn Street suit, a thick silk tie. His shirt alone costs more than I would spend on a coat, and he has shaved carefully so that his face is perfect. As Dr Dodd continues with her questions and I put forward my sad replies, I watch as Stephen loses himself in the violence of what is happening here. His back slumps. His knees fan out, his big hands hanging between them. His tie coils on his right thigh. He is staring at the colourless linoleum tiles as the woman behind us tries uselessly once more to get Daniel to say the word ‘car’ and to keep him anywhere near the table of toys she has set out for him. Daniel keeps wheeling away from her as she grabs his arms, then he drops like a stone when she attempts to get him to stand at the toy table. All this is happening slightly out of our vision, but we hear it along with the battery of questions. While the commotion of Daniel’s attempt to escape from the woman continues, I am forced to report on the mental health of my family, that my father killed himself in the basement when I was four years old, that my mother went through a depression around the time of her cancer diagnosis. The only time Stephen looks up, in fact, is when the doctor asks if I am receiving any psychiatric help at present, to which I reply, firmly, that I am not.

      ‘Well, you might reconsider that,’ she says. ‘Your son is very likely autistic. Frankly, you may need help coming to terms with this. Let me see what the speech and language report is.’

      I cannot bear to look at Stephen. All the times he has been annoyed with me for being so focused on our children, for providing every opportunity for their pleasure and comfort at the expense of his and my own, for busily singing nursery rhymes instead of going with him to films, building dollhouses out of cartons instead of arranging dinner parties, for failing to accompany him to his firm’s Christmas party, but instead sitting on the floor having picnics with Emily’s stuffed toys and playing peekaboo with Daniel. Then suddenly I have a thought that makes me feel sick to my stomach: when did Daniel stop playing peekaboo?

      ‘Stephen,’ I say urgently. ‘When did Daniel stop playing peekaboo?’

      He shakes his head, doesn’t answer. He’s looking at Dr Dodd. She’s saying something but I cannot seem to focus. All I can think about is how so many of the mothers practised ‘controlled crying’ and found suitable nannies, while I gave myself wholly to every whim of my children. This method of child-rearing is a mistake according to those who think we should tame toddlers and thwart manipulating pre-schoolers, but I took pleasure in the sanguine, parasitic and entirely innocent fashion with which my children enveloped me. And yet,