To make things more complex (and you know those circus artists always keep adding more complicated things to their acts), we decided to test his ability to handle himself with increased food freedom by rewarding him monetarily for his honesty. First, a little background: even though the oxytocin/naltrexone has been helpful in decreasing his hyperphagia (intense appetite drive) which has permitted us to unlock our kitchen and stop policing him in the home, we still had episodic reports from school that Sasha continued to sneak sweets. My case report references this as “hedonic food seeking continued in the absence of homeostatic hunger” or something to that effect. The incidents were largely opportunistic; there are often treats in the classroom and Sasha's lower carb lifestyle (dating back to before we ever started oxytocin) has dictated (in his IEP) that he is restricted from indulging in the cookies, cakes, and candies that are often sold or available at school. No fair! I can only imagine how hard this has been for him and it’s no wonder he has resorted to sneaking or grabbing these foods when he felt he had a chance to take them. These food restrictions harken back to the pre-oxytocin days when he was stealing food left and right. "No fair" is certainly true but more important than fairness, we felt that restricting him from sweets was possibly causing him to feel deprived, and causing him feel the need to steal them. Given that we do not want him to continue these behaviors or have to always keep him under scrutiny around sweets or even worse, never give him a chance to become independent, we knew we had to do something. Ultimately, if Sasha is ever to be come an independent adult in the real world, he will need to learn how to handle himself around all types of food.
At 15 and with only a little more than three years to go before graduating from high school, we decided that we could no longer afford to protect him from sugar. We decided that it was preferable for him to be "fat and free" rather than "thin and in(carcerated)" and that he absolutely needs to stop sneaking or taking foods that do not belong to him, period.
In case you are wondering about his food; his eating habits at home continue to be about the same as it's been in the last few years. We keep to a relatively low-ish carb food plan: we eat mostly unprocessed whole foods (high fiber vegetables, meat, eggs, dairy, nuts and seeds, legumes, whole fruit and eat a modest/low amount of whole grains like whole wheat bread, oats or corn). The main thing we do not keep in the house is processed snack foods or anything with added sugar (with some exceptions like a birthday cake or ice cream for a special occasion).
With the roller skate-wearing-balancing-on-a-board-balancing-on-a-rolling-cylinder act, now we introduce some juggling balls... we have designed a new plan and have given Sasha a goal with a reward. The goal is to steer totally clear of touching or taking anything (usually high carb foods). The reward for not stealing food (or trying to cover up or lie about it) is to earn $1 per day for each day of honesty. The punishment for stealing (and lying about it) is a fine of $10. The punishment for merely stealing (but admitting it right away when confronted, no lying) is $5. There is no statute of limitations so if we receive a report even weeks later, he will still be fined- the fines comes from his savings so each day is a fresh start and he still can earn that dollar if he keeps himself honest. Also, we have let him know that even suspicious behavior (wandering or loitering uninvited into a room with food, for example) will be counted against him. In other words, he needs to be totally transparent and behave with vigorous honesty so as not to raise any suspicions. We check in with his teacher (who has his aides make notes on paper every day) at the end of the week for her report.
We've been doing this for about three weeks now and so far, it's going well. He had one slip on the weekend with a family friend (took some food from her but admitted it right away = minus $5) but no actual reports of stealing at school, yay! His teacher reports that he does seem to circle around food to check it out but does not get close enough to touch it. Now for the first time ever in his life, the deal enables him to possess money to spend on... anything he wants. Of course, this means that he can purchase cookies, candy or whatever they sell at the (frequent) bake sales at his high school.
As far as we know, he is taking advantage of his new found freedom and has been seen eating cookies in the morning but as far as we know, it isn’t daily and the cookies are purchased with his own money. I can only hope that the novelty of the cookie buying power will wear off and that he will be able to practice some self control if his weight begins to rise out of control again. “Hope” is the key word here, of course, since I have little control over him now and will definitely have no control when I’m dead and gone. Better to start now training him and take the risks (obesity) than wait until he is 18 and old enough to be prosecuted as an adult for theft. Like I said, better fat and free than thin and in(carcerated)!
You can see how these new juggling balls can complicate the roller skate balancing act. He may very well gain weight and we won’t know how much is due to the limitations of oxytocin versus his ingestion of too many cookies. Oh, well. As much as I would like to have a tightly controlled study environment in a closely supervised and locked laboratory setting, we don't have that and can't have that because it is not real life. For better or worse, we have to prioritize our parenting experiment over our oxytocin experiment.
Life is like a live circus act... there are no guarantees that life or the show will go as planned. Now we are practicing for the removal of the "safety net" and just hope he doesn’t hurt himself too badly when he falls. I suppose we can replace the net if he demonstrates that he can't handle life without it but we have to take it down sooner or later and we owe it to him and to ourselves to see if he can handle it for the sake of his development into a trustworthy, independent adult.
First train the kid with the net, then remove it and hope for the best. Isn’t that what parenting is about, after all?
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