"Mmm, so good, Justin. Do you want some?" I kept talking and reached my arm out. I was getting closer; in fact, I was close enough now for him to reach my outstretched hand and the food. I stood still, keeping up my banter and holding the muffin out to him. It seemed like hours, but within 30 seconds he tentatively reached out of the crib. He stopped halfway to the muffin and pulled his arm back in. He seemed to be holding his breath. And then, suddenly, he grabbed at the muffin and pulled it into the crib. He scooted over to the furthest corner and watched me. I stood in the same place, smiled, and tried to bring some light into my voice, "Good, Justin. That is your muffin. It's ok. It's good."
He started to eat. I waved goodbye and walked slowly back to the nurses station.
"Well. Just wait a minute he'll be screaming and throwing things again," said one of the nurses, who seemed almost disappointed that he hadn't displayed his "bad" behavior for me. "I expect so," I said on my way out.
From what I'd learned so far about the effects of neglect on the brain, I knew that the only way to find out whether Justin had unexpressed potential, or had no capacity for further development, was to see if his neural systems could be shaped by patterned, repetitive experience in a safe and predictable environment. But I hadn't yet learned the best way to structure this experience.
I did know that the first thing I needed to do was decrease the chaos and sensory overload surrounding Justin. We moved him to one of the PICU "private" rooms. Then we minimized the number of staff interacting with him. We began physical, occupational and speech/language therapy. We had one of our psychiatric staffers spend time with him every day. And I made daily visits.