ABOUT THIS STORY
Over about six months, photographer Alex Washburn spent countless hours with the Brunner family, recording special moments as well as everyday life. Her photographs were the impetus for this report by staff writers Joan Garrett and Andrew Pantazi, who completed the picture through numerous interviews with the family, mental health experts and others.
AVOIDING PARENTAL DEPRESSION
• Is what I'm reading right now likely to be relevant to my child?
• Is it new information?
• Is it helpful?
• Is it from a reliable source?
Source: Autism Speaks
AUTISM BY THE NUMBERS
• 1 in 110 children are affected by autism; 1 in 70 in boys. Some studies have shown that 19 percent of the younger siblings of autistic children are also diagnosed with autism. In families with two or more autistic kids, a new sibling's chances of being autistic rise to more than 32 percent.
• 48 percent of mothers in the Interactive Autism Network said they had been diagnosed or treated for major depression.
• 22 percent of fathers in the Interactive Autism Network said they have been diagnosed or treated for major depression.
• ASD (autism spectrum disorders) affect an estimated 3 million individuals in the U.S.
• In Tennessee, 1 in 205 children are affected by autism.
• In Georgia, 1 in 145 children are affected by autism.
• In Alabama, 1 in 227 children are affected by autism.
Source: Autism Speaks, national Centers for Disease Control and Prevention
• Chattanooga Autism and Behavioral Services
1000 E. Third St., Suite 100
• Chattanooga Autism Center
3097 Broad St.
• Orange Grove Center
615 Derby St.
• Siskin Children's Institute
1101 Carter St.
• Families for Early Autism Treatment
P.O. Box 23731
• ASSET (Autism Society of Southeast Tennessee)
P.O. Box 28091
Creative Discovery Museum holds a camp for autistic children in the summer for ages 7 to 10. For more information about Friends Discovery Camp, call 423-648-6045 or 423-648-6040.
Autism: Fill Your Toolbox
The Chattanooga Autism Center, in partnership with the Autism Society of America East Tennessee Chapter, will host its third annual conference for parents and professionals on May 4 from 8 a.m. to 5 p.m. at the Chattanooga Convention Center.
Greater Chattanooga Aspies
This Asperger Syndrome support group meets the third Tuesday of each month from 6 to 8 p.m.
For more information, contact Scott Kramer, founder/executive director, at GCAspies@gmail.com
Midday sun comes through the windows of the Brunners' family home on a back street in Clifton Hills, and the harsh glare hides a lot. It covers the signs of poverty. The cracks in the linoleum floor, trash on shelves, the streaks of dirt on the walls, the signs of want that alone are obstacle enough, but here aren't even the worst thing.
And the laughter heard on the street even through closed windows, is surprising, considering all that has happened inside these walls.
Six sisters and brothers sit cross-legged, kneeling or squatting around an old computer monitor watching YouTube music videos because they don't have television. One stands up to dance. So does another. They look to make sure their parents are watching the impromptu performance.
Their mother, Kim Brunner, a short, worn woman with thick glasses, sits and settles into the corner of the couch and watches them, forgetting, for a moment, that so many of her dancing children have been born sick and different, that the days themselves are a dance between doctor's offices, counseling sessions and school meetings.
On days like today, when Kim has taken her pills for depression, bright thoughts come with the sun. She brags about Marilyn, her baby.
At 9, Marilyn speaks in clusters of words, not sentences. "But she can sense when you need something," her mother says proudly.
She brags about her son Kenneth, who is learning to read at 13. Finally. Reading. She never believed it could happen.
They are so beautiful, her six children. So imperfect. So real. So much her own.
But like so many mothers know, loving them can feel as much natural as impossible. All the worries she once had for herself are replaced with new questions.
What will they eat? What will they wear? Where will they go to school? Will they be able to walk across the street without holding my hand? In the end, when they are grown and she is gone, will they choose right?
For any parent, raising a child can be a trial at times, but for parents like Kim, who have children with autism or mental disabilities - kids that can be among the hardest to raise - the stress is constant.
There are missed Sundays at church, fewer invitations for play dates, sideways looks from teachers. There is a slow grieving year after year for the lost chance at the emotional bonds they had expected with their babies.
Experts say the pressure is on par with that of a combat soldier's. It can be so steady for so long that the body forgets how to fight it. Chemicals in the brain go haywire.
So they swallow Xanax and Celexa and Zoloft. And they cry because sometimes, when their minds turn dark, they want to leave their babies and run away.
Helen and Heidi, the first two, now 18 and 17, were born healthy. They grew up with their mother's pale coloring and quiet temperament and their father's irreverent silliness.
But the boys and Marilyn, the youngest girl, were another story.
Their growth was stunted, and they didn't talk and walk as easily as Helen and Heidi. And as time unfolded, doctors told Kim why.
Originally doctors thought David, the oldest boy, was mentally delayed. But later, as they noticed his awkwardness in conversation, his lack of empathy for others, the diagnosis changed to Asperger's syndrome, a disorder on the autism spectrum.
Around the same time, Kenneth, the fourth oldest, was diagnosed with a more serious form of autism. He could memorize words and patterns but rarely, if ever, relate to others emotionally. He couldn't read or communicate clearly. Facial expressions, changes in conversational tone, those things didn't register in his mind.
Then Glen, the fifth, was also born sick with a heart defect that made him frailer than other children. Medications delayed his learning at school. Surgeons made a hole in his heart when he was a baby, creating tunnels because there was no place for blood to go.
Marilyn, the sixth, was a surprise pregnancy and diagnosed as developmentally disabled. As children around her spoke in full sentences and drew their names in crayon, she silently colored outside the lines.
Before her babies were diagnosed and labeled, Kim hadn't known her chances of having an autistic child were 1 in 110, just like every other mother. She didn't know that one child with autism meant the likelihood of having another.
By the time she knew for sure that her children were affected, she already had five children.
She had wanted that big family. She wanted to brag about her babies with the other mothers mingling among church pews after Sunday services. She wanted the kind of life her father had talked of wanting.
She imagined little ones dangling from her hip, running through her legs, a crowded dinner table brimming with stories.
"One child would teach the other one, and that child would teach the next one. I figured it would not be that hard," she said. "In reality, the vision changed to something else."
When the diagnoses started to pile on, Kim thought about nothing but her children. She stopped buying herself new things. She slept less, showed less affection for her husband, stopped calling old friends.
Before she had become a mother, when she was in college at Tennessee Temple University in the early 1990s, she saw herself one day as a missionary, traveling from country to country. But those dreams became nothing but journal entries as her children got older and their needs multiplied.
She waged war with the disabilities every day, fighting for slight improvements, pushing through regressions in behavior, making promises to herself that they could improve. If she worked hard enough, learned enough, they could change.
"I was always thinking of how they are behaving, how they get dressed. 'Oh man, that's a spot on their clothes. Oh, they wore the wrong socks today,'" she said.
Parents with disabled children often watch themselves disappear over the years. Their time is spent excusing their children from embarrassing situations in grocery stores, at church, at school. They find it hard to commit to their careers or improve their financial situation because of the unpredictability of their children.
Studies show the estimated lifetime cost to care for an individual with autism is $3.2 million, and medical spending is four to six times greater than for those without autism - up to $30,000 a year out-of-pocket because many therapies they want for their children aren't covered by insurance or publicly funded services, some studies show.
Parents find themselves repeating the same things: "Don't touch that ... Don't do that ... [So and so] is talking to you ... Listen ... Don't raise your voice ... Don't hit."
Kim can't forget the time Kenneth screamed at her when she tried to take an ice cream cone out of his hand at a grocery store, when the clerk had to help her talk him down.
She can't forget when David bit his sister, prompting her husband to quit his job to help protect the children from one another.
Eventually, some parents become victims of their children's disabilities. The adults can be at risk of showing autistic symptoms, subtle impairment of social skills, increasing repetitive interests and other psychiatric symptoms.
In the most-terrible cases, mothers and fathers pushed over the edge have murdered their longtime-ailing children, taking their own lives or both.
IN THE BEGINNING
In the early years, deterioration like that seemed impossible for Kim.
Her mind was buttressed by the hope of improvement. She collected books on the disabled, on parenting, on how to salvage good from the toughest circumstances.
She tried homeschooling and made small strides. When she eventually sent the children to school, she juggled the inevitable phone calls and parent/teacher meetings and behavior plans as if they were a full-time job.
She became the breadwinner so her husband, Filip, could have more of a hand with the children. She went to work at a nonprofit organization called Lifeline Inc. that helps mothers like her deal with their children's disabilities.
She enrolled in college again and the couple used their credit cards and tax refunds to pay for her to finish her undergraduate degree, her master's and then start working on her doctorate in Christian counseling from a local seminary.
One year she applied to take the family to a summer camp for the disabled. They could not afford to pay to attend so she asked her church to help them with their cost.
During those days, surrounded by families like her own, she felt that she and her children were knit together somehow.
When people met Kim's children, they often told her how happy and close all six of them seemed. They teased each other and seemed to speak a language all their own.
Other parents saw Kim and Filip and called them angels. How can you handle all this? they would ask.
No one knew how Kim was slowly crumbling.
Thoughts of suicide came unexpectedly in the fall of 2011.
Something minor would happen at work, and she would start to worry about a million shortcomings. Thoughts would snowball until she started to believe she was so worthless as an employee and a mother that there was no point to her life at all.
When she drove home from the office, she looked at the concrete curbs on the road and imagined flipping the van.
As the dread built, she wanted to tell someone, but didn't know what to say. She begged God to save her.
"Dear God, I really want to cry," she penned in her journal. "This is not fair. I am sorry I messed up. I can't do anything anymore. Please help me to understand why you want me to live and help me do it right. Lord help me."
In October, the thoughts became so regular and so serious, she admitted them to a support group at her church and her husband took her to a local hospital for help. The doctors told her she was severely depressed and needed medication but would have to wait a month to get it.
In the meantime, the doctor told her not to drive. But even looking at the family van reminded her of how much she wanted to end things. She didn't think she could survive another month.
"I can't deal with [these thoughts] anymore," she told Filip, again and again. "I need help!"
She started thinking about killing herself in other ways.
One night, when her husband was gone, driving the children somewhere, she stared at the knives on the kitchen counter and planned in her head how she would slit her wrists and bleed to death.
But before she got the knife in hand, her heart started to race and in a panic she ran to hide in her bedroom until Filip came home. When he got back, she told him she needed to go back to the mental health center.
"I need to be with you all the time," she told Filip, shaking. "I can't be by myself."
A caseworker made sure she had no knives or dangerous weapons before she was admitted for a three-night stay at Joe Johnson Mental Health Center. They prescribed her Zoloft, Remron and Invega for depression and mood stabilization.
She was scared the first night, and she wrote down her prayers to God. She was afraid that one day the children would get better and not need her anymore. And if they didn't get better, she was afraid that she couldn't be what her children needed for as long as it would take.
She worried too, that people would find out how broken she was, make her leave her job or quit school.
"Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God," she quoted to herself.
In group sessions at Joe Johnson, she realized she wasn't alone. Many others had found themselves at the end of themselves, but were still surviving. Life was full of pain, but Jesus had borne it for her, she said.
"Thank you for the gift of life," she wrote. "Thank you for the beautiful walks here. Thank you for Filip and the kids. Help me as I sort everything out. One thing at a time. One day at a time."
Still, she was afraid to go back into her world.
"I'm nervous. I don't want to leave," she told the staff when they cleared her.
"You won't know until you try," the doctor said.
In the weeks after she came home, there were still mornings when she didn't want to get out of bed, days when the alarm went off and she could hear the children rustling in the kitchen or yelling down the hall and was afraid to touch a toe to the floor.
Filip went with her to work for the first days back and stayed with her at the office. Three weeks later, she started driving again.
Kim can't really articulate why she got better in the months after her hospitalization. Colors were just suddenly brighter. Disappointments felt lighter.
The medications did their part. So did God, she says.
The daily challenges are the same. The family is still poor. The school still calls with problems. The house is still too small, too dirty.
A lot of parents with children like hers will burn themselves out under the pressure to reinvent their sick children, waiting their whole life for a dramatic turnaround.
But she says she is tired of plumbing for answers when there may be none. Autism runs in families, but the causes are unknown. Some researchers blame the environment; others blame genetics. She is as confused as anyone.
Now she resolves to live by moments, day by day, week by week. And even though it sounds cliché, that's the advice she gives to other mothers she meets at the end of their rope.
There are too many things she would have missed if she had left her family.
Helen, her oldest, plans to go to college in the fall.
Glen, 12, started drawing pictures of airplanes and Army tanks that he copies out of library books. He says he wants to be an artist one day.
David, 15, isn't as angry as he used to be and kisses Kim goodnight.
Kenneth spoke a full sentence at church last month.
It's not perfect, but it's enough to hold onto.
"Can the Lord heal them? Yes," she said. "Will he heal them? That is up to his time, I guess.
"Right now I have to love them as they are."