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When Patty Manning-Courtney stands before an audience to lecture on raising autistic children, she often returns to a pivotal moment from twenty years ago that defined her career. At the time, she was a young developmental pediatrician tasked with evaluating three-year-old twin boys with bright blue eyes and strawberry blonde hair. After confirming they both had autism, the boys' grandfather asked her a question that stopped her in her tracks: âHow can you be so calm? Youâve just diagnosed both of my grandsons with autismâ.
Her responseââI know itâs going to be okayââwas something she felt compelled to say in the moment, even though she admitted she wasn't entirely sure back then what "okay" actually meant. After 25 years of practice and thousands of similar conversations, she now lectures with the conviction that this mindset is the foundation for progress, resilience, and joy.
A central theme of Manningâs message is the "soft bigotry of low expectations". She argues that if we do not expect children with autism to progress, gain new skills, or manage their behaviors, they likely won't. Instead, she advocates for assuming competenceâtalking directly to the patient rather than just the caregiver and believing in their ability to achieve milestones like sleeping through the night or using the bathroom.
Manning shares that "okay" does not necessarily mean meeting traditional societal markers of success. While the twins from her early career eventually went to college, she emphasizes that they would have been "okay" even if they hadn't. True success is found in moments like her patient Lydia, who, when asked what Manning could be to her after retirement, bypassed the expected answer of "friend" and humorously suggested "real estate agent".
Manningâs lectures also focus on the transformation of the family unit. She describes the journey from "disintegration" to finding hope and joy. Families often face immense societal pressure to "fix" their children, but Manning has watched parents move toward celebrating their children for exactly who they are.
To survive the "competitive sport" of parenting and the judgment that often comes with invisible disabilities, Manning highlights the importance of:
Perhaps the most touching part of Manning's experience is how her patients changed her. Many parents have told her they are better people because of their children, citing increased patience and a deeper appreciation for life's small thrills, like a child learning to zip a coat. Manning herself used these lessons of listening, patience, and trust to lead the operational response to COVID-19 at her Childrenâs Hospital.
Ultimately, Manning's lectures serve as a reminder that while life may throw "enormous curveballs," developing a mindset of "it's going to be okay" allows families to stand back up and make sense of their existence.
By expecting it to be okay, it often becomes so.