"Remnants"

by Fred Chappell
originally published Cthulhu's Reign, 2010

The star-headed old ones have revived and taken over the earth.  Most humans have been killed outright or experimented on, then killed.  Only scattered survivors remain.  Vern, a teenage boy, his autistic sister Echo, their mother, and their dog, Queenie, live as scavengers in the wilderness, eating and taking shelter when and where they can, and avoiding the star-heads and shoggoths.  The star-heads are busy terraforming the entire planet into something more to their liking.  Echo is a telepath, and "Moms" and Vern have to deal with her visions, which are confusing, sometimes helpful, sometimes dangerous.

In space, a small ship and crew searches for survivors on earth. They are from a different race, who have also been rescued from the old ones, who are taking over other planets as well.  They too have a telepath, who reaches out to Echo, though the girl's mind is difficult to read or communicate with.

Vern/Echo/Queenie/Moms take refuge in a cave, where Vern finds the remains of a previous group who apparently committed suicide rather than being taken by the old ones.  He is despairing, but Echo continues to receive messages from the rescuers, though it is almost impossible for her to communicate them coherently to her family.  Finally, they make contact with the rescuers and set out for a new life in the stars.

A memorable, slightly disturbing story with a positive outcome.  Chappel remains one of the most literate Lovecraftians.