Author name: Ahmad

Written by Stephen M. Edelson, Ph.D. Center for the Study of Autism, Salem, Oregon Autistic individuals typically have problems processing auditory information. One auditory processing problem occurs when a person hears speech sounds but he/she does not perceive the meaning of the sounds. For example, if someone says the word ‘shoe,’ the person may hear the speech sound, but he/she does not understand the meaning of the sound. Sometimes the lack of speech comprehension is interpreted by others as an unwillingness to comply. However, the person may not be able to retrieve the meaning of the sound at that particular time. Eric Courchesne of the University of California at San Diego has found significant impairments in auditory processing in autistic individuals using P300 brain wave technology (see Courchesne, 1987 for a review). The P300 brain wave occurs 300 milli-seconds after the presentation of a stimulus. (The ‘P’ refers to the positive polarity of the brain wave.) The P300 is associated with cognitive processing, and this brain wave is considered an indication of long-term memory retrieval (Donchin, Ritter, & McCallum, 1978). Edelson et al. (1999) examined auditory P300 activity prior to and three months following auditory integration training (AIT). Three autistic individuals participated in the experimental AIT group and two autistic individuals participated in a placebo group. Prior to AIT, all five individuals had abnormal auditory P300 activity, indicating an auditory processing problem. Three months following AIT, the results showed dramatic improvement in P300 activity for those who received AIT (i.e., a normalization of P300 activity) and found no change in those who received the placebo. We do not know the underlying reason for auditory processing problems in autism; however, autopsy research by Drs. Bauman and Kemper have shown that an area in the limbic system, the hippocampus, is neurologically immature in autistic individuals (Bauman & Kemper, 1994). The hippocampus is responsible for sensory input as well as learning and memory. Basically, information is transferred from the senses to the hippocampus, where it is processed and then transferred to areas of the cerebral cortex for long-term storage. Since auditory information is processed in the hippocampus, the information may not be properly transferred to long-term memory in autistic individuals. Auditory processing problems may also be linked to several autistic characteristics. Autism is sometimes described as a social-communication problem. Processing auditory information is a critical component of social-communication. Other characteristics that may be associated with auditory processing problems include: anxiety or confusion in social situations, inattentiveness, and poor speech comprehension. Interestingly, those individuals who do not have auditory processing problems are often ‘auditory learners.’ These children do very well using the Applied Behavior Analysis (ABA) approach, whereas those who are visual learners do not do as well with this approach (McEachin, Smith and Lovaas, 1993). Given this, one might suspect that many visual learners have auditory processing problems and that visual learners will do quite well with a visual communication/instruction approach. It is also possible to provide visual support with ABA programs that have an auditory component. In this way, the visual learner can process the auditory information more easily. The better autistic children understand auditory information, the better they can comprehend their environment, both socially and academically. The better we understand the autistic child, the better we can develop ways to intervene in an effective manner. References Bauman, M.L., & Kemper, T.L. (1994). Neuroanatomic observations of the brain in autism. In M.L. Bauman & T.L. Kemper (Eds.), The neurobiology of autism. Baltimore: Johns Hopkins UP. Courchesne, E. (1987). A neurophysiological view of autism. In E. Schopler & G.B. Mesibov (Eds.), Neurological issues in autism. New York: Plenum Press. Donchin, E., Ritter, W., & McCallum, W.C. (1978). Cognitive psychophysiology: The endogenous components of the ERP. In E. Callaway, P. Tueting, & S. Koslow (Eds.), Event-related brain potentials in man. New York: Academic Press. Edelson, S.M., Arin, D., Bauman, M., Lukas, S.E., Rudy, J.H., Sholar, M., & Rimland, B. (1999). Auditory integration training: A double-blind study of behavioral, electrophysiological, and audiometric effects in autistic subjects. Focus on Autism and Other Developmental Disabilities, 14, 73-81. McEachin, J.J., Smith, T., & Lovaas, O.I. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal of Mental Retardation, 97, 359-372

By Victoria Katsarou Research at the Yale Developmental Disabilities Clinic promises to revolutionize physicians' approach to autism by providing an opportunity for earlier diagnosis of the disorder. Dr. Fred Volkmar, co-head of the clinic, said the research offers an entirely new way of thinking about and treating the condition. The two-part experiment was led by Dr. Rhea Paul and subjected 30 autistic and 30 unaffected toddlers between the ages of 18 and 36 months to the same auditory stimuli in order to discern the extent to which autistic and other children reveal the same sound preference. According to Paul, at the age of seven to ten months, toddlers normally "tune in to the language they are learning and show preference towards the specific kinds of sound structures that they are attempting to learn." Paul holds a joint appointment at Southern Connecticut State University and the Yale Child Study Center. She is a professor of communication disorders and pursues research on autism and related disabilities, attempting to compare the auditory preferences of toddlers with autism to those of other children in similar age groups. The experiment's first part focused on toddlers sitting in their mothers' laps in a booth while various sounds were broadcast from one of two sides. Parents wore headphones so as to not influence the children's reactions to the sounds. Paul measured the how often and for how long toddlers turned their heads in response to those sound structures resembling normal speech. Children with autism revealed a preference toward speech-resembling sound structures, but they responded less strongly than normal children. Additionally, autistic children kept their heads turned in the same direction for much longer periods of time. Paul also measured the amount of time that toddlers concentrated on speech with pauses placed at the end of clauses and sentences, as opposed to speech with abnormal pauses. Again, the preferences of autistic children were very similar to those of normal ones, but much weaker. "Distinguishing between these two forms of speech is an important ability: it represents one of the ways through which children learn about grammar," Paul said. "These results reveal that autistic children have no defects in their basic equipment for breaking language down. They have the tools, but they are unable to spend the same time listening." The discovery shed light on new ways of dealing with autism. Historically, researchers have placed the greatest focus on developing autistic children's speaking skills. But Paul said autistic children's exposure to language proves more beneficial than efforts to make them talk. "It wouldn't help to just talk more to them," Paul said. "When the child is looking at you while you're talking, you have to give it some form of reinforcement in order to capture its attention." These results suggest a means of measuring the different preferences displayed by autistic children, which could contribute to earlier diagnosis of the condition. Dr. Ami Klin, co-head of the Developmental Disabilities Clinic at the Yale Child Studies Center, identified this possibility of earlier diagnosis as the most important contribution of the experiment. "Children's preference for speech sounds as opposed to other sounds in their environment is one of their most important mechanisms of socialization," Klin said. "We knew that children with autism are born without this preferential attention. The trick was how to measure that. By being able to measure it, we can maximize the outcome of our treatment. The earlier we identify children with autism, the earlier we can provide treatment and the better the response that we will get."

Written by Stephen M. Edelson, Ph.D. Center for the Study of Autism, Salem, Oregon One reason why some autistic individuals engage in behavior problems is to obtain attention. That is, they may have learned that by ‘acting up,’ they will receive some form of attention (i.e., reinforcement). Even though the attention given to them may be negative, such as a caretaker saying ‘Stop that,’ the child may still interpret the interaction as positive. If a person tends to receive attention following a behavior problem, then the caretaker should do his/her best to ignore the behavior. If this is not possible because the person may hurt him-/herself or others, then the caretaker should minimize contact with the individual while displaying little or no facial expression (neither approving nor disap-proving). Consistency is very important because the behavior problem will continue if the individual receives intermittent attention for the behavior. In fact, the behavior will be stronger and more resistant to extinction if intermittently reinforced. Several behavioral strategies have been developed to provide attention to an individual but not contingent on the behavior problem. These strategies include: Differential Reinforcement of Appropriate Behavior (DRA) - The person receives attention to an appropriate behavior (determined in advance). For example, if the person works on a specific task for a certain amount of time and does not engage in the behavior problem, then he/she is given positive attention. Differential Reinforcement of Other Behavior (DRO) - Attention is provided to the person for any appropriate behavior. For example, if the person acts, in general, appropriately during a certain period of time and does not engage in the behavior problem, then he/she is given positive attention. Differential Reinforcement of Incompatible Behavior (DRI) - Attention is given to behaviors that are incompatible with the behavior problem. For example, if the person, who is known to tantrum, sits quietly for a certain amount of time, then he/she is given positive attention. Functional analysis. It is important to conduct a functional analysis of the person's behavior problem in order to determine whether the behavior serves to obtain attention or occurs for some other reason (e.g., to avoid a demanding situation). The information obtained from a functional analysis should include: Who was present? What happened before, during and after the behavior? When did it happen? and Where did it happen? Attention is important for social development, and it is natural for a person to seek attention from others. Thus, individuals with autism and other related disorders should receive attention, but the attention should not be contingent on a behavior problem.

A thought I shared... figured so many others could maybe use it... here it is.... from Donna Williams www.nobodynowhere.com Sometimes we become all we are because of family and all they gave us. Sometimes we become all we are in spite of family (or lack of) and all they did not give us. Sometimes we can despair and wait to be found, resenting all who try to raise us up because they are not the one's who 'should have'. Sometimes we stand outside of our pain for a moment and view ourselves from the perspective of the benevolent stranger, pick ourselves up from off the side of the road where we got lost and carry this person a while, hearing them out, helping them air off and answer their own questions in the process, complain and come to determination to build their own life, from scratch if necessary, without self love if necessary, if only out of being sick of waiting, being sick of being lost, being sick of envying all who got luckier than we did. I realised after I did all this stuff that I so loved life and that I loved it so much BECAUSE beauty, however simple, contrasts so strikingly ESPECIALLY when contrasted against what is ugly and unfair and then I stopped resenting and felt luckier, even luckier than those who could have it all and yet it may feel like nothing too significant for they had never carried that 'endless dark night of the soul' long enough to truly appreciate its value. :-) Donna Williams www.nobodynowhere.com www.donnawilliams.net

Dear Donna, I am co-founder of a group called aspies for freedom. I have found your books and approach very inspiring, I am diagnosed with AS and my son is too. One of the main aims of aspies for freedom is to fight against the idea of a cure for us. We dont want to lose who we are, and have future autistics wiped through genetic screening. Could you give your opinion on a cure, or support us in anyway, have a look at our website? Many thanks for your time, Amy Roberts. http://as4freedom.proboards32.com/ Dear Amy, Thanks for your letter asking for my view on Aspies for Freedom and your concerns about the push to 'cure' Autism. I felt the reply and the topic were worth a wider forum so I've sent my reply back to you but also out on the airwaves. As a consultant in the field of Autism for the last ten years I have seen many people diagnosed at both the Autistic and Asperger's end of the spectrum. I have found that Aspies are a far more homegenous group than those with Autism. The only thing the whole lot generally have in common is that of having a different style of information processing, generally in that they are 'mono-tracked' in a 'multi-track' world but saying that, the underlying causes of this are different for different people. Where those causes are to do with a delayed development in neurological integration these things will likely be fairly fixed for life and I totally support you in saying that this style of information processing needs to be supported on all levels as that person's 'normality'. This is often far more the case among the Aspie community than among the Autie community. In the Autie community, the delay in neurological integration is often dramatically improvable where gut/immune/toxicity issues are treated so that information processing capacity is freed up and neurological integration ends up kicking in. Immune deficiency is known to effect around 20% of people diagnosed as Autistic and I'm sure you'll appreciate that it would be equally inhumane to treat immune deficiency. Personally, I was sick every six weeks for most of my life, with bugs lasting up to 3 months at a time till my lungs were too weak to cough and I had to hang upside down off the side of the bed to drain much from my lungs. I feared suffocation in my own lung infections, my throat was often too infected to swallow without great pain and I spent most of my childhood with chronic ear infections. So you can appreciate that such things MUST be treated and cured and that if that decreases the level of someone's information processing issues, then so be it. Up to 60% of children with Autism have Salicylate intolerance causing them sometimes painful and socially limiting inflammatory bowel problems, often excruciating excema, recurrent infections and fragmented vision so severe they may never be able to read or recognise a face and may be 'object blind' and essentially stuck in a purely sensory world. Whilst I've been there and loved that world where interpretive meaning did not exist, any Aspie who can enjoy reading and books and recognise the face of their partner when walking in a supermarket together will know how essential treatment for such toxicity issues can be. Auties with this severity of problems are not asking to be non-autistic, just to be less terrified and gain access to the world of meaning. Most who do so won't be non-autistic but in fact simply more Aspie than Autie. Up to 30% of children with Autism will have Rapid Cycling Childhood Bipolar according to the National Autistic Society UKs website. This bipolar state in its extreme can fluctuate up to several times a day and result in severe self injury, violent behaviours and real endangerment to self and others. In this state I have attacked myself ferociously and had no idea this was my body, I have kicked people down stairs, I have run at furniture over and over smashing myself into it, I have believed I could fly and wanted to jump off buildings and I have believed I could control traffic and would walk out infront of oncoming cars and the emotional extremes from before age three left me traumatised at the overwhelming power of emotion to the degree I became terrified of feelings and being overstimulated be external initiations and the constant extremes and utter loss of control severely effected peronality development, trust in interaction and sense of self. The contant taxing of my health by such states underpinned much of the immune deficiency meaning it condemned me to chronic infections and eventually chronic fatigue. It would be utterly inhumane to not treat a severe Bipolar condition in an adult and the same is true of an affected child where such Bipolar is being labelled part of their Autism. So again, whilst I of all people no the glories of Bipolar, I acknowlege what it costs and takes and I would impose on no child that they be refused treatment for a traumatising medical condition. One could argue the same is true of children who have severe endogenous Depression leading to severe rigidity, mutism and withdrawal. It would be inhumane to refuse any person treatment for depression, including a child. Of course environmental causes for depression should always be addressed first. A large percentage of children with Autism have (often treatable) Obsessive Compulsive Disorder and Tourette's and in a severe degree this can be overwhelming, bring on depression, severely exaccerbate social phobia and make children prisoners in their own body. I have had compulsive coughing of Tourette's so badly at 2 years old that I was hospitalised for coughing up blood constantly as a result. I have had tics to slap myself to the degree my jaw was riddled with abscesses. I have had OCD so badly I became terrified of breathing in an uneven

Brief Details Managers are actively passing over mildly Autistic employees for promotion because they do not have good social skills, a practice that is waiting to backfire at an employment tribunal. Employers in industries where autism rates are high are setting themselves up for a range of tribunal cases especially when the European Union's discrimination legislation is fully implemented in the UK, it was claimed today. Chartered Clinical Psychologist, Dr David Ruthenberg, told HR Gateway that many employers are passing over Asperger's suffers for promotion as they lack the 'soft skills' demanded of managers: 'In my experience of working in the "Golden Triangle" around Cambridge, employees are feeling very frustrated by colleagues leapfrogging them into management positions because of their lack of social skills. 'This is a time bomb waiting to go off, especially when EU legislation is fully implemented in the UK, as there are many ways to help them. BT, for example, actively recruits Asperger's suffers through the National Autism Society for certain roles and career paths. There is no excuse,' he said. Currently working with Nortel, Ruthenburg warns that industries such as IT, engineering and pharmaceuticals are some of the most at risk, but many steps can be taken to help sufferers, and not steps that demand a severe amount of company reorganisation: 'Managers need to be educated on matters of Asperger's and Autism, while firms could take into account the personality of sufferers. Open plan spaces and networking all go against the Apserger personality. Sitting in a small office undertaking meticulous tasks that need attention to detail is what would suite them. 'Many firms have the problem that sufferers tend to be very bright, talented people which they end up losing because they do not understand their position. Create roles for them where they can excel and advance so that they are not looked over for promotion,' he advised. Rates of Asperger's in the population may be as high as one on 100 although the diagnosis is difficult. It is caused by different hardwiring in the brain meaning social skills, planning and the inability to learn from previous social encounters may be prevalent. Suffers may have mild obsessions about personal behaviour or domestic rituals which could concern colleagues unless they understand that it is necessary to reduce personal anxiety.

After years of campaigning by the parents of Piers Bolduc - a young man with Asperger syndrome who was incorrectly diagnosed as schizophrenic and incarcerated in Broadmoor - health chiefs have finally promised that moves are in hand to secure his release. Stephen Ladyman, minister responsible for mental health, told Piers' MP David Liddington that he would ensure the 28-year-old (who has spent nine years in the special hospital for the criminally insane) was released as "expeditiously as possible." That was more than a month ago; since when inertia at the Home Office and Department of Health has meant that a precious place secured for Piers at The Hayes, a special centre in Bristol for those with Asperger's (the high-achieving end of the autism spectrum) has gone to someone else. Thus Piers remains wrongly locked up for slightly wounding a young man with a penknife while taking powerful anti-psychotic drugs he should not have been prescribed. Piers' case, first highlighted in the Sunday Telegraph, is far from isolated. Stephen Ladyman told the Commons that 31 people with autism, 21 of those with Asperger's, were held in three special hospital. But many more are inappropriately detained, sectioned under the mental health act in secure psychiatric wards, hospitals, care homes and units for those with learning disabilities having suffered misdiagnosis and inappropriate treatment, often with powerful anti-psychotic drugs. The one positive aspect of Piers' detention in Broadmoor was that his condition was recognised and steps were taken to wean him off the drug cocktail that had worsened his condition. The same cannot be said for Matthew Thomas, now 43, who has been in and out of hospital since he was 17. Matthew was sucked into the mental health system in 1978 when a breakdown during his exams led, as with Piers, to a wrongful diagnosis. His parents, Jackie and Geoff Thomas, have been unable to get their son out of the system. Even though Asperger's was finally diagnosed nine years later, Matthew remained on the cocktail of anti-psychotics, tranquillisers and anti-depressants he has taken most of his life. To his parents Matthew had always appeared a "bit different." But it was not until he was studying for his "O" levels that he suffered what everyone thought was a mental breakdown. He was taken into "The Priory" in Roehampton and was diagnosed as schizophrenic. His parents, then knowing nothing of Asperger syndrome, went along with the diagnosis. It led to two prolonged sessions of electro-convulsant therapy (ECT) and a cocktail of powerful drugs - his parents list no fewer than 23 different ones in those early years. As they watched their son get worse, only one Registrar dared challenge the diagnosis and suggest Matthew's schizophrenia was "atypical." His already sceptical parents read everything they could and became convinced Matthew was not schizophrenic. They sent him to the US where the diagnosis was finally overturned. Back in the UK a year later at the Maudsley, he was officially diagnosed with Asperger's and his parents were told he "did not have one schizophrenic feature." Nick Priechenfried was only 14 when he was given his first dose of anti-psychotic drugs by a GP. Although another doctor took him off them, the reprieve was short-lived. Nick was correctly diagnosed with Asperger's but seven years later he was still sectioned and diagnosed as schizophrenic and put on the cocktail of psychiatric medicine his mother says wrecked his life. (cont'd.) He ended up in the Medium Secure Unit at Horton Hospital, Epsom, with very ill and disturbed patients. Even though leading autism experts confirmed the diagnosis of Asperger's, Nick's treatment with powerful anti-psychotics continued. Following other disastrous placements, Nick eventually went to the Eric Shepherd Unit in Hertfordshire. Three years ago, psychiatrists there weaned him off all medication, resulting in a huge improvement in both his mental and physical health. As Nick says: "If you are put on anti-psychotics when you do not need them, you soon develop a psychosis." What has happened to people like Piers, Matthew and Nick is nothing short of scandalous. But it is a simple message that they and their parents have been trying to convey to Stephen Ladyman and his fellow health chiefs. Not only is the continuing misdiagnosis, treatment and inappropriate placements for people with Asperger's devastating for those involved, it actually costs millions. An investment in proper services now - particularly with the huge increase in children being diagnosed on the autistic spectrum - would save money in the future. Why isn't the government listening?

From the September-October 2002 issue of the Autism Asperger’s Digest magazine By David F. Freschi Q: I am a new aide and the classroom teacher does not provide me with much direction. I’m not sure what I’m doing is best for the child with autism I work with. Help! Q: The school has agreed to hire an aide for my son, who has autism. I get the impression they don’t have a clue as to what this person should be doing. What should the aide be doing? Q: What exactly is the role of the paraprofessional? The aide in my classroom seems to think that her role is to replace me in my job. What do I do? So you’ve got an aide, now what do you do? There has been steady growth in the number of paraprofessionals in our schools, especially those assigned to work with children with Autism, Asperger’s, and similar challenges. Each of the three questions above highlights common themes and concerns that arise when employing a paraprofessional for the student with Autism/Asperger’s: 1. What is the role of the paraprofessional? 2. What knowledge and skills does this person need to be effective? 3. How do we make good use of this resource? A paraprofessional can provide tremendous benefit but also pose significant risks. On the plus side, the paraprofessional can support the student’s learning, help to develop social skills, support other students, allow the teacher to focus on teaching strategies, and promote functional application of curriculum knowledge. On the down side, the paraprofessional can increase dependency, slow the development of communication, sabotage the school/home relationship, and interfere with integration and interaction with peers. The Role of the Paraprofessional There are some pretty straightforward Do’s and Don’ts for a paraprofessional working within the school system. The primary role is to assist the teacher in helping the child have a successful educational experience. Their job is to support learning and social skills and help the child expand his/her communication. They can be of great benefit with behavioral issues by coaching the child in working with other students, modeling appropriate behaviors and offering suggestions for alternative behaviors. The paraprofessional will often be the person that deals with issues as they come up in the “real” world. They are the ones who might have to deal with the meltdown in the lavatory, navigating the hallways, or interacting appropriately on the playground. They also have the opportunity to support academic skills learned in the classroom. “Count the spoons at your table, John.” “Before you go up the slide you need to use your words.” “That is a beetle. What did we learn about beetles?” It is not the paraprofessional’s job to be the student’s personal servant, to over rule the teacher or sabotage her plans, or be a private information source for parents on what the school is doing wrong. Once this type of behavior starts, disaster is usually not far behind. Required Skills and Knowledge In working with various school systems, classroom teachers and paraprofessionals themselves, we have identified a cluster of skills that all paraprofessionals need to have to be successful with their students. These skill areas are: • Basic knowledge of the disability. How does the disability impact the child’s learning? Do you know what visual learning is? What will we do when the child follows a direction literally when that is not what the teacher meant? Will we talk more or less when the child is having a tantrum? When the schedule is disrupted how will we handle it? All of these situations and more will happen on a daily basis. Without some basis for understanding the disability, the child often ends up paying for our mistakes. Every child is a unique individual, and a few mistakes here and there will happen. However, lack of a sound understanding of autism/AS and the outward manifestations of the disability will result in harm to the child through lost time and inappropriate or ineffective teaching methods. At the barest minimum, the paraprofessional should have taken an introductory course in Autism or Asperger’s that includes a discussion of effective teaching techniques in relation to behavior, communication and sensory issues. There are a number of these available. • The use of reinforcement. The use of reinforcement and motivators is critical for learning. With students who may not respond well to social reinforcement, knowledge of reinforcers and the skillful use of reinforcement become very important. We must know when to reinforce, how often to reinforce, how to fade and how to increase expectations. Furthermore, paraprofessionals need to be keen observers of children with autism/AS to ascertain what types of reinforcers will be important and meaningful to a particular child. No two children with autism are alike; having an assortment of meaningful reinforcers is a must. Observation is another skill that needs to be learned and practiced. It does not come naturally. • Supporting and promoting communication. The paraprofessional must know what the student’s communication system is and how to use it to promote initiation and independence. They will often be the one who has the real life opportunities to help the child communicate with peers, other people in the school and in the community. • Knowledge of behavioral intervention techniques. Mistakes can be costly in dealing with students who have behavioral challenges. The para needs to know how to reinforce acceptable behavior and how to avoid strengthening negative behavior. They need to know how to avoid “blackmail” situations and that just because; “It worked with my kids at home.” it may not be appropriate for these students. Also, with the last revision of the Individuals with Disabilities Education Act (IDEA), paras need to be well-versed in Positive Behavior Interventions, Strategies and Supports or at a minimum, know what they are and how to best implement the plan put forth in the student’s IEP. • Promoting independence. (Arguably the most critical of all) One of the most frustrating, difficult, and debilitating problems for

By Jane Gross Sixth grade was a trying time for Karen Singer's autistic son, who spent recess wandering the periphery of the playground by himself and sometimes hid in the school bathroom when he needed a safe place to cry. He knew he was doing something wrong as he reached the social crucible of middle school, but he did not know how to fix it. At home he begged his mother to explain: "Why am I like this? What's wrong with me? Intensive behavioral treatment, popularized over the last 10 years, prepared him academically and helped him get by in regular classes for years. But social skills are more elusive for autistic children, and the gap widens with each passing year. Classmates who once tolerated his peculiarities now shunned him. Their interests had changed to hanging out and being cool, while he remained preoccupied with saltwater fish and Yu-Gi-Oh trading cards. During group projects the boy rigidly held his ground on small matters, like what color ink to use. When challenged, he blurted out, "You're stupid!" or other inappropriate retorts. "It was shocking how it all of a sudden fell apart," said Ms. Singer, who asked that her son, now 13, not be identified by name or hometown and thus be further stigmatized. "He'd never say, 'I don't want to go to school.' He'd make it through the day, then come home and melt down." Last fall the Singers moved their son to a private school for children with learning disabilities, persuading him that it was not a failure but rather an opportunity to feel less anxious. And he does. The Singers' anguished choice is an unintended consequence of improved diagnosis and new behavioral therapy. A generation ago most autistic children would have been written off as hopeless. Now, as their numbers are increasing, many learn to speak and to tame their most difficult behavioral traits. They are autism's success stories, moving from one-on-one instruction to typical public school settings. Last year 27 percent of this country's 141,022 autistic children were educated in public school classrooms with normal children, up from 11 percent of the 22,664 autistic children of a decade ago. But these high-functioning children face a host of new problems as they approach adolescence, when social interactions become more complicated. Parents, educators, researchers and clinicians all say that the majority of such children become conspicuous in the third grade and are bullied or ostracized by the time they reach middle school. Dr. Sandra L. Harris of Rutgers University, a pioneering educator and researcher in autism, said advances might have fed false hopes. "The intellectual skills of some of these children may lead people to expect more than is possible socially," Dr. Harris said. "They miss so much nuance that it can't be fixed in a 100-percent way. That was the hope. Now we know it's more elusive than that." Christine Grogan, the director of a school for autistic children in Paramus, N.J., urges educators to be cautious about what they promise parents, adding, "There are many people in the field giving false hope" about whether remaining in the mainstream is realistic for more than a tiny number of children over the long haul. Virtually nothing in the social arena comes naturally to autistic children. They must be taught how to have a conversation. To show empathy by asking questions. To resist arcane topics that do not interest others. Not to talk too loudly or to stand too close to the other person. To master the vocabularies of sports and flirting. Even those with I.Q.'s above average struggle to read body language or to imagine what other people are thinking. If they learn a joke, they may tell it a dozen times. They are too literal-minded to understand white lies and too rule-bound to understand they should not tattle. They overreact to routine teasing and invite ridicule by carrying their books over their heads or accepting a dare to kiss a girl.

This from Dennis Debbaudt's Autism Risk & Safety Newsletter - Winter 2005 edition. His newsletter, plus a Spanish version of this article can be had here To ensure safety and lower risk for a child or adult with autism, parents and care providers will need to become proactive and prepare an informational handout. A leading cause for for concern are children and adults who run away or wander from parents and care providers. Tragically, children and adults with autism are often attracted to water sources such as pools, ponds, and lakes. Drowning is a leading cause of death for a child or adult who has autism. Wandering can occur anywhere at anytime. The first time is often the worst time. Another concern is preparation in the event that you become incapacitated or injured while caring for a person with autism at home or in the community. An informational handout should be developed, copied and carried with you at all times--at home, in your car, purse or wallet. Also circulate this handout to family members, trusted neighbors, friends and co-workers. The handout will also come in handy if you are in an area other than your neighborhood and are approached by the police. If wandering is a concern, contact law enforcement, fire and ambulance agencies. Ask your local 911 call center to "red flag" this information in their 911 computer data base. Dispatchers can alert patrol officers about your concerns before they arrive. When we provide law enforcement with key information before an incident occurs, we can expect better responses. Alert your neighbors The behaviors and characteristics of autism have the potential to attract attention from the public. Law enforcement professionals suggest that you reach out and get to know your neighbors. Decide what information to present to neighbors Plan a brief visit to your neighbors Introduce your child or adult or a photograph Give your neighbor a simple handout with your name, address, and phone number Ask them to call you immediately if they see your son or daughter outside the home This approach may be a good way to avoid problems down the road and will let your neighbors: Know the reason for unusual behaviors Know that you are approachable Have the opportunity to call you before they call 911 Knowing your neighbors can lead to better social interactions for your loved ones with autism. Prevention If wandering is an issue for your family, consider contacting a professional locksmith, security company or home improvement professional. Autism Emergency Contact Handout Model Name of child or adult Current photograph and physical description including height, weight, eye and hair color, any scars or other identifying marks Names, home, cell and pager phone numbers and addresses of parents, other caregivers and emergency contact persons Sensory, medical, or dietary issues and requirements, if any Inclination for elopement and any atypical behaviors or characteristics that may attract attention Favorite attractions and locations where person may be found Likes, dislikes--approach and de-escalation techniques Method of communication, if non-verbal sign language, picture boards, written word ID wear jewelry, tags on clothes, printed handout card Map and address guide to nearby properties with water sources and dangerous locations highlighted Blueprint or drawing of home, with bedrooms of individual highlighted * * *