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Posted by Sylvia on Monday, April 19, 2004 (14:52:46)
Sentinel & Enterprise 28/03/2004
By Rebecca Deusser
LEOMINSTER - Four-year-old Zachary Zupko recently tried something for dinner other than take-out-style French fries.
That was the first time the 4-year-old had varied his dinner plans.
"Other parents don't understand this is a major milestone," said Zachary's mother, Janice Zupko. "It is a miracle."
Zachary Zupko is not a picky eater. He has autism.
But after more than a year of early intervention treatment at the Bennett School, Zachary Zupko and his parents have learned how to manage the disorder and work toward a more typical life.
Leominster and Fitchburg public school districts each hired autism specialists last spring to coordinate student needs after receiving a grant from the Massachusetts Department of Education.
Autism is a neurological disorder that negatively affects normal development of the brain in areas of social interaction and language skills.
A world of their own
Leominster has 60 autistic students in its school system, and Fitchburg has 56.
Autism is one of several Pervasive Development Disorders that vary in severity.
"It's like a child in a world of their own," said Dr. Jennifer Schott, a Leominster pediatrician who treats at least 20 patients with a Pervasive Development Disorder.
Some children with a severe case of autism may rock over and over, like Dustin Hoffman's character did in the film "Rain Man."
But autistic children have a wide range of abilities and development, said Schott.
"Autistic children tend to have problems with language and social interaction," said Schott. "When a diagnosis first comes up, I'll ask a parent if they also notice repetitive behavior such as lining up toys or playing with an object for hours."
Schott said children with social problems and repetitive behavior -- but normal language skills -- could have a different Pervasive Development Disorder, called Asperger's Syndrome.
Schott emphasized children with a Pervasive Development Disorder are not retarded, although some with severe cases can have cognitive impairments.
When autistic children reach age 3, the typical age of diagnosis, they are eligible to attend preschool in public schools.
Linda Trombi works as the liaison between preschool teachers, tutors and parents of autistic children participating in immersion classes at the Bennett School in Leominster.
Fitchburg has similar programs at the Goodrich School, the South Fitchburg School and Fitchburg High School, said autism specialist Roann Demanche.
A raw product
"We get the raw product," Trombi said. "Many children are unresponsive to their names and avoid eye contact."
The Bennett School runs two immersion preschool classes. The classroom is made up of 12 children, including six who are autistic.
Trombi said preschool teachers work with applied behavior analysis tutors, who work one-on-one with autistic children to teach basic skills such as letters, numbers and colors.
"Autistic students need to be taught in steps," said Trombi, who writes teaching programs.
A recent lesson Trombi developed helps a student learn to cut paper with scissors.
"Unlike a typical child, who might learn by observation, we need to start with a small strip of paper," Trombi said. "Then we build up using bigger and bigger pieces, until (the student) learns to cut a whole piece of paper."
While an autistic student might be ready to enter a typical kindergarten class by age 5, the child will likely behave differently from classmates.
"In many ways, it's still a mysterious (condition)," said Luke Robert, the new autism specialist for Leominster schools. "It's hard to know expectations."
Robert said while many children have social idiosyncrasies, such as outbursts or trouble staying still, the behavior of autistic children tends to be more exaggerated.
Still, many autistic children thrive in a school environment, because they are often rigid and bound to routine and rules, Robert said.
"When life becomes more predictable, life becomes better (for these kids)," Robert said.
A fear of the unknown
Janice Zupko said it's "fear of the unknown" that prevents Zachary Zupko from trying new experiences such as eating different foods.
"It's hard to get him to budge on food or to transition from one activity (such as video games) to another," Leominster resident Janice Zupko said. "It's difficult to be in his head, to try to understand where he's coming from."
Robert said intervention programs have been widely available in public schools for at least five years, but the need for stronger programs is increasing.
"It's reaching epidemic proportions," Robert said.
Public health officials do not have a clear idea of how many cases exist.
"We don't really have an idea how many children (have autism). There is limited data," said Robert Knorr, who is coordinating a statewide project to discern how many autistic children live in Massachusetts.
Knorr, the deputy director of Epidemiology in the Center for Environmental Health at the Massachusetts Department of Public Health, said the project is a first step toward finding exactly how many Massachusetts children have autism.
"If the numbers are increasing, then we need to understand why and if there is an environmental connection," Knorr said. "Numbers are definitely higher, but we don't know by how much or if it is even real."
Knorr said some studies show four to six children out of every 1,000 in the United States have autism, when previous numbers estimated only one in 1,000 children were autistic.
Results from the Massachusetts project will be released this summer.
Schott said she believes the number of autism cases is increasing because diagnosis is getting better.
Scott also said while the cause of autism is unknown, mumps-measles-rubella (MMR) vaccinations do not cause the disorder.
"The one British study (that suggested the link) was later retracted," she said.
While aggressive, early therapy gives autistic children the best prognosis, there is no drug to stop the disorder, Schott said.
"There are no medications to make it go away," Schott said.
However, some drugs can be used to treat specific symptoms, such as problems with focusing or sleeping.
Schott said parents often blame themselves when they learn their child might be autistic.
"I try to take the blame off them, because it is nothing they did," Schott said. "Many parents come to me with concerns and feel validated or relieved to get a diagnosis."
Sheila Corrado of Leominster said when her son Logan was diagnosed with autism last year, she felt denial.
"I thought, 'No way,'" Corrado said. "It took a long time to accept it."
Corrado said her 3-year-old son started the early intervention program at the Bennett School last fall.
"I feel very lucky to live in Leominster and to have this grant," Corrado said.
Janice Zupko agrees.
"Without this program, I don't know where we'd be," said Janice Zupko, who urged parents to seek testing if they suspect their child could have autism.
"The earlier the diagnosis, the better," she said. "Early intervention works for these kids. My son is an example that they can learn and do well."
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