Recognizing autism oftentimes difficult

By Emily Richmond (contact)

Friday, May 4, 2001 | 4:48 a.m.

The videotape shows a boy at his first birthday party, excited family and friends vying for his attention. But unlike other children at the party, Jeffrey LaRoy wasn't trying to talk. He wasn't reaching for balloons or pointing at the cake.

"You can tell this little boy could care less that he's the center of attention," said Dr. Johanna Fricke, who uses the video of Jeffrey to teach students how to diagnose autism early. "It breaks your heart."

The signs so clear to Fricke, an associate professor of pediatrics at the University of Nevada School of Medicine, were all but invisible to Jeffrey's parents, who had neither the training nor the expertise to recognize the early signs of the neurological disorder.

"Some parents talk about a moment when a light bulb goes off, but for us it was much more gradual," said Florence LaRoy, now an advocate for parents of children with disabilities. "My greatest regret is that we didn't realize sooner, and that Jeffrey lost so much valuable time when he could have been getting help."

Jeffrey wasn't diagnosed until age 5. A diagnosis as early as 18 months is possible, although most children begin showing symptoms at about age 2 1/2. Autistic children often fail to bond with other people, even their parents. They may display unusual repetitive behavior, such as rocking themselves or repeating a single word. Some are nonverbal. Others have difficulty expressing themselves through words or actions.

A standard screening test for autism at 18 months uses nine questions. Two or more "No" answers could point toward autism, Fricke said.

Does your child:

Enjoy being swung or bounced on your knee?

Ever pretend to feed themselves or a doll from an empty cup or plate?

Use their index finger to point at objects of interest?

Take an interest in other children?

Enjoy playing peek-a-boo or hide-and-seek?

Bring over objects to show you?

Use their index finger to point to ask for something?

Play properly with small toys such as cars or blocks without just mouthing, fiddling or dropping them?

Enjoy climbing on things, such as stairs?

Pediatricians require more training to make an early diagnosis of autism, which is critical to a child's success in therapy later, Fricke said. Some pediatricians miss warning signs not because they're careless, but because autism wasn't part of the curriculum when they were in medical school, Fricke said.

Fricke said the Hollywood image of autistics as "savants" is inaccurate. Although some autistic people demonstrate special skills in music or mathematics, most do not, and 85 percent of autistic people have some degree of mental retardation.

Although there is no known cause or cure, autism is not brought on by bad parenting, Fricke said. It also knows no social, economic or racial boundaries. The disorder's spectrum ranges from mild to severe.

Autism isn't unlike quicksand. The parents pull with all their strength to free their children and rejoice over each small gain. But fighting the disorder requires constant vigilance. To let up is to watch the child slide back into autism's sucking grasp.

"It's exhausting, both physically and emotionally," LaRoy said. "You can't turn your back for an instant."

The most effective treatment is intensive, repetitive behavioral adjustment, Fricke said. Autistic children must be taught everything, from the simple command of "Watch me" to how to respond when someone smiles at them. One aspect of the therapy is identifying what triggers problem behaviors and teaching the child new ways to respond, she said.

In addition to being expensive -- some treatment programs require up to eight hours a day of therapy at a cost of $30,000 a year -- the behavioral adjustment can be frustrating for both the parents and child.

Many autistic children have a heightened sensitivity to noise and touch. Some problems can be solved by changing the environment, such as carpeting classrooms to reduce echoes. But those are short-term solutions, said Jan Crandy, whose 7-year-old daughter, Megan, is autistic.

"The world isn't going to change for our children," Crandy said. "We have to prepare them for that reality."

It took years for Jeffrey LaRoy, now 17, to adjust to such common sounds as a vacuum cleaner and the garbage truck's semiweekly visits, his mother said. Other sounds, such as crying babies, continue to frighten him.

"When he sees a baby he gets upset even if it isn't crying," LaRoy said. "He anticipates the problem and that can set him off. We're working on that."

Outside his parents' Las Vegas home, Jeffrey talks about his rabbit, Patches, and plans for a weekend trip to Catalina Island. When asked about school, Jeffrey sounds like any aggrieved teenager with too much homework.

"It can be a real pain," he says, gazing determinedly away from his visitors.

While the emotional toll is great, parents of autistic children aren't looking for sympathy.

Jackie Roundtree of Elko, whose severely autistic daughter is still in diapers at 13, said she can't imagine her life any other way.

"When she kisses me good night or smiles at me, I know what love really is," Roundtree says.