MENTAL HEALTH NEWSTM YOUR TRUSTED SOURCE OF INFORMATION, EDUCATION, ADVOCACY AND RESOURCES SUMMER 2006 FROM THE LOCAL, STATE, AND NATIONAL NEWS SCENE VOL. 8 NO. 3 Understanding and Treating Autism Spectrum Disorders National Institute social overtures, something is wrong. Re- of Mental Health (NIMH) search has shown that parents are usually correct about noticing developmental prob- lems, although they may not realize the spe- ot until the middle of the twen- cific nature or degree of the problem. tieth century was there a name The pervasive developmental disor- for a disorder that now appears ders, or autism spectrum disorders, range N to affect an estimated one of from a severe form, called autistic disor- every five hundred children, a disorder der, to a milder form, Asperger syndrome. that causes disruption in families and un- If a child has symptoms of either of these fulfilled lives for many children. In 1943 disorders, but does not meet the specific Dr. Leo Kanner of the Johns Hopkins criteria for either, the diagnosis is called Hospital studied a group of 11 children pervasive developmental disorder not and introduced the label early infantile otherwise specified (PDD-NOS). Other autism into the English language. At the rare, very severe disorders that are in- same time a German scientist, Dr. Hans cluded in the autism spectrum disorders Asperger, described a milder form of the are Rett syndrome and childhood disinte- disorder that became known as Asperger grative disorder. syndrome. Thus these two disorders were described and are today listed in the Diag- What Are nostic and Statistical Manual of Mental The Autism Spectrum Disorders? Disorders DSM-IV-TR (fourth edition, text revision) as two of the five pervasive be reliably detected by the age of 3 years, unusual behaviors in their child. In some What are the Autism Spectrum Disor- developmental disorders (PDD), more and in some cases as early as 18 months. cases, the baby seemed "different" from ders? The autism spectrum disorders are often referred to today as autism spectrum Studies suggest that many children eventu- birth, unresponsive to people or focusing more common in the pediatric population disorders (ASD). All these disorders are ally may be accurately identified by the age intently on one item for long periods of than are some better known disorders characterized by varying degrees of im- of 1 year or even younger. The appearance time. The first signs of an ASD can also such as diabetes, spinal bifida, or Down pairment in communication skills, social of any of the warning signs of ASD is rea- appear in children who seem to have been syndrome. Prevalence studies have been interactions, and restricted, repetitive and son to have a child evaluated by a profes- developing normally. When an engaging, done in several states and also in the stereotyped patterns of behavior. sional specializing in these disorders. babbling toddler suddenly becomes silent, The autism spectrum disorders can often Parents are usually the first to notice withdrawn, self-abusive, or indifferent to see NIMH Reviews ASD on page 32 In Our House: This is Aspergers By Debra Bloomgarden “Mostly, relief that you didn’t tell me sections of the bookstores, pouring usually very noisily. And on “toast days,” Mother of an Asperger’s Child there was nothing going on,” I told her through websites, and making phone calls. nothing helps—the meltdowns just wash quietly. There were some things that were some- over in waves—when something as sim- For most of my daughter's life, my what familiar but other things that were ple as the butter melting in the “wrong asked, “What do you think this is?” husband and I had been quietly asking harder to understand. We asked more pattern” on the toast becomes the domino The psychologist-evaluator from our people—our parents, other parents, our questions. that falls. school district’s Committee for Pre- pediatrician—didn’t they think there was Asperger’s at three years old? The My daughter’s photo from the first day school Special Education (CPSE) something different about our child? And reaction was unanimous – wow, she’s of school this year shows a smiling, curly Ihad just finished telling me that my re- most of them looked at us with unbeliev- awfully young to be diagnosed with as- headed blonde beauty, dressed in sweat- cently turned three year old daughter was ing eyes and just chuckled and said, “well, perger’s. Are you sure? pants with a t-shirt that has a picture of a an obviously bright little girl who also had she’s very bright.” But after lots and lots of reading and snarling, toothy, very scary reptile. She her challenges. And then the psychologist was handing talking, and lots of evenings in support will only wear scary shirts to school— “Some kind of learning disability?” I me her card and telling me to call if there groups and several trips down to the city scary reptiles, amphibians, dinosaurs or offered. was anything she could do and a moment to the Columbia University Developmen- insects. And she knows science facts She shook her head. “I think this is later, she was gone. tal Neuropsychiatry Unit** for evaluation about them, forward and backward. Asperger’s,” she said slowly, and peered In one week, my husband and I were by a team of “experts,” Asperger’s Syn- We leave the house in predictable at me to see the effect of her words. going to sit down with the CPSE and ad- drome is now a part of our lives. ways, mostly because mom uses a wheel- Asperger’s. Well, I had heard of it, but vocate for services for our daughter. What Routine. When things are routine and chair and there is only one doorway out of my mind raced, trying to remember what exactly was Asperger’s and what should predictable, life can go fairly smoothly. our apartment building that is easily I’d heard. we be asking for? There followed a School days can be routine. Weekends wheelchair accessible. Well, that and the She watched me as I looked over at mostly sleepless week of taking care of and vacation days are never routine. fact that my daughter will usually be hid- my daughter watching a video while we my daughter through her seemingly end- Meltdowns are not tantrums, they are ing under a coat or book to get out the talked at the dining room table. “What are less meltdowns, reading the OASIS book* “overflow.” Our child’s life is too tough you feeling right now?” she asked. cover to cover, haunting the parenting and her whole world is dissolving— see In Our House on page 15 NON PROFIT Mental Health News Education, Inc. ORGANIZATION 16 Cascade Drive U.S. POSTAGE PAID Effort, PA 18330 WHITE PLAINS, NY PERMIT NO. 153 PAGE 2 MENTAL HEALTH NEWS ~ SUMMER 2006 Mental Health News Advisory Council Sigurd H. Ackerman, MD, President & Medical Director Pam Forde, Director Dominick Lepore, MS, CTRS, Vice President Edythe S. Schwartz, ACSW, Executive Director Silver Hill Hospital Putnam Family Support and Advocacy Westchester Medical Center - Behavioral Health Center Putnam Family & Community Services Nadia Allen, Executive Director Michael B. Friedman, LMSW Andrew P. Levin, MD, Medical Director J. David Seay JD, Executive Director Mental Health Association in Orange County Public Policy Consultant Westchester Jewish Community Services NAMI - New York State Richard Altesman, MD, Representative Maureen Friar, Executive Director Robert M. Lichtman, PhD, DAPA Janet Z. Segal, LCSW, BCD, Chief Operating Officer American Psychiatric Association National Assembly Supportive Housing Network of New York Rockland Psychiatric Center Four Winds Hospital Gene Aronowitz, PhD, Director of Operations Steven J. Friedman Constance Lieber, President, Board of Directors Kren K. Shriver, MPH, MD, Clinical Director Fordham-Tremont Community Mental Health Center Mental Health & Public Policy Analyst NARSAD Hudson River Psychiatric Center Peter C. Ashenden, Executive Director Kenneth M. Glatt, PhD, ABPP, Commissioner Glenn Liebman, President & CEO Michael Silverberg, President Mental Health Empowerment Project Dutchess County Department of Mental Hygiene Mental Health Association In New York State NAMI - New York State Chris Ashman, MS, Commissioner Arnold Gould, Co-President Robert Litwak, CSW, Assistant Executive Director Alan B. Siskind, PhD, Executive Vice President & CEO Orange County Department of Community Mental Health NAMI Queens/Nassau Mental Health Association of Westchester Jewish Board of Family and Children’s Services Jeannine Baart, MS Flemming Graae, MD, Chief, Child & Adolescent Hon. Nita M. Lowey Jeffery Smith, MD Mental Health Education Consultant Psychiatry, Westchester Medical Center U.S. Congress - 18th District Private Practitioner Alan D. Barry, PhD, Administrative Director, Steven Greenfield, Executive Director Paige Macdonald, Executive Director Steven H. Smith, PsyD, Consulting Psychologist Department of Psychiatry, Norwalk Hospital Mental Health Association of Nassau County Families Together in New York State Grace Church Community Center Alexander J. Berardi, LCSW, Executive Director Ralph A. Gregory, President & CPO Lawrence Mandell, President & CEO Thomas E. Smith MD, Medical Director KEYSTONE United Way Of Westchester & Putnam United Way of New York City Hall-Brooke Behavioral Health Services Al Bergman, Chief Executive Officer Mary Guardino, Founder & Executive Director Randall Marshall, MD, Associate Professor of Clinical Andrew Solomon, Contributing Writer, Magazine SLS Health Freedom From Fear Psychiatry, New York State Psychiatric Institute The New York Times Sheldon Blitstein, CSW Mark D. Gustin, MBA, MPS, Senior Associate Director Richard H. McCarthy, PhD, MD, CM, Associate Professor Hon. Andrew J. Spano NY United Hospital - Behavioral Health Services Kings County Hospital Center of Psychiatry, Albert Einstein College of Medicine Westchester County Executive James Bopp, Executive Director Abraham Halpern, MD, FACP, Professor Emeritus Steven Miccio, Executive Director Hon. Nicholas A. Spano Rockland and Middletown Psychiatric Centers of Psychiatry - New York Medical College PEOPLe New York State Senate - 35th District Wendy Brennan, Executive Director Mary Hanrahan, LCSW, Government Relations Specialist David H.