SCHAFER AUTISM REPORT "Healing Autism:

No Finer a Cause on the Planet" ________________________________________________________________

Tuesday, December 30, 2003 Vol. 7 No. 257

EDITORIAL

* Wall Street Journal: The Politics of Autism

COMMENTARY

* National Autism Association Responds

RESEARCH

* Study Supports ‘Hidden Hordes’ Theory* to Explain Autism Growth

CARE

* Online Doctor Visits Gain Popularity

TREATMENT

Two Success Stories

* Lifeline For Christopher

* Minnesota Student Is ‘On The Road’ To Success

EDITORIAL and Rebuttal COMMENTARY

Wall Street Journal: The Politics of Autism

Lawsuits and emotion vs. science and childhood vaccines.

Monday, December 29, 2003 12:01 a.m.

For any parent, there are few more traumatic diagnoses than that a child suffers from autism. But the increasing political attention to that affliction is having the unintended and dangerous consequence of limiting vaccines for all children. This is a story of politics and lawyers trumping science and medicine. It concerns thimerosal, a preservative that was used in vaccines for 60 years and has never been credibly linked to any health problems. Nonetheless, a small but vocal group of parents have taken to claiming that thimerosal causes autism, a brain disorder that impairs normal social interaction. The result has been an ugly legal and political spat that has spilled into Congress and is frightening some parents from vaccinating their children against such deadly diseases as tetanus and whooping cough.

Like night follows day, the dispute has also brought in the trial lawyers.

Vaccine makers are supposed to be protected from lawsuits by 1986 legislation, but the lawyers are exploiting loopholes to file billion-dollar suits that threaten to punish the few companies that still make vaccines.

Congress tried to fix this by including a liability provision in homeland security legislation a year ago. But three Northeast Republican Senators--Olympia Snowe, Susan Collins and Lincoln Chafee--demanded it be taken out until Congress could have a full airing of the thimerosal-autism issue. The Senators haven't yet honored their side of that deal.

Perhaps that's because if they did their position would be exposed as scientifically untenable. The claim is that thimerosal, an organic mercury compound, can cause neurodevelopmental disorders. But study after study has shown that there is simply no such link.

A 2002 University of Rochester study compared the blood mercury levels of infants who'd received vaccines with and without thimerosal. All had levels well below the super-cautious EPA safety standard. This was followed last March by a study published in Pediatrics magazine, in which researchers compared the physical manifestations of autism and mercury poisoning. They found that the symptoms weren't the same, nor were the brain tissues similar.

Perhaps the best evidence comes from Denmark, one of those European nations that likes to monitor most everything about its citizens. Researchers recently examined the health records of all children born in Denmark from 1971 to 2000 for autism diagnoses. Though Denmark eliminated thimerosal from its vaccines in 1992, the researchers found that the incidence of autism continued to increase. A second research team reviewed the records of nearly 500,000 Danes vaccinated for pertussis. They also found that the risk of autism and related disorders didn't differ between those vaccinated with thimerosal and those without.

None of this is to deny that the incidence of autism may be rising, though there is a dispute about why. The definition of the disease has broadened in recent years, encompassing even mild learning disabilities, and doctors have become better at diagnosing it. Some statistics show that as autism diagnoses rise, those for mental retardation fall--suggesting children were previously misdiagnosed. Parents are also more keen to have a proper diagnosis, because many schools now offer more extensive educational services for autism than they do for other disorders. The good news is that research is beginning to reveal autism's causes and signs, in particular evidence of a genetic link. Studies have found that if one identical twin has autism the other has a very high chance of having severe social impairment. Scientists are already focusing on a handful of genes that may play a role.

In a important study this year, researchers found that a small head circumference at birth, followed by a sudden growth spurt of the head before the end of the first year, is a reliable early warning sign. (Brain growth that early can't be triggered by vaccines.) Autism is a terrible disease and it's understandable that some parents would want to look for scapegoats. One lobby group, Safe Minds, has been especially active in blaming vaccines and has found a powerful ally in Indiana Republican Dan Burton, who runs the House Wellness and Human Rights Subcommittee. His family has had its own painful experience with autism.

But their understandable passion shouldn't be allowed to trump undeniable evidence and damage childhood immunizations that are essential to public health.

Vaccine makers stopped using thimerosal a few years ago, but the autism lawsuits threaten those companies with enough damage that their ability to supply vaccines is in jeopardy.

Senate Majority Leader Bill Frist has a proposal to offer liability protection against thimerosal claims and modernize the federal Vaccine Injury Compensation Program--which pays out to the rare family whose child is truly harmed by a vaccine. Congress could both redeem itself and improve public health by making this bill a priority when it reconvenes in January.

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COMMENTARY

Rebuttal to "Politics of Autism" Editorial

Another editorial was published in the Wall Street Journal entitled "The Politics of Autism." The WSJ has already posted an opinion about this with their previous editorial "Where's My Flu Shot?", why another one? I think that's exactly what we need to know.

Here's a step by step rebuttal/response that may be helpful when writing to the Wall Street Journal: Points to make in any response to the WSJ editorial:

1. General points: Parents just want good and honest science; that is their "passion" in the interest of their children and all children. It is ironic they called their editorial "the politics of autism" when their approach is solely political. WSJ Journal has a political and industry profit promoting agenda-- It is the Wall Street Journal that is politicizing this issue by: a. repeatedly editorializing on it from one perspective without reporting the facts in a balanced way b. failing to rely on the science as the critical issue, but instead blasting trial lawyers and misguided parents c. the WSJ transparent agenda is to boost pharma profits--their cover is the supposed shortage of vaccines--this has been exposed to be a ruse because the flu vaccine shortage has nothing to do with thimerosal claims; this is also illustrated by the recent Prevnar shortage that resulted from industry problems wholly unrelated to liability or lawsui ts; How exactly does "attention to "that affliction" [autism] result in "unintended and dangerous consequence of limiting vaccines for all children."

2. Responsive points:

a. "Thimerosal never credibly linked to health problems"

Rebuttal: WSJ ignores thousands of articles in the scientific literature--there are no studies showing the safety of thimerosal

b. "spat" "frightens parents" and discourages vaccination Rebuttal: there is no evidence showing that vaccination rates have decreased--the critics of thimerosal are not opposed to vaccination--Is the WSJ opposed to safety in vaccines? WSJ later says that thimerosal has been removed- so then how does the claim regarding thimerosal discourage vaccination with thimerosal free vaccines?

c. "lawyers are exploiting loopholes" in vaccine law Rebuttal: the only "loophole" being exploited is the civil rights of children to seek damages for injuries caused by large corporations

d. " Senators haven't yet honored their side of the deal" to air the issues.

Rebuttal: let's have a full and fair debate rather than ramming through giveaways in the dead of night

3. Science: WSJ claims to rely on science that is "trumped" by lawyers, but it distorts the science.

a. "study after study has shown there is simply no such link":

Rebuttal: generally discredit the studies cited (some points listed below--others well laid out in critiques on Safe Minds website) in the editorial and to criticize the WSJ for failing to mention studies that do support a link (they conveniently left those out, e.g. Geier's studies, and many that show neurotoxicity of mercury)

b. WSJ cites Pichichero "University of Rochester" study;

(1) Claims it compared the blood mercury levels of infants who received vaccines with and without thimerosal-- simply not accurate

Rebuttal: A. mercury cannot be measured by blood level; B. study sample tiny-40 some odd children; did not account for where the mercury went after it disappeared from the blood so rapidly; C. did not measure blood level early enough and did not prove it was excreted--takes a lot longer than the study protocol waited to excrete mercury by biliary transport, which is the way mercury is excreted

(2) WSJ relies on Baumann & Nelson study in Pediatrics.

Rebuttal: This was not new science but a review article only, see Mark Blaxill's rebuttal to this --one major problem is that this article examined the features of so called Classic autism

(3) Reliance on Denmark thimerosal studies; Madsen (Pediatrics) and Hviid (NEJM) study.

Rebuttal: SafeMinds has pretty much responded to this and their points should be utilized (e.g. data disappearance or manipulation; conflicts of interest; rates in Denmark lower even now; vaccine administration different and fewer number of vaccines in Denmark than in U.S. thus not comparable plus other points;

c. Rise in Autism-WSJ ignores epidemiological studies

(1) "MR goes down as autism rates go up" argument-- Disability substitution argument:

Rebuttal: What studies show that mental retardation declines as autism increases? An article by Mark Blaxill, Walter Spitzer, and David Baskin, published in JADD, clearly refuted this theory, so much so that Croen herself conceded in a response letter to Mark's paper.

(2) "Keener parents seeking services"

Rebuttal: Similarly the MIND study said parents seeking a diagnosis to get access to treatment was not a reason for the increase--there is no scientific support for this WSJ allegation

d. WSJ says "Research is beginning to reveal autism's causes and signs"

(1) "Genetic Link" --"Studies have found that if one identical twin has autism the other has a very high chance of having severe social impairment"

Rebuttal: how does WSJ Journal explain the fact that there is discordance in rates of twins with autism--this strongly suggests there is a strong environmental component and that genetics is not the "cause" -- " Scientists are already focusing on a handful of genes that may play a role".

Rebuttal: WSJ is overly simplistic and misleading in their speculatory assertion about genetic science--scientists have claimed for years that they have found an autism gene--they have "isolated" it to 5, 10, or 20 genes and the research is usually not verified or replicated. There is no dispute that genetics play a role--life is genetic--this has more to do with susceptibility rather than cause.

(2) "Head size study" --WSJ says small head size at birth plus a growth spurt prior to one year is a warning size of autism

Rebuttal: Even Courchesne, the lead author of this study was quoted in the LA Times that this theory is not incompatible with an environmental trigger to autism

4. WSJ Journal says that parents, SafeMinds and Dan Burton are seeking

scapegoats:

Rebuttal: --We parents just want honest answers, honest and complete scientific inquiry and, in the absence of studies showing that it is safe, complete removal of thimerosal from all vaccines. This is the responsible position rather that the industry protectionism advocated by the WSJ.

5. WSJ says "vaccine makers stopped using thimerosal a few years ago"

Rebuttal: Still in flu, tetanus, and still on the shelves even now. 2003 PDR still lists it as an ingredient in childhood vaccines.

6. WSJ says "Passion shouldn't be allowed to trump undeniable evidence and damage childhood immunizations"

Rebuttal: there is no evidence of thimerosal safety; the only damage to childhood immunizations is being done by the vaccine makers and the regulators who are acting irresponsibly in failing to properly test vaccine safety, and by failing to remove a known neurotoxin from injectable vaccines.

7. Frist bill -- WSJ wants open debate on vaccine issue so that sufficient vaccines can be manufactured.

Rebuttal: Parents favor legislation that protects the health of children and their civil rights. We reject legislation that allows unsafe vaccines to be manufactured at the risk of the health of our children.

Last few points: the Denmark study...severely flawed. The CDC study...the first one suggested a connection and was never published...this last (manipulated) one suggested no connection and almost had neon lights attached to it. My child has never had an abnormal head circumference (come to think of it, I haven't met anyone whose autistic child had this). The vaccine supply has nothing to do with any of this. Finally, Senators Collins, Chaffe, and Snowe (along with Dan Burton) stood up for our children's rights. Senator Frist tried to sell them out.

Anytime the other side wants to meet to debate the science, we're all waiting...

Lori McIlwain

WHAT YOU CAN DO

Please fax or email the WSJ and send a copy of your letter for us to post in our Grassroots Center -- [Also, cc: it to the Schafer Autism Report

It only takes 5 minutes to make a difference!

CONTACT INFO: Letter to the Editor EMAIL ADDRESS: wsj.ltrs@wsj.com FAX

NUMBER: 212-416-2255

Sample Letter:

Regarding your December 29th article entitled, "The Politics of Autism," the author (whoever they are) fails to establish themselves as either an expert of autism, parent of an autistic child, politician, or freelance copywriter hired by a public relations firm on behalf of big-money drug companies. I'm also wondering why this so-called "opinion" is being published by WSJ again when a similar opinion was published two weeks ago? To this writer, I am only going to make a few points (actual facts)...

First, I am a parent of an autistic child---and, yes, he was permanently damaged by ethylmercury thimerosal, a compound used in vaccines and pregnancy shots (as a sterilizing agent more than a preservative.) Second, the NVICP doesn't work---it's a broken program. Don't believe me? Ask a group of parents who have been through it. I personally wish to litigate for the discovery phase, not the "money," which seems to be brought up only by the Bill Frist's of the world (Bill, refer to my advertisements addressed to you in the Congress Daily issues last April---found another word for "frivolous" yet?) Anyone who says we're all in this for monetary gain is just plain ignorant.

Third, we've continued to ask for hearings---we've asked for a White House Conference, we've all but invited the CDC over to our house to compare notes.

Has anyone ever agreed to any of these things? No. Maybe because the actual unmanipulated science that rightfully fingers the rise in thimerosal as the logical cause of the rise in autism would have to be publicly acknowledged. People like Dr. Thomas Vaerstraten who once wrote an e-mail to his colleagues (recovered by the Freedom of Information Act) entitled "It just won't go away," would actually have to contend with the fact that the connection won't go away because the connection is real.

* * *

RESEARCH

Study Supports ‘Hidden Hordes’ Theory* to Explain Autism Growth ‘Epidemiology and Possible Causes Of Autism.’

ds=14695031&dopt=Abstract

Jick H, Kaye JA.

Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, Massachusetts 02421, USA. hjick@bu.edu

OBJECTIVES: To review the recent literature on possible causes of the increase in frequency of diagnosed autism reported from three countries, and to compare the medical diagnoses and drug therapy from a new series of autistic boys and their mothers with that of comparable nonautistic boys and their mothers.

DESIGN: Case-control evaluation.

PARTICIPANTS: Members of over 250 general practices in the United Kingdom.

MEASUREMENTS AND MAIN RESULTS: Frequency of exposure to drugs and presence of preexisting clinical illnesses in autistic children and their mothers were compared with nonautistic children and their mothers over time. According to published studies, the incidence of boys diagnosed with autism rose dramatically in the 1990s. Numerous published studies have concluded that the measles-mumps-rubella vaccine is not responsible for the large rise in diagnosed autism. In our study, boys diagnosed with autism had medical and drug histories, such as vaccines, before diagnosis, that were closely similar to those of nonautistic boys, except that developmental and sensory disorders were far more common in autistic boys. No material differences during pregnancy were found between the mothers of autistic boys and those of nonautistic boys in relation to illness or drug therapy. In the early 1990s, boys with diagnosed developmental disorders were infrequently diagnosed with autism. In the later 1990s, such boys more often were diagnosed with autism.

CONCLUSION: A major cause of the recent large increase in the number of boys diagnosed with autism probably is due to changing diagnostic practices.

PMID: 14695031 [PubMed - in process]

* The "Hidden Hordes" theory of autism is a term created by detractors of the conclusion that the growth of autism has remained constant over the last decade and is only an artifact of better diagnosing. If true, there should be "hidden hordes" of now-teenaged and young adults with severe autism undiagnosed or misdiagnosed since almost all new diagnosis are of infants and toddlers. -LS.

* * *

CARE

Online Doctor Visits Gain Popularity

Physicians weary because of legal liability

As a computer programmer, Kurt Soutendijk is comfortable with technology, so when his physician asked patients to try online doctor visits, he tried it.

Over the past few months, Soutendijk saved himself two trips to the doctor's office by using the Internet to renew a prescription and go over his medications. When his son came down with a sore throat, however, Soutendijk didn't log on he drove him to the doctor's office.

"If it's something that I feel the doctor actually needs to look at, I want to go in," Soutendijk said.

More patients like Soutendijk want the option of Internet visits, especially for everyday ailments, but doctors have been slow to respond. According to a survey released last month by Jupiter Research, only 9 percent of the nation's doctors use e-mail more than five times a week to talk to patients. When they do, it's usually to schedule an appointment or resolve a billing question.

Monique Levy, a health-care analyst at Darien, Conn.-based Jupiter, said doctors are reluctant to practice online medicine because most insurers won't pay for it. A few plans, including Blue Shield of California and Blue Cross and Blue Shield of Massachusetts, do.

Doctors also worry about legal liability if an online patient develops complications that might have been avoided if the patient had been examined at the doctor's office, she said.

The payment obstacle may be removed Jan. 1, when the American Medical Association creates a reimbursement code for online communication between doctors and patients. The move will make it easier for doctors to seek reimbursement from health plans, but each insurer will have to decide whether to cover e-mail consultations, an AMA spokesman said.

Levy predicted that online medical care will grow as a cheaper, easier alternative to visiting the doctor's office, especially for patients with chronic conditions that require constant monitoring.

Tiena Health, the medical group in suburban Dallas where Soutendijk and his son are patients, began signing up online patients in June.

"We're starting to see them trickle in, one or two a day," said Scott Conard, Soutendijk's physician and one of the group's six doctors. "People are still trying to figure out how this works."

In a typical online visit, patients are guided through a series of questions about their symptoms. Some answers if they report shortness of breath, for example prompt a warning to see a doctor in person. Otherwise, the doctor makes a diagnosis based on the patient's answers.

Conard said he sometimes gets more information from a patient with an online visit than he does from a phone conversation between the patient and his nurse.

Patients are typically notified by e-mail that their results are available on a password-protected Web site. Many visits end with the doctor calling in a prescription for a mundane condition such as blocked sinuses. Sometimes, Conard said, the symptoms prompt him to ask the patient to come in for a more thorough exam.

Conard charges $35 for an online visit, compared to $50 to $150 for an office visit.

A cottage industry has grown up quickly to serve online medical pioneers like Conard. MyDocOnline, a Round Rock-based unit of German pharmaceutical giant Aventis SA; RelayHealth Corp. of Emeryville; and others sell software to run a virtual doctor's office.

Kirk Schueler, the chief executive of MyDocOnline, said the Internet could improve communication between doctors and patients. He said many patients with chronic conditions fail to get adequate follow-up care, partly due to the hassle of getting in to see the doctor.

"From the drug company's point of view, if we could increase the number of patients seeking a therapy and getting therapy, it would be a huge benefit for the pharmaceutical companies and the patient," he said.

Eric Zimmerman, senior vice president at RelayHealth, touted a study by researchers at Stanford and the University of California, Berkeley, that said online communication between doctors and patients led to more satisfaction and lower costs.

Zimmerman conceded that doctors' fear of legal liability "is a hurdle," but he believes it may be mostly perception. RelayHealth requires doctors using its software to confirm with their malpractice insurer that online visits are part of the policy. All were told they were covered, he said.

Alan Dappen, a family doctor in Vienna, Va., who sees most of his patients by phone or e-mail, said online medicine makes practical business sense.

Dappen charges $15 to $20 for each five-minute consultation long enough to cover most routine conditions, he said. Dappen said he breaks even by seeing about eight patients a day in person, because he has one nurse instead of an office staff of five or six people to deal with insurance paperwork. He said his model could be the future of health care.

"If I can show doctors that you can make a similar amount of money as you can in your old practice, people will abandon ship right and left," Dappen said.

* * *

TREATMENT - Two Success Stories

Lifeline For Christopher

ontent&sourceNode=99871&contentPK=8243351 <- - address ends here.

A grateful Exeter mum has paid tribute to a pre-school assistant who helped spark a breakthrough with her severely autistic four-year-old son.

Mum-of-three Sarah Chalker, from Pinhoe, thought she was "going mad" when her youngest son Christopher suddenly stopped interacting with his family and playing with his toys about two years ago.

Within weeks, the toddler was diagnosed as being severely autistic, which means he can barely speak or communicate with the world around him and has panic attacks when he is in unfamiliar situations.

Christopher started having speech and language therapy at Honeylands Children's Centre, and Sarah also took him to Pinhoe Pre-School several times a week, so he could be with youngsters in a mainstream setting.

But little Christopher's disability meant he struggled to mix with the other children and staff, and he would sit in a corner and play on his own.

That was until pre-school assistant Anita Beardsell started working with him and trying to understand his difficult behaviour.

Mum Sarah, 36, explained: "When Christopher started at the pre-school he had no speech at all and was using hardly any words.

"If he wanted anything he would grab your hand and take you to it, and you'd have to ask him: 'Is it biscuits?' Is it a drink'. And so on.

"We had to go into the pre-school a quarter of an hour early or he would just panic.

"And he would always find a cubby-hole or corner to hide in. He wouldn't sit down for story-time or for registration in the morning. But now he is communicating much better. He can say: 'Bye, bye' and 'See you soon'. His newest word is 'dinosaur', which comes from his favourite cartoon.

"The staff, and especially Anita, have really worked with him. If they found he was saying a particular word they would carry on using that one word with him the rest of the day.

"Anita also got Christopher to sit down with her for a few minutes. Then, the next time, it would be a little bit longer and so on, just to help him get into a routine. You have to introduce things slowly to autistic children.

"Christopher just took to Anita. There was something special there. Now he will sit on her lap and stay there for five to 10 minutes at a time. He'll also sit on the floor with all the other children."

Former nurse Anita, who used to work in the Royal Devon & Exeter Hospital's Bramble ward, said: "Christopher has changed a lot through language. He is joining in. His vocabulary is really coming on, he's more sociable and joins in at snack-time and other group activities, whereas before he would not have been able to.

"When he started here he would spend a lot of time sitting at the computer by himself. But now he likes singing along to nursery rhymes, does colouring in and plays in the sandbox.

"We just tried to get him into a routine and praised him when he did something right.

"It is difficult working with a child like Christopher because he can't tell you if he has got a headache or is feeling sick.

"There are always going to be times when he won't or can't do things.

"He reacts badly when his routine is interrupted and he is not sure of what's going on."

Christopher was just 19 months old when his mum suspected something was seriously wrong.

Sarah said: "He has started making more eye contact with us now, but that was one of the first things I noticed him stop doing.

"He got more and more into himself and he would flap his arms, and I would think to myself: 'Why is he doing that?' Then he stopped looking at us altogether.

"He stopped playing with his toys and games and started doing strange things, like with his building blocks, he would only build up his yellow blocks or his purple blocks.

"I thought I was going mad and did not know how to help him. It was like losing your little boy.

"He just went into a world of his own. It was quite frightening."

Sarah sought medical help and after an assessment at Honeylands, Christopher was diagnosed with autism.

His mum believed the symptoms started a month after the toddler had the controversial MMR jab - even though numerous medical studies have found no link between the measles, mumps and rubella vaccine and autism.

Sarah said: "Christopher had a terrible reaction to his booster. He was violently sick and had a high temperature, and just screamed. It was not just me being a fussing mother - he just went downhill. But I would not say to other parents: 'Don't have the jab'."

The brave mum, husband Roy Halsey and two other children, Jamie and Sophie, have learned to cope with Christopher's challenging, and often eccentric, behaviour.

Sarah said: "Christopher has to stick to his routine or else he gets into a state and has a real tantrum, and that is just one of a host of things Anita had to learn about. But she has really brought Christopher out of himself.

"All the staff and children took him under their wing and tried to help him."

In the new year, Christopher will start at Ellen Tinkham School, where he will have specialist teaching and speech and language therapy every day.

Anita said: "It has been good to see how Christopher has changed. I will miss him."

Pinhoe Pre-School superviser Jane Mauruschat added: "We try to treat children with special needs the same as other youngsters.

"Any parent coming in to see the class would not be able to differentiate between them."

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* * *

Minnesota Student Is ‘On The Road’ To Success

This article tells the story of how one student with special needs benefited from inclusion in regular classes in the Lakeville Area School District, Dakota County.

Ryan Birkemose hopes to someday improve the system of roads we use in our daily lives.

The McGuire Junior High School ninth-grader’s fascination with road systems pours forth each time he looks at a map or steps into the seat of a car.

Ryan will be afforded every opportunity to reach and attain his goals as he enters high school this fall. Learning to live with a form of functional autism, Ryan has gained support from his teachers, education specialists and family.

His experience in Lakeville schools has been vastly different than those with autism who navigated the school system 20, even 10, years ago. Since that time, research and teaching methods have found that including students with special needs into mainstream classrooms benefits all students (see related story).

Lakeville’s Special Education Advisory Council highlighted such success during National Inclusive Schools Week during the first week of December.

Council members praised the work of all teachers in helping to meet the needs of special education students.

"It’s important to bridge the gap between special ed and the general classroom," said Renae Ouillette, director of special education. "Ryan is a pretty good case for why they need to be there."

Ryan carries a full load of ninth-grade courses, including math, science, history and English. A member of an after-school writing club at Kenwood Trail Junior High School, Ryan takes additional art instruction in St. Paul and is in confirmation classes at his church.

His advancement toward entering high school this fall is due to his hard work, determination and support from a variety of sources in the schools.

What works Ryan has received special education services of some form since he was in preschool.

Challenges Ryan faced in elementary school included maintaining his focus, being overwhelmed by the length of some assignments or taking tests.

Birkemose credits Karen Cadigan, former Eastview Elementary School teacher, with determining what teaching methods worked best for Ryan.

"For Ryan it has been a blessing to have had teachers that work along with special education teachers," Birkemose said, "and that the curriculum has been in the past developed according to his ability."

For a time, Ryan was largely separated from regular classes. When working with Cadigan, classroom assignments were made more manageable as Ryan’s goal was to demonstrate he understood and could apply concepts. It was not a matter of completing 20 problems repeating the same concept.

On tests, the feelings of stress exhibited by other students or distractions made taking test more difficult, so a silent room was made available.

When Ryan moved to Cherry View Elementary School, he expressed interest in being in general classrooms more often. This was seen as a positive sign as his mother says change is often difficult.

Robin says Ryan benefitted from inclusion not simply based on classroom instruction, but also in developing social skills needed to adapt.

His learning became even more sophisticated in junior high school.

For a time, Ryan was challenged by math concepts. Richard Zeman, his general classroom teacher, gave him constant encouragement and showed him great patience, according to Robin. Now she says Ryan has little problem with math.

As a ninth-grader, Ryan sees Judy Miller, special education teacher, once a day. During his time in Miller’s room, he is able to have a quiet place to work on assignments. There he has his own desk where he can keep books and papers.

While there are always new challenges, Robin says French was difficult for Ryan at first because he had to re-learn sentence construction — likely a common reaction among most students.

Ryan is proficient at memorizing French vocabulary words as he is recalling names and dates from history. He’s also expressed a strong interest in writing.

"He has turned into quite a writer," she said. "He loves writing stories."

Ryan’s focus on transportation and writing has led him recently to combine both with an extensive research paper on Robert Moses — a developer of the early transportation systems around New York City. He also likes to read. His main research text is a hefty 1,000-plus page book.

Getting excited about an area of interest is something Ryan takes to with vigor. This focus should help him no matter what road he takes.

"I know whatever he does he is going to give it his all," Robin said.

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