PROVIDENCE, R.I.
- KRT NEWSFEATURES
(KRT) - After a 90-minute bus ride, Matthew Lemek starts his day in a
school gymnasium in Portsmouth, R.I., walking off pent-up energy and
getting comfortable in his own skin.
Without prompting, he marches around the gym, singing a favorite
song.
"C is for cookie, good enough for me," he repeats over and over and
over.
"Matthew, walk normally. You're not a soldier," teacher Kim Schuller
says matter-of-factly.
He stops marching and goes silent. For a few minutes. Then the
10-year-old begins singing again.
Across the bay in South Kingstown, amid the din of a second-grade
classroom, Kody Gallup retreats behind a row of green plastic bins,
leaving behind the chatter of classmates. Clutching a favorite book
about sharks, he sits in the corner to read. His lips move as he turns
the pages, reciting passages again and again and again. . . to himself.
Matt and Kody are part of what many call an epidemic afflicting a
growing number of children across the country. Their communication and
social skills are so impaired that they find it almost impossible to
navigate our larger, unpredictable world.
Repeating familiar words and phrases, reciting songs, withdrawing
into their own world often helps them to get through the day.
They are among 500 children in Rhode Island suffering from one of the
disorders along a spectrum that starts with autism and includes two
others: Asperger's syndrome and something called pervasive developmental
disorder not otherwise specified.
Up from 41 identified cases in l994, Rhode Island's current autistic
population has increased by more than 1,000 percent in eight years.
Similar increases are being experienced across the nation.
The Center for Disease Control and Prevention recently reported a
10-fold increase in the disorder nationwide since 1980.
Kelley and Michael Gallup suspected something was wrong. Kody, their
middle child, was 3 and he wasn't speaking. He often wouldn't come when
they called his name.
They were heartbroken when they were told that Kody had autism.
"It takes everything away, all the dreams for that child," Michael
Gallup says.
"Had we done anything wrong to cause this?" Kelley Gallup often
wondered in the middle of the night.
Maureen and Michael Lemek struggled with the same gnawing questions.
Matthew, their first-born, had a hard time playing with other
children and became easily overwhelmed and frustrated. He was diagnosed
when he was four with Asperger's syndrome.
"I felt like someone kicked me in the stomach," Maureen Lemek says.
As a pediatric audiologist with a background in communication disorders,
she berated herself for not figuring it out sooner.
Experts across the country agree that autism is a genetic disorder in
the brain four times more likely to affect boys than girls. But they
don't agree on what's causing the dramatic increase.
There's no question that broadening the definition of autism in the
l990s to include two related conditions has contributed to the rise. But
doctors, psychologists and educators disagree about how much that
expanded definition accounts for the explosion.
One popular theory is that childhood vaccinations are somehow
triggering autism. So far, no rigorous scientific study has provided
evidence of such a link.
Anne Walters, who runs the private special-needs Bradley School in
Portsmouth, says she suspects an as-yet-undiscovered environmental
influence. However, her colleague Rowland Barrett, at Bradley Hospital
in East Providence, is skeptical.
"I think it's been an undiagnosed and an underdiagnosed problem,"
Barrett says. "I think the numbers have always been there. It's just
awareness about the disorder has increased."
The Gallups and the Lemeks have stopped worrying so much about what
might have caused their sons' autistic disorders. They are far more
focused on how to stop autism from overtaking their sons' lives.
Transitions - changes of any kind - are apt to throw a child with an
autism disorder off course, often causing an emotional meltdown.
That's why the Lemeks start preparing Matthew for the switch from
summer to winter clothes in August, reminding him each week that soon
he'll have to switch to long pants.
Even then, he resists and tries to wear shorts as long as possible.
To ease into the chaos of the Christmas season, his parents try to
restrict talk about Santa, presents and Baby Jesus to the month of
December.
Leaving Christmas behind is just as hard. Recognizing his own
discomfort a few years ago, Matt invented what the family calls the
January tree to help ease him out of the holiday blur.
He designed an elaborate tree out of a pink feathered boa and fragile
sticks as branches. He found a silver star and placed his creation atop
an overturned laundry basket covered with an ivory blanket, mimicking a
Christmas tree stand.
He knows the tree must come down each year at the end of January, but
the strategy helps him cope with the shifting seasons.
"You're always trying to balance accepting who he is and appreciating
his different abilities with giving him the skills to function in the
real world," says Maureen Lemek.
The Lemeks regularly weigh Matt's needs against those of his younger
sister, Meredith, a second grader who doesn't always understand why Matt
does what he does. It's hard to explain to a child why a long-awaited
trip to the Roger Williams Park Zoo was cut short when her brother
became so agitated the family had to leave.
Matthew struggles daily between the disorder that can separate him
from others and his naturally affectionate nature.
Matthew will put on puppet shows for Meredith and sometimes creates
costumes for plays in which they both perform.
Other times he avoids contact.
One day, Meredith tries to play with her brother.
Matthew freezes, his arms tight against his body. "Get away from me,
Meredith!" he says.
"She just wants to play, Matt," his mother says.
He immediately walks over to Meredith and hugs her.
"Socially, Matt's behavior can be difficult to understand," Maureen
Lemek says. "You learn their signals, and try to remove them from
situations they can't handle and give them outlets."
Matt's parents work to strike a balance between letting him express
himself and trying to modify his behavior.
When the family goes hiking in the woods of the Arcadia Management
Area, not far from their Richmond home, Matt frequently assigns them
roles to play, as he directs the family show.
Another day, his parents and younger sister Meredith become dwarves
in his rendition of Snow White. A stand of trees is the cottage. And
Matt critiques everyone's performance.
"Sometimes it's irritating and sometimes it's really fun," Maureen
Lemek says. "It's like he knows he's not sure how to engage us, so he
pulls us into a familiar story. Sometimes I tell him I want Matthew, not
Matthew-Pinnochio, and he knows. He tries."
In the late 1990s, the spike in autism numbers prompted a statewide
study on the effect on local school districts. That study led to the
creation of an autism support center at the state Department of
Education to train teachers and provide guidance to local schools.
The department estimates it costs $20,000 a year to educate each
child with autism spectrum disorder, compared to $15,000 a year for
other disabilities and $7,500 a year for mainstream students.
Last August, school officials in South Kingstown discovered that they
had what they thought was a "bubble" of autistic children at Matunuck
Elementary School. Four of the district's elementary schools each had
one or two autistic children; Matunuck had five.
Kody Gallup, now 8, is one of them.
To help him, the district hired a special education teacher to run a
new program that emphasizes social and communication skills and provides
Kody and the other students with the routines and predictability they
need.
"The problem starts as neurological, but it then becomes not having
access to the world around them," said Kevin Plummer, a psychologist who
works with the South Kingstown school district. "We want to get these
students in the game early and make sure they're not isolated."
Kody relies on a schedule of pictures and words stuck on a
two-foot-long Velcro strip - a map that guides him through his day.
These small, laminated pictures of an addition sign, with "math" written
underneath, or an American flag, to signal the pledge of allegiance,
serve as visual cues warning Kody of what's coming next.
He removes each small picture just before the next activity, then
sticks it back on the timeline when the task is complete.
On this winter day, after each task, Kody keeps returning to the
shark book he wants to read in the quiet corner with the squishy bean
bag chair he loves to curl up in.
His special education teacher, Jen Duggan, gently takes the book from
him.
"Here, keep it safe. Keep it safe," she repeats, as she puts the book
back on the shelf.
Kody relaxes, the words pacifying him.
His one-to-one teaching assistant, Deb DeLuise, convinces him to come
to the occupational therapy corner, and he follows, flashing her an
angry look, mouth clenched, eyes glaring.
The activity is designed to help Kody relax and gain control over his
body.
He lies on his back on a long flat board that swings from ropes
attached to the ceiling.
Kody's sneakers dangle off the end, and he stares at the square
pattern above him. He knows the routine, and counts in groups of five,
up to 100.
"Five, ten, fifteen, twenty," he recites with DeLuise, with each
gentle swing.
Then, he loses interest in his counting lesson and begins to sing to
himself.
"Twinkle, twinkle little star, how I wonder what you are," he chants,
over and over.
As a reward, DeLuise shows him two fingers and tells him he has two
minutes to lounge in the baggy chair with his shark book.
"Every day, we're trying to stay one step ahead of the disorder,"
Duggan says of the cues and emotional support Kody receives. "Sometimes
you're ahead of it, and sometimes you're not."
Kody returns to the regular second-grade classroom next door to watch
a video about Antarctica.
"Technology type stuff, he just loves," Duggan says. "Anything on a
computer, a TV he just absorbs all the information."
Kody begins murmuring, again and again, "doe, doe, doooooe, doe," as
his fingers play with a bright orange action figure.
"Shhh, Kody, you have to be quiet," says a little girl with pony
tailssitting near by.
DeLuise places a Velcro-backed card in front of Kody that has a face
with a finger in front of lips and she makes the same gesture. The
laminated visual cue reads "no tech talk," a term for the chanting and
repetitious sounds of his inner world.
But Kody continues to moan softly, even as his eyes focus on the
television screen. Gradually, he quiets down.
Later, Duggan watches carefully as Kody reads; his memory is so
developed he often memorizes favorite stories, then recites them instead
of reading the books.
"Reading is more difficult for him because of language processing
problems," Duggan says. "If you're not talking in complete sentences,
it's hard to write and read complete sentences."
The key is to find methods that make sense to autistic children.
"It's not that they can't learn - it's how do they learn best?"
Duggan says. "You just have to find that learning style. It's just much
more difficult."
Matthew's first venture into public school was a failure. By second
grade, his behavior went "off the wall" Maureen Lemek says.
"He would yell and scream and just get overwhelmed. The
unpredictability of being in school with other kids was just too much."
Some mornings, Maureen Lemek would dissolve in tears after getting
her 7-year-old on the bus.
"I'd just be distraught, not knowing if I did the right thing,
knowing he'd fall apart as soon as he got to school."
Three years ago they found the Bradley School in Portsmouth. Run by
Bradley Hospital, the nation's first psychiatric hospital for children,
the school requires Matt to spend three hours a day on a school bus, but
the Lemeks think it's worth it.
But they are eagerly awaiting the opening of a new $4-million
facility in South Kingstown next month , which will cut Matt's commute
down to 30 minutes each way.
At Bradley, Matthew, now 10, is in a class with seven other students
who have similar problems.
One recent morning, Matt starts to stiffen as he does a word search
worksheet.
He splays his hands over his ears, elbows on his desk, and starts to
make a guttural noise.
"Uhhh, uhhh," he says.
"Use your words, Matt," his teacher says.
"I can't find F," he says in an annoyed voice.
"That's okay, you'll find it. Keep looking," she encourages.
He finds F.
A few minutes later, he's earned a free period, when he can pick what
he'd like to do.
His teacher, Kim Schuller, breaks up the day into half-hour
increments. Each time a student completes a 30-minute block, following
directions and avoiding an outburst, they get a star next to their name.
After several, they can take a free period.
He checks out a Disney Web site on the computer, then heads to a
corner, where he rolls, back arched, on a large rubber ball.
He pushes back with his hands above his head, then bounces back up
when his feet hit the floor.
Back and forth, back and forth.
The rolling motion comforts him.
While Kody can say words and often drifts into dialogue from Monsters
Inc., Ice Age and other favorite movies, it's hard for him to sustain a
conversation, even with his parents.
"Do you want help with that, Kody?" his mother asks one afternoon as
she prepared him an after-school snack.
"Help," he responds.
Kody is affectionate with his parents and siblings and makes eye
contact easily. He can read, tell time, tie his shoes and ice skate.
A home-based therapist comes to the house three afternoons a week to
work on improving Kody's social and communication skills. This also
gives Kelley Gallup time to bring Kody's older brother, Kyle, to hockey
games, or spend time with younger sister Kaitlyn.
"We don't know where he'll end up, so you just have to focus on
today," Kelley Gallup says. "You try to look to tomorrow, but not too
much further than that."
The Lemeks feel the same way.
Instead of planning the future, the family focuses on the present.
The experience has taught them to see beyond his disability, and more
deeply into who their son is.
"I've always thought he was an amazing kid, and I still do," Maureen
Lemek says. "You never know what will happen in the future with anyone.
But I am completely confident that our son will meet his potential."
For now, she savors each small success as it comes.
The most recent is a 5-by-7 photograph that sits on the television in
the living room.
It's different from all the family portraits and pictures of Matt and
Meredith throughout the house. In those, Matt's gaze is averted to one
side, or his face has a blank expression.
In this new picture, Matt sits close to his best friend at Bradley.
Their heads close together, arms around each other's shoulders, both
boys look straight into the camera lens, contented and free.
Matt is smiling.
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