Schafer Autism Report - Monday, July 07, 2003

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On Wednesday, June 25, 2003, the Senate Health, Education, Labor and Pensions (HELP) Committee unanimously passed its bipartisan IDEA reauthorization bill, S. 1248.

The bill that was passed was an amended version of the one that was introduced two weeks ago. In response to the feedback that the Committee received, some changes were made, most significantly in the discipline provisions. S. 1248 will go on to a full Senate vote sometime between July 7th and the end of July.

Our goal over the next few weeks will be to discourage any amendments on the Senate floor that would diminish the protections currently in the bill and to encourage amendments in the areas we still have concerns.

Please call, email or fax the Senators your comments on S. 1248. This is particularly important for the Republican Senators.

1. Please thank them for the positive provisions in S. 1248, including the most recent changes to the discipline provisions and

2. Then express our top three remaining concerns (this information is provided below).

3. Make sure to use personal stories to illustrate the importance of your points.

2. Improvements in the transition provisions, including an increased focus on post-high school outcomes. No option for voluntary binding arbitration

3. An improved version of the resolution session that H.R. 1350 requires before parents can go to a due process hearing

4. A two year statute of limitations from time parent should have known about violation (as compared to a 1 year statute of limitations from date of actual violation) Governor does not set rate for attorney’s fees; instead fees continue to be awarded by the courts.

6. Strengthened enforcement provisions apply if a state is not complying with IDEA.

The grassroots response convinced the Committee that three important requirements from the current IDEA discipline provisions should be added to S.1248 and that a due process issue should be clarified! Thank you to all those who contacted their Senators or the HELP Committee staff!

already been done, was added to the discipline provisions of S.1248. This will help keep the behavior from recurring.

2. The word “knowingly” was put in front of the words “possesses or uses illegal drugs” to conform to current law. The effect of this change is that the school system must look at whether our children understood that they had illegal drugs in their possession before applying the disciplinary procedures. This is a significant protection since the school system would not otherwise have to consider the child’s disability for drug offenses under S. 1248.

3. A parental notification requirement from the current IDEA discipline provisions was added to S. 1248. This notification would inform parents that a disciplinary action is being contemplated for their child and inform them of all the procedural safeguards that apply.

4. It was clarified that a hearing officer can order compliance with the IDEA procedural requirements.

Senators that regular report cards are meaningless for children who have below grade level goals and functional goals. We rely on the periodic reports that are tied to the short-term objectives. The elimination of short-term objectives will create more paper work for teachers who are writing these periodic progress reports because they are going to have to provide a narrative explaining the various steps that have been made toward achieving the annual goal. These steps are essentially short- term objectives or benchmarks. If these progress reports are not done properly there will be litigation to clarify how annual goals are to be measured without short-term objectives or benchmarks.

2. Limitations on the subject matter of a due process hearing. In S. 1248 the subject matter of a due process hearing is limited to the issues raised in the due process complaint notice. This requirement will force parents to figure out everything that could possibly be an issue in the hearing. There is no opportunity to add issues later if they have inadvertently been left out (putting parents without an attorney at a great disadvantage).

Tell your Senators that in order to minimize litigation and relieve pressure on parents to hire attorneys early in the process, parents should be able to add an issue without filing a separate due process complaint for that issue. Otherwise parents are going to be heading into the mandatory meeting with the school system and the IEP team (in S. 1248 this is called an “Opportunity to Resolve Complaint” meeting) prepared for an adversarial due process hearing, instead of a collaborative resolution session.

3. Placement while a discipline decision is appealed. S. 1248, children who are ordered to alternative educational placements for more than ten days do not have the “stay put” right to remain in their current educational setting while the decision is being appealed. Under current law all children are entitled to “stay put” except in cases involving drugs, weapons and the substantial likelihood of harm to oneself or others. The loss of “stay put” is a huge concern, especially for children with transition problems. Explain to your Senators the amount of regression your child would suffer in the time an appeal might take. This is especially unjust if an appeal determines that the disciplinary action was inappropriate. You should point out the increased risk of litigation if the child needs additional services in order to catch up.

Remember that your voices have made a difference in the development of S. 1248! We need to make sure the Senators continue to hear our appreciation and concerns so they are prepared to protect our children’s rights when S. 1248 goes before the full Senate in July.

On the NDSS Advocacy Center Website, we have a letter prepared that you can sign and send to your own Senators via e-mail. Just click on http://capwiz.com/ndss/issues/alert/?alertid=2705606 and enter your zip code in the box on the right. Then just follow directions. If you have questions or comments about this information sheet, contact Patty Smith at psmith@ndss.org. If you or others you know would like to be added to the NDSS mailing list, send name(s) and email address to alauritzen@ndss.org. National Down Syndrome Society, 666 Broadway, New York, NY 10012, Phone: 800-221-4602; Fax: 212-979-2873; e-mail: alauritzen@ndss.orginfo@ndss.org Web site: http://www.ndss.org

(PRDDC) Craig A. Durfey, Founder, CraigD3976@aol.com . Please note that the Schafer Autism Report does not necessarily recommend the actions above or below. They are provided for our readers’ information only.]

Request all families who have been affected by children with autism to support Federal legislation HR 1350 amendment H.AMDT.98, to provide training first responders and school safety personnel how to best respond to children with autism author U.S. Congresswomen Loretta Sanchez and was agreed by voice vote.

However the US. Senate S.1248 did not include this very important issue of training first responders or school safety personal how best respond to children with autism. We need to be sure to let our Senators, House Representatives know to include this in the final Conference report to be sent for President George W. Bush to sign into law.

Pediatric literature doesn’t contain any medical cures, guidelines, or consensus for treating autism. However, most current treatments focus on improving overall function. Typically, this goal involves enrolling the child in an appropriate and intensive early intervention program to promote development of communication, social, adaptive, behavioral, and academic skills. These programs can also decrease maladaptive and repetitive behaviors, and help the family manage stress by providing information about community resources, such as respite care and support groups.

Clinicians should tailor interventions to developmental and behavioral needs as well as the family’s coping style and resources. Interventions may include parent education and support, highly structured social play, individualized school-based education, behavior management and training, medical treatment, and respite. Parents of children who have just received an autism diagnosis may find help through talking with other parents of autistic children.16 Help parents find a “parent to parent” organization, and give them the contact information for a local Autism Society of America chapter.

The federal government mandates age-appropriate early intervention and school programs, which are often based on a developmental delay rather than a specific diagnosis. The federal Individuals with Disabilities Education Act of 1990 (and subsequent revisions), mandates “appropriate” educational plans for children with developmental disabilities or delays and allocates specific rights to their parents. Services include speech-language therapy and occupational and physical therapy for preschool and school-aged children.

Several treatments consistently benefit children with autism. The treatments mentioned here don’t indicate exclusive treatment, nor do they serve as a standard of care. Al-though specialists will likely direct the care of a child with autism, remain actively involved, even if you disagree with the family’s treatment decisions.

Behavioral Technology and Social Skills Training Behavioral training and management is the cornerstone of treating autism at any age. Behavior management and structured teaching of skills help to prevent undesirable behaviors and help caregivers more clearly teach and give directions to children with autism. Discrete trial training is one form of applied behavior analysis. It involves intensive, one-on-one teaching so children learn small parts of behaviors or skills in short, repeated sessions. As a child learns skills, the teacher adds new ones in carefully planned sequences.

The “social story” uses scripted scenarios to help children with autism understand and follow specified social protocols.17 Another approach uses symbols or pictures to demonstrate appropriate and inappropriate behaviors.

Children with autism should be in childcare centers and classrooms with typically-developing children so they can model desirable behaviors. A teacher can extend this modeling by creating a “circle of friends,” in which she invites children to join a circle with an autistic child. The teacher then encourages the children to express concerns about the difficulties the child is having and help create solutions.

Communication training involving preverbal and verbal communication and occupational and physical therapy are also essential for managing autism. These are most effective when interwoven throughout a total program. Because children with autism often have a core deficit in functional communication, they typically need intensive intervention to develop receptive and expressive communication.

Based upon behavioral principles, speech therapy may focus on acquiring language skills or helping the child communicate more effectively by correcting errors in semantics or pragmatics. Gestural, verbal, pictorial, and technological systems and discrete trial training can effectively teach language. Each child needs an individualized program, with family and teacher support, to learn communication. Careful assessment is critical, as well as skilled training and commitment of the adults who will use the system with the child.14 Occupational and physical therapy can help address any coordination concerns and motor deficits.

Unconventional treatments abound partly because no medical cure exists for autism. Many parents pursue alternative therapies because of a desire to try almost anything that might help, claims of improvements from other families, or rising skepticism regarding scientifically-based treatments. Become familiar with the more popular alternative therapy treatments for autism, such as unconventional diets, vitamin supplementation, sensory integration, and vision treatments. Approach parents’ choices with objectivity and compassion.

Tell parents that many people are urging scientific evaluation of treatments. Advise that they should be skeptical of any treatment- especially those touted as a “cure,” a method that will lead to “recovery,” or one that will benefit all who have autism. Encourage parents to speak with a health care provider and ask themselves these questions before starting any proposed treatment:

In this full-length doctor’s interview, Thomas Spencer, M.D., explains how a different kind of drug is offering hope to the 2 million children in the United States with ADHD.

What do you consider the main thing people think they know about ADHD but don’t? Dr. Spencer: Well, it depends on when you heard about it. But in general, the public is a little bit behind on the wealth of new findings. [ADD] used to be defined as a motoric overactivity -- hyperactivity, minimal brain dysfunction, these old terms. In about 1980, the term changed to attention deficit disorder. It’s not really a total deficit, but a control of attention, more of a cognitive disorder, a brain disorder with behavioral features at times. That was a huge shift from kids who were overactive for whatever reason to somebody who had trouble paying attention, focusing, completing tasks, and who may or may not be hyperactive. There are other medical findings. Some psychiatric disorders are primarily psychosocial, primarily in relationship to family and upbringing. ADHD turns out to be more medical than many of these other disorders. It’s 70 percent genetic. That is, on average, 70 percent of its ideology, its cause, is genetic. That ‘s rare and it’s among the most genetic of disorders. A number of the brain studies that they’ve been able to do with the individuals with ADHD show remarkable findings. We’ve seen them with some of the other brain or psychiatric conditions, but they’re really quite striking and quite consistent in this disorder. I think the public is usually unaware of these things. It takes several years for it to kind of get out.

It’s almost gotten to the point where the terms ADD and ADHD have become interchangeable. Do you think that’s another area where people get confused? Dr. Spencer: That’s a good question. The names have changed over time, and by and large, when people use either name, they mean the same thing. It is a problem that some individuals with ADHD are very active and hyperactive, and some are not hyperactive at all. They simply have attentional problems or school-related problems, and we now think it’s differing forms of the same condition, so the titles have changed over time. Essentially, we mean the same area of conditions and both parts of it, the hyperactivity and the inattention, are related and can go together.

Are they usually treated the same way? Dr. Spencer: It depends on the type of treatment that you’re talking about. Medical treatments tend to work similarly for both conditions, but psychosocial treatments or environmental treatments may be quite different. If a child is simply disorganized, has poor discipline, and can’t function well in school, but is quiet and not a behavioral problem, you’d be working on school remediation, organizational issues, learning issues, per se, or social issues, say if those were primarily. There are other kids who are so full of energy that they’re a bit disruptive and they need some behavioral feedback. That’s a different kind of psychosocial treatment for a similar condition.

Does a child’s diet have anything to do with ADHD? Dr. Spencer: Your question about diet was actually formally studied. Everybody had the impression that diet was closely related. If diet was to be a cause of the problem, then if you changed diet, then people would get better, and it hasn ‘t been shown to be true. Kids with ADHD tend to crave junk food and sugar. They eat poorly. If you eat a lot of sugar, you’re a little more hyper, but even if you exclude sugar and all these additives and eat a very bland, difficult-to-enforce diet, you don’t improve that much. That was actually tested. There were lots of double-blind controlled studies of that. The American Academy of Pediatrics wrote a position statement saying that there may be a few sensitive individuals, but by and large, diet isn’t a good treatment for ADHD, and it’s not usually part of the cause.

The Essential Difference: Men, Women and the Extreme Male Brain Men and women have different brains. This notion has been the subject of increasing scientific analysis, media interest, and pulp psychology of the “men are from...” variety. Now, Simon Baron-Cohen (professor of psychology at Cambridge University) has drawn on 20 years of clinical and academic experience and attempted to summarise the research on this subject—an impressive proportion of which is his own—and its implications for the

brain: “empathising” (type E), “systemising” (type S), and “balanced” (type B, which is a meld of types E and S). With a reader friendly style and using fascinating data, he states his central claim that, on average, men have a type S brain, while the female brain is predominantly type E. There are exceptions, in that some men may have a type E brain and some women a type S brain. He goes on to consider the current (and evolutionary) strengths and weaknesses of these three types of brain.

He defines empathising as having a cognitive and an affective component—you perceive what another person might be thinking and you have an appropriate emotional reaction. Systemising is “the drive to understand a system and to build one.” Its aim is to “discover the causes of things,” allowing control of one’s environment. At its extreme, the author argues, the systemising brain is autistic (what he calls the “extreme male brain”). This explains the islets of ability seen in some autistic people (despite their associated mental retardation) and the narrow, yet often profound, depth of focus in the enthusiasms of people with Asperger’s syndrome (such as, probably, Newton and Einstein).

Some of the data that Baron-Cohen presents are depressingly deterministic. The author’s own team followed up a group of infants at one and then two years of age. They discovered that the higher the levels of prenatal testosterone, the less eye contact the child made as a toddler (with a correspondingly smaller vocabulary). The implication is that by measuring testosterone one can predict a toddler’s potential for empathy. What is new about this line of inquiry is that it opens up a possibility that autism may be connected to prenatal concentrations of testosterone (the research has yet to be done).

Baron-Cohen rightly concludes his exploration of this contentious subject by considering the ethical implications. We now contemplate a future where prenatal sex hormone levels could be altered, so as to avoid the possibility of autism or even a child with a “systemising” brain. Would this serve humanity? Quite rightly, Baron-Cohen defends the importance of brain variety, including the extreme male brain. “Without autism,” argues one of his autistic patients, “we might not have fire and the wheel.” Our difference is essential.

Iain McClure, consultant child and adolescent psychiatrist Vale of Leven Hospital, Alexandria, West Dunbartonshire imcclure@vol.scot.nhs.uk

Prevalence of Autistic Spectrum Disorder In Children Attending Mainstream Schools In A Welsh Education Authority

Developmental Medicine & Child Neurology (2003), 45:377-384 Mac Keith Press Copyright © 2003 Mac Keith Press DOI 10.1017/S0012162203000720 E Webb MSc FRCP FRCPCH a1 c1, J Morey MRPsych a2, W Thompsen MRPsych a3, C Butler Gmus Med a4, M Barber MRCPCH a1 and WI Fraser FRPsych FSocMed a2 a1 Department of Child Health, University of Wales College of Medicine, Cardiff, UK. a2 Department of Psychological Medicine, University of Wales College of Medicine, Cardiff, UK. a3 St. Davids Hospital, Carmarthen, Dyfed, UK. a4 School Services, Cardiff County Council, Cardiff, UK.

All mainstream primary schools in Cardiff were invited in July 1998 to participate in a prevalence survey of autistic spectrum disorder.

Teachers of each class filled in a questionnaire based on ICD-10 criteria for autistic disorders.

The Autism Spectrum Screening Questionnaire (ASSQ) was completed on children identified with problems identified by the questionnaire.

A total of 11692 children born between 1 September 1986 and 31 August 1990 were screened: 234 (2%) children were identified as requiring an ASSQ; 151 of 234 (65%) ASSQs were returned.

Thirty-five children, unknown to specialist services or with complex features, required additional assessment.

When the overall rubric was disentangled we found a diverse population of affected children including a handful who did not fit easily into ICD-10 classification.

Correcting for incomplete ascertainment we found a minimum prevalence of 20.2 out of every 10000 (SE=4.5) for autistic spectrum disorder in this population.

[Playing the “autism card” as a criminal defense is a two-edged sword. It may provide justice to the individual perpetrator in court. But every time autism is used as a defense for committing a violent crime, it creates and reinforces a public stereotype of autistic people being dangerous sociopaths to be avoided. -LS.] http://www.expatica.com/main.asp?pad=2,18,&item_id=32560

Amsterdam — Psychiatry experts called to give evidence at the Amsterdam Appeals Court contradicted each other when asked on Thursday whether the convicted killer of maverick politician Pim Fortuyn has a subtle form of autism.

The court requested expert witness testimony earlier this week in an attempt to determine whether Volkert van der Graaf, 33, has a condition known as Asperger Syndrome. Van der Graaf was sentenced on 15 April to 18 years jail for killing Fortuyn, but both the prosecution and the defence submitted appeals against the sentence.

If it is proven that Van der Graaf has Asperger, he could be sentenced to an unlimited period of detention in a secure hospital on the grounds of diminished responsibility.

Youth psychiatrist Menno Oosterhoff said Asperger is so subtle that psychologists at the Pieter Baan Centrum (PBC) missed symptoms and wrongly diagnosed him. He believes Van der Graaf has Asperger Syndrome and should be re-examined. The PBC examined Van der Graaf after he was arrest on 6 May 2002, the day that he killed Fortuyn.

Oosterhoff, a psychiatrist attached to the the Academic Centre for Child and Youth Psychology in Groningen, came to his conclusion based on media reports about the killer and the public prosecutor’s closing speech in the Amsterdam trial.

He said Asperger patients have a disorder in the true meaning of the word, giving as example several statements from Van der Graaf in which he admitted he had not yet given enough thought to the consequences of his act and the fact that he had not expressed regret for the murder.

But in contradictory testimony, PBC psychologist Jacob Oudejans said Van der Graaf did not have Asperger and that the Utrecht-observation clinic had taken into consideration the possibility that he might have autism when it conduction its examination. He said it became quickly apparent that Van der Graaf did not have autism.

The Amsterdam-Osdorp court has directed criticism at the PBC report, which stated Van der Graaf had a personality disorder, but ruled out the possibility it played any role in the murder of the anti-immigrant Fortuyn.

Fortuyn founded the populist LPF party before he was shot and killed in the lead up to the 15 May 2002 national election.

Oudejans said Van der Graaf had made a “political assessment of the danger of Pim Fortuyn” before carrying out the murder.

Meanwhile, the court requested the prosecution call a second psychiatric expert to the witness stand.

Forensic psychologist Corine de Ruiter was sworn in and agreed with Oosterhoff. Both of them said they could not understand why the PBC came to the conclusion that Van der Graaf’s disorder had not played a role in the murder of Fortuyn.

Van der Graaf, of Harderwijk, claimed on Tuesday he would never kill again and defence lawyer Stijn Franken also said on the first day of the appeal that 18 years jail was too harsh, reminding the court that no one without a prior conviction had received such a stiff penalty on conviction of a single murder.

The prosecution is expected to again demand a life sentence be imposed on Van der Graaf. It maintains its claim that the killer attempted to seriously frustrate the democratic process by murdering Fortuyn and asserts the court failed to take into account the lack of remorse expressed by Van der Graaf.

When Roseanne Smith reported her 16-year-old son, Ashton, missing 24 days ago, police assured her that he probably ran away.

But from the start, Smith insisted it was out of character for her son to miss his 11 p.m. curfew. The teen suffers from a form of autism that makes it unlikely that he would deviate from his everyday routine.

Now, no longer considered a runaway, Mountlake Terrace police are classifying him as “missing and in danger.”

“There’s nothing to indicate he was abducted,” said Detective Mike Haynes. “But we have not been able to rule anything out.”

A photo of the Mountlake Terrace High School student has been posted on missing children’s Web sites and tacked up at bus stops across Snohomish County.

Ashton Smith suffers from Asperger’s Syndrome, a disorder that can be characterized by regimentation or repetitiveness.

“Ashton has been gone for 23 days, outside of his normal routine, and I feel Aston would could come home, call me or something,” his mother said yesterday. “He would be lost without his normal routine.”

She said the teen interacts socially at a fifth-grade level and can be easily manipulated.

Smith, 42, who is unemployed, said getting police to reclassify her son as missing was a struggle.

She said she begged Mountlake Terrace police and state officials to issue an Amber Alert — a statewide emergency broadcast — when he first disappeared but her request was rejected because it didn’t meet the criteria.

Sue Wagner, missing children’s clearinghouse coordinator for the State Patrol, said an Amber Alert is issued when the missing child is under 18, law enforcement believes the child is in danger and there must be enough “descriptive information” to think a broadcast would assist in the recovery of a child.

“If somebody had seen Ashton get into a car it would fit the criteria, absolutely,” said Wagner, who is working closely with Mountlake Terrace police. “The problem is, if we did this on every missing child the plan would be ineffective. People would turn a deaf ear to it.”

Since the state’s Amber Alert system was signed into law by Gov. Gary Locke in October, it has been issued three times.

Ashton Smith’s parents are divorced. Among those questioned has been Wesley Smith, the teen’s father.

He told police he thought Ashton was depressed and perhaps suicidal, Detective Haynes said. But Ashton’s mother disagrees.

The teen was last seen about 9 p.m. June 9 in the cabana area of the Maple Glen apartments, where he lives, in the 5400 block of 212th Street Southwest in Mountlake Terrace.

He is white, has brown hair and eyes, is 5 feet 8 inches tall and weighs 140 pounds. He was wearing a gray or green T-shirt, blue jeans, white socks and blue Velcro sandals.

Geraldine Dawson, a University of Washington psychologist and director of the school’s Autism Center, said people who suffer from Asperger’s Syndrome have “routine and predicable lives.”

“It is a developmental disorder that affects the child’s ability to read social cues and to communicate nonverbally,” Dawson said. “You can almost think of it as a social-learning disability.”

Dawson said children who have Asperger’s Syndrome have much better language and cognitive abilities than most children diagnosed with “classic autism.”

While Roseanne Smith keeps busy tacking up fliers at bus stops in Snohomish and King counties, Haynes is disappointed that his tracking down of more than 30 tips has been unsuccessful.

“I’ve personally searched the parks in this city and the wooded areas within a mile of the complex,” Haynes said.

Ronnie Mich has autism. The money his father left was allegedly stolen, and his home was sold. The emotional loss may be greater.

Ronnie Mich woke up at 6:30 a.m. Tuesday in the familiar surroundings he’d known for all his 61 years.

It was moving day at 195 Carlisle Rd. in Audubon, but the autistic man didn’t fully grasp the cascade of events - the deception and the generosity - that led to this moment.

Ronnie looked in his small closet filled with shirts and slacks lined up neatly on wire hangers and picked out a pair of green trousers. On the door was a collection of neckties, each one tied by his father before his death nearly three years ago.

He needed every item in the room to be in its place. His pillow had to be centered on his double bed, a reminder to sleep in the middle, not too close to the edge.

Stuffed animals and the board games he loves playing sat on the bureau, and pictures of horses, dogs and cats adorned the walls. A sign on his door said, “Ronnie’s Room.”

Like the rest of the modest house, his bedroom was a 1950s time capsule, part of the ordered haven where he was supposed to live out his days.

His father, Stanley Mich, had seen to that. He’d worked hard and lived frugally, amassing $1.2 million - enough to provide for his son’s 24-hour care.

But now, with that money gone - allegedly stolen by the executor of the estate - and the house sold to pay off mounting debts, Ronnie was moving to a home for seniors with disabilities.

His neighbors and longtime friends, George and Elaine Stone, and caretaker Amanda Bramble helped him through the final hours, trying to calm his fears.

“Are they going to like me there?” asked Ronnie, slowly and softly pronouncing each syllable. “Are you going to visit me?”

At 7 a.m., he sat down for breakfast for the last time at a 50-year-old Formica-and-chrome table in the kitchen of his two-story home. His meal was the same as always: Wheaties, orange juice and coffee.

“He doesn’t want to leave, but he has no choice,” said George Stone, 58, who grew up with Ronnie on the block and was the driving force in a community effort to rescue him when his plight became known in May.

“What we have to do will be a shock to him. He understands he has to leave, but I don’t think it’s sunk in.”

In a few hours, Ronnie would walk out the door, leaving everything he’s ever known - the home his grandparents built nearly 100 years ago and his father bequeathed to him.

When his wife, Ethel, died in the 1950s, Stanley focused completely on the welfare of his son, then about 12.

He saved wages from his routes selling newspapers and potato chips and candies, and happily watched his wife’s telephone stock skyrocket.

He sought the help of lawyer Dennis O’Brien, a fellow parishioner at St. Rose of Lima Roman Catholic Church in Haddon Heights.

O’Brien, who was Ronnie’s age, had an office a few blocks from the Mich house and often bought large numbers of charity raffle tickets from Ronnie, who sold thousands in the neighborhood over the years.

Before Stanley died of cancer in September 2000, he named O’Brien executor of his estate and guardian to Ronnie.

Stanley didn’t know that the lawyer had been disbarred in 1999 and placed on five years’ probation for misappropriating thousands of dollars entrusted to him by clients.

Two years after Stanley’s death, Elaine Stone became suspicious about O’Brien’s handling of the estate after spotting a $5,000 property-tax-delinquency notice posted at a local bank.

O’Brien was supposed to have been paying the bills. On May 2, he was arrested.

Of the $1.2 million, all that remained was $163, said the new executor of the Mich estate, Charles Thompson, a family friend and Elaine’s brother.

O’Brien was charged with money laundering and theft in the alleged embezzlement of more than $1.5 million from six estates, including Mich’s.

The Camden County prosecutor’s complaint described him as a “marauder” and “manipulative, cunning individual” who preyed on the elderly.

O’Brien is being held without bond in the Camden County Correctional Facility and faces a parole-violation hearing Friday.

O’Brien’s attorney, Robert Agre, was on vacation and unavailable for comment.

About 35 people, including members of O’Brien’s church, have contacted prosecutors, saying they believe they also have been victimized. The losses may exceed $3 million, authorities said.

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