SCHAFER AUTISM REPORT "Healing Autism:

No Finer a Cause on the Planet"

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RESEARCH

* ADHD Kids Have Smaller Brains

* Behavior Problems Common In Kids With Ill Siblings

TREATMENT

* Risperidone Aids Severe Behavioral Problems Linked With Autism

FORENSIC

* Murder Charge in Fatal Plunge of Student, 15

* Two Psychiatrists To Evaluate Asperger's Boy, 14, in Poodle Sodomizing

EDUCATION

* Much Better Autism & Dog Story: Teacher's Therapeutic Dogs

Aid In Classrooms

CARE

* UK Reporter Receives Police Apology Over Restraint Abuse Expose

ADVOCACY

* B.C. Must Pay For Autism Treatment

AWARDS

* O'Brien Honored As Hero To Children With Autism

RESEARCH

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United Press International via COMTEX -- Children with attention deficit hyperactivity disorder have smaller brains overall and smaller key brain structures than children without the condition, researchers reported Tuesday in the largest brain imaging study ever conducted on these patients.

The reduced brain components could play a role in causing the over-activity, distractibility and impulsiveness that are hallmarks of ADHD, Judith Rapoport, chief of the child psychiatry branch at the National Institute of Mental Health and an author of the study, told United Press International. The findings of smaller brains "provide support in conjunction with other data like genetics that there is a clear biological factor in ADHD," Rapoport said.

She noted the smaller brains also were found in ADHD patients who never had taken Ritalin or other drugs used to treat the condition, so the size decrease is not caused by medications.

In the 10-year study, which appears in the Oct. 9 issue of the Journal of the American Medical Association, Rapoport and colleagues used magnetic resonance imaging or MRI to scan the brains of nearly 300 boys and girls ranging from ages 5 to 18. They found ADHD patients had brains 3-to-4 percent smaller, on average, than children without the condition. The ADHD kids also had smaller brain regions, including frontal lobes, temporal gray matter, basal ganglia and cerebella.

The study "helps to focus our attention on what brain regions may be doing things we didn't know very much about," F. Xavier Castellanos, a professor of child psychiatry and radiology at New York University School of Medicine in New York City and lead author of the study, told UPI. "For example, the cerebellum is a part of the brain we don't really understand and it seems to play a role in ADHD."

The smaller basal ganglia and cerebella, in particular, could account for some ADHD symptoms, Rapoport said. The basal ganglia is a part of the brain involved in planning and the reduced size could be related to the impulsiveness and restlessness seen in ADHD patients, she said. The cerebellum plays a role in coordinating movement so a decrease in this region may be linked to hyperactivity and increased movement, she said.

Brad Peterson, a psychiatrist at Columbia University in New York City, told UPI the research indicates the brain "starts out smaller and stays smaller" in children with ADHD. He said the finding that multiple regions of the brain were smaller in the ADHD kids "may suggest that there is no one area or structure" that causes the condition. Instead, a size decrease in many different brain regions may be necessary to cause the symptoms of ADHD, he said.

The smaller brain volumes might be the secondary results of other anatomical abnormalities, so the brain could possibly be suffering indirect effects from defects elsewhere in the body, Jerry Rushton, a pediatrician at the University of Michigan in Ann Arbor, Mich., told UPI.

The research also found the size reduction appears to have happened early on during brain development, Rapoport said, which could indicate that a critical signal or molecule is lacking during development.

Rapoport noted there are normal variations in brain size so this technique could not be used to diagnose people with ADHD. Also, the brains of the kids in the study do not appear to be progressing or getting smaller as they age, she said. Copyright 2002 by United Press International.

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Behavior Problems Common In Kids With Ill Siblings

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Berlin - Brothers and sisters of children with a chronic illness are significantly more likely to have behavioral problems than children without health problems in the family, according to new study findings.

The results come from the largest-ever study into children suffering from the rare condition spinal muscular atrophy (SMA), a progressive muscle wasting disease that confines patients to wheelchairs and in its later stages affects basic muscular functions such as breathing.

Dr. Christine Laufsweiler-Plass, who conducted the study at Cologne University Hospital, looked at children between 6 and 11 years of age, including 42 SMA patients, 17 siblings of SMA sufferers, and a "control" group of 28 other children with no chronic illness in the family.

Laufsweiler-Plass used a checklist, in which parents or other individuals rate a child's problem behaviors.

"There was a statistical difference between the number of siblings who scored as unusual on the...test and the number of those from the control group," she told Reuters Health.

The tests showed that 35.3% of the SMA siblings were disturbed in terms of behavior, compared with 14.3% of the control children.

The study did not determine the factors that may have contributed to the behavioral problems, she said. However, more social support for the parents appeared to help.

"It seemed that the parents coped better, and thus their healthy child did better, when they had sufficient social support, be that family or friends," she said.

"The caring parent usually has to get up three times a night to turn and check their sick child. Their relationship to the healthy child suffers, of course it does. But rather than money, it seems like a social support network is perhaps the most important factor in helping them cope."

Laufsweiler-Plass said her research had been accepted by the journal Developmental Medicine and Child Neurology and should be published next year.

The report of the entire study conducted by the university hospitals of Bonn and Cologne, which covered 96 children and examined a range of other factors such as IQ, coping mechanisms and incidence of incontinence, should be published next year. Copyright © 2002 Reuters Limited. All rights reserved.

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Risperidone Aids Severe Behavioral Problems Linked With Autism New Data from RUPP Study:

[From The Brown University Child and Adolescent Psychopharmacology Update Posted 09/27/2002. "Buyer Beware!" this drug can have some side effects. Thanks to Greg Nicholson. -LS]

Introduction: Risperidone may help treat the serious behavioral disturbances that accompany autism and closely related disorders such as pervasive developmental disorder (PDD), says Lawrence Scahill, Ph.D., principal investigator of a large, multi-site, eight-week, placebo-controlled clinical trial at the Yale Child Study Center.

The work is part of the Research Units on Pediatric Psychopharmacology

(RUPP) studies that have been underway at eight major U.S. sites since the mid-1990s. (See below for RUPP Update). Scahill and colleagues published their research in the August 1 issue of the New England Journal of Medicine (347:314-321).

"We're not proposing this as a treatment for autism," says Scahill. "We've tried to say that in the paper as squarely as possible, because with aggression, self injury, tantrums in response to usual environmental demands, those kind of serious behavior problems with autism, this is a reasonable medicine to try.

"It's a strong medicine and it's a medicine that really shouldn't be used unless one is aiming at those target symptoms," Scahill says.

Participants were 101 children and adolescents ages 5 to 17 who met the DSM-IV criteria for autistic disorder, with tantrums, aggression, self-injurious behavior, or a combination of these problems. Those receiving a drug that was deemed effective for the treatment of these behavioral disturbances were excluded. In order to meet the criteria for the study, potential subjects had to be free of other serious medical and psychiatric disorders requiring medication.

The participants -- 82 boys and 19 girls -- were randomly assigned to receive risperidone or placebo. The primary outcome measures were the score on the Irritability Subscale of the Abberant Behavior Checklist and the rating on the Clinical Global Impressions -- Improvement scale at eight weeks. Brown University Child and Adolescent Psychopharmacology Update 4(9):1, 2-3, 2002. © 2002 Manisses Communications Group, Inc.

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FORENSIC

Murder Charge in Fatal Plunge of Student, 15

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A student at a school for troubled children in Upper Nyack, N.Y., was charged with second-degree murder yesterday in the fatal plunge of his roommate from a second-story window, the Rockland County district attorney's office said.

The student, Ian Sinovoi, 17, is accused of pushing Jeremy Gaulin, 15, last Thursday evening from the window of the dormitory room the two shared at the Summit School for only a day or two, said Michael E. Bongiorno, the district attorney.

Mr. Gaulin of Hastings-on-Hudson, N.Y., suffered head injuries and died on Saturday at Nyack Hospital. Mr. Sinovoi, of Manhattan, was first charged with assault. But yesterday a Rockland County grand jury indicted him on a murder charge.

Investigators were still searching for a motive. "There was no conflict that we can uncover so far," said Sgt. Bernard Cummings, a detective in the Clarkstown Police Department, which covers Upper Nyack.

He said the death was ruled a homicide based on witness reports, but he would not elaborate.

James Filenbaum, a lawyer for Mr. Sinovoi, who is being held without bail in the Rockland County Jail, said his client would plead not guilty to the murder charge. Mr. Filenbaum faulted the private school for not providing more supervision of its students, who struggle with learning disabilities and emotional problems.

Mr. Sinovoi suffered from Asperger syndrome, a psychiatric disorder thought to be related to autism, and Mr. Gaulin had attention deficit disorder, Mr. Filenbaum said.

"You have a child with Asperger's syndrome, who by definition is someone who cannot read social cues and is susceptible to being easily frustrated," he said.

A receptionist for the school said yesterday afternoon that all administrators had left for the day and were not available for comment.

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Two Psychiatrists To Evaluate Asperger's Boy, 14, in Poodle Sodomizing

Two psychiatrists will evaluate the Tucson teen accused of mutilating a poodle last month to determine if he is mentally competent to stand trial.

Dan Cooper, the lawyer representing Chris Faw, 14, asked Pima County Juvenile Court Commissioner Theodore Knuck to delay setting a trial date pending Faw's evaluation.

The teen sat in court yesterday flanked by his parents and his lawyer as the judge ordered the psychiatric evaluations.

Deputy Pima County Attorney Peter Hochuli requested that psychiatrist Dr. Bernard Morenz evaluate Faw on behalf of the state. Cooper requested that Dr. Herschel Rosenzsweig evaluate Faw.

Faw is a special education student at Rincon High School. He has Asperger's syndrome, a neuropsychiatric disorder similar to autism.

Cooper said Asperger's syndrome results in difficulty processing information, a lack of coordination and poor social skills.

Faw is charged with felony animal cruelty for allegedly sodomizing Prince, a 7-year-old toy poodle, with a tree branch on Sept. 20. The dog had to be euthanized because of severe internal damage.

Faw denies being involved with the attack, Cooper said. He said he does not believe Faw is competent to stand trial.

"I don't think he knows what's going on," Cooper has said.

Faw, who was originally held in detention, was released from custody last week while awaiting trial. He is under house arrest with an electronic monitor, and must be accompanied by an adult at all times.

Faw's next court appearance was scheduled for Nov. 22.

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EDUCATION

Much Better Autism & Dog Story: Teacher's Therapeutic Dogs Aid In Classrooms

The kids in Teresa Owens' class don't do a lot of running and jumping. But that doesn't mean they don't have their own brand of fun.

Owens teaches special education at Kalifornsky Beach Elementary. The five students assigned to her intensive needs class have a range of disabilities, both physical and mental. Some come to class in wheelchairs and move only with the help of teachers and aides. Some stare toward the ceiling, displaying varying degrees of autism and often ignoring other people.

But on days when Owens' special friends attend class, even the most wandering eyes brighten a little.

"He says Nellie and Maggie, but he still won't say Teresa or Mrs. Owens," the teacher confesses as a student walks down the hallway with one of the canine visitors.

Nellie and Maggie are Owen's golden retrievers -- and an increasingly visible part of the K-Beach community.

The dogs spend most of the day in Owens' classroom, socializing with her students.

"In this classroom, they are motivating, a comfort. They're sensory stimulation for kids that have more intensive physical needs," Owens said.

The warmth, softness and movement offer the students physical interaction they sometimes lack.

"It gives them a sensation they may never experience," Owens said. "We have a lot of medically fragile kids, a lot of kids in wheelchairs. In a small way in our classroom, they get that interaction that a lot of kids get and take for granted."

The dogs also can serve as a form of equipment. In addition to the specialized chairs, floor mats and bean bags that litter the classroom, the dogs also can be used to help position students with mobility disabilities.

For example, Jonathan Johnson, left to his own devices, will crawl across the room on his belly. But under Owens' watchful eye, Johnson can stand up holding onto Maggie.

Sky Brooks doesn't stand, but Owens' will often lay the boy beside cuddly Nellie to let him feel the dog's rhythmic heartbeat and breath.

The dogs also serve as motivation for the students. When the children are reluctant to try something new, time with the dogs is an excellent reward.

"The kids love them. With students with very, very limited movement, we get smiles and laughs when they're kissed on by the dogs," Owens said. "It's amazing to see kids who didn't talk or relate to people talking to animals."

But even with all they do in the special needs classroom, the dogs' services don't stop at Owens' door. In fact, Owens said, they are playing a larger role in the school all the time.

For example, Nellie and Maggie are integral parts of the school's Title 1 program. The remedial math and reading teachers often borrow the dogs as a reward for their students.

Other teachers use the dogs to help calm their classes. One fifth-grade teacher, Owens said, likes to bring the dogs into her classroom after lunch when she reads aloud to her class.

In part, the dogs' presence is a reward to the class for calming down in the boisterous afternoon hours. The dogs also help calm overly active children by providing an energy outlet.

"The kids who are real wiggly can pet them and keep their hands moving, but still concentrate and pay attention," Owens said.

The dogs also are important to the reading program at the school. Students who need extra help or who are afraid to read aloud in front of their peers can use the dogs as practice.

"(The dogs) love the attention, the voice talking to them, being petted," Owens said. "And they're not going to laugh or make jokes or get bored."

Some students, such as Brooke Ansotegui and Alea Perkovich, fourth-graders in Connie Tobin's class, stop by to read just for fun.

"These little girls come in almost every day," Owens said. "They take their recess to come here and read with us, to the dogs and to the students."

"I love to read and I just like coming in here and reading to them and playing with them and stuff," Brooke said.

Alea agreed.

"I love to read also," she said. "And these are really sweet kids. If they have to be in here and do work and stuff, maybe they should have a lot of fun, too."

And then there are the lessons about pets in general. Throughout the day, students from various parts of the school stop by Owens' room to walk and groom the dogs.

"It teaches appreciation for animals, how to care for them," Owens said.

Students learn safe ways to approach people with dogs, how to walk dogs on leashes and how to brush and pet dogs properly.

And these programs are just the beginning, Owens said.

Owens -- and Nellie and Maggie -- joined the K-Beach staff this fall, but all three have been involved with special education most of their lives.

Owens began working with people with disabilities when she was in high school and has been teaching for 18 years.

She was teaching adaptive physical education in Kotzebue when she got Nellie and Maggie, now 4 and 5, respectively.

When the dogs were puppies, she started bringing them for school for walking field trips and outdoor activities -- and things grew from there.

But as many services as the dogs provide at the school, Owens pointed out that not all animals are suited for the classroom.

Nellie and Maggie were both bred as therapeutic dogs. Their breeding makes them especially calm, even for golden retrievers, Owens said.

They also have been through the Pet Partners program sponsored by the Delta Society, which trained them as animal assisted therapy dogs. Owens said that peninsula pet owners who are interested in training their dogs for therapeutic activities should contact the Delta Society for more information before introducing the animals to groups of people.

In addition, Nellie and Maggie have passed a series of puppy obedience classes and taken the Canine Good Citizen test. And, they have spent most of their lives being socialized for the classroom.

"At times, they're stepped on or their tails are yanked and they don't really respond," Owens said.

As she thumbed through a photo album last week, Owens recalled the many programs the dogs worked with in Kotzebue and talked about programs she'd like to set up here.

Most of the programs were similar to the ones now growing at K-Beach. Nearly 160 of the Kotzebue school's 500 students participated in the dog walking program. Remedial reading students read stories to the animals, and Nellie and Maggie worked with intensive needs students, including one who suffered grand mal seizures.

"Nellie could sense when he was going to have one," Owens said. The dog would nudge the boy to sit down and then lay with him through the seizure and until he woke up.

In Kotzebue, the dogs also were part of an incentive program to improve attendance and punctuality. Kids who showed up to school on time, regularly, were allowed to spend time with the animals. And it worked, Owens said.

The dogs also worked with the counseling department, helping upset students open up.

One day, Owens recalled, a girl whose grandfather had died was crying and refused to talk to anyone. Owens offered Maggie to the counselor to help. Telling the crying child that the dog really needed to be brushed, the counselor turned away and pretended to work at her computer.

"She told (Maggie) all about her Tata (grandfather), and after about a half an hour, she stood up and said she was ready to go back to class," Owens said.

Owens said that attendance isn't a problem at K-Beach, but that she has offered the dogs to the counselors there. She also said the dogs will be involved wherever a need arises.

"It's been so successful. Every time I move to a new district, I find a way (to bring the dogs in)," Owens said. "The support from this school has been phenomenal. The principal (Sylvia Reynolds) is extremely supportive and the teachers are very, very supportive.

"So many amazing things happen with a program like this. It's amazing to me that it can be that simple."

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UK Reporter Receives Police Apology Over Restraint Abuse Expose

Undercover reporter Donal MacIntyre and his BBC team were today given an unreserved apology from Kent police, who also paid substantial damages after settling a libel action out of court.

The journalist said he was "delighted we have been completely vindicated" after police criticism of his investigation into the treatment of residents at a care home.

It is thought to be the first time police have paid out in a libel case.

MacIntyre sued after an edition of his 1999 series, MacIntyre Undercover, was criticised by police as "misleading".

But in a high court statement today the force accepted the comments were incorrect and unjustified.

MacIntyre's series was a flagship of investigative journalism and the criticisms were a huge embarrassment to both the BBC and the presenter.

Although no figures were released today the damages and costs are said to be "substantial" and are understood to add up to a six-figure sum.

MacIntyre is giving the cash to two charities for people with learning disabilities.

In the programme he worked at the Brompton care home in Gillingham, Kent, using secret filming techniques to expose the practices of staff.

At the time of its broadcast, he said the programme had showed it was a home "where some of society's most vulnerable are assaulted by those looking after them, where restraint methods are used that can kill".

The findings caused uproar and led to an inquiry by Kent police, for which the reporter handed over hours of tape.

But following an investigation lasting months - and which led to two workers being cautioned for five offences of criminal assault - police criticised the programme, which they said was "misleading".

MacIntyre launched a legal battle against senior figures in the force, including the Chief Constable of Kent, Sir David Phillips, to defend his reputation.

Today the police agreed the programme "served the public interest in alerting viewers to the poor standards of management and care within the home".

They accepted the programme gave "a fair and accurate impression of life at the Brompton Care Home and exposed distressing and unacceptable behaviour by some members of staff".

Police apologised "unreservedly", withdrew the remarks and promised not to repeat them.

Outside court today MacIntyre said: "Kent police today acknowledged that the Brompton Care Home programme gave a fair and accurate impression of life there and exposed distressing and unacceptable behaviour by some members of staff.

"This programme was very important to me as it gave a voice to some of the most vulnerable people in society.

"People with learning difficulties have a right to quality care and protection, free from abuse, and I am delighted that we have been completely vindicated."

[RELATED LETTERS]

Exposing Crimes Against The Vulnerable

The public apology by Kent police has vindicated MacIntyre Undercover's exposure of a dire culture of neglect at the Brompton care home (Libel police ignored damning report, October 9).

The home's residents were vulnerable people who were subjected to threatening and abusive behaviour. The documentary was a shocking demonstration of how physical interventions, or restraint, can lead to abuse when used inappropriately. As a result, this previously taboo subject became a key area of concern and people with learning disabilities and autism now have the protection of national guidelines when they are subject to physical interventions.

Unfortunately, our research shows that people with a learning disability continue to experience hate crime, sexual abuse and other crimes every day. They are still not being heard - and believed - by the police and given a fair deal by our legal system.

All allegations of abuse must be taken very seriously and must be fully and sensitively investigated - particularly when they involve people who may have difficulty in communicating their experiences. Yet until important changes are made in law and policy to ensure that vulnerable people enjoy equal protection and the same basic human rights that the rest of us take for granted, these crimes will continue.

- John Harris British Institute of Learning Disabilities

- David Congdon Mencap

- Dr Jean Collins Values into Action

I participated in the making of this programme in that I viewed extensive video footage of life at the home. I was left in no doubt that there were serious matters warranting criminal and social services investigation.

It was therefore with incredulity that I read the report in the Sunday Telegraph, which while obviously damaging to Donal Mcintyre and the BBC also had the effect of trivialising the abuse and ill treatment of people with learning disabilities.

The programme makers had a duty to take action on their concerns and were right to report them to Medway social services department. Had there been no retraction, the clock could have been turned back to a time when people with learning disabilities were seen to be unworthy of the protection of the law.

- Richard Mills National Autistic Society

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* * *

ADVOCACY

B.C. Must Pay For Autism Treatment

Vancouver (CP) -- British Columbia's highest court has ruled the provincial government must pay for expensive early-intervention treatment for autistic children.

The B.C. Court of Appeal upheld a previous ruling that declared the government had violated the Charter of Rights and Freedoms by not providing funds for such care.

The treatment can involve 40 hours of therapy a week and cost up to [Canadian] $60,000 a year.

The original lawsuit was brought by four families with autistic children who want the Lovaas treatment used.

They were each awarded $20,000 in damages.

But the families argued the award was too small and that the government was still not providing adequate treatment for autistic children.

In upholding the lower court ruling, Appeal Court Justice Mary Saunders did not order the government to use the Lovaas treatment, but said it must fund some kind of intensive therapy.

If it doesn't, she said a legal application may be made to enforce her order.

B.C. Attorney General Geoff Plant said the government is examining the impact of the ruling but said the province is in fact funding early-intervention treatment.

"We have a program in place for that purpose," he said. "So we'll be studying the reasons for judgment and deciding what implications they have for us in the days a weeks to come."

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AWARDS

O'Brien Honored As Hero To Children With Autism

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In recognition for his commitment to children with autism and their families, the Philadelphia Chapter of the Autism Society of America presented O'Brien with its first Hero Award.

"He's our guy," said Gianina Griffin, coordinator of Chester County's autism support group. "He knows all of the issues, and gets information from parents and professionals."

"There would be people from all over Pennsylvania who would be here if they could," said Peggy Beck, co-president of the ASA's Philadelphia Chapter. "What he's done benefits people in the entire state."

"I feel uncomfortable being recognized as a hero," O'Brien said to the group, who crowded into his Far Northeast office. "Like many people in this room, I've made a lifetime commitment to children with autism and children with disabilities."

O'Brien's journey to becoming an advocate for autistic children started with his own family. His sister's son, Christopher, now 16, was diagnosed with autism, and O'Brien learned firsthand the hardships on a family and the aggravation in getting services for his nephew.

"We all know the achievements and possibilities, if we take advantage at the age-appropriate levels with appropriate programs," he said.

Since taking the lead, O'Brien has established a stakeholders group, which addresses critical issues in early intervention service for young children with disabilities. He's led the fight to maintain funding essential to the operation of approved private schools for children with disabilities, and ensured ongoing availability of Medicaid-funded behavioral health services for children in need.

O'Brien has founded and serves as a chairperson for the bipartisan autism caucus in the assembly, and is now seeking the creation of a service delivery system that will empower and support individuals throughout their lives.

He continues to work with autism experts and researchers in the state, and is at the center of an effort to secure funding for the formation of a Center of Excellence, which would be devoted to discovering the causes of autism spectral disorders, and developing treatments.

"This disorder was once viewed as one with no hope for effective treatment," Beck said. "Due in large part to Representative O'Brien's work that has changed. He's done a wonderful job educating the assembly and the community about the needs of this population, and making sure that legislation gets passed and services are put in place that are urgently needed."

O'Brien accepted the award from Beck with his mother, Patricia, and his sister, Mary Maurer, in attendance.

"My involvement with all of you has made me a much different person," O'Brien said. "You've enriched me in a very special way. The dreams that you have for your families, I share with you."

Beck recalled a rally, held last spring in Harrisburg, to protest the discontinuance of funding for services.

"I can remember the sea of faces from all over the state," Beck said to O'Brien. "We were inspired by your leadership, and empowered by your work to fight for our kids. We moved beyond our local groups and found our voice as a community."

While O'Brien and those in attendance acknowledge that much has been done to help autistic people and others with disabilities, they also understand that the work must continue.

"This is not the next thing that we're going to get to," O'Brien said. "It's got to be the thing that we're dealing with now. This issue has arrived, but we still have a lot to do."

"He's done this, not because it's popular, but for the simple reason that he cares about the value and quality of human life," Beck said. "He is a bright light, a beacon, that reminds us of the things that are right in our world." ©News Gleaner 2002

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