SCHAFER AUTISM REPORT "Healing Autism:

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CALENDAR LISTING:

RESEARCH: "Movies" Follow-up. Lorenzo's Oil, Rainman

* Lorenzo's Trial

* 'Rain Man' Amazes Audience in PA

* Institute of Medicine Immunization Safety Review Meeting

* Study Links Antibiotics in Pregnancy to Allergies

* Study Sees 2nd Fetal Benefit in Folic Acid

CARE

* Free Autism Screenings Offered in Connecticut

* THE AUTISM CRISIS: Number Of County Children Diagnosed With Autism

Is Exploding

FUNDRAISING

* O.C. Triathlete's Motivation Now Comes From Without

* Readers' Posts

RESEARCH: "Movies" Follow-up. Lorenzo's Oil, Rainman

Lorenzo's Trial

A 10-year study has finally proved - after all the doubts and ridicule - that Augusto and Michaela Odone's home-made treatment for their son Lorenzo's genetic disorder really does work.

Lorenzo Odone was only five years old when his parents noticed that he kept bumping into the furniture. A horrifying diagnosis followed: Lorenzo had a rare, incurable genetic disorder that affects only boys, known as adrenoleukodystrophy (ALD). He would lose all his bodily functions and die within two to three years. If you've seen the 1992 Hollywood film Lorenzo's Oil, you'll know what happened next.

The Odones, neither of whom had medical training, were not going to sit around and watch their son deteriorate. "We were not prepared to believe that there wasn't a cure," says Augusto Odone. So they set out to find one, ignoring doctors who said the literature would be too "complex" for them to understand. The result was, says Odone "a case of man bites dog": after two years immersed in medical texts and journals, badgering specialists across the globe and wrestling with neurogenetic theories, they discovered a blend of plant oils that they believed would delay their son's disease. On May 29 this year, Lorenzo, now severely disabled, turned 24.

To say there has been scepticism among doctors, scientists and support groups about the efficacy of "Lorenzo's Oil" would be an understatement.

They scoffed at the idea that an oil invented by novices could halt the disease. They put the boy's survival down to a combination of superlative care and luck. Parents of ALD boys who found that the oil did not save their sons accused the family of offering false hope. But now the Odones, who have been called anything from quacks to prophets, finally seem to have been vindicated. A clinical trial of the oil led by a world authority on ALD has just been published. It shows that Lorenzo's oil works.

Dr Hugo Moser, a leading expert in ALD and director of neurogenetics at Baltimore's Kennedy Krieger Institute conducted the 10-year-long trial, set partly in the US and partly in Europe. It followed 104 boys with the ALD gene, all less than six years old and symptom-free when the trial began. The results were dramatic: the boys who were not scrupulously given the oil were nearly three times as likely to develop symptoms as boys who were given the oil without fail. As Moser puts it, Lorenzo's oil may not be "an absolute preventive" but it certainly "reduces the chances of developing the symptoms".

The oil is a combination of two fats extracted from olive oil and rapeseed oil. It works, it is thought, because of the way it affects the "very long chain fatty acids" in the boys' bodies. In boys with ALD, the enzyme that breaks down these fatty acids is impaired. They can't properly metabolise these acids, which then build up and begin to damage the central nervous system. Specifically, they destroy myelin - the white matter that insulates the nerves and allows impulses to be conducted from one part of the body to another. This is why some of the early signs of ALD include memory loss, emotional instability, difficulty with vision, hearing and motor function.

This devastating process of gradual brain damage is known by specialists as demyelination. Usually, boys who have the childhood form of ALD will be bedridden, blind and unable to swallow by the age of 10. They will die soon after.

Sadly, Michaela Odone is not here to see these results. Having given up work, social life, entertaining and all other interests to care for her son, she died of cancer in June 2000. Augusto Odone, though, sounds matter-of-fact about their public vindication. "For me, this isn't ground-breaking," he says. "I already knew it worked." He describes how, at the end of the film about his family, there is a shot of some young boys "jumping up and down". These are all boys with the ALD gene "I knew those children," Odone tells me, "I put them on Lorenzo's oil. I have followed those children as they are growing up. None that I know of have got the disease".

That the oil came too late to stop his son from developing the symptoms must be hard to bear. Lorenzo lost most of his bodily functions and has been bedridden for 18 years. His mind, however, is "still there" - his father says he communicates by blinking and raising his fingers; he loves music, and being read to. "If I'd invented Lorenzo's oil two years before, it would have been different. Most probably he would not have got the disease," says Odone. "Still, it will save the lives of many children who are destined to have the childhood form of ALD".

Until now, the main treatment for childhood ALD has been a bone marrow transplant. Many specialists believe this still offers the best hope of survival. Some are saying that the trial only proves that Lorenzo's oil delays the symptoms and none are saying that Lorenzo's oil should now be used to the exclusion of all other treatments. Moser's trial was, after all, relatively small, and for obvious ethical reasons there could be no placebo group. None the less, says Dr Ian Duncan, professor of neurology at the University of Wisconsin, the consensus among specialists is that "this is an extremely important finding". Most, he says, now "acknowledge that this therapy can work". Moser, who was a doubter in the beginning is now recommending that every presymptomatic boy with ALD is given it.

It's not yet clear what will happen to the boys who have taken the oil and reached the age of 10 (by which time the disease has normally shown

itself) without symptoms. ALD comes in two main forms - Lorenzo's kind and an adult type, which shows up in the late teens or early 20s and acts more slowly ("you can," says Duncan, "live for long periods" with the adult form). The boys studied are still teenagers, so nobody knows yet whether they will develop the adult type. Indeed, says Duncan, we don't even know whether these boys will be at a higher risk of developing the adult form of the disease.

Sadly, for the boys who did develop symptoms, there is still no cure (though Odone certainly believes the oil has played a part in his son's survival this far). In a message to parents of boys with ALD, Odone told the New Scientist: "Give the oil as soon as you know your son carries the genetic defect. If you wait, the symptoms might come and then you are in a different ballpark." Duncan, who specialises in "re-myelination" in childhood disorders, confirms this: "The oil does not promote myelin regeneration."

This, for Odone, is the next challenge.

'What I want to do," he tells me, "is to restore functions in Lorenzo." He now runs an organisation called the Myelin Project which funds research that will "increase the odds that a way will be found to bring back myelin". If this were to happen, the implications would go far beyond ALD boys. Several other diseases destroy myelin - multiple sclerosis (MS) is perhaps the best known. About 85,000 people in the UK suffer from MS, and the Myelin Project estimates that "demyelinating" diseases affect about a million people in industrialised countries alone.

The Myelin Project is currently financing Yale University doctors to do pioneering surgery that will see whether it is possible to rebuild myelin.

Three MS patients so far have had myelin producing cells taken from their ankles and transplanted into the right frontal lobe of the brain. This, Duncan explains, will eventually show whether you can "promote the brain to repair itself".

It is too early to tell whether these cell transplants will work - whether they will multiply so that the patient begins to regain lost bodily functions. But for many people who hope desperately for a cure for diseases like ALD and MS, the very fact that such experiments are under way is positive. "The drive and determination behind the Myelin Project is our best and brightest hope for the future," says Diana McGovern, who has multiple sclerosis, and is honorary secretary of the British Trust for the Myelin Project. Odone is certainly a tireless ally to have. His favourite aphorisms are "Fortune favours the brave" and "You never know until you try." He will, he says, repeat these to the doctors he works with until the Myelin Project has put itself out of business.

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'Rain Man' Amazes Audience in PA

By all appearances, Kim Peek is a typical mentally retarded man; thick glasses, a laughing voice, quick to give strangers a hug - all are often symptoms of those facing mental challenges.

But, when you sit down to talk with Peek, you find out he's a lot different.

He is a "megasavant," meaning he has many talents. He has read more than 8,000 books, for example, and can remember everything he has read. It is estimated only one of 70 million people share the same abilities.

His father noted Kim can open a book and his left eye can read the left page while the right eye reads the right page. During a test of his comprehension years ago, Kim read eight pages in 53 seconds; his father read the same eight pages in 23 minutes. Two hours later, when tested, Kim had a 98.7 verbatim recall of what he read. His father's recall was 45 percent. "I was normal,"

his father said.

His son has a knowledge quotient of 194, comparable to Albert Einstein's score of 149.

Peek, for whom the Academy Award-winning motion picture "Rain Man" was patterned, was in town Monday night as the final event of The Arc of Crawford County's 50th anniversary celebration.

Sitting in a chair along the middle of one wall at the center, he shared his talents with approximately 200 people in attendance.

Peek has the ability to remember events in 12 different categories including sports, music, the Bible and history.

He travels the country with his father, Fran, to display his talents as well as to inspire parents whose children may be autistic or have other mental challenges.

Neither Peek nor his father accepts any pay or gratuity for their appearances, just lodging expenses.

During the 90-minute program, Kim displayed a great sense of humor as well as amazing knowledge. His father explained the scientific reasons for his son's talents, noting his brain lacks the ability that normal people do to discard information.

Kim accepted questions from the audience and gave the answers - ranging from headlines on certain dates, to World Series and Triple Crown winners, to the name of obscure islands near Ecuador.

He quickly recited the 66 books of the Bible, turning to a sing-song recitation by the time he got to the book of Acts in the New Testament.

Asked how many years the New York Yankees have won the World Series, he quickly answered 25 and proceeded to name the years. He could recite the television channels in Rochester, N.Y., as well as the old area code and the new area code. "Wow" was the response from the member who asked the question.

What was different about April 4, 1947? "It was a Monday, the day after Easter," Kim replied. "What's this here? Hey. It's Number 42. Jackie Robinson has broken the color barrier," he said, reciting the apparent words written that day about the former Major League Baseball player as the audience applauded.

What day did the first shuttle land on the moon? "No shuttle landed on the moon yet," he replied, adding the first man and rocket landed July 20, 1969, and told the names and the words spoken.

Reminiscent of a game show, Kim sat and fielded question after question, being stumped by only two - the name of the inventor of "white out" (the liquid eraser) and who Martha Carrier was.

"I don't know that," he said without hesitation or apology of the first question. He said Carrier was involved with the air conditioner, referring to a food refrigerator he had from the Carrier company. She was, in fact, a witch in Salem. When told of her identity, he immediately responded with other information about the Salem area.

Every time a date was given, Kim would tell what day of the week it was and what happened that day, and ended by telling the questioner the year he or she could retire.

Arc director Randy Gorkse was master of ceremonies. He said Kim often answers questions in the literal sense. Asked for Lincoln's Gettysburg address once, Kim gave him the street address where Lincoln lived.

As he began his program, he gave his philosophy about life. "Learn to recognize and respect differences in others and treat them as much as you would like them to treat you and you will make this a better world to live in."

While his message was serious, Kim often laughed aloud with his own joke or sang a tune in response to a question about an obscure opera or a song featured in a movie.

His father encouraged parents with autistic children to make certain they are tested through MRIs, not just X-rays, so specialists can determine how to help them. He noted the many strides made in the field of mental challenges.

He also advised them to enjoy and to love their children. "Everyone is different," he said.

All contents © copyright 2002 The Meadville Tribune.

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Institute of Medicine Immunization Safety Review Meeting

[From the IOM.]

This posting contains three announcements about the upcoming meeting of the Immunization Safety Review committee.

* * *

Study Links Antibiotics in Pregnancy to Allergies

015/hl_nm/pregnancy_allergies_dc <- - address ends here.

New York (Reuters Health) - A large study of British children suggests that women who have an infection or take antibiotics during pregnancy are more likely to have a child with an allergy-related condition, such as asthma, hay fever or the skin condition eczema, researchers report.

However, the findings do not mean that pregnant women should forgo necessary antibiotics during pregnancy, according to Dr. Michael J. Welch, a pediatrician in private practice in San Diego, California, and a spokesperson for the American Academy of Pediatrics. Studies have shown that certain conditions, such are urinary tract infections, can increase the risk of preterm labor, fetal death or mental retardation in the baby if they are not treated with antibiotics.

"This is an interesting study but all of the pieces of the puzzle are not in and pregnant women should not alter their antibiotic use," Welch told Reuters Health.

In the study, Tricia McKeever and colleagues at the University of Nottingham in the UK evaluated the medical records of nearly 25,000 British children and their mothers, according to a report in the American Journal of Respiratory and Critical Care Medicine.

Children exposed to antibiotics in the womb had a higher risk of developing asthma, hay fever and eczema than children whose mothers did not take the medication during pregnancy.

"Approximately one third of the mothers were prescribed one or more courses of antibiotics during pregnancy and this exposure was associated with an increased incidence of all three allergic disease," the authors write. The researchers found that an infection during pregnancy was also associated with a small increased risk of allergies in a woman's offspring.

Because a person's immune system develops while he or she is still in the womb, some experts speculate that "factors that modify microbial exposure at this time may have a long-term impact on the risk of developing allergic disease, but research in this area has been limited," the researchers note.

More study is needed to confirm the findings.

SOURCE: American Journal of Respiratory and Critical Care Medicine 2002;166:827-832.

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Study Sees 2nd Fetal Benefit in Folic Acid

Folic acid, the B vitamin that has been found to prevent birth defects, may also reduce the rate of miscarriages early in pregnancy, researchers say.

Folic acid, found naturally in liver and raw vegetables, plays so important a role in fetal growth that the government requires that grain products be fortified with it. But not every country has such a program, and some studies have raised concerns that higher levels of the vitamin may be linked to miscarriages.

The new study, being reported on Wednesday in The Journal of the American Medical Association, was conducted in Sweden, where fortification has not been introduced. The researchers, from the Karolinska Institute in Sweden and the United States' National Institute of Child Health and Human Development, studied 468 women who suffered miscarriages before the 20th week of pregnancy and 921 others.

It found that women with low levels of the vitamin were at nearly a 50 percent increased risk of miscarriage. Women who had higher levels showed no increased risk. "Fortification most likely will not increase spontaneous abortion rates," the authors said, "and might even decrease them."

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CARE

Free Autism Screenings Offered in Connecticut At the Institute for Educational Planning During November in Milford

[Thanks to Kathy Mannion at the Connecticut Center for Child Development.]

The Institute for Educational Planning (IEP) in Milford, CT is offering FREE Autism SCREENINGS during the month of November for any child up to six years of age that a parent, doctor, or educational provider suspects may have autism or a related disorder. Screenings will determine the need for a full evaluation.

Screenings consist of a clinical observation, parental interview, and the administration of screening tools used to identify behaviors that are consistent with a diagnosis of autism. Immediately after the screening, findings and recommendations will be shared with the parents and/or doctor. Contact resources will be provided if a full evaluation is recommended. The duration for the screening will be approximately fourty five minutes to one hour.

For additional information or to schedule an appointment for a FREE SCREENING during the month of November, please call IEP at 203-876-5917.

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THE AUTISM CRISIS: Number Of County Children Diagnosed With Autism Is Exploding Dozens of autistic children and teenagers will soon reach the age of 21. Who will provide support for them then?

The numbers are amazing, startling even.

Seventeen Bucks County children received special education services for autism, a mysterious incurable developmental disorder, in 1991. Ten years later, there were 277 - and more are identified every day.

In 10 years, the county has experienced a nearly 16-fold increase in the number of school-age children with autism.

That has created a new worry: What happens when they grow up and lose the state help they were eligible for as children? It's a fact of life that educators, state and county officials and parents will deal with in unprecedented numbers over the next five to 10 years.

"The clock is ticking for our children," said Ambry Ward, who has a mildly autistic 14-year-old son. "You don't know what is on the horizon at all."

Richboro mother Evy Clark knows. That's why she is panicked. Her son Michael, who is autistic and mentally retarded, turns 21 Thursday.

His state-funded childhood support services ended Oct. 1, and last week she was told his one-to-one in-home support will be cut almost in half - from 59 to 29 hours a week.

"Nothing is made to compensate for that," said Clark, who works full time. "A person is supposed to leave their autistic and mentally retarded son at home alone."

Autism spectrum disorder, the formal name for autism, is the fastest growing caseload for the Bucks County Department of Mental Health/Mental Retardation, administrator Phil Fenster said. Almost 10 percent of Pennsylvania's 3,439 autistic children lived in Bucks as of 2000-01, state statistics show.

What no one seems to know is what happens after autistic Pennsylvanians turn 21, the age when their public education ends, along with their eligibility for childhood medical and support services.

"I'm not sure what the answers are. There are no good answers," Fenster said. "Nobody knows. There has been no concrete planning for this by the state of Pennsylvania."

What's behind the increase is discussed and debated - Is it better, earlier and expanded medical diagnoses? Does it reflect Bucks' overall population growth? Are more people moving here because of the availability of services and resources? No one knows for sure. What is known is the numbers are exploding.

"Startling demographics" is how Warren Smith describes the numbers.

He is director of special education for the Bucks County Intermediate Unit, a regional education service agency that provides special education and other services to local schools.

At the intermediate unit, which provides most school autism programs, enrollments have more than doubled since 1997. This year, the agency has 305 students in autism support classes that provide need-specific therapy and instruction, and it added two more middle school classes, bringing its total to eight.

Among Bucks' kids under age 3, autism diagnoses account for almost 10 percent of the average 520 kids receiving services for mental, developmental or physical disabilities, said Lisa Parker, early intervention coordinator for the county MH/MR department.

Social workers and educators have little experience preparing so many kids with such wide ranges of autism disorders to meet the adult world. In the last five years, the intermediate unit knows of fewer than six students who have "aged out" of the agency's autism support programs.

It's a fraction of the number heading that way, said Smith, the IU's special education director. Last year, 27 percent of county children with autism receiving special education services were 12 to 21 years-old, up from 20 percent in 1995.

This year, Flemming Godiksen, an IU transition coordinator, is working with roughly 18 students between 16 and 20 years old who are moderately to severely autistic. He has another five students with Asperger's, a milder form of autism.

"The floodgates are opening up," he said. "I'm being inundated with them this year."

Few Services Autistic children have been eligible for special education services since 1990, and like other eligible children, they can attend school until age 21. In Pennsylvania, they also qualify for one-to-one support services at home and at school, based on medical need until that age.

After that, most autistic adults are stuck.

Virtually no state services or programs exist for autistic adults because Pennsylvania's adult system doesn't recognize developmental disabilities, which include cerebral palsy and brain injuries, advocates said as well as autism.

The first attempt at a model program - the Autism Pilot Project, started in 1998 - has served up to 20 adults with autism in southeastern Pennsylvania through low-income housing waivers and one-to-one community based support services like a personal aide.

The pilot project is being evaluated to see if it can be taken statewide or should be piloted in other areas, said Jay Pagni, a state Department of Welfare spokesman.

"Autism is a square peg in a round hole and it creates barriers of access," said Rep. Dennis O'Brien, R-Philadelphia.

The state lawmaker has urged the Legislature to address the needs of those with developmental disabilities. He blames ignorance as the reason the state has overlooked the needs of autistic kids and adults and their families.

"Everyone sits there and points the finger at someone else - 'You pay for it.' And the system breaks down," O'Brien said. "If we identify these kids, we have to pay for them. That's where it becomes whose plate is it coming off of."

The situation is better for autistic adults diagnosed with mental retardation. They continue to be eligible for some services, but only to address mental retardation.

And, like Clark's experience, the service hours may be reduced.

Autistic adults with mental illness also may be eligible for some adult services, but those services are difficult to obtain.

"The programs they [autistic adults] need are things not traditionally provided to adults through mental health services," added Fenster, the county MH/MR administrator.

A Unique Disorder Autism is unique because there is no typical autistic person, advocates said. Different children may experience similar symptoms, but have widely different behaviors, patterns, skills and abilities.

Consider David Ward-Grygo, the teenage son of Ambry Ward and her husband, Gerry Grygo, of Middletown. Besides Pervasive Developmental Disorder-Not Otherwise Specified, he is also diagnosed with obsessive compulsive disorder.

When David was diagnosed at 2 1/2-years-old, doctors weren't sure he would ever talk, his parents said. That fear turned out to be unfounded.

"He is very outspoken," Ambry said. "He's no shy guy."

Still, when Ambry kisses her only child, she still must do it in an even number of kisses - two, four, six kisses - or he gets upset.

David has made major progress on controlling problem behaviors and developing skills, which the family credits to early diagnosis, intervention and therapy.

Before he entered elementary school, when David needed a haircut, the barber came to the house and Gerry took a half-day off work to help hold David. No more. The teen also no longer needs to be sedated to get his teeth cleaned at the dentist. The orthodontist even was able to put on braces without first sedating him.

"There are so many things you take for granted," Ambry said. "For us, they are major, major things to accomplish."

Educating children with autism is equally challenging. The intermediate unit offers four levels of autism support classes based on communication and functioning skills.

"You're trying to break into their world," explained Parker, the county's early intervention coordinator. "You don't see that with a lot of other kids."

Children with moderate to severe autism often have few or no communication skills, requiring the most intensive intervention, therapy and training. They are also the group that educators have the least experience preparing for life beyond high school.

Realizing that, last spring the intermediate unit began developing job training sites for autistic students and this year expanded from two to five sites. The sites are designed to meet the needs of autistic students such as building endurance levels, ability to concentrate, control behaviors for longer periods, Godiksen said.

Two years ago, the intermediate unit organized a study group, the Autism Support Work Group, a multi-agency panel to address the service needs of autistic children and their families.

The group's work has included compiling surveys and resource lists made up of health professionals such as doctors and dentists with expertise in the care of autistic children. This year, though, the main focus is preparing children nearing age 21, said Caryn Kadel, group co-chair.

For children with Asperger's or PDD, milder forms of autism, the situation is different. They often have great academic ability and more communication skills, but possess poor social skills and coping abilities, educators say.

Council Rock - whose 80 autistic kids mostly have milder forms of the disorder - works intensively with elementary students to get behaviors under control and raise functioning levels. In middle and high school, many kids can spend part of the school day in regular classes with extra supports, said Charles Lange, director of special services.

Higher functioning students may be able to attend college after high school, Lange and other educators said.

That is the Ward-Grygo family's hope for their son.

David excels academically, but falters in social skills and behavior, his parents said. He can't follow social cues the way many kids do. He has problems with social boundaries. He doesn't recognize sarcasm. Problem-solving skills aren't always at his fingertips.

His parents hope seven years is enough time to prepare David for the adult world. They hope there's enough vocational training and support services and enough supportive employers willing to hire workers with her son's disorder.

"They grow up - childhood is a blink, but adulthood is years and years long," Ambry said. "They need more time to mature. They need more time than age 21."

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FUNDRAISING

O.C. Triathlete's Motivation Now Comes From Without

Ironman He raises money for autism research.

=2002&month=10&day=15 <- - address ends here.

Newport Beach - All those miles, all those after-work runs and early-morning bike rides, and Evan Dameshek was selfish. He knows this now. Probably knew it before, but really not until it hit him in the form of a 3-year-old boy drifting into another world.

Three years ago Dameshek started doing Ironman triathlons - races comprised of a 2.5-mile swim, a 112-mile bike ride and a 26.2-mile run.

They require 18-24 hours of training a week, a schedule that inevitably affects marriages and family. "This is a pretty selfish endeavor," Dameshek said. That's why Dameshek, 40, of Laguna Beach, will compete in Saturday's Ironman World Championship in Kailua-Kona, Hawaii - with a selfless purpose: to help his son and thousands like him.

Last spring Dameshek and his wife, Kimberly, learned that one of their 3-year-old twin boys, Jake, had autism, a disorder marked by a withdrawal from reality.

The cause is unknown, and one out of 250 newborns are diagnosed with autism per year, according to the Center for Disease Control.

From that point, Dameshek decided to literally run for his son's life. He has raised about $17,000 for Cure Autism Now and expects to add $3,000 by Sunday to win the Janus Charity Challenge, an Ironman-sponsored "contest" in which Janus donates $10,000 to the charity of the triathlete that raises the most money.

"It's been a real driving force of my training," Dameshek said. "When I knew I was doing Kona I wanted to make it less about me and more about others."

Dameshek, like most participants, just wishes to finish. He qualified through the race lottery but has completed three Ironmans, each in about 16 hours - roughly twice what pro triathletes clock.

The time consumption - training and fundraising on top of running his finance company - has been more exhausting. "Every minute, every workout, every sacrifice was emotional," Kimberly said. "His level of commitment and discipline went to a level I never imagined. He showed others that if I'm willing to go this far, you can give $25, $50 "

Autism has been in the spotlight - Time magazine recently did a cover story on it and NFL great Dan Marino and actor John Travolta are spokesmen for the disorder.

The process has educated Dameshek, a former semi-pro hockey and baseball player from Montreal. "Why us?," Dameshek said. "Maybe we have a better way to deal with it. Not that other people wouldn't care as much, but we're in a place, financially where we can help our son and more people."

Said Kimberly, "The first four Ironmans he did were about Evan. This time there's not any element in it. It's about his little boy and a worldwide problem."

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Readers' Posts

I would like to talk to parents experienced in seeking a residential placement for higher functioning autistic kids with severe behavioral issues. Particularly, the pros/cons of addressing it as a Regional Center issue or as an educational issue (ie: funded by school district). What changes when proposed ed/res placement is out of state? Sally marinkirks@attbi.com

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I am looking for a social skills group for my 4 1/2 yr old ASD boy in the St. Louis, MO area. Anyone that could pass along information, I would greatly appreciate it. Reply to annbrendel@yahoo.com

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Any good ideas on how to teach play and leisure skills to our seven year old? I seem to have run out of creative ideas. I need to get the creative juices running again. Does anyone have some ideas that they have tried that have shown good response? I appreciate any help any of you have to offer. Paula Starr arcinformation@charter.net

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How can I stop the actions and violent reactions to "Trigger Words"? Seven year old developed severe trigger word problem after Lovas Therapy type of program. How do I desensitise our child from these words. Paula Starr arcinformation@charter.net

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